The enigmatic Mr.P, his assembled team of superheroes, and the journey to the darkest depths of the Twilight Zone
Before I start this post I want to acknowledge 2 things. Firstly, it’s likely to be a long one. I ask for forgiveness for any sense of self indulgence. Secondly, (and in part the reason for the length) I’m about to try and describe an experience which on many levels is beyond words, certainly beyond my ability to articulate. This is the stuff that only Vulcan mind-melds could really do justice to! In the run up to my brain surgery I met with 3 truly remarkable people. The first was Mr. P, the neuro-scientist who was to perform the actual operation and attempt to remove my tumour. I’d already read up about him and discovered he was a very gifted and well respected surgeon. He was also 42, the same age as me. I’m very fortunate that I’ve been lucky enough to meet many unique and talented people during my life, but here I was, sitting in front of a real life brain surgeon. I felt humbled. He was understated, calm, softly spoken and gentle. He commanded confidence and I thought to myself, “if someone has to start digging around in my brain, this is the guy to do it”. There was just a tiny aspect of something else as well, something intangible. The closest word I can come up with is ‘arrogance’ but that word implies derision which is not intended. Maybe I would better re-emphasis ‘confidence’ but it was more than that. Perhaps it’s just that for a man to know, I mean ‘actually really know’ that he can and will operate on another man’s brain a special kind of rare self-belief is essential to any chance of success. The second person I met was the anesthetist who I’m going to call ‘Mr. X’. In truth, I can’t remember his name which is genuinely shame on me for what he did for me. I can’t help but fantasize though that perhaps he didn’t actually tell me his name, or maybe he didn’t even have one. Or exist at all. He was a truly extraordinarily presence. He was one of those people who doesn’t seem to really be in the same plane of reality as everyone else - like somewhere between life and death. In many ways I guess that is where he exists for all the patients he cares for. Considering that we’re only now, as humans, at the very beginnings of unraveling a basic understanding of the nature of consciousness, it’s incredible that such individuals exist who can manipulate it with the finesse and subtlety of a fine artist. The final person to meet was Miss. C. She was not a medical team member as such, but joined the surgery as an expert on the mapping of the brain; which parts control and support which functions. She was highly intelligent but she was also young, quite a bit younger than me I reckoned. She carried that brash ‘in your face’ slight over-confidence that very talented, but ‘younger than their colleagues’, team members often have to, in order to establish equality within a group. And this was clearly a group of very gifted individuals. Her job was going to be to spend the entire operation with me to monitor my cognition and mental responses. She was to talk to me, take me through a series of mental exercises and communicate with the surgeon on how I was doing. Between them, their goal was to remove the tumour without causing me brain damage. Mr. P though was clear; he said ‘I won’t take away your ability to communicate, but as the goal is to remove as much tumour as possible to attempt to extend your life, I will push it as far as I can. There will be a judgement that a compromise between your ability to communicate, and your life, will justify a level of potential damage’. After my wife had left me on the night before the operation, I was in a small ward with 3 other men, all either asleep, or unconscious. I’m not ashamed to admit that for the first time since this all started, a had a little weep. I couldn’t believe this was about to happen to me, and I quite simply didn’t want to go through it. I got myself together and watched ‘The Green Lantern’ on iTunes - it was truly dreadful but just what I needed as a distraction. I fell asleep about about 2am. I got woken up the next morning at about 5.30am and I immediately felt different. I suddenly thought ‘Fuck it! If these people are prepared to put in this effort into trying to save my life, then I’m going to match that commitment and do the whole thing justice’. It was scary for sure, but I also felt excited. This was a truly unique experience and if I made it through, it would be a hell of a story. I had to drink a little liquid which would create a dye in my brain - the purpose was to dye the tumour pink under a UV light, this way the surgeon could determine what was tumour and what was normal grey matter. It meant that the whole procedure was under UV so it was a bit like being in a rave! It tasted disgusting, like the worst taste I had ever sampled! About an hour later they wheeled me into the preparation room and Mr. X was waiting me, smiling broadly as I came in. He had a thick Scottish accent and explained he was going to give me a little something that he likened to a ‘very fine single malt’. He then proceeded to start to hook me up for various lines and tubes to facilitate the operation. I can’t remember exactly when they all went in but in total I ended up with 4 lines into my left arm (1 of which was into my main artery), 2 lines into my right arm, a tube with a pump attached onto both feet, oxygen tubes into my nostrils, a drain tube into my skull and a tube pushed into my penis. The infantile competitive part of me couldn’t help itself from considering that had a put a tube up my arse I would have had the full house. Maybe next time I thought. Mr. X explained that whilst I was not going to be under a general anesthetic, he would be sedating me to keep me calm and that he would vary the level of sedation during the operation to suit the stage. During the part where they would slice a flap in my scalp and then cut a hole