WE were operating on a rup- tured intracranial aneurysm (ballooned and weakened area in an artery) in the middle of the night. In such an operation, the intention is to place a clip on a 9 mm aneurysm, which, in effect, secures it from re-bleeding. While doing so, one has to ensure that the parent vessel from which the aneurysm arises, is not compromised. To witness the astounding anatomy of the brain under a microscope at anytime of the day is special, but at 1 am, there is something rivetingly enchanting about it. The obstreperous buzz of the operating room is doused at night. There are fewer people. Exits and entrances are less dramatic. You talk softly, you communicate less, and you can even hear your assistant breathe.

We neatly dissected silvery strands off the blood vessel and identified our target. I took a slightly curved titanium clip, and in a gentle, nimble move, opened its fangs and placed it gingerly along the entire length of the neck. This is the operation. That’s it. We were done. I, then, carefully inspected the anatomy with an endoscope to get a 360-degree view, to ensure there was no remnant hiding opaquely out of sight. Unfortunately, about 2 mm of the neck still lay unclipped. “We have to advance the clip a little,” I decreed. “Leave it, sir, it’ll thrombose eventually,” proposed my assistant, who usually believes in my sagacity more than I do. After all, everyone desires a good night’s sleep. When I was a resident in training, I remember coaxing my boss that the operation was “superbly performed,” so that he would leave and allow me to close quickly, such that I could catch a few winks of much-needed slumber before the brightness of the next day loomed over us.