Outside the Box

When the media spotlight found Dale Swift ’80 in 2003, as he was helping to separate Egyptian twins joined at the skull, it introduced us to a pediatric neurosurgeon who’s not afraid to bypass conventional wisdom to do things better.

by Lisa Watts

» Sidebar: Preparing for health professions

As Joshua, diapered toddler, sleeps in the center of the room under blue paper blankets, a half-dozen nurses, surgeons, and aides dressed in hospital scrubs set to work in well-rehearsed patterns. They gather supplies, start up monitors, and plug in instruments, all while chatting about Christmas shopping, hometowns, even – because of a visitor from Wooster – how the Fighting Scots did this fall.

This feels like watching a routine dental procedure, but it’s not.

As surgeons insert a slender probe through a hole they’ve drilled in Josh’s skull, they watch the images on a monitor: pink brain lobes laced with red blood vessels. The camera finds an ethereal white tissue that ripples to the beat of Josh’s pulse. Here is the edge of an enormous cyst that has been crowding out the toddler’s brain. Guided by the camera, the surgeons insert tiny scissors. They hope to tear open the white membrane without nicking any blood vessels.

This is brain surgery.

At the center of the action, a tall, slight figure in a cinched surgical gown perches on a rolling stool. His telltale long, thin ponytail is tucked under his scrub bonnet and his thick-framed surgical glasses lend him a certain punk-nerd look. With quiet authority, Dale Swift ’80 orchestrates the proceedings.

Christy, the scrub nurse, chats blithely while Swift and the resident drill holes, cut skin, sponge up blood. She gives one small shudder when Swift works a tunnel for a catheter tube up under Joshua’s abdominal skin. "It just looks painful," she shivers, then returns to handing the doctors their sterile instruments.

Mary, the anesthesiologist, sorts her supplies and sways absentmindedly to the music on the small boom box – Dave Mason’s "Let it Flow" – while fluid from Joshua’s cyst seeps out the plastic tubes.

This is Swift’s third operation of the day with one still to go. Each surgery lasts a few hours, long enough to tire your legs. Swift has taken in little more than strong coffee, a cup in the morning and one in mid-afternoon. Eating, he says, just makes him sleepy.

Today’s procedures are all routine. Earlier he implanted a DuoProx pump in a seven-year-old girl with cerebral palsy. The pump will inject medicine directly into her spinal fluid to relax her muscles, which her disease makes rigid.

A DuoProx representative, observing the surgery, whispers, "You’re watching the master. Dr. Swift really cares about his patients. He’s not like an auto mechanic doing a tune-up."

Even routine surgeries challenge Swift. "This is a field where you can strive for perfection, even though you can never achieve it.

"Half the time I’m scared to death," Swift admits of surgery. "If you lose that feeling, you might need to reconsider what you’re doing."

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