Brain surgery is tricky business. Brains aren’t exactly labeled to let surgeons know which parts do what, and a single brain tumor could bump up against many different regions responsible for many different things. To make sure they’re pinpointing the right spot — and not doing irreparable damage to the wrong one — brain surgeons keep patients awake during the entire surgery, sometimes asking them questions to make sure everything is still in working order. In the case of musicians, sometimes the best way to know that is by having them play their instrument. Right in the middle of surgery
Music On The Brain
Sometimes, playing music in the operating room is a way to know if the procedure was successful. A few years before undergoing brain surgery in 2014, violinist Roger Frisch began to notice a trembling in the arm he used to bow his instrument. He was diagnosed with essential tremor (ET), a common neurological condition that, for many, is just a bothersome inconvenience. But for a violinist who requires ultra-fine motor control to communicate with his instrument, it can be career-ending. Doctors decided to treat the condition with deep-brain stimulation surgery, which involves implanting electrodes in the parts of the brain causing the tremors.
For the 90 minutes preceding the surgery and during the procedure itself, Frisch, bolted to a table with a metal halo attached to his open skull, periodically bowed long notes on the violin to test the severity of the tremor. Once the surgeon had implanted one electrode, the tremor immediately improved — but didn’t disappear. After the second electrode, however, the tremor was gone completely.
In 2017, Indian musician Abhishek Prasad went through brain surgery to fix dystonia. The neurological condition caused stiffness and spasms in Prasad’s hands that made it difficult to play guitar. Like in Frisch’s case, Prasad’s surgeons implanted electrodes into his brain, asking him to strum each time a new one turned on. “He was fully awake all through, and the result was available on the operating table because his fingers had started moving normally on the guitar,” the surgeon, Dr. Sharan Srinivasan, told the BBC.
Every Good Boy Does fMRI
Other times, handing a musician their instrument during surgery helps doctors rest assured they aren’t robbing the patient of their life’s work. In 2015, 25-year-old saxophonist Dan Fabbio was working on a master’s degree in music education when he suddenly felt dizzy, nauseous, and began to “see and hear things that I knew were not real.” Doctors found a mass in his brain that, while benign, was located in a region associated with music function.
“When I met Dan for the first time, he expressed how concerned he was about losing his musical ability, because this frankly was the most important thing to him in his life, not only his livelihood, but his profession and his interest in life,” said University of Rochester neurosurgeon Web Pilcher.
To make sure Fabbio’s musical ability was kept intact, Pilcher teamed up with two other experts — neuroscience professor Brad Mahon and music theory professor Elizabeth Marvin — to scan Fabbio’s brain in an fMRI machine as he listened to and hummed back various melodies and performed a few language tasks. That fMRI scan helped surgeons create a 3D map of Fabbio’s brain that pinpointed which areas were important for his language and musical abilities.
For the surgery itself, Fabbio and Marvin modified a Korean folk song so Fabbio could play it on saxophone with one hand, and without breathing so deeply that he disturbed the surgery. When surgeons cut into Fabbio’s brain and began to remove the tumor, Fabbio performed the humming and language tasks he had in the fMRI. Finally, with the tumor removed, the team brought Fabbio his saxophone and see if he could play. He could. The surgery was a success. “It made you want to cry,” said Marvin. “He played it flawlessly and when he finished the entire operating room erupted in applause.”