If I ever need brain surgery, I guess they'll probably have me try to respond to JIRA tickets and troubleshoot npm dependency conflicts during the operation.
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.
> The doctor said his patient, who has been identified only as C.Z., played the theme song from the 1970 movie "Love Story," and the Italian national anthem, at various times throughout the surgery.
FWIW, it was not the entire 9 hours, but still cool though. I guess I read the headline wrong and thought it was during the whole operation
Though I cognitively understand why it's the case, the fact that operating on the brain isn't painful still weirds me out. Something about the part of the body that processes pain not feeling pain feels bizarre even though I can see why there'd be no benefit to having pain receptors there.
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.
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?
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 ?
I never quite fully grasped the purpose of having patients stay engaged during brain operations. Is it possible to undo a brain incision? If not, what good is it to know a patient's abilities are degraded after having made a cut? Is it just to mitigate compounding unexpected damage?
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.
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.
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.
I am ancient. When I was your age there was a very old joke that went some thing like “Dr., will I be able to play violin after the operation?“ The doctor says: “absolutely.“ And the patient says “great, because I don’t know how play violin at all“. I was sure other old-timers had use this joke before my latest operation, and I was going to overturn it by saying “good because I actually do play violin.“, knowing they were expecting the other punchline. Alas, this joke has completely expired. No one under 30 or so has heard it. I looked like a damn fool.
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.
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.
Really interesting. Back at university I got the chance to attend a surgery since our physics department donored a graphics card for the medical department running a DecAlpha with True64 which had a pixel error. And this machine was used for brain surgery. So better not to have a pixel error.
Most of the surgery 8 hours was done with 2 doctors and 2 medical physicists in front of the computer and simulate where to drill a hole in the head and where to pass a needle without touching a vessel.
After the coordinates were found the actual surgery 1 hour happened with the patient awake.
Also I was very impressed when the neurologist came in and hooked up with a Windows 2000 laptop to the brain pacemaker (against Parkinson’s) and tweaked the stimulation currents.
The patient had to count the weekdays aloud and started mumbling around the word “Thursday”. Afterwards the neurologist typed onto his laptop, pressed “enter” and the patient could talk again.
I wonder what the nerdy software developer equivalent is of this. I can't play an musical instrument. However, I'm plenty fine with: (1) Fusion 360, (2) .NET Web Development, (3) playing FPS/RPG/simulation/puzzle computer games.
> “Moreover, the patient is left-handed. This makes things more complicated […]
There’s something bizarrely amusing about this. I’m now picturing a surgeon saying, “I’m sorry, I can’t operate on you because you’re left-handed.”
I wonder if discrimination based on handedness is unlawful anywhere. Under Australia’s Fair Work Act (for employment) and Equal Opportunity Act (for public life), you’d have to classify it in as a disability to get it covered, and I don’t know whether that’d be allowed by a judge or jury or whatever (to say nothing of sinister persons refusing to consider it a disability).
> 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.
Is this because playing sax is the only function he cared about preserving? Or did he perform other tasks too when they were operating in other parts of the brain?
> "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.
I wonder what brain activity data they collected during this. I’ve been wanting to analyze intercranial EEG of people listening to music to understand the degree to which the brain directly resonates to the frequencies and envelopes of music.
Makes sense, doing an intellectual activity while getting brain surgery probably helps them like when they tell you to move your muscles around when getting normal surgery.
Integration testing of the brain during surgery? I wonder if the apparatus for this kind of complex testing can be simulated. Seems incredibly powerful....
[+] [-] peterkelly|3 years ago|reply
https://www.smithsonianmag.com/smart-news/watch-musician-pla...
Related research study on the practice: https://pubmed.ncbi.nlm.nih.gov/32505870/
If I ever need brain surgery, I guess they'll probably have me try to respond to JIRA tickets and troubleshoot npm dependency conflicts during the operation.
[+] [-] busyant|3 years ago|reply
for me they will ask me to play chess. and they will stop cutting when i start making good moves.
[+] [-] q7xvh97o2pDhNrh|3 years ago|reply
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.
