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Contentsred barHeroes of MedicineThe Tumor War
Blk Bar Heroes of Medicine
A Childs Pain
The Plant Hunter
In Search of Sight
A Dark Inheritance
Too Big a Heart
Seeing the Future
The Tumor War
The $28 foot
Drop Your Guns
The Wired Prairie
To Hell and Back
Beyond the Call
Bloodless Surgery
Rescue in Sudan
Physician Heal Thyself
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21972

His malignant tumor removed, a grateful Steven Schulman, right, calls Dr. Keith Black "God." Such encomiums make the doctor uncomfortable

Black focuses his attention exclusively on Schuler's exposed brain and the voracious tumor that threatens it. An hour and a half earlier, he had drilled a series of holes into Schuler's cranium, then connected the dots with a surgical jigsaw. He had lifted out an oval-shaped piece of skull, then cut through and peeled back the dura mater, a thick membrane that protects the brain and spinal cord.

Navigating methodically, Black now divides the tumor from the normal brain, cauterizing severed blood vessels as he goes. He cuts all the way around the edge of the tumor, gradually detaching its mass. Fifteen minutes later, he lifts the bulk of Schuler's cancer out of the hole he has made and places it in a stainless-steel bowl. "Call the tumor guys to come down and get a specimen," he orders. Another piece of the tumor will be sent to Black's own lab while he goes back in to clean up the cavity.

Schuler's death sentence has been postponed, perhaps for years. By the following day, she will be walking the halls. Not surprisingly, she will feel deep gratitude. This is not uncommon; most of Black's patients exhibit an awe for his skills that borders on worship. "You're God," exclaims another patient on being told his tumor has been removed. "No, I'm not," Black replies, quietly but firmly. He gets such comments frequently, and they make him very uncomfortable. No one is more acutely aware than Black of the perils of the physician-God complex. A lot of his patients would like him to play God and tell them they will never be sick again. They look for it in his eyes. He is therefore careful not to promise too much, not to let his eyes promise too much, even when there is hope.

And hope is a rare commodity when it comes to brain cancer. Although successful treatment of tumors like Schuler's malignant astrocytoma can give patients three to five years more, the mean survival period for people with the most common and deadly brain cancers (glioblastomas) is about five months without surgery--and about a year and a half even after successful operations, according to one study. Like Black, neurosurgeons at top cancer centers around the country are working on a variety of experimental techniques that they hope will improve patients' survival. Any one of them may turn out to be a winner.

What makes Black unique is not immediately apparent. He has a steady hand, a remarkable intelligence, an ability to concentrate on the task in front of him, and a lot of experience at removing tumors. But plenty of surgeons can claim these. It is something else entirely that distinguishes Black from most of his colleagues: an absolutely unshakable devotion to a single task. Says Dr. Edward Oldfield, chief of surgical neurology at the National Institutes of Health: "This is the unique feature of his career--the way he is using rather striking advances in basic science in the application of new treatments." Keith Black is fighting an all-fronts war against brain cancer.

The war began when Black was still in college, at the University of Michigan. By the time he got there, he had already made it clear that he was no ordinary young man, most likely because he came from no ordinary family. His father, Robert Black, was principal of the segregated Boykin Street Elementary School in Auburn, Ala., during the George Wallace era. When he could not integrate the student body, he integrated the staff instead and began teaching French to fourth-graders. When his sons wanted to swim in the all-white community pool, he told them to do it. And when young Keith showed an early fondness for dissection, he brought home a cow's heart from the local slaughterhouse. "He was the ultimate educator," Black recalls. "He instilled in us an attitude that there is nothing that you cannot do."

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