trouble in this case is bleeding uncontrolably. so if that bullet cut a major artery, that's hard to clean up that kind of -- with that kind of trouble. and fortunately here that was not the case. and then of course the brain swelling we worry about. and, again, something we can't really control but we can try and at least lessen the impact of and that's where we take off the bone fragment that's are there and maybe even a little bit more. that's where judgment comes in. >> it's a judgment call that trauma neurosurgeons are forced to make. a through and through bullet injury causes direct damage to the brain much it's the secondary damage due to swelling where you try to minimize the risk. the simple things they can do in the operating room, simply lifting the head of the bed up can reduce the swelling in the head. insert certain medications to shrink the brain. that can help as well. also, as they did in congressman giffords case, they can remove part of the bone here to decrease that swelling. so one thing to keep many mind,