Sunday, August 28, 2011

"The Brain is Sexy"

That's what one of my peers said to me as we were watching neurosurgeons take off the half the top of the neurocranium of some poor victim of a hit and run accident. I'm nowhere near far enough in my education to pretend like I knew exactly what was going on, but the patient had been operated on before and had since suffered sinus problems. The surgeons were going to go back into the skull and plug up the sinus. The procedure was described to me in writing as an "anterior fossa skill base repair in a child with traumatic brain injury and a fracture through the anterior skill base that extends into the frontal recess." Yeah, whatever that means. I only recognize a few words in that, and I think my definition for one of them is wrong (recess is that time you get to play on the swings, right?).

I've been interested in neurosurgery since I was a little kid, when I read Ben Carson's Gifted Hands. Smart black kid reads about another smart black kid growing up and becoming one of the best neurosurgeons in the world? C'mon, I ate that shit up! Since, I have strayed from the path of not only neurosurgery or even surgery for that matter, but medicine as a whole. That's another story, and the end result is I'm back on that path now. Being in the operating room with those surgeons was inspiring. But I was only there for a short period of their life. They are in the hospital at 5am to prepare for rounds, give updates on all the patients at 6am, and then go to see them at around 7. Surgeries start at 7:30 am, and in neurosurgery, the longest ones can go until midnight. I've heard the average surgery is 4 to 5 hours long.

There was another case where a 17-year old boy with bad epilepsy had been implanted with electrodes from his brain to a fMRI. They monitored his seizure activity, saw where it was located, and determined if the area of the brain was safe for excision. Unfortunately, they found that the seizures were coming from the locomotive and language area of the brain, and doing anything in that area would be too risky. I watched as they cracked open his already sawed-through skull and removed the electrodes. When they peeled back the dura--the thin layer of membrane covering the brain--it was the first time I'd seen a brain in person. It was beyond cool, to see in person the thing that controls our humanity. I wish they could have done more for the boy, but even the ability to identify the source of a problem, determine if it can be fixed, and if so, actually go in and fix it....that's crazy to me. And awesome.

The brain boggles my mind. That thought by itself is crazy. The brain...thinking about itself. Fully utilizing  a process we don't understand to try and...well, to try and understand. Then I look over at my dog, Rambo, with his glowing eyes and propensity to pee five times a day whether I'm around to take him outside or not, and I think about how he'll never even come close to understanding himself the way I do. Or, at least, asking the questions that lead to understanding/the knowledge that you just can't, in fact, begin to understand. Yet his brain make those same connections (just less of them). But still, it's so limited. If you think about it, we're all kind of a prisoner of our brains. We perceive the outside world through a series of interpretations. Analogous to someone who has been blind his whole life, what else is there to perceive that we're missing out on? How much of the world is as we actually see it? Who knows.

If you're religious, I think it's fair to say that the brain is the closest connection to our soul. We often say 'with all your heart', but no...if you get a heart transplant, you're still you. Get your leg amputated, you're still you. If I take out a slice of your brain...well, then, you essentially become a little bit more like something else.

These are my random thoughts, transcribed over a series of a few days. The brain and my recent experiences in the hospital have definitely given me ideas for stories. We'll see what happens.

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