A neurosurgeon discovers his pandemic baking has much in common with his profession l Expert Opinion

I’ve been baking a lot more since the onset of the pandemic, like many people. It’s been an escape from a burning world, a reminder of how humans have harnessed “good” microbes like Saccharomyces cerevisiae, or baker’s yeast, a tonic to unhinged “evil” ones such as SARS-COV-2, mutating around the globe for the last two years.

Along the way, I’ve become a more serious amateur baker, studying more methodically, with a greater commitment, though still only for family and friends.

Leavened bread was first described in ancient Egypt around 1000 BC, but the oldest evidence of neurosurgery predates bread by about 6,000 years. Why were our ancestors compelled to use stone tools to crack open a skull? Maybe it would help. Maybe it was human curiosity — coconuts, skulls, bear caves. What’s inside?

While the constancy and antiquity of bread comforts us, it’s quite innovative. The urbane and modern baguette came in 1920, nearly 40 years after Victor Horsley first cured epilepsy with brain surgery, and ciabatta wasn’t even invented until 1982.

Both baking and neurosurgery are amalgams of physics, chemistry, biology, technology, method, tradition and social context, then they diverge. Joyful moments punctuate neurosurgery, when surgery goes beautifully, when patients do great. These are personal triumphs, for patient, family and doctor, but it’s only one at a time, and there are tough moments too.

Bread can light up a party and it scales. A symbol and a reality of sustenance, it can feed a family, a village, a country. Dostoevsky said it best, “…there is nothing more indisputable than bread.” It sounds more poetic in Russian.

Joy follows bread everywhere, mostly. My wife and I, actually mostly my wife, laugh occasionally about the disaster of saumon en croute that I attempted for New Year’s Eve one year from the 1973 Simca’s Cuisine.

Even the olive eye baked into the brioche couldn’t save it. Neurosurgeons like me fail to shy away from such ambitions. We can still eat smaller mistakes.

Pain de mie is ordinary sandwich bread baked in a covered container so there’s minimal crust and it comes out rectangular. It requires just the right amount of dough, so the oven spring expands the dough enough to fill the container but not explode it. In one trial, I let one loaf rise five minutes longer than the other hoping to get a better fill of the pan.

The first came out perfect, the second collapsed – over-proofed – but I’d just done a controlled experiment. After thousands of neurosurgery cases, I have a good idea of what might happen and how things might fail, where the risks are. After a thousand or so loaves of bread, I’m just getting to know the nuances of dough.

I’ve learned that baking for me isn’t an escape from neurosurgery. It’s a foil, a mirror image. Other-handed expressions of craft and of me, a maker. This bothered me at first. They seemed so opposite. One in bone and delicate tissue, serious and professional, scientific; the other in crust and crumb, empirical, creative and light, literally harnessing gas. But it’s really not so.

Bedside neurosurgery, all medicine, is more empirical and experiential than anyone cares to admit. There are formulas, calculations and principles of course, but patients are not controlled experiments, and the best practitioners can interpret incomplete sets of data, divining what should be the next move.

Conversely, baking has become a lot more controlled and scientific with modern technology. “Baking is about precision,” I say to my kids. A lot of people have mirroring activities in their lives. A millwright restores old cars. A nurse decorates cakes off shift, an area of baking that I’m weak in. A marketing manager runs a nonprofit. All of these activities are other-handed expressions of individuals, and I’m just like them.

One thing is for sure. Both baking and neurosurgery remain artisanal. The hearts of these two crafts are still fundamentally human, the best results from hands, head and tools working together, living doughs desiring to learn more, immersed and buoyed by surrounding society, mirror images of each other, rhythmic ebbs and flows of experiment and experience.

Last night, I baked two loaves of pain de mie. They both came out beautifully rectangular, a thin crust and a fine buttery crumb. My family devoured one loaf before it even cooled, in about 30 minutes. I guess I’ll keep going.

Patrick Connolly is Penn Medicine Clinician and neurosurgery chief at Virtua Health. The opinions expressed in this article do not represent those of the University of Pennsylvania Health System or the Perelman School of Medicine.