Present tense: a phenomenology of grief in neurosurgery.

This paper applies phenomenological insights to the neurosurgeon's lived experience of grief, approaching it not as a discrete psychological reaction, but as an enduring aspect of professional life shaped by repeated encounters with loss, complication, and responsibility. For neurosurgeons, grief is not limited to moments of patient loss but emerges gradually through the cumulative weight of adverse outcomes, moral uncertainty, and the recognition of medicine's limits. Despite its pervasiveness, grief is often treated as something to be managed, resolved, or privately endured. Drawing on phenomenological attention to embodiment, temporality, and perception, this paper explores how grief subtly alters how neurosurgeons experience time, inhabit their bodies, and engage in clinical decision-making and interpersonal relationships. Grief is thus understood not as an episodic disruption but as a coexisting presence that shapes meaning, attentiveness, and ethical orientation in everyday practice. Rather than offering prescriptive strategies for overcoming grief, this paper seeks to render it intelligible as a constitutive element of neurosurgical work, with implications for reflective practice, sustainable coping, and ethically attuned engagement with patients, families, and colleagues.