[HN Gopher] Man plays his saxophone through 9-hour complex brain...
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Man plays his saxophone through 9-hour complex brain surgery to
remove tumor
Author : Vaslo
Score : 121 points
Date : 2022-10-15 12:39 UTC (10 hours ago)
(HTM) web link (www.cbsnews.com)
(TXT) w3m dump (www.cbsnews.com)
| boomboomsubban wrote:
| 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.
| dheera wrote:
| 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?
| boomboomsubban wrote:
| I think it'd be one of the least painful places. The scalp is
| thin, and isn't overly sensitive, think of how professional
| wrestlers often cut their scalp on purpose. And I don't think
| the skull has a ton of nerves in the first place.
|
| A relative had brain surgery for a tumor, and if I'm
| remembering what she said from fifteen years ago correctly
| she said the anesthesia shot hurt, than the rest was more a
| relief than anything as the tumor had been applying constant
| pressure for years.
| aix1 wrote:
| > think of how professional wrestlers often cut their scalp
| on purpose
|
| Wait, what?
|
| (I am even hesitant to ask as I'm not sure I'm ready to
| hear the answer, whatever it might be.)
| tomcam wrote:
| Scalps bleed like crazy and they don't hurt much. Plus
| performing live has some kind of anesthetic quality.
| nottorp wrote:
| Had that happen to me accidentally. I felt just fine(tm)
| but everyone was looking at me like i was dying. In
| hindsight i probably looked like Carrie from Stephen
| King's novel, could feel the blood on my face.
|
| Bleeding stopped in a minute or two just by holding a
| towel on the scratched part.
| tomcam wrote:
| Love that story. I would absolutely flip out if it
| happened to my wife or kids even knowing what I do.
| Entinel wrote:
| So when pro wrestlers bleed there are two ways, blading
| and hard way. Hard way is exactly as it sounds, someone
| got hit so hard they got busted open. The second and what
| the OP is referring to is blading, you get a thin razor
| blade and nick your scalp-forehead area and you start
| bleeding. It isn't as extreme as they made it sound.
| Andoryuuta wrote:
| I just googled it because I've never heard of it
| before... it's pretty crazy.
|
| Apparently, the wrestlers cut themselves on their scalp /
| forehead some time into a match to make the match look
| more intense, with the blood from their head mixing with
| sweat and dripping down...
|
| A 17 year old kid was even hospitalized due to blood loss
| from it.
|
| https://en.m.wikipedia.org/wiki/Blading_(professional_wre
| stl...
| grogenaut wrote:
| Oh wow you're in for a fun day of googling, on the innner
| world of wrestling. Look up Face, Heel, Turn, Kayfabe,
| and then go deeper if you want.
| failrate wrote:
| When you see a wrestler blading or doing a bump, it is
| still painful. Probably not as painful as it looks, but
| still painful.
| boomboomsubban wrote:
| I wasn't trying to imply cutting the scalp would be pain
| free, but it wouldn't be "excruciatingly painful" like
| the poster said.
| speedylight wrote:
| I think that it's less about the pain because yeah you could
| probably use some sort of a local anesthetic for the scalp
| tissue, but I can't imagine what all the vibrations and
| sounds passing through skull feels like, especially when
| power tools are used to drill into the skull or cut out a
| small section.
| hamandcheese wrote:
| > but I can't imagine what all the vibrations and sounds
| passing through skull feels like, especially when power
| tools are used to drill into the skull or cut out a small
| section.
|
| I imagine it might be similar to having a cavity filled.
| sudhirj wrote:
| If the drill is medical grade and extremely fast, you might
| not feel any vibrations at all, almost like a laser. Should
| feel like a scrape more than anything.
| OJFord wrote:
| I don't know what you (personally) imagine when you say
| 'medical grade', but surgery (other than robots and
| keyhole I suppose) is pretty brutal and mechanical. A
| 'medical-grade drill' is basically whatever's been
| approved for medical use, not (necessarily, though I
| don't doubt they exist) something special that isn't also
| sold for drilling masonry.
| spookthesunset wrote:
| When I've had surgery that was the joke the doctor told.
| It's just a $10,000 version of a tool you'd pick up at
| Home Depot.
|
| Obviously there are some things that would be different.
| For example a big issue is you'd want to use non-toxic
| lubricant on all the parts. Not sure what non-toxic means
| but I'm sure there is something (vegetable oil?
| Silicone?)
|
| You'd also want to make sure it won't fling off tiny
| metal or plastic shards from the tool. Don't want that to
| get into the body. You'd probably have to seal up any
| ventilation openings in such a way that crap couldn't
| escape.
|
| I'm sure mechanically you'd want it to be as tight of
| tolerance as you could get away with--you probably don't
| want a lot of slop when cutting open some dudes skull.
| Vibration and such probably play into that tolerance
| bit...
|
| Of course it could just literally be a rebranded Ryobi or
| something for all I know. But I'm pretty sure it isn't.
| Too many additional requirements means it is probably
| something slightly fancier.
| nottorp wrote:
| Wife had a broken leg and they inserted a metal rod in to
| the bone. She said the operating room sounded like a car
| repair shop.
| OJFord wrote:
| Strange, I imagine, because you'd have the vibrations and
| sounds as you describe of the actual cutting, but also the
| feeling (whatever that's like) of reducing intracranial
| pressure.
| agumonkey wrote:
| 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 ?
| tsol wrote:
| Those are the nerves running through your skull. That's where
| a headache comes from. I learned this from having years of
| migraines.
| yellowapple wrote:
| I'm understanding this right now, from currently having a
| headache.
