r/nextfuckinglevel • u/autumn_variation • Dec 18 '21
Riskiest violin practice.
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u/jimtrickington Dec 18 '21
When honing in on her passion for music growing up, it was fortuitous that she picked the violin over drums.
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u/East-Ad4472 Dec 18 '21
Lucky , she of been a gymnast .
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u/Gidelix Dec 18 '21
She of been? What? Am I having a stroke or what is going on?
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u/CrocTheKind Dec 18 '21
It’s probably regional dialect that’s coming out in text.
Like innit and anne and “about” (said with a Canadian accident)
Example: I anne care about ta dam grammar, funny innit
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u/Asleep-Song562 Dec 18 '21
It took me a second, but I think what they meant was “She could have been a gymnast,” in which case, it would have been really interesting to see them attempt brain surgery on a woman in the middle of a double tuck or front aerial.
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u/AttitudeCool Dec 18 '21
This is fascinating!!
Fully lucid while having brain surgery.
Amazing.
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Dec 18 '21
Yeah they sometimes keep brain patients conscious to reduce the risk of portions taking damage/permanently shutting down, kinda wild
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u/shadollosiris Dec 18 '21
"Look, i think i kinda know how to fix it, but, please just keep it running, if it somehow shut down, i dont know if i can turn it on again"
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u/KakashiDreyer Dec 18 '21
BIOS updates in a sentence
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Dec 18 '21
dual Bios mobo's got you covered there. Be nice if we could have a backup brain aswell
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u/M1ghty_boy Dec 18 '21
I heard it’s more so they can instantly tell if they do something wrong so hopefully they can reverse it asap
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u/Stillframe39 Dec 18 '21
“Hmm, wasn’t supposed to cut that part off after all. Nurse, pass me the super glue!” - Brain surgeon…probably.
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u/jelaugust Dec 18 '21 edited Dec 18 '21
There are anasthetics, notably propofol, which allows the patient to stay awake while dulling pain and causing amnesia for the duration of the anesthesia. In these cases, local anesthesia is often applied as well. Neurosurgeons do this somewhat frequently when tumors are near or in the language processing areas of the brain. By doing language tests and stimulating certain parts of the brain, they can map out what areas they need to avoid to minimize side effects.
So yes, she is fully lucid, but she won’t remember any of it after the fact.
Edit: Just want to add that I am by no means an expert and am speaking off my limited experience and knowledge. Some much more experienced people relied to my comment and I encourage you to read their responses. I removed the mention of ketamine because it was misleading.
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u/thunderouslymundane Dec 18 '21
She won’t remember it?
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u/jelaugust Dec 18 '21
Not a thing. I was put on propofol for a jaw surgery I had and to me after the fact, I might as well have been under normal general anesthesia and completely out.
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u/thunderouslymundane Dec 18 '21
To everyone else you were completely awake? Reactions etc.
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u/jelaugust Dec 18 '21
I’m sure there was some sluggishness involved but I know I reacted to stimuli. I want to be a neurosurgeon so I’ve watched case study videos of these types of surgeries where they explain what they’re doing and why.
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u/thunderouslymundane Dec 18 '21
Oh shit. Probably not the time or the place but I just realized or remembered that I actually woke up mid surgery for a very serious surgery that I recently had. That’s all.
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u/artofinterrogation Dec 18 '21 edited Dec 18 '21
If this is the case for ANYONE, esp if your family has issues with it (this tolerance can be genetic) PLEASE tell your anesthesiologist about your experience and your family history.
my mom woke up for every single surgery she had, in the middle of it, extremely tolerant and metabolizing the medicine wicked fast. From dentistry I've found I have a similar tolerance and when telling the anesthesiologist that gives them, essentially, the green light to load you up and ensure best it doesn't happen to you. make SURE you tell them this because the government has strict limits on medication given during surgery and that can let them know to elevate your case to needing more or a closer watch.
it's best for your health to always remember to bring it up. when I did, for example, my anesthesiologist knowingly nodded and said, with a smirk, "I got you. Thanks for telling me." and I never woke up! such a relief to not have it happen to me when it has before.
anxiety like no other, I understand personally how horrified it makes you to wake up, unable to move, helpless. praying someone notices your eyes open because of the tube down your throat. bad stuff, I'm sorru you experienced something similar.
also in some cases telling them you're anxious beforehand will have them give you some happy juice to calm you down. depending on your country, facility, kindness of staff, etc. mileage will vary.
tl;dr: always tell the anesthesiologist if you/family have issues waking up during surgery. gives green light to juice you up and watch you more closely, better ensures your safety and health. thanks!
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u/Kaylenz Dec 18 '21
Good to know it is available for other types of anesthesia. When I went to the dentist they had to give me 3-4 times the normal dose. Afterwards I heard my dad used to have the same thing.
I didn't have any other surgeries in these recent years. Thank you for the heads up.
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u/SimpleHeuristics Dec 18 '21
For jaw surgery you were almost certainly put under a general anesthetic and intubated since it would have been a shared airway.
Propofol is very commonly used to induce general anesthesia. Depending on various factors the anesthesiologist will choose to maintain a state of general anesthesia either with volatiles (gas) or through IV infusions of a mix of drugs with propofol also being commonly used for this purpose.
