Sunday, January 22, 2012

Idiot's Guide to Brain Surgery


by Conor Hunt, '12

Do you like saving lives?  Do you have in interest in the brain? If both of your answers were yes, then think no further! Become a neurosurgeon today!

…Okay, maybe it’s not that easy. And thank God it isn’t! Dr. Erich Anderer, Regis ’93, sought to correct some common misconceptions about neurosurgeons as well to inform us of what he devotes his life to.
He began with the most basic question: what does a neurosurgeon do? A neurosurgeon is involved in the surgical treatment of nervous system disorders. This is not to be confused with a neurologist, whouses research, diagnosis, and pharmacology.

But Anderer’s presentation captured my undivided attention when he described surgery as “somewhat of an art.” Being a surgeon almost demands that you think outside the box.  He gave us an example of a boy whose head had been impaled by some form of sharp object. The object had gone deep into his brain, damaging areas in the occipital lobe as well as the temporal lobe. Where would we perform surgery on the boy in order to inflict the least amount of damage? he asked us.

After a couple of brief silences and a handful of wild guesses, Anderer told us that there really wasn’t one right answer.  Since one answer didn’t take precedence over others, a neurosurgeon would have to look at the situation from a functional standpoint to determine which route would be the most effective and least dangerous. But no one way is without risk. A neurosurgeon could just as easily make an error operating on the occipital lobe verses the frontal lobe.

And this is where it becomes even more intriguing. The ethics of a neurosurgeon require that the patient be aware of all the potential risks of such a dangerous surgery. For example, if a surgeon decides to enter the brain through the parietal lobe, the patient would run the risk of sensory extinction, receptive aphasia (the inability to understand speech), and alexia (the inability to read).

Thus, patients have the power to choose the route of operation that their surgeons will take. For example, a pilot would most likely want to avoid any risk of damage to both the occipital lobe and the primary motor cortex. Proper vision and motor control are crucial for all pilots. As a result, a preferable route of operation would be through the regions of the temporal lobe. While hearing damage is most definitely unfortunate, one could still function as a pilot with such damages.

It was this concept of patient choice that brought Dr. Anderer’s presentation to one final question:  do medical/scientific advances threaten our inherent humanity?

“Surgeons try to do as little as possible,” explained Anderer, because changes to the brain can radically affect one’s personality.

While both medicine and surgery can prevent one’s life from degenerating, it is ultimately a patient’s responsibility to take the steps necessary for full recovery. All the more reason for surgeons to perform operations with caution and reverence. It is critical to possess a knowledge of and respect for what you are dealing with – human life.

Dr. Anderer’s presentation was straightforward, accessible, and most importantly, candid. He clearly loves his profession and did an admirable job of presenting a number of issues and topics that are central to his “art.” The Brain/Mind/Soul Seminar will continue to research more about these stimulating topics as we move forward into the second half of our year.



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