Short abstract
Live from Brainworks at the Science Museum's Dana Centre, London NW1 Thursday 28 October www.danacentre.org.uk/
Rating: ★★★
How many non-neurosurgical medical professionals have had the chance to observe a full course of brain surgery during their entire medical training and careers? Probably very few, but about a hundred Londoners witnessed such an operation last week. The British public's first opportunity to see brain surgery live was broadcast from the United States, as Dr Robert Hadosh, medical director of the Neuroscience Institute at Overlook Hospital, New Jersey, removed a recurring meningioma of 3.5 cm in diameter from a 71 year old patient with a history of previous operation and radiation.
The two-and-a-half-hour event, which started with the drilling of the skull and ended with rebuilding it with plastic cement and sealing it, was organised by the Science Museum's Dana Centre with New Jersey's Liberty Science Center, an organisation that shares Dana Centre's dedication to narrowing the gap between science and the public. Liberty Science Center has previously broadcast live surgery to a total of over 4000 people, and this experience must have contributed to the professionalism of the “show,” which was punctual, technically competent, and impeccably coordinated between facilitator Nancy Butnick and the surgery team.
And, like many popular shows, this one also had audience participation: spectators were able to ask questions directly to the surgery team. The event soon became a pleasant chat about diverse topics: what does it smell like in the surgery room, can mobile phones give you a brain tumour, is there such a thing as postoperative depression, what caused the tumour to grow, what is a neurosurgeon's typical day like, what is the role of the brain in learning, and what is plasticity of the brain.
In tune with the young audience, which was mostly composed of medical students and those considering a medical career, Dr Hodosh compared neurosurgery to playing Nintendo, while, educationally, pointing to the carotid artery, and the optic and olfactory nerves. Meanwhile, he resected the tumour imbedded in scar tissue left over from the previous operation and obtained a rapid pathohistological confirmation of the diagnosis, while the audience examined a cutting and cauterisation bipolar device and a plastic model of a brain circling around the room.
Figure 1.
What does it smell like in there?
Credit: ALEX MACNAUGHTON
The only subject Dr Hodosh bluntly refused to discuss was the cost of the operation, although we did learn that this particular patient was on Medicare and did not need to pay anything. He also informed us that written consent was obtained from the patient for filming and broadcasting the operation, which is probably essential for the continuation of his practice. The “[American] malpractice rate is outrageous,” he said. Nancy Butnick, the leader of Liberty Science Center's programme development, said that in the event of a complication the surgeon would be able to cut off visuals and sounds. Luckily, there was no need for this.
I had my worries about this event. What effect did all the unnecessary talking have on the sterility of the operation room? Did the presence of cameras compromise the surgeon's focus? But my chief worry was how ethical was it to make a spectacle out of someone undergoing brain surgery, even if it was for educational purposes and the patient consented.