I'm in ur head fixing ur brain

October 15, 2008 7:05 AM

Bluegrass banjo player Eddie Adcock underwent brain surgery while awake and playing the banjo.

The BBC has video of the operation (poss. NSFW or the squeamish; audio here). The operation was to fix tremors in Adcock's hand, the banjo playing was feedback. The BBC carried a story a few years ago on awake brain surgery when it was more uncommon; this woman has had two such operations. You can even find an online preparation guide for it.

From an article about the procedure on Ted Kennedy:

"It is just mind-blowing," said Dr. David Korones, associate professor of pediatrics, oncology and neurology at the University of Rochester Medical Center in Rochester, N.Y. "You walk into the operating room and see on one side of a sheet a person's brain exposed — it looks just like it does in the movies … and walk around on the other side and you can talk to the person."

(I'm sure he chose the phrase "mind-blowing" carefully.)

If it's still not weird enough for you, Conor Mather-Licht read Vonnegut aloud while undergoing "awake craniotomy with mapping" (again with the possibly NSFW/NSFTS thing).

posted by mandal (37 comments total)

Does "when it was more uncommon" imply that brain-surgery-while-awake is happening more and more now?

/clamps hands tightly over braincase
posted by DU at 7:12 AM on October 15, 2008

Wow! That is an incredible video. Best of luck to Eddie. Sounds like he's still got the skills.
posted by JBennett at 7:16 AM on October 15, 2008

I nearly flipped my lid when reading this!
posted by Pollomacho at 7:17 AM on October 15, 2008 [1 favorite]

I was under the impression that most direct, open-up-the-skull type brain surgery was done with the patient awake. Helps let the surgeons know when they've got the right part, and which parts to leave alone.
posted by echo target at 7:23 AM on October 15, 2008

They've been doing it on House M.D. every damn week. Of course, it's the same episode every damn week.
posted by stavrogin at 7:26 AM on October 15, 2008

If my hands stop working, I'll let them have a go. Nothing is worse than having an ability stripped away and watching helplessly as it goes.
posted by chuckdarwin at 7:30 AM on October 15, 2008

I'm curious about what would make a brain-surgery video NSFW. Squeamish, certainly, but do some workplaces have policies against watching brain-surgery videos?
posted by kingbenny at 7:36 AM on October 15, 2008 [1 favorite]

Tragic. Even neurosurgery can't cure banjo playing.
posted by Jode at 7:41 AM on October 15, 2008 [15 favorites]

That's wild, almost like a piano tuner, tweak, hit some keys, repeat until tuned. I can'tr wait for the day they can make mood adjustments this way; "are you happy now? *tweak* how about now?"
posted by Cat Pie Hurts at 7:42 AM on October 15, 2008 [1 favorite]

There was a documentary on the PBS series POV titled "When Your Head's Not A Head, It's A Nut" about a young woman who underwent brain surgery to correct debilitating epilepsy, filmed by her brother. She was awake during the procedure, which was filmed. The doctors knew that they had to make a cut near her speech center, so they would show her pictures of things and have her name them while they deadened various spots. When they found a spot that interfered with her speech (interestingly, her ability to produce profanities was unimpaired), they knew "OK, better not cut there!"

It was fascinating and horrifying to watch. The doctors, for all their skill and good intentions, were basically stabbing in the dark.

Highly recommended.
posted by adamrice at 7:49 AM on October 15, 2008

About four months ago, I got to sit in on a similar surgery, performed on a woman undergoing Deep Brain Stimulation as an attempt to reduce her Parkinsonian tremors. It wasn't quite as invasive - it was just (just!) two holes, each about the size of a quarter.

Still, though, it was impressive - she was awake for at least 60% of the procedure, and it was nothing short of amazing to see her tremors completely disappear as they placed the electrodes.

Also, there's a wonderful documentary, The English Surgeon, about an English doctor who travels each year to the Ukraine to do brain surgery. They spare no details during the procedures.
posted by god hates math at 7:54 AM on October 15, 2008 [2 favorites]

Does "when it was more uncommon" imply that brain-surgery-while-awake is happening more and more now?

