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"The problem with neurosurgery," says Eelco Hoving, a pediatric brain surgeon, "is that it is very unforgiving."
小儿脑外科医生埃尔科·霍文说，“神经外科的问题在于它非常无情。”
Even the specialists often have to start by cutting into someone's head to get a better idea of what they're treating.
即使是专家也常常必须从切入某人的头部开始，才能更好地了解他们正在治疗的疾病。
In the case of neurological tumors, for instance, you often don't know what you're dealing with until you remove a flap of skull and biopsy a small portion of brain tissue for analysis.
例如，在神经肿瘤的情况下，你通常不知道自己在处理什么，直到切除一块颅骨并活检一小部分脑组织进行分析。
That's how things work at the Princess Máxima Center, a partner of UMC Utrecht, one of the biggest research hospitals in the Netherlands, where Hoving is the clinical director of neuro-oncology.
这就是玛西玛公主小儿肿瘤中心的运作方式，该中心是荷兰最大的研究医院之一乌得勒支大学医学中心的合作伙伴，霍文是该中心神经肿瘤科的临床主任。
The sample is then sent to the lab, where two things happen.
然后样本被送到实验室，在那里发生两件事。
The pathologists sequence and profile the brain tissue and attempt to identify what kind of tumor is present, a laborious process that can take a week, often longer.
病理学家对脑组织进行定序和分析，并试图确定存在哪种肿瘤，这是一个费力的过程，可能需要一周甚至更长的时间。
In parallel, the lab takes a small cross section of the sample, freezes it, and thinly slices it with a scalpel -- effectively taking a "frozen snapshot," says Hoving -- and then reviews it under a microscope in a process called a quick section.
同时，实验室会采集样本的一小部分横截面，将其冷冻，然后用手术刀将其切成薄片，霍文说，这实际上是拍摄“冷冻快照”，然后在显微镜下对其进行检查，这个过程称为快速切片。
While a quick section can help identify what kind of tumor is present in just 15 to 20 minutes, it's far less reliable than the slower method.
虽然快速切片可以在短短15到20分钟内帮助识别肿瘤类型，但它的可靠性远不如较慢的方法。
This leaves neurosurgeons with a dilemma as the patient lies there, brain exposed.
这让神经外科医生陷入了两难的境地，因为病人躺在那里，大脑暴露在外。
A series of tricky determinations is made with imperfect information: Is there actually a tumor here?
利用不完整的信息做出一系列棘手的决定：这里真的有肿瘤吗？
And if it is in fact cancer, is it an aggressive form that needs to be excised quickly?
如果它确实是癌症，那么它是否是一种需要快速切除的侵袭性形式？
Or is it a milder tumor that can be treated with something less invasive, like chemotherapy?
或者它是一种较温和的肿瘤，可以用化疗等侵入性较小的药物来治疗？
Hoving specializes in operating on kids and teenagers, so he understands these limitations viscerally.
霍文专门从事儿童和青少年手术，因此他内心理解这些限制。
He remembers operating on a young patient a few years ago.
他记得几年前曾为一名年轻病人做过手术。
The quick section indicated a highly malignant embryonal tumor called an ATRT.
快速切片显示出一种高度恶性的胚胎肿瘤，称为ATRT。
Because ATRTs are aggressive, Hoving decided the best course of action was to respond aggressively in turn.
由于ATRT具有攻击性，霍文认为最好的行动方案是依序积极回应。
He made the call to perform a radical resection, carefully taking out more than 98 percent of the tumorous tissue -- a deliberate and mentally draining process that requires unblinking concentration for hours on end.
他决定进行根治性切除手术，小心翼翼地切除98%以上的肿瘤组织--这是一个深思熟虑且耗费精力的过程，需要连续几个小时目不转睛地集中注意力。
As a result of the procedure, the patient lost some motor control in one of his arms.
手术的结果使得患者的一只手臂失去了部分运动控制能力。