[+] [-] bombcar|3 years ago|reply
[+] [-] ASalazarMX|3 years ago|reply
- Works as designed
- It's a feature
- This is egregious! I'll get to fix it immediately
Doctors: Oh no, we cut too much!
[+] [-] panzi|3 years ago|reply
[+] [-] marstall|3 years ago|reply
[+] [-] throwoutway|3 years ago|reply
FWIW, it was not the entire 9 hours, but still cool though. I guess I read the headline wrong and thought it was during the whole operation
[+] [-] tomcam|3 years ago|reply
[+] [-] boomboomsubban|3 years ago|reply
[+] [-] pineal|3 years ago|reply
[+] [-] dheera|3 years ago|reply
[+] [-] agumonkey|3 years ago|reply
[+] [-] SeanAnderson|3 years ago|reply
[+] [-] jac241|3 years ago|reply
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.
[+] [-] ceejayoz|3 years ago|reply
[+] [-] SamoyedFurFluff|3 years ago|reply
[+] [-] roflc0ptic|3 years ago|reply
[+] [-] locallost|3 years ago|reply
[+] [-] vanattab|3 years ago|reply
[+] [-] tomcam|3 years ago|reply
[+] [-] sgtnoodle|3 years ago|reply
[+] [-] StrictDabbler|3 years ago|reply
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.
[+] [-] bjoli|3 years ago|reply
Edit: I apparently skimmed the article too skimmily.
[+] [-] ceejayoz|3 years ago|reply
> at various times throughout the surgery
[+] [-] yellowapple|3 years ago|reply
I still absolutely loathe that song to this day.
[+] [-] analog31|3 years ago|reply
[+] [-] yur3i__|3 years ago|reply
[+] [-] weitzj|3 years ago|reply
Most of the surgery 8 hours was done with 2 doctors and 2 medical physicists in front of the computer and simulate where to drill a hole in the head and where to pass a needle without touching a vessel.
After the coordinates were found the actual surgery 1 hour happened with the patient awake.
Also I was very impressed when the neurologist came in and hooked up with a Windows 2000 laptop to the brain pacemaker (against Parkinson’s) and tweaked the stimulation currents.
The patient had to count the weekdays aloud and started mumbling around the word “Thursday”. Afterwards the neurologist typed onto his laptop, pressed “enter” and the patient could talk again.
[+] [-] api|3 years ago|reply
[+] [-] sebazzz|3 years ago|reply
[+] [-] jcadam|3 years ago|reply
[+] [-] iancmceachern|3 years ago|reply
[+] [-] chrismorgan|3 years ago|reply
There’s something bizarrely amusing about this. I’m now picturing a surgeon saying, “I’m sorry, I can’t operate on you because you’re left-handed.”
I wonder if discrimination based on handedness is unlawful anywhere. Under Australia’s Fair Work Act (for employment) and Equal Opportunity Act (for public life), you’d have to classify it in as a disability to get it covered, and I don’t know whether that’d be allowed by a judge or jury or whatever (to say nothing of sinister persons refusing to consider it a disability).
[+] [-] jlg23|3 years ago|reply
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....
[+] [-] green-eclipse|3 years ago|reply
This is fascinating. Why would this be?
[+] [-] pineal|3 years ago|reply
[+] [-] thomasahle|3 years ago|reply
[+] [-] dansimau|3 years ago|reply
> "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.
[+] [-] dr_dshiv|3 years ago|reply
[+] [-] mikotodomo|3 years ago|reply
[+] [-] aliljet|3 years ago|reply
[+] [-] Llamamoe|3 years ago|reply
[+] [-] asah|3 years ago|reply
[+] [-] danjc|3 years ago|reply
Similar to write some code, run the app, repeat.
[+] [-] slmjkdbtl|3 years ago|reply
[+] [-] Anunayj|3 years ago|reply
> npm run test
38/48 tests passed, 10 failed.
Ah schmutz, looks like we made a mistake
> git revert
[+] [-] KrishnaShripad|3 years ago|reply
[+] [-] daniel-cussen|3 years ago|reply
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