Although he has been practicing epilepsy surgery since 2005, and has become very proficient in routine epilepsy surgery with his original microscopic skills in skull base surgery, he has only gained a deeper understanding of the recent development of magnetic resonance negative epilepsy since last year. The magnetic resonance-negative epilepsy is a new development in epilepsy surgery, and is also at the forefront of the world. There are a small number of hospitals in China that perform this type of surgery, but the level is uneven. We have also been performing this type of surgery only since early 2014. Through the efforts of the past two years, we finally made more significant progress in this area. The most impressive case was a patient surnamed Wang, 26 years old, who had suffered from seizures for more than 10 years. He had been to several large epilepsy centers in Beijing and had been treated many times with no results at great expense. He came to the hospital this time with the intention of giving it a try. At that time, the EEG results showed that the seizure waves originated from the front of the left side of the brain, i.e. the temporal lobe or frontal lobe of the left side of the brain. Judging from the EEG, the epileptic foci originated from one place and it should be possible to do surgery, so the patient was admitted. After admission, different sequences of MRI were repeatedly done and no problem could be found. Because of my serious attitude, the family especially trusted me and said I could definitely cure her disease. Through multiple examinations, all the advanced tests that can be done in our hospital and in Hunan Province (PET-CT of the head) were done, and many discussions and consultations were held with the neurology department and other staff of our department, but still we could not determine whether the epileptic lesion was in the temporal lobe or frontal lobe. It is important to know that these are two different sites, and both sites are important and cannot be cut indiscriminately. After thinking over and over for a week, looking at the patient’s MRI countless times, and looking up relevant information, the patient was waiting in the ward, and still could not be sure. At that time, I privately prayed to heaven: “God, how to give such a difficult patient for me to treat, who can help me!” I knew that there was no one in Hunan province who could help me. At that time, there was a national epilepsy conference in Guangzhou, so I brought the case to a very famous doctor who looked at it and asked me to find a very experienced EEG doctor to read the EEG carefully. That doctor was very nice and spent half an hour looking at the EEG and said with great certainty that the epilepsy originated from the temporal lobe. Although I agreed with her (a very astute analysis), there was still something I couldn’t explain. I had to come back and continue to think about it. I repeatedly compared the HD MRI of the head (an advanced MRI sequence) with the EEG of the seizure period, and vaguely felt that the temporal lobe epilepsy mentioned by the expert could not fully explain the patient’s symptoms. I was so excited that I went to the professor in charge of neuroimaging in the radiology department for advice, but they didn’t think it was an abnormality, which made me confused again and I felt very disappointed and helpless. At that time, I discussed my idea with the patient and suggested to do open cranial placement of cortical EEG, saying that there was little hope of success and if it failed, the money would be wasted and the pain of the operation would be wasted. The family insisted on doing cortical electrodes, saying that they would admit it even if it was not done well and they would not blame the doctor. So the surgery was done, and when the electrodes were placed, the electrodes were placed in the parts I thought were abnormal, but the temporal lobe that the Guangzhou doctor said was also placed, for fear that what they said would be correct. The patient had a seizure during the postoperative monitoring, and the seizure originated from the area I thought was abnormal, not from the temporal lobe as the expert said. This removed the brain tissue where the epilepsy originated and expanded the resection of some of the brain tissue. A miracle happened after the operation, and the epilepsy that had been present for more than 10 years disappeared and has not recurred until now. We then entered this case into a national competition and stood out in the preliminary rounds in the central and southern regions, and won the Grand Prize in the final rounds in the southern region (the competition is held in the northern and southern regions of the country), and entered the national final rounds, and finally took the National Grand Prize through the selection of many great neurologists and neurosurgeons in the country. With this experience, we have done several more difficult patients and achieved more satisfactory results. Therefore, I feel that if one wants to progress, one is bound to encounter difficulties. In the face of difficulties, whether to back off or to rise to the occasion, the timid will choose the former, while the brave will choose the latter. The former will live a comfortable life, but the latter will spend a lot of energy and time, suffer a lot of internal and external torture, and sometimes even misunderstanding from the patient, but the result is completely different. After conquering this difficult case, our level of epilepsy surgery has reached a new level, and the level of epilepsy surgery in Xiangya Hospital has reached the first-class level in China (as evidenced by the Grand Prize), and we really feel that “difficulties” are the steps of human progress. Only by stepping on the difficulties can we reach a new height and truly feel that “the infinite scenery is at the peak”. Of course, in this harvest, we especially thank the patient’s trust, without her trust, we could not have progressed, so we will give back the skills we learned to other patients, so that more patients can benefit. This article is published with permission from Dr. Yang Zhiguan.