Man plays his saxophone through 9-hour complex brain surgery to remove tumor

lol!

I’d be afraid that using JIRA would register as complete brain death.

- Not a problem

- Works as designed

- It's a feature

- This is egregious! I'll get to fix it immediately

Doctors: Oh no, we cut too much!

I've always wondered about this. Is there a doctor in the house who could clarify the value of having this kind of lagging indicator?

Presumably, the idea of having the musician playing is to give the doctor a heads-up in case they slice into a valuable area of the brain. But, by the time the music playing is affected, the slice would have already happened — so then, what's the point?

I agree it's a great way to harvest social media likes (which presumably helps pay the medical bills, so I suppose it's nothing to sneeze at). But it's tough to see how it'd meaningfully help a fine-grained surgery. That abstract on PubMed ^ seems to say much the same:

> ...playing music did not improve or modify surgery.

> If I ever need brain surgery, I guess they'll probably have me try to respond to JIRA tickets and troubleshoot npm dependency

for me they will ask me to play chess. and they will stop cutting when i start making good moves.

Man dicks around on YouTube through 9 hour complex brain surgery to remove tumor.

Yeah I'd get tired of that theme within say 7.5 hours

Wouldn't it be excruciatingly painful to get to the brain though? Or is there a way to locally anaesthetize so that you don't feel your scalp being sliced open and your skull being cracked open?

The way it usually works is that we have anesthesia put the patient entirely to sleep to start and then we wake them for the sensitive part of the case when we need to perform stimulation and cognitive testing. We use local anesthetic like lidocaine and marcaine on the scalp while opening to minimize pain when temporarily awake. Then the patient goes back to sleep for closing. It’s a tough balance for the anesthesiologists to maintain —- they are as critical to the procedure as the neurosurgeon is.

What weirds me out is that I experienced regular pain in various part of my brain. Not migraines, more like post traumatic sensations with very acute painful areas (front, back, side, center..). Is this only blood vessel nociceptors ?

You don’t make more cuts there

It’s not binary. You go slowly, and stop if it’s starting to impact the behavior you’re observing.

What’s the alternative, knowing that you’re working with a system with unknown specific architecture and whose only way you can get feedback about how you’re doing is via the patient? You can stimulate parts of the brain without damaging it btw. The surgeon just needs to know what that part is specifically.

You electrically stimulate around the spot with a probe where you’re planning to resect. If the patient can’t perform whatever task you’re evaluating then you know you can’t resect in that area. Generally looking for a 1cm margin between tissue you’re going to resect and a positive stim site.

Can’t undo brain cuts. CNS neurons don’t repair themselves like peripheral neurons or your skin. Generally not cutting glioma brain tumors out per se more likely to use ultrasonic aspiration to suck the tumor out piecemeal. Depends on the tumor though.

Well you can definitely stop cutting deeper if you know something is up!

Others have explained, but what I've heard from a brain surgeon on TV: it's extremely delicate and they don't always know how deep they can go, so they probe bit by bit and when they notice it's having an effect they stop. The surgeon I listened to was also a gifted storyteller, it was very very impressive and inspiring. That's really a hell of a job.

This Simpsons episode isn't 30 years old yet, is it? https://youtu.be/JlmzUEQxOvA

That joke was famous for about 70-80 years. I know Henny Youngman told it but I doubt it was his.

You were telling a joke that was old long before you were born and you grew up in a world where others might know it because we were all watching old shit on television.

That television was mostly written by men who were born between the wars.

There's a precise birthdate where a child's life would never force them to watch reruns of Gilligan's Island and it is nearly the same as the birthdate for never watching Night Court or The Maltese Falcon.

Reruns died sharply and took a bunch of the 20th century monoculture with them. It's very surprising.

I don't imagine it was 9 straight hours but like a song an hour or every half an hour

Won’t have been the entire time. Just during critical points.

> at various times throughout the surgery

Back in high school we did one of those playathon things where a bunch of us band kids basically held a 12-hour jam session as a fundraiser for something or other. About 11 of those 12 hours were cumulatively spent riffing on "Superstition". I was on trombone, and spent most of those hours improvising solos in a desperate yet futile attempt to make it not horrifically repetitive.

I still absolutely loathe that song to this day.

Jazz bassist here. I'd be worried that the surgeon would go to the bathroom, or get another drink, during my solo.

Everyone will think the album art is just an elaborate illustration.

You should pick one up. Learning how to read music and play an instrument at the same time is good for the brain.

It's an interview, you have to pass a software engineer interview

> I wonder if discrimination based on handedness is unlawful anywhere.

Most probably. But I think judges would agree that this is a "discrimination" not in the social or political sense but as a rather scientific method to determine whether a procedure is suitable/beneficial/at least not harmful.

If not, sign me up to sue all gynecologists because they refuse to treat my (a man) ovaries....

Without further information regarding the exact location of the patient’s tumor, it is hard to comment in detail. However, one way handedness affects awake glioma resection is that while right handed people typically have their language dominance localize to the left hemisphere, left handed individuals are more likely to have right sided or even codominant language function. Assuming this was a right sided tumor, the surgeon probably meant that he also had to account for avoiding speech deficits in this left handed patient that he wouldn’t worry about in a right handed one.

From TFA:

> "To play an instrument means that you can understand music, which is a high cognitive function. It means you can interact with the instrument, you can coordinate both hands, you can exercise memory, you can count — because music is mathematics — you can test vision because the patient has to see the instrument, and you can test the way the patient interacts with the rest of the team," he said.

I take that to mean that playing the instrument uses many brain functions and so they're able to monitor many things at once.

for brain surgeries, the head is immobilized.

I think the procedure is do some surgery, stop, have the patient play the sax, repeat.

Similar to write some code, run the app, repeat.