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Demands on a Neurosurgeon Under Routine Clinical Conditions' "e;Hardly any other field of surgery requires such meticulous asepsis. No other field requires such a protection of the tissue and such reliable hemostasis. No one will question that neurosurgery makes exceedingly high demands. However, the degree of the demands on the personal- ity of the surgeon who has to carry out very serious operations to the exclusion of all others and has little opportuinity to recover psycholog- ically by working on simpler cases is concealed from the outer world. The mental strain which the coworkers and staff have to tolerate may not be denied"e;. So wrote Wilhelm Tonnis in 1939. Although fifty years have now elapsed, his appraisal is still relevant today - hence my intention to discuss the everyday demands placed on neurosurgeons. My aim is not self-glorification to engender sympathy; rather it is to highlight the effects and repercussions of such demands for the well-being of the patients entrusted to us. The major onerous demands include: - those in the operating theater - those resulting from staff problems in nursing - those resulting from legal developments - those resulting from the increasing administrative tasks that cost valuable time and energy which are lost to our actual work in look- ing after patients: science and research also suffer from this. I shall not go into the latter point within this preface. Let me first turn to the strains occurring in the operating theater.