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The Art of Neurosurgery
Brain surgery may be code for ‘rigorous, exacting science,’ but even neurosurgeons, it seems,need an occasional jolt of the arts to spur their creativity and help them think outside the box.
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IF YOU THINK all neurosurgeons do is carve up gray matter, you should have seen this year’s meeting of the Society of Neurological Surgeons. Choosing the wire whisk over the knife, they were – figuratively speaking – mixing up the gray matter as the oldest, most prestigious neurological society in the world heard from an assemblage of famous architects, composers and filmmakers.
Hosted by the Department of Neurosurgery in the Keck School of Medicine of USC, the meeting had a visionary agenda: to encourage brain surgeons to think outside the box.
“This may look like an unusual group of speakers to have at a neurological surgery gathering, but when you think about it, the disciplines are not so separate from each other,” says USC neurosurgeon Michael Apuzzo, the program’s moderator. “We all face the same problem of trying to develop original thinking.”
Apuzzo, who briefly studied architecture at Yale and retains a passion for music and the arts, believes there is much to be learned from a cross-fertilization of ideas. So he invited three “arts” deans and three superstar artist-alumni to address the neurosurgeons:
• USC Thornton School of Music dean Larry Livingston
• USC School of Architecture dean Robert H. Timme
• USC School of Cinema-Television dean and USC Annenberg Center for Communication executive director Elizabeth M. Daley
• Composer/songwriter Frank Wildhorn, a USC School of Theatre alumnus whose Broadway credits include Jekyll & Hyde and The Scarlet Pimpernel
• Award-winning architect Jon Jerde ’66, designer of L.A.’s Universal CityWalk promenade and the Bellagio resort and casino in Las Vegas.
• Cinema-school alumnus Walter Murch, who received Oscars for both film editing and sound mixing on The English Patient.
APUZZO BROUGHT TOGETHER this colorful mix of people to, as he puts it, “tackle a question not normally addressed at such forums – how best to foster creativity in a discipline which, to the layman, would seem to offer a limited scope for experimentation and innovative thinking.”
On the surface, it may seem that “creativity” has little role in a scientific discipline like neurosurgery, which is highly technical and functionally complex, requiring concentration, discipline and attention to detail. But neurosurgeon must also be resourceful in dealing with problems unique to each case.
“That’s where the creativity comes in,” Apuzzo says.
“There are many intellectual Gordian knots in the field of neurosurgery, and lots of fundamental problems in the field that haven’t changed in the last 100 years.”
Also addressing the meeting were some less artistic individuals, including Keck School dean Stephen J. Ryan and chair of neurosurgery Martin Weiss.
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Other Stories
Arts Take Center Stage
Mission Days Live Again, Digitally
Cyber-Alternative to Ritalin?
The Art of Neurosurgery
When You're Hot, You're Trojan
Changing Lives, One Smile at a Time
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On the Non-Cutting Edge
SURGERY WITH GAMMA RAYS
IT SOUNDS MORE like a Star Wars creation than a real-world medical device: a knife that doesn’t cut but instead attacks brain tumors and other intercranial disorders with a focused burst of radiation while the patient remains awake under local anesthesia.
It’s a Leksell Gamma Knife, Model C, manufactured by Sweden’s Elekta Instrument AB. And USC’s University Hospital is the only facility in the state, and only the fifth in the world, to own one.
Neurosurgeon Michael Apuzzo, director of the University Hospital Gamma Unit Facility, unveiled the state-of-the-art $3.5 million device in June. The hospital had installed an earlier version of the Gamma Knife in 1994, but Apuzzo characterizes the new model as “the new gold standard of radiosurgery.”
The 20-ton medical device gives brain surgeons a non-invasive method for treating inoperable cerebral tumors, pituitary tumors and a range of neurological conditions with pin-point accuracy.
“Only a few years ago, the outlook was bleak for many traditional patients with these conditions,” says Apuzzo. “Now these patients and others for whom surgery is not an option can be treated with this non-invasive procedure that involves little discomfort and minimum risk.”
The 20-ton Gamma Knife allows surgeons to treat otherwise inoperable cerebral tumors, pituitary tumors and a range of neurological conditions without opening the skull. During the procedure, the patient’s head is placed in this helmet-like structure. |
THE "CUTTING" is done by 201 beams of gamma rays emanating from a helmet placed on the patient’s head. Through narrow holes in a secondary helmet that resembles a giant beauty salon hair dryer, these beams of radiation are focused precisely on the target. The patient’s head is held rigid in a metal frame, and a computerized imaging system establishes the desired beam coordinates. The two-hour treatment, known as radiosurgery, is painless and allows the patient to return to work the next day. Conventional brain surgery, by contrast, takes several hours under general anaesthetic followed by intensive care and a long convalescence.
Like many of the great technological advances of our day, the Gamma Knife is only as good as the personnel operating it. That’s not a problem at USC. Since 1979, University Hospital has been a national leader in stereotactic radiosurgery. Led by Apuzzo and Zbigniew Petrovich, chair of radiation oncology, the Keck School of Medicine team has pioneered the use of Gamma Knife technology in the western United States.
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Apuzzo |
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Illustration by Michael Klein / Apuzzo photograph by Michael Chiabaudo |
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