| pineal wrote:
| 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.
| noduerme wrote:
| The couple of times I've woken up from anaesthesia, I was
| apparently pretty rambly and nonsensical for awhile. I wonder
| if I'd be able to play piano like that. To some extent,
| playing is automatic, sub-verbal for me. Maybe it would come
| out great and I just wouldn't remember it, but... how do you
| gauge the performance given that they're still coming out of
| anaesthesia?
|
| While I'm asking, there's a question that's been driving me
| crazy since a recent colonoscopy where I was sedated with
| fentanyl and (? something like diazepam). I think I remember
| being awake and remembering most of the procedure immediately
| afterwards, but within about an hour I couldn't remember
| anything except one moment when I was in pain and shouting
| that I was going to explode, as a nurse put another ampule in
| the drip line. What's bugging me is, was I really
| experiencing pain like that and aware the whole time, and the
| drugs just erased my memory of it afterwards? Or was that
| just a breakthrough moment in an otherwise uneventful
| procedure where I felt relatively little?
| chrismorgan wrote:
| > _"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).
| jlg23 wrote:
| > 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....
| SeanAnderson wrote:
| 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?
| roflc0ptic wrote:
| You don't make more cuts there
| vanattab wrote:
| Well you can definitely stop cutting deeper if you know
| something is up!
| ceejayoz wrote:
| It's not binary. You go slowly, and stop if it's _starting_ to
| impact the behavior you're observing.
| SamoyedFurFluff wrote:
| 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.
| locallost wrote:
| 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.
| jac241 wrote:
| 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.
| elteto wrote:
| Fascinating! What is ultrasonic aspiration and how does it
| work?
| amelius wrote:
| How do you know what task to evaluate?
|
| And what if this was not a saxophone player, but a tennis
| player? Or both?
| Firmwarrior wrote:
| The worst is when you're performing brain surgery on a
| brain surgeon. The operating theater can get really
| crowded.
| cfu28 wrote:
| Operating theater overflow :)
| ayewo wrote:
| You seem knowledgeable about the topic.
|
| I'm also curious as to the answer to this question [1]. Why
| does left-handedness make brain surgery slightly more
| complicated?
|
| 1: https://news.ycombinator.com/item?id=33215614
| SeanAnderson wrote:
| Oh, that makes sense. Cool that we can "dry run" explore with
| electric pulses! Thanks for explaining :)
| infogulch wrote:
| "dry run" is a great analogy!
| Anunayj wrote:
| Makes a small change
|
| > npm run test
|
| 38/48 tests passed, 10 failed.
|
| Ah schmutz, looks like we made a mistake
|
| > git revert
| daniel-cussen wrote:
| bjoli wrote:
| That dude has steel lips. I am a professional bassoon player, and
| playing anything for 9 hours straight would make my lips bleed.
|
| Edit: I apparently skimmed the article too skimmily.
| yellowapple wrote:
| 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.
| yur3i__ wrote:
| I don't imagine it was 9 straight hours but like a song an hour
| or every half an hour
| ceejayoz wrote:
| Won't have been the entire time. Just during critical points.
|
| > at various times throughout the surgery
| sebazzz wrote:
| 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.
| jcadam wrote:
| You should pick one up. Learning how to read music and play an
| instrument at the same time is good for the brain.
| api wrote:
| Sell recordings and title it "with an open mind."
| teeray wrote:
| Everyone will think the album art is just an elaborate
| illustration.
| peterkelly wrote:
| A similar thing was done with a violinist a couple of years ago:
|
| 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.
| marstall wrote:
| lol!
| ASalazarMX wrote:
| - 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!
| zasdffaa wrote:
| WONTFIX - (skull closed)
| q7xvh97o2pDhNrh wrote:
| 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.
| simon_acca wrote:
| They are not slicing while the guy is playing. Rather they
| stimulate electrically the area that they are about to slice
| to check if brain function is affected.
| q7xvh97o2pDhNrh wrote:
| Ah, so it's actually a _leading_ indicator. I guess that 's
| obvious now that you've mentioned it, but for some reason
| it never occurred to me. Thanks!
| bombcar wrote:
| I'd be afraid that using JIRA would register as complete brain
| death.
| busyant wrote:
| > 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.
| green-eclipse wrote:
| > "Moreover, the patient is left-handed. This makes things more
| complicated because the neural pathways of the brain are much
| more complicated."
|
| This is fascinating. Why would this be?
| pineal wrote:
| 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.
| aliljet wrote:
| Integration testing of the brain during surgery? I wonder if the
| apparatus for this kind of complex testing can be simulated.
| Seems incredibly powerful....
| thomasahle wrote:
| 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?
| dansimau wrote:
| 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.
| abhorrence wrote:
| The vision but seems plainly wrong to me, many (and I'd posit
| most) musicians who have been playing their instruments for
| years can play with their eyes closed. Definitely would test
| proprioception though!
| soulofmischief wrote:
| Well, those musicians likely have highly developed internal
| visualization skills, but of course I'm not keen on how
| transferable that is to real vision.
| Llamamoe wrote:
| What the heck. Why? What if he moved or panicked and disturbed
| the surgeon?
| danjc wrote:
| 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.
| asah wrote:
| for brain surgeries, the head is immobilized.
| jcadam wrote:
| That would make playing any sort of wind instrument quite a
| bit more difficult.
| mikotodomo wrote:
| 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.
| throwoutway wrote:
| > 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
| tomcam wrote:
| Yeah I'd get tired of that theme within say 7.5 hours
| dr_dshiv wrote:
| 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.
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