Carson turns to the highlight cases of his career. When he meets Maranda in 1985, she has had grand mal, and later focal, seizures since she was eighteen months old. When she comes to Carson’s attention, she is seizing up to one hundred times a day, “making the right side of her body useless” (148). Specialists had offered a variety of diagnoses and prescribed thirty-five different drugs before an accurate diagnosis in 1984 of Rasmussen’s encephalitis. An attempt was made to stop the seizures using an induced barbiturate coma, but this was ineffective. Finally, doctors told Maranda’s parents that her condition was inoperable.

When Maranda’s mother contacts Johns Hopkins, the idea of a hemispherectomy—the removal of the damaged brain hemisphere—is put forward, and at the request of seizure specialist Dr. John Freeman, Carson, who had never performed the procedure—considers the surgery as a last hope for the child. Maranda is brought in for evaluation, and her parents agree to the surgery as the only alternative to watching their daughter die while doing nothing. Carson warns them of possible complications, including paralysis, due to the lesion being on the dominant side of her brain. Alternatively, the surgery may end with Maranda’s death.