“In terms of sheer imperial arrogance, Noah Behringer was actually typical of the neurosurgical caste. Yet many of his colleagues hated Behringer, not only for his eccentricities but for his audacity. These mostly short and Jewish men were meant to be the cowboys, the Clint Eastwoods in this landscape. The brain surgeons stood atop the heap, sneered and sighed and rolled their eyes at internists, at oncologists, at phlebotomists, at the neurologists. All other specialties lay beneath them in sheer balls––even the cardiac surgeons. Pop a heart out, put it on a plane, stick it in another body. Make a dozen mistakes––hell, you could *drop* a heart. Whereas one nick, one wrong turn, the brain died. A heart surgeon was Scotty in the engine room, sweating, up to his elbows in greasy parts. The brain surgeons were the Vulcans. His comparisons, Behringer was aware, were forty years out-of-date. Scotty no longer ran the engine room. Most of those actors were probably dead. (It was a miracle he'd been able to identify the *Big Lebowski* T-shirt, entirely due to a girlfriend, whose favorite film it had been.) To be woefully out of touch with everything except medicine since the day you entered the machine was the price of doing business, of rising to this place, and Behringer's compensations were as pathetic as the next guy's despite attempts to read the latest best seller, or to do more than trot his weekly *New Yorker*s from mailbox to recycling bin, having grasped nothing but the occasional article by Oliver Sacks or Atul Gawande, the rest an opaque hash of fashionable names, communiqués from a world that had left him behind.”