Difficult scenarios faced by a Neurosurgeon!

This week I attended a fascinating talk given by a consultant Neurosurgeon. He talked about the attributes a good doctor should have, attempting to get into medical school, his personal journey into Neurosurgery, showed us two videos from theatre (which were very interesting but difficult to understand due to the complexity of the brain!) and described some scenarios he has faced as a consultant which required some of the attributes he described earlier and asked us how we would have dealt with them. Both are difficult to deal with in their own way and have stuck in my mind since the talk.

1.) A 50 or so year old well educated man has been diagnosed with a brain tumour. After discussing his options with you he agrees to undergo an operation to remove it. You see him in clinic a week after the surgery with his entire family. You bear the bad news that the tumour is in fact cancerous and cannot be cured however it can be controlled with additional treatment. If he has the treatment there is a good chance he will live for at least 2 years and a small chance that he will live for 5 years. However he makes the decision that he wants to die and despite encouragement from his family refuses any further treatment and dies 4 months later.

2.) A 35 year old architect has been diagnosed with a brain tumour. He and his female partner visit you to talk about surgery. He agrees to undergo an operation to remove it and accepts the risks of possible weakness of the arm/leg and mild speech difficulty. He is extremely anxious about the surgery and whether or not this tumour is cancerous. 2 days later the partner arranges to see you separately and tells you that she is 4 weeks pregnant however she is planning to abort the baby as she is worried that if her partner's tumour is cancerous he may not be around long enough to be a father to the child. She wants to know from you exactly what his chances are of being the same person he is now after surgery and has already made an appointment at the abortion clinic next week.

If you had been the surgeon how would you have dealt with the situations? How would they have made you feel?