Well, that kind of depends on point of view, right? If you have the right tools (axe, large club, etc.), and if the vict... patient is not expected to survive, you could technically call yourself a brain surgeon - of course, very different kinds of people will pay you to perform that type of operation.
Can you show me where fools with axes are paid $500,000/yr? If it was easy, I'm sure many people would have done it.
...that was (my attempt at) a joke. The fools with axes would be hired killers, gangsters/mobsters, debt collectors or something like that (too many movies, I know).