Unlike many colorful expressions in English whose origins are lost to us, the comparison of majorly consequential tasks to brain surgery makes perfect sense. One false move or miscalculation can result in instant death. The chances of irreversible, life-altering damage are high, should a scalpel slip or a surgeon mistake healthy brain tissue for diseased. This can happen more readily than we might like to think. “It can be very difficult to tell the difference between the tumor and normal brain tissue,” admits Dr. Basil Enicker, a specialist neurosurgeon at Inkosi Albert Luthuli Central Hospital in South Africa.
An operation Enicker led makes the procedure seem like just as much an art as a science. During an “awake craniotomy,” the surgeon and his team removed a tumor from the brain of Musa Manzini, a South African jazz bassist.
To help them monitor the operation as they went, they had him strum an acoustic guitar in the OR. “Presumably, had he hit a wrong note,” writes Kimon de Greef at The New York Times, “it would have been an immediate signal for the surgeons to probe elsewhere.” He also carried on an extended conversation with one of the surgeons, as you can see in the video above.
Such procedures are not at all unusual. In a similar case at the University of Texas’ MD Anderson Cancer Center, young musician Robert Alvarez strummed his guitar while surgeons removed a tumor near his speech and movement centers. In 2014, de Greef reports, “a tenor in the Dutch National Opera, Ambroz Bajec-Lapajne, sang Schubert’s ‘Gute Nacht’ as doctors removed a tumor. In 2015, the saxophonist Carlos Aguilera read music and performed during an operation in Spain.” That same year, a Brazilian man played the Beatles while he underwent brain surgery.
Not all of them are musical, but awake craniotomies are so common that Manzini “watched quite a lot of YouTube videos,” he says, “to prepare myself mentally.” As for the shock of being conscious while surgeons poke around in your most precious of bodily organs, millimeters from possible paralysis, etc., well... it’s certainly more comfortable now than in some of the earliest brain surgeries we have on fossil record—some 8,000 years ago. One wonders how Neolithic patients passed their time under the knife.