People suffering from a brain tumor begin to lose certain functions as the ailment progresses. Surgery to remove them is the best known practice to solve the issue, but not all brain surgery surgery procedures are alike. Sometimes removing a tumor doesn’t ensure that lost functions are returned, to mitigate the possibility of losing even more function, or to retain learned skills, the surgery can be performed during an “awake craniotomy”. This leads to these two stories about musicians playing their instrument during brain surgery.
At the King’s College Hospital in London, surgeons performed surgery on a violin player’s brain. As they were removing her brain tumor, they woke her up in the middle of the operation to have her play a Gustav Mahler composition, George Gershwin’s “Summertime,” a jazz classic. As she filled the operating room with the beautiful sound of her violin, the surgeons continued to remove her tumor.
Dagmar Turner, 53, had a tumor settled in the frontal lobe of her brain, near the area that controls precise hand movements, coordination, and language. In 2013, she found out about her slowly growing tumor, but in late 2019 the doctors told her it had become more aggressive. So, she decided to have surgery, to remove it once and for all.
Turner recalled doctors saying, “Your tumor is on the right-hand side, so it will not affect your right-hand side, it will affect your left-hand side.” However, her left hand is more important to her, as it’s the one that does all the work, pushing down on the strings to play the notes.
Keyoumars Ashkan, consulting neurosurgeon at the King’s College Hospital, said:
We knew how important the violin is to Dagmar, so it was vital that we preserved function in the delicate areas of her brain that allowed her to play.
Ashkan isn’t only a neurosurgeon but also an accomplished pianist as well. Therefore, he understood the importance of a musician being able to play their music. He and his colleagues came up with a plan to keep the hand’s functions from getting damaged.
Before Turner’s operation, the neurosurgeons spent two hours mapping her brain to identify which areas were active when she played the violin and which were controlling movement and language. Then, they opened up her skull and started to perform surgery. Halfway through the operation, they woke her up from her anesthesia nap and had her play the violin. This activity allowed the surgeons to see and avoid any parts of the brain that she needs to play while cutting away bits of the tumor.
Along with the “Summertime” classic, they also had Turner play parts of a song by Spanish singer and songwriter, Julio Iglesias.
The surgery was successful and Turner was released from the hospital only three days after surgery. “We managed to remove over 90% of the tumor, including all the areas suspicious of aggressive activity while retaining full function in her left hand,” said Ashkan.
Turner, who currently plays her instrument in the Isle of Wight Symphony Orchestra, was relieved that the surgery was successful and didn’t rob her of the skills that she’s developed over the past forty years.
Turner said:
The violin is my passion. I’ve been playing since I was ten years old. The thought of losing my ability to play was heartbreaking.
Turner is not the first musician to play their instrument during brain surgery. In July 2016, a music teacher named Dan Fabbio played his saxophone as surgeons removed a tumor from his brain. Dan was 25 years old when he was diagnosed with a benign brain tumor, which was found in an area of the brain that’s active when people listen to and make music.
Music is the most important thing in Dan’s life, it is his passion as well as his job. Thankfully his surgeon, Dr. Web Pilcher, has a passion of his own, mapping of patient’s brains so they can retain as much function as possible after surgery. Dr. Pilcher mapped Dan’s brain with the help of his colleague Brad Mahon, who is a cognitive neuroscientist.
Brain mapping is a fundamental process that uses an imaging technique called functional MRI. Mapping the patient’s brain activity before the operation allows surgeons to enter the operating room with detailed information about a patient’s brain. That information helps doctors determine what kinds of functions are at risk during the surgery.
Pilcher and his team used that map as a guide during the surgery. Dan was not only awake during the operation, but at one point, he played the saxophone and completed some language tests, all with his brain exposed.
Once his tumor was removed, Dan was given his saxophone. Lying on his side, he played a beautiful modified Korean folk song he’d prepared for that moment. “He played it flawlessly, and when he finished, the entire operating room erupted in applause,” Marvin recalled. It’s amazing to know that a person can play an instrument so beautifully during surgery.
As a musician, Dan always heard music in his head. For example, as he brushed his teeth with an electric toothbrush, he would hear melodies that harmonized with the vibrations of the toothbrush. When the tumor showed up, he stopped hearing those rhythms. About a month after surgery, Dan was brushing his teeth when the harmonies and melodies returned. “He realized at that point that his brain had recovered completely,” said Dr. Pilcher.
Dan’s case is described in a study published in the journal Current Biology.
