The dramatic focus of The Healing Blade is a procedure called the standstill, developed for neurosurgery about ten years ago.  For a patient, what is ³standing still²‹at zero on every meter‹is each measure of life known to medical science. A person undergoing a standstill has no breath, no heartbeat, no blood flow, no viable temperature, and most important, no brainwaves or other brain activity that clinically define being alive.

The standstill is fascinating in its implications at a time when theologians, cosmologists and many of the rest of us wonder aloud if something human survives death and if there is an individual spirit that can transcend time and place and molecular substance, since whether something actually does so or not appears beyond resolution. The standstill does not answer the question, but it offers a fascinating place to look. Patients are taken down to death itself and brought back again. That much is certain.

These stories take place at Barrow Neurological Institute in Phoenix, Arizona, where more standstills have been done, and done with more successful outcomes, than anywhere else in the world.  Initially I set out to write a book on the brain, wondering how such a vast topic might be narrowed. The neurosurgical operating room, the only place the living brain is actually exposed to eyes and touch, seemed a fascinating place to start.  It was not long before the fight for life of real people emerged as the drama, the tale. Inevitably, looking over the shoulder and trying to see through the eyes of one of the worldıs great neurosurgeons at one of the major neurological institutes became the compelling twin focus. But to paraphrase T.S. Eliot, In our end is our beginning, in our beginning our end. For me, and I hope for readers, the world first glimpsed in ³The Power of Resolution² ultimately opens out into the mysterious universe of the brain itself.

These are all true stories; the writer is a reporter, no more or less.  No quotes have been altered or imagined, no names have been changed, and no endings have been given a happy spin or edited out.  There are no compound characters, and scenes that may appear imagined are all rendered through the eyes of one or more witnesses, but most often I am the witness. I did not pick operations to write about, in the style of some popular magazines, in which the ending had already turned out happily as I began writing, leaving the drama ³cooked² from the outset and the reader manipulated. However, like every journalist, I am responsible for focusing on some stories more than others, and for skill or lack of it in telling them. I witnessed their unfolding, usually the whole of it, but more importantly they grabbed and held me. There are no pseudonyms in The Healing Blade. If unable to reach a patient for permission, I used only his or her first name and last initial; no patients refused to be identified.

Every story has one overarching point of view, that of the story-teller.  I am responsible for any misstatements, distortions of perspective, or omissions of fact, though I made my very best effort to avoid all of those. Perhaps most important of all to a work of journalism, none of the major subjects of this book read it in advance, nor did anyone at Barrow Neurological Institute approve any part of its contents.  The sole exception to this is the narrative of the Morbidity and Mortality Conference beginning on page 138. No one attending these ³M&Ms² is allowed to take any form of notes or to take any paper handed out for discussion, nor can the discussions themselves be continued outside. Those prohibitions apply to everyone, including the BNI director. No one outside BNI may even sit in on M&M conferences. To my knowledge, those rules are universal in American medical institutions. I was permitted to attend any M&M conference I chose without advance notice, to take notes, and to carry the notes out with me. In return for that unique privilege, I agreed that any passage of the book reporting on an M&M conference would be approved by Dr. Robert F. Spetzler, in order to protect the confidentiality of the patients and physicians involved. Although this was not part of the bargain, I destroyed all M&M notes once I had used them. 

The Healing Blade opens on Tuesday, April 25, 1989, and ends eight years later on Wednesday, August 20, 1997. The book originally was published in hardcover by Simon & Schuster in 1993, so the new edition represents a continued unfolding of a story that will never come to a conclusion.  This offered a unique challenge in attempting to prepare this edition.  ³New edition² implies that the author has gone back and altered much of the original text to improve its currency and perspective. That was precisely what I could not do, because I did not want to offer a revisionist view of the past. As a result, to preserve the integrity of the earlier stories, the only changes I made to the original material were in correcting bona fide errors, of which there were mercifully few, thanks to expert medical readers and terrific editors at Simon & Schuster.

The forecasts made in 1992 as the hardcover went to press are seen by the conclusion of the Beck Press edition with the advantage of five yearsı perspective. They remain remarkably current, thanks to the vision of the sources. Thus, although a substantial amount of the text has been changed or added, it is all at the end of the book. Chapter Nine opens just as the hard- cover version did, but now there is a transition midway through as the story moves beyond its original ending toward the present. Chapter Ten is entirely new and has never appeared before.

A good, true story is like river rafting‹wild but not too wild, controlled but not too much so. The stories themselves rather than the writerıs imagination offer the powerful and different currents pulling onward, sometimes breathtakingly fast, sometimes very gently. There are eddies that slow, where you can get pulled in and feel becalmed. If at times the natural excitement of these stories bogs down in explanation, I apologize. I simplified the best I could for the general reader, trying to compromise when necessary between the precise view of the physician and a clear view for the reader. The more you want to know, the more you can let yourself be drawn into the more challenging passages. However, if you really want only the powerful currents, let them pull you. The stories wonıt be lost if you pass by the more tech- nical passages, but they wonıt drag you down if you stay with them awhile. For me, The Healing Bladeıs fictional kin is the techno-thriller and it can be read in the same ways.

Far more importantly, there are emotional upheavals here beyond my control or anyone elseıs, and the reader should know that going in. People die, sometimes with all the world pulling for them; others survive utterly unbelievable odds to live, sometimes when hardly anyone seems to care. Even Dr. Robert Spetzler, one of the worldıs great neurosurgeons by the judgment of his peers, has very limited control over the outcomes of his efforts. Thatıs the point, finally. In the neurosurgeonıs perfect world, the dangers, however terrifying, all would end in good outcomes, wrought by flawless skill and judgment. There would be no ugly surprises, and everyone would go home as good as new. These stories are of the world we actually live in. Hereıs to that other world and those who try to make it so.

Ed Sylvester Tempe, Arizona September 1997