Thursday, January 21, 2016

“The Terrible Beauty of Brain Surgery”


A good friend of mine sent me a link to this NY Times article by Karl Oveknausgaard, which is subtitled “A witness in an operating room where the patients are conscious.” Here’s the link: http://www.nytimes.com/2016/01/03/magazine/karl-ove-knausgaard-on-the-terrible-beauty-of-brain-surgery.html
 
The article is about a famous British neurosurgeon, Henry Marsh who allowed Oveknausgaard  to interview him and watch in Tirana, Albania as he demonstrated a surgical procedure he helped pioneer, “… called awake craniotomy, that had never been performed in Albania. The procedure is used to remove a kind of brain tumor that looks just like the brain itself.” (Interestingly, the article never mentions the type of brain tumor.)

The “awake craniotomy” procedure is used to remove a kind of brain tumor that looks just like the brain itself. Oveknausgaard writes that “Such tumors are most common in young people, and there is no cure for them.”

He goes on to write that “In order for the surgeon to be able to distinguish between tumor and healthy brain tissue, the patient is kept awake throughout the operation, and during the procedure the brain is stimulated with an electric probe, so that the surgeon can see if and how the patient reacts.”

This just makes my skin crawl.

I’ve first read about this type of surgery in Suzy Becker’s book, “I’ve had brain surgery, what’s your excuse?” and the thought gave me the chills then, and I’m still chilled reading about it years later. http://www.amazon.com/Brain-Surgery-Excuse-Becker-Paperback/dp/B00POEURZ0/ref=sr_1_fkmr1_2?ie=UTF8&qid=1453403913&sr=8-2-fkmr1&keywords=i%27ve+had+brain+surgery+what%27s+your+excuse+suzy+becker   

So why do this? That question is definitively answered when Oveknausgaard notes that: “The procedure is used to remove a kind of brain tumor that looks just like the brain itself. 

Such tumors are most common in young people, and there is no cure for them.

In order for the surgeon to be able to distinguish between tumor and healthy brain tissue, the patient is kept awake throughout the operation, and during the procedure the brain is stimulated with an electric probe, so that the surgeon can see if and how the patient reacts.”

Now if doesn’t make you a bit nervous, Oveknausgaard writes that Marsh “… explained the awake craniotomy procedure, saying that for a neurosurgeon, it is a constant temptation to try to remove the entire tumor, but if you go too far, if you remove too much, the consequences can be severe. It may lead to full or partial paralysis of one side of the body or other functional impairments or personality changes. When the patient is awake, this allows the surgeon first of all to determine where the dividing line lies, and second, to observe the consequences of the procedure directly and immediately, and stop before any serious damage is done.”

For those of you who love morbid details, here’s a sneak couple of sentences by Oveknausgaard writing about the operation itself: “The silence was total. The single focus of attention was a head clamped in a vise in the middle of the room. The upper part of the skull had been removed, and the exposed edge covered in layer after layer of gauze, completely saturated with blood, forming a funnel down into the interior of the cranium. The brain was gently pulsating within. It resembled a small animal in a grotto. Or the meat of an open mussel.”

The article is fascinating, upsetting, informative and penetrating (in more ways than one). 


Picture: Dr. Mentor Petrela and Dr. Artur Xhumari close up the head of Ilmi Hasanaj. The author, Karl Ove Knausgaard, stands second from right.
Credit Paolo Pellegrin/Magnum, for The New York Times

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