A Neurosurgeon Reflects On The ‘Awe And Mystery’ Of The Brain
But given that the tumor looks like the brain, and if you’re operating near what we call eloquent brain – that is brain where, if it’s damaged, the patient suffers serious troubles such as paralysis or inability to speak – something like that – it’s very – it can be very helpful to have the patient awake, talking or moving the relevant limbs as you remove the tumor to make sure you’re not doing any harm.
And I was one of the first people to do this in this country many years ago. And it was considered rather eccentric at the time. But, in fact, it’s now the standard way of operating on these tumors and is practiced everywhere.
.. But it is one of the various themes of the book, which is this extraordinary fact which is very hard to come to terms with. It is a fact for all people who work with the brain that thinking and feeling is a physical process. It doesn’t feel like it. You know, my thoughts don’t feel like electric chemistry. But that is what they are. And I find it quite a consoling thought that our modern scientific view of the world which has explained so much – we can’t even begin to explain how consciousness, how sensation arises out of electric chemistry. But the fact of the matter – it does.
.. So does the work that you do as a neurosurgeon increase or diminish your sense of the mystery of consciousness?
MARSH: It increases it.
.. But you’re very nervous, as you describe it, during this procedure because you just recently performed surgery removing a tumor…
MARSH: Which had gone very badly, yes.
GROSS: Yes, from the cervical spine – cervical spinal cord of a woman. And she was left paralyzed on one side of her body.
MARSH: Yes.
GROSS: You fear that you removed too much of the tumor, and that’s what damaged her spinal cord. And you confess to several times when you felt responsible for a spinal or brain damage as a result of a surgery. And I’m interested in why you wanted to share that. You’ve even given a lecture called, like, the 10 worst mistakes I’ve ever made.
MARSH: Well, something like that. I’m a great believer that doctors and patients should, in a sense, be equals, I mean, especially as we give advice. I’ve always hated sort of paternalistic, condescending doctors. And I’m all for patients making demands and patient’s rights. But it’s a two-way process. And I think patients in the modern world where – certainly in England, you can’t open the newspapers without reading about the latest medical scandal and incompetent doctors. Now its incompetent nurses.
The public need to understand that medicine, actually, is often a very uncertain process.
.. I think, on the whole, if you – as a patient, if you go and see a doctor, and you could only choose one quality, I think most of us would go for honesty (laughter) because if you see an honest doctor, if he knows what should be done, he’ll tell you. If he thinks somebody else can do it better than he can, he can tell you. And I think honesty is, in a sense, a more important quality than steady hands or nerves of steel or heart of a lion – all the old cliched ideas of what surgeons should be like.