This is one of those things that gets done more and less as technology evolves; it has been done for decades when the surgeon is working around some particularly important area of the brain, such as the motor cortex or speech area, but there are other ways of monitoring brain function, such as somatosensory evoked potentials. Awake surgery is becoming more common these days as more sterotactic procedures such as the tremor ablation surgeries mentioned above are being done. These do not involve a full craniotomy and are typically done with some degree of sedation, which is decreased during the testing and increased during the more painful parts of the procedure.
posted by TedW at 8:04 AM on October 15, 2008 [1 favorite]

tremor ablation surgeries

My brother had this done a couple of years ago. (Unfortunately, insurance will only pay for one such operation, so he's steady on one side, trembly on the other.) He was conscious, but sedated a bit for the pain and general squickiness of having his brain hanging out where God and everybody could see.

I mourn the fact that no one thought to record the operation. :-(
posted by SuperSquirrel at 8:20 AM on October 15, 2008

Oh man. Talk about a performance. And Eddie Adcock playing horizontally. Heart rending to hear this guy playing so beautifully under the circumstances, not in a regular theater but in an operating theater, being directed to play by a surgeon. Wow. The world is an amazing place. What team work. The surgeons must have had to listen to his playing agility while also poking around those incredibly complex areas of the brain.

Wonder which hospital he was operated in? Wonder why he said it was painful? Wouldn't his skin have been numbed with local and then the brain doesn't feel the surgical invasion?

Maybe it was the sound of his cranium being sawed open, the smell of the bone burning under the saw? unnnggg.

While awake for about an hour, I had brain surgery. Not a craniotomy, where they saw open the cranium, but a procedure with the surgical equipment piped in through the carotid artery in my groin. I loved the experience, being awake for the science of it. Made me want to watch and know about surgeries, if I didn't throw up at the gore. Was scared out of my gourd that I'd come out a vegetable or only speaking ungrammatical Punjabi, not English. One has to sign a waiver saying one knows one may not come out ok. It's scary.

Wanted to take my teddy bear for companionship but couldn't because it wasn't hygienic. The nursing staff made a tiny surgical cap for my teddy bear when I came out of the operating theater. awww. Wonder if Eddie's banjo was bathed in antiseptic or if the nurses made a surgical cap for it too?

Kind and skilled neurosurgery people rock.

It will take Eddie Adcock about a year to get his memory and functioning skills back but I bet playing will help him in his recovery process. Using both hands seems to exercise both sides of the brain. It helped me to type comments in MetaFilter with both hands to get my brain back on track after surgery.

Wishing him an excellent recovery. And Eddie, if you read this, you might ask your docs/consider taking magnesium/calcium citrate and Mega-Glutamine (I like this one) to help with the recovery process.
posted by nickyskye at 8:20 AM on October 15, 2008 [4 favorites]

My understanding is that surgery with the least amount of anesthetic is always preferable. Since the brain and certain areas of the intestine lack sensory neurons/pain receptors, awake surgery is preferred since it is possible. It's not done for any other type of major surgery simply because all other parts of your body have pain receptors.
posted by junesix at 8:24 AM on October 15, 2008

Fuck. Amazing.

thanks.
posted by fourcheesemac at 8:30 AM on October 15, 2008

I know it is amazing, and This Modern World We Live In, and all, but it is still pretty gross when you think about it.
posted by paisley henosis at 8:37 AM on October 15, 2008

Definitely less anesthesia is better. I'd been told there is this anesthesia that causes deliberate amnesia, so one doesn't remember the trauma of having one's brain looked at. It's called Versed and isn't especially well liked. But I wanted to remember every second of it, asked that not to be administered and he didn't, which was nice of him to respect.
posted by nickyskye at 8:39 AM on October 15, 2008

Wow, I wasn't expecting so much personal experience in the comments. Sincerely, thanks for sharing that.
posted by mandal at 8:48 AM on October 15, 2008

Anyone who is still watching Heroes won't be surprised that "Dr. Korones" can now play the banjo with amazing fluency.
posted by mecran01 at 8:59 AM on October 15, 2008