in my skull to expose the brain, the sedation would be stronger, and it may be that I wouldn’t remember much of that part. I’m very grateful that as far as I was concerned, I have no memory of that part at all; it was the part that I most dreaded and Mr. X’s expertise got me through it completely blissfully unaware. The next thing I was aware of was Miss. C squeezing my hand and asking me if I was awake. I opened my eyes and blinked at her and said “hello”. She explained that they had already tried to ‘awaken’ me once and that I had responded by trying to stand-up to walk away! Not a good idea when your brain is hanging out! I laughed but she asked me quite sternly not to do that again. Once I was awake, the operation started. I can only share what I remember, and it’s a little like sharing the content of a dream, or vision. How much of it was completely real, or imagined? I will never know. I was lying on a diagonal table on my right side so my left side was available the surgeon. Glued to my forehead was a little ‘button’ which acted as a ‘beacon / GPS locator’ to provide a frame of reference to the surgeon on the various displays and projections that gave me a sort of ‘google maps’ view of my brain. The display was a combination of scan images from the previous day, combined with real-time scan information from his equipment. My forehead also acted as a kind of ‘tent pole’ for a series of sheets that made a little space that I was laying in, and that Miss. C was sitting in with me. It was a strangely comforting and intimate space. The sheets also shielded me from being able to see the rest of the surgical team and my own brain, which was a big relief to be honest. A laser grid was being projected onto the surface of my brain and that matched the ‘google maps’ view available to the surgeon. This enabled him to be able to identify a space on my brain to investigate its purpose to determine if it was safe to cut into or not. As the tumour was quite deep inside my brain, he would have to burrow down to get to it and needed to find a safe route through by determining parts of my brain that didn’t seem to ‘do anything’ and therefore could be cut through. In order to do that, the first thing they did was to try and deliberately disrupt my brain to determine which parts had function. He would select a grid space on the map, apply a little electric shock to that space and then see what happened. Miss. C would have me perform a simple basic (like recite the days of the week) and whilst I was doing it, they would apply the shock. In some cases nothing would happen (potentially safe) and in others I would react (do not cut!). “Monday, Tuesday, Wednesday, Thur………asfascsac!”. It was mind bending stuff. Bit by bit the surgeon built up a map of what was active or inactive and created a path through to the tumour. As he worked, Miss. C cleverly combined basic tests with normal conversation, always watching me for any reaction. I started to talk to her about my album and it’s incredible coincidental link to what had happened to me. About the nature of consciousness and whether or not as a scientist she believed in the nature of a soul. Did she find any conflict between the scientific absolutes of knowledge and the philosophical nature of spiritualism? God knows what she might have thought of me, along with all the other team members working on me. But having a deep and meaningful conversation about the nature of identity whilst having brain surgery at the same time is a pretty powerful trip I can tell you. Eventually Mr. P worked if down down to the tumour. If was one of only 2 times that he spoke to me through the operation and he told me he was going to start removing it. They cannot use a normal ‘knife’ to cut a tumour out because it would contaminate the brain, so instead they use a sort of ‘sonic gun’ which uses sound waves to disintegrate through tissue. It sounded almost exactly like a loud dentist drill and when he started using it, I suddenly thought “holy shit! that things inside my brain!”. Eventually he hollowed the tumour out and came to the place where the interface of the tumour meets the rest of the normal brain, and this is where my speech centre was located. His work here was extremely delicate and it took a very long time to painfully work through to remove the tumour without doing further damage to my brain. It was during this point that Mr. P spoke to me for the second time. I was chatting away to Miss. C when he suddenly said “Mark, would you mind not talking for a while and to keep very still”. I’m not sure exactly what happened at that point as the whole thing was very hazy, but there was suddenly an intense period of activity and they all started working furiously. I did something strange and my arm threw a flannel I had been holding involuntarily and Miss. C exclaimed “his eyes are rolling!”. I felt completely calm in myself and the moment passed, but I thought I heard Mr. P say “I’m not sure how to make it stop” and it seemed like something that gone wrong. I said “is everything alright?” and Miss. C said “yes don’t worry”, rather unconvincingly actually. Mr. X popped his head into my ‘tent’ though and looked at me and said “you look alright to me son”. Moments later things calmed down and if there had been a problem then they had clearly solved it. Not long later, Miss. C told me they had finished and that they would start to stitch me back to together again. Mr. X worked his magic again and the next thing I knew, I awoke in the recovery room being tended my two nurses. Mr. P arrived and asked me how I felt. He told me that the surgery had gone very well - better than he had hoped. He had been able to remove all of the tumour that was visible. He told me that he would ring my wife and tell her know I was OK and she could come and see me. The operation had taken about 8 hours in total. Go here to the start of the journey. Go here for next blog entry. Go here for previous blog entry.