Thoughts of a Brain Surgeon [From Reader’s Digest 1981. November.]

From the frontiers of science and the far horizons of personal courage, these stories of medical triumphs and miracles will reaffirm your faith in the awesome powers of the human spirit. Dramatic victories and human triumphs.

SELECTED AND EDITED BY THE EDITORS OF READERS DIGEST

Thoughts of a Brain Surgeon  [By ROBERT J. WHITE, M.D.]

She was a lovely little girl, six years old, exceptionally pretty, bright, happy.  But our studies showed a large tumor in her brain.  Operating, I found the hemisphere markedly enlarged by giant cyst associated with the tumor.  I started in after the fluid—filled mass and. Disaster!  Suddenly the hemisphere collapsed and the large vessels on its surface ruptured, flooding my operating field with blood.

My colleagues and I struggled to stem the torrential flow, but we were losing the battle.  Gloom settled on us.  With my fingers, I held little pads of cotton tight against the hemorrhaging vessels, striving desperately to control the bleeding.  At last I succeeded.  I dared not to release my fingers; all I could do was pray while the child was transfused.

As I waited, I felt terribly inadequate, humble.  Who was I to be engaged in such awesome work, to think it was my responsibility, and mine alone, to remove this ugly growth from this little girl’s brain—the tissue substrate of her highest functions, her wonderful personality, her intelligence, memory, emotions, free will?  This area where we were operating, that was where she was, it was who she was.

Half an hour passed.  The operating room was alive with a terribly quiet tension.  No one, including me, believed I could lift my fingers from the pressure points without releasing another river of blood.  I kept applying digital pressure and preying, praying to God to will the necessary strength into my hands.

And then, quite suddenly, I felt relaxed.  I knew I had done all was in my power to do, and I was full of comfortable certainty that I could proceed.  Somehow God was in the room with us.  Carefully, slowly, I released my pressure on the vessels, one finger at a time.  There was no bleeding until all my fingers were free.  Then one vessel began to bleed, but it was easily controlled.

It took 4 ½ hours to remove the tumor.  I stayed close to the little girl’s bed for the next week.  Her wounds healed well; no re-hemorrhaging, no neurological deflect, no brain damage.  The result was all that had been hoped for, and the girl today is normal, happy teen-ager.

In 1974 I operated on a young boy who had suffered two massive brain hemorrhages—the result, studies showed, of a small tumor at the very center of his brain.  The hemorrhaged areas were badly infected.  The lad became comatose; he was dying.  We placed tubes into both sides of the brain and literally washed out the brain cavity with cold antibiotic solutions—a revolutionary new technique of our own devising.  Later we placed the boy on a respirator, a breathing machine, and reduced his body temperature.

For weeks the fight for life continued.  I kept praying, not only for the boy and his parents but also for the strength to sustain the entire medical team in the sad and exhausting case.  Then, almost imperceptibly and for reasons not yet clear, the boy began to improve.  After a fortnight we removed the cooling blanket.  Another two weeks and we were able to remove him from respirator, then to remove the drainage tubing from the brain.  Now, in my daily meetings with the distraught parents, I began suggesting the possibility that their son might survive, even if incapable of anything resembling a normal life.  Yet, unaccountably, he continued to improve.  By the time we discharged him, I was able to describe him as a spastic with severe mental retardation—far better than we had dared hope.

Several months later, the parents brought the boy back to me for an examination.  I am still astounded at what I found: he was in all respects completely, utterly normal—happy, active child.  The tumor is still there, in the center of his brain—we continue to keep a close watch on it—but it has caused no further trouble nor has grown.

If I seem to be saying that I have witnessed miracles that is not what I believe.  To be sure, I have been in many extremely dangerous operating-room situations—several of them apparently hopeless—in which to my amazement the patient has survived and prospered.  But I see nothing “miraculous” about these successes.  I don’t think they would have occurred without the combined hest efforts of all the medical professionals in that, I believe; it would not have been achieved without Divine help in making the decisions and in the actual technical performance.

Many research scientists seem to lose faith as their knowledge increases.  For me, the opposite has occurred.  My experiences with my patients, and in my neurological research trying to unravel the mysteries of the brain, have put me more than ever I awe of the brain.  And I am left with no choice but to acknowledge the existence of a Superior Intellect, responsible for the design and development of the incredible brain-mind relationship—something far beyond man’s capacity to understand.

Just think about this wondrous organ, the human brain.  The most sophisticated computer man will ever build will not match the complexity, efficiency and performance of this gelatinous mass of tissue weighing approximately three pounds.  With its topography of small hills and narrow valleys crisscrossed with red and blue streams, one-brain looks much laid any other.  But somewhere in there is what makes each of us unique.  For the brain contains the mind, the relationship between the container and its contains, science knows very little.

I am convinced that the brain is the repository of the human spirit, the soul.  Therefore, to me the brain is a holy place.  Still, it is subject to injury and illness, and sometimes it is necessary for us to enter and search its depths for tumors, hemorrhages, and infections.  To work in this area strikes me as an almost religious undertaking, and one demanding the highest of human skills.  I need a very solid set of beliefs to sustain me in such work.

I recall a lovely, long-ago spring day when I was called to a veteran’s hospital for consultation in the case of a man in his early 30s who had a malignant brain tumor.  His room was full of colorful, homemade get-well cards, several with pictures on them of a beautiful little dark-haired girl, and her repetitive plea; “Get well soon, Daddy”; “Come home soon”; “I miss you so much” But as I studied the young man’s records and examined him, I knew he would not be going home again.

My depression was profound.  I would mot want to try to weather such moments without the realization that understanding is beyond me, without faith that the patient and all involved with him are moving ahead, that they happen now to be center stage in a grand drama of time and space in which each of us figures significantly.

For me, the practice of medicine and religious faith are inextricably interwoven.  I prey a great deal, especially before and after surgery.  I find prayer satisfying.  I feel there are immense resources behind me, resources I need and want.

I knew great and good men among my colleagues who seem able satisfactorily to explain things to themselves in terms of mathematics and chemical formulas, and are comfortable in assuming that what is not explainable today will come clear as science continues to progress.  Yet the notion that human life is nothing more than a chance confluence of complex molecular biology and electrical activity strikes me as a defiance of logic.

From purely scientific standpoint, it seems to me the human brain-mind is so far beyond anything science have ever developed that a Superior Intellect-Creator is demanded to explain the uniqueness and individually of the human being.  No matter how much we learn about brain, we can never expect to explain the mind completely.  And I have to believe all this had an intelligent beginning that someone made it happen.  I can’t accept the proposition that at random points in time such substantial entities as intelligence, personality, memory and the human body just sort of fell together.

I also find it unreasonable to suppose that the brain death those powerful entities of intelligence, personality and memory simply cease to exist.  Far more reasonable to believe that the essence of us escapes from a container, the brain, which no longer is capable of supporting us, and finds support in a new dimension.

As to what becomes of the essence of us at brain death, I can’t presume even to speculate.  I can only say that logic leads me inescapably to faith—faith that the uniqueness, the individuality, of the human being lives on in this concept we call the soul.

 

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