Into the Magic Shop: A Neurosurgeon’s Quest to Discover the Mysteries of the Brain and the Secrets of the Heart

Doty describes the case of a pregnant woman he once encountered in the ER. The woman had preeclampsia and developed a brainstem hemorrhage before she could be treated. With no obstetrician on hand, and the mother now brain-dead, Doty had to perform an emergency C-section and then deliver the news to her family.

Noting that this “wasn’t the first time [he] had walked away from a family with blood on [his] clothing” (158), Doty resumes his own story. On the morning he’s scheduled to leave for college, his father returns home drunk and threatening violence. Afraid for his mother’s safety, Doty punches his father, breaking his nose and sobering him up. He then kisses his parents goodbye and hurries to catch the bus out of Lancaster.

Once in college, Doty struggles to balance his coursework with a full-time job and trips home to care for his mother and father. By his junior year, his GPA is well below that of most premed students, and it isn’t clear that he’ll even have enough credits to graduate. As a result, he has a difficult time even scheduling his premed interview, during which he talks passionately about his interest in medicine and the obstacles he has had to overcome simply to get into college. The initially skeptical committee ultimately chooses to provide him with a letter of recommendation, and their secretary—who overheard Doty’s speech—tells him about a summer premed program at Tulane designed specifically for disadvantaged students such as himself.

Doty is admitted to the program but worries he won’t be able to find the money to move to New Orleans. Around the same time, Doty’s father calls from a Los Angeles jail asking for help getting back on his feet, so Doty arranges for him to rent a room. He’s shocked when his father reciprocates a few weeks later, sending him a thousand dollars so he can go to Tulane.

The next fall, Doty is in the process of applying to medical school when he learns from his mother that his father left to visit family, only to show up weeks later in a Tennessee hospital. Doty calls the hospital and discovers that his father is critically ill with pneumonia; over the next few days, his organs begin to fail, and Doty scrambles to book a flight to Tennessee. The night before his departure, Doty wakes up abruptly and sees his father sitting on his bed. He looks calm, apologizes for being a bad father, tells Doty he loves him, and says goodbye. Shortly afterwards, the hospital calls to tell Doty his father has died.

Roughly two weeks later, Doty is admitted to Tulane’s medical program. Since he doesn’t have enough credits to graduate, he strikes a deal with the dean of admission allowing Doty to transfer credits from medical school towards his undergraduate degree.

Doty excels in medical school, which he pays for with a scholarship from the US Army. He then completes a “flexible internship” doing rotations in several different specialties, all with the ultimate goal of becoming a plastic surgeon; he’s drawn to the idea of helping children with facial deformities, but he was also attracted to the money and prestige of the specialty. He therefore initially applies to a general surgery residency—a prerequisite for training in plastic surgery.

While waiting to hear back, Doty does a rotation in neurosurgery and begins to consider completing a residency in that specialty. Although his supervisor supports this decision, he also warns Doty that he will have to wait: the army only trains one neurosurgeon per year. Doty refuses to accept this, going directly to Walter Reed’s chairman of neurosurgery and telling him it would be a mistake not to accept him immediately. Doty ultimately gets his wish; the next prospective resident was forced to drop out of the program, and the others on the waiting list were unavailable on short notice.

At Walter Reed, Doty quickly proves to be a technically skilled and compassionate doctor. However, his attitude towards his supervisors nearly gets him placed on probation at one point. Doty admits that confidence in the magic made him act rashly: “I got in trouble frequently. I had not yet learned discretion or discernment. I was confrontational with my chairman and often in front of others” (186).

Meanwhile, Doty has gradually stopped practicing Ruth’s techniques in favor of spending his free time partying with his fellow residents. One night, he and his friends get into a car accident that leaves Doty severely injured. When he wakes up after his first surgery at Walter Reed, Doty hears doctors talking nearby and realizes that he’s still in mortal danger: the first surgery missed something, and he’s now bleeding internally.

At this moment, Doty finds himself “outside” his body, watching as he’s wheeled back into surgery. He then blacks out and wakes up floating on a river, where he sees loved ones—living and dead—lining the banks, and watches scenes from his past life. He feels an overwhelming sense of peace and love as he approaches a bright light at the end of the river, but he realizes that if he entered it, he would not be able to return to life. This causes him to speed back the way he came. When he regains consciousness, he asks a nearby nurse whether he flatlined while on the operating table, and she says that he didn’t.

Doty’s near-death experience is characteristic of the phenomenon, which is well-documented throughout history. Various scientific theories have been proposed to explain these experiences, and certain parts can be replicated in a lab. Doty’s own experience doesn’t cause him to become religious, but it does affirm his “absolute belief that who we are today doesn’t have to be who we are tomorrow and that we are connected to everything and everyone” (203).

By 2000, Doty is worth more than $75 million. Although some of this wealth consists of tangible assets like houses and cars, much of it exists in the stock market; Doty was a successful neurosurgeon, but began to earn much more after becoming the CEO of a company (Accuray) that had developed a new technology for treating brain tumors. Doty, who had believed in the importance of CyberKnife, stepped in to save Accuray when it was struggling, finding investors and helping secure the technology’s FDA approval.

The fact that Doty was able to save Accuray earned him a reputation as a financial guru; as a result, he ended up holding valuable stock in many of the companies that appeared during the dot-com boom. Now 44, Doty is divorced and estranged from his daughter, but he is also on the cusp of buying his own personal island and retiring.

Around this time, Doty travels to New York on business; he has decided to place his Accuray stock in an irrevocable charitable trust and is also scheduled to meet with a hedge fund manager about investing in a new startup. During the meeting with the manager, an investor friend of Doty’s who’s also present stuns Doty by drunkenly demanding a controlling share in the company; he and the hedge fund manager nearly come to blows.

The episode unnerves Doty, who hopes to back out of the deal. Within a few weeks of the meeting, however, the dot-com bubble bursts, and Doty sells his houses and cars, but is still in debt: “All the money, power, and success I had dreamed of and visualized in my head since I was a teenager was gone—vanished in one big pop of a bubble” (216).

While Doty is still reckoning with these losses, he happens to come across a box of notes he took on Ruth’s four precepts: relaxing the body, taming the mind, opening the heart, and clarifying intent. Doty tries to do so, but he struggles to envision any future for himself and decides to return to Lancaster.