I nwould have though that modern medicine would have at least given Alcock a Gibson to work with instead of a deering "Goodtime" banjo. Of course, the Gibson is heavier... could have slipped. All in all, amazing post.
posted by zaelic at 9:10 AM on October 15, 2008

I am waiting for the day when a brain surgeon, having developed hand tremors, is asked to perform brain surgery while undergoing brain surgery to ensure that the operation is proceeding successfully. As our corps of competent brain surgeons ages, several will operate on each other at a time, in series. Eventually, we will have surgeon-circles of mutually noodle-scrambling neurosurgeons. This will become a standard procedure. And then will make a teeny, tiny mistake which induces a wild spasm. Negative feedback is a bitch.
posted by phooky at 9:44 AM on October 15, 2008 [2 favorites]

I have a pretty wild imagination, but this is something I never would have imagined actually happening. Thanks for the links.
posted by Slack-a-gogo at 10:04 AM on October 15, 2008

This is why I love this site. That is a great story. I did loads of neuro psychology at University and stories like that are brilliant. I wonder what he played...?
posted by snowmonkey at 10:24 AM on October 15, 2008

stavrogin: "He needs mouse bites to live!"
posted by sixswitch at 10:27 AM on October 15, 2008

Pfft! That's not so great. I performed my own brain surgery while playing the banjo.
posted by callmejay at 11:02 AM on October 15, 2008

Good Morning America did a piece on this too: Modern Medicine Restores Legendary Banjo Player
posted by homunculus at 11:13 AM on October 15, 2008

Brain surgery is ancient.
posted by ZaneJ. at 11:59 AM on October 15, 2008

I wonder what he played...?

I'm thinking Dueling Banjos would be a little inappropriate for brain surgery.
posted by Pollomacho at 12:02 PM on October 15, 2008

Also, there's a wonderful documentary, The English Surgeon, about an English doctor who travels each year to the Ukraine to do brain surgery. They spare no details during the procedures.

n'thing the wonderfulness of this documentary. What's also interesting about this is that they're doing the surgery with rusty old Black and Decker power drills and disposable bits that the English guy has salvaged from his UK practice.

Very moving and well worth the watch.
posted by PeterMcDermott at 12:21 PM on October 15, 2008

Monkeys move paralysed muscles with their minds: Sending brain signals through electrodes to a paralysed wrist muscle restores movement.
posted by homunculus at 1:03 PM on October 15, 2008

nickyskye: I had Versed once. Not for surgery, per se; they wanted to intubate me while I was still awake, since they'd had trouble doing it when I was anesthetized. (Apparently, my gag reflex stays strong longer after I stop breathing than one might hope.) I still remember it, but I wonder to what extent that's because I was fascinated by the whole thing.
posted by spaceman_spiff at 2:27 PM on October 15, 2008

I nwould have though that modern medicine would have at least given Alcock a Gibson to work with instead of a deering "Goodtime" banjo. Of course, the Gibson is heavier

Heavier indeed. It's an old neurosurgeon's motto: "open-skull surgery, open-back banjo."

Tragic. Even neurosurgery can't cure banjo playing.

Oh no you did not.
posted by cortex at 2:42 PM on October 15, 2008 [3 favorites]

Tears came to my eyes watching that. And it wasn't, I think, out of human feeling for Adcock (though I do wish him the best). It was more like the feeling you get seeing new photographs of a nebula or hearing about deep-sea dives--My god. The natural world is overwhelmingly awesome, and we're still only starting to interact with it, and there is so much more.
posted by hippugeek at 10:04 PM on October 15, 2008 [2 favorites]

Man 'roused from coma' by a magnetic field
posted by homunculus at 1:27 PM on October 16, 2008 [1 favorite]

Unless it's a pre-war Gibson, a Deering Goodtime is a better sounding banjo for your money.

But I'm a Frailure, screw y'all and your resonating banjos.
posted by mediocre at 3:13 PM on October 16, 2008

Tears came to my eyes watching that.

Boom deyada, boom deyada..
posted by mediocre at 3:14 PM on October 16, 2008