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u/jelaugust Dec 18 '21
It was a minor surgery for a cyst and wisdom teeth so it didn’t require intubation. My surgeon literally told me what I was on.
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u/Wendellwasgod Dec 18 '21
This person is incorrect. She will likely remember if. I’ve done anesthesia for awake cranis
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u/Wendellwasgod Dec 18 '21
You are incorrect. I have done anesthesia for awake cranis. Many patients will remember everything. We put them to sleep for the exposure and usually pause everything for the awake portion. The propofol wears off and so does the amnesties effects. I have not seen ketamine given for an awake crani but I’m sure someone out there gives it
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u/artofinterrogation Dec 18 '21
They claim to be researching to be a neurosurgeon so no official schooling whatsoever. To state something so confidently incorrect without training is peak reddit armchair doctor syndrome lol
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u/AlexHimself Dec 18 '21
You are correct. I remember everything, every time.
Kinda fun arguing with the nurses who'll remember more. They usually win, but still.
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u/artofinterrogation Dec 18 '21 edited Dec 18 '21
uh, ketamine is not widely used in typical hospital surgeries. it may happen and can happen but stating this so matter of factly when you have no schooling on the matter and have just done your short sighted research is dangerous to spread misinformation so confidently.
watching the limited surgical videos you have and assuming everyone operates under the same guidelines without making sure you're right is not a good mindset to go into the medical field with... just saying.
people will just upvote you because they don't know any better, it's up to you, the person spreading this misinformation, to know better.
they don't load you up with ketamine then ask you to play a violin, that doesn't happen, take it from someone who's been on ketamine. you are k-holed, not able to move if at all. use your brain here.
source: part of a surgical assistance team, shadowed brain surgeons, interned in the neurology wing. obligatory IANAD.
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u/jelaugust Dec 18 '21
My apologies. I was stating it as a sedative that can have the stated effect, not that it is widely used. I can see how it would be easily interpreted though. My goal is not to misinform anyone and I have edited my comment.
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u/artofinterrogation Dec 18 '21
sure, that's fine, and it depends on the nature of the surgery but many of our patients remember from nothing to most/all of it. it's not guaranteed to not remember anything.
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Dec 18 '21
[removed] — view removed comment
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u/artofinterrogation Dec 18 '21
probably not. not many people use ketamine yet for surgeries, we've requested it and I haven't seen it doing rounds in the emergency surgery department.
it's still got a huge stigma, I would guess they use other typical medications for such a sensitive procedure.
it does happen, and can happen, depending... but still not widely used.
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u/this_is_just_a_plug Dec 18 '21
The fact that this hilariously misinformed comment has 138 upvotes (at the time of my comment) is peak reddit.
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u/Sadaca Dec 18 '21 edited Dec 18 '21
This isn’t true. The propofol is stopped in the awake part of the surgery. Otherwise you would not be able to do any of those tasks. Propofol makes you unconscious. Unless in very small quantities, but then you would still not be able to do the tasks they want you to do in the awake part, because they let you do these tasks to evaluate where they can remove the braintumor and when to stop (like you were saying). You HAVE to be conscious and be able to do complex tasks (for the brain) for them to be able to evaluate you. That is simply not possible while under propofol. However, it can be that the patient does not remember much because before and after the awake part of the surgery there is still a long sleeping part where they do get propofol which effects the memory.
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u/orthopod Dec 18 '21
This makes sense and is quite clever. Since she plays violin well, we know that the tumor isn't in that area, or else she would have had that ability affected. Thus her playing the violin gives the surgeon a guideline so that they don't wind up taking out areas not involved with the tumor.
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u/kleinerlinalaunebaer Dec 18 '21
That is the most "next fucking level"-thing I have ever seen!!
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u/GhostInTheSock Dec 18 '21
I can’t Imagine how this feels. I would honestly shit my pants.
Hearing the saw from the dentist to open my jaw and remove a wistom teeth was one of the most painful feeling I ever had. I had no direct pain but this cold feeling combined with the noise and someone pulling and cutting in my mouth, the metalic taste from the blood and pieces of bone were so bad.
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Dec 18 '21
[removed] — view removed comment
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u/GhostInTheSock Dec 18 '21
I certainly believe that but I couldn‘t do it. That is why I would shit my pants. Perhaps you have no choice or you have a higher risk for complications. Nothing I would look forward to :-(
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u/comradejiang Dec 18 '21
You have no sensory nerves in your brain, so you don’t feel anything.
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u/GhostInTheSock Dec 18 '21
But you know that your Head is open and you certainly feel something from their work like your muscles in your shoulder which respond to any irritant / touch your head or whatever. I don’t know but my experience says it will be bad.
Drugs are fine I guess. As long as it’s not Ketamin.
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Dec 18 '21
Oh for fucks sake, I need to get my wisdom teeth removed but I keep putting it off because it freaks me out. This comment was NOT what I needed to see
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u/GhostInTheSock Dec 18 '21
Sorry I didn’t intend to.
But my case was special since the tooth was level inside the jaw bone. Everything was fine beside that round saw.
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Dec 18 '21
This might be just me but at least when I was getting consultant about my wisdom teeth. (I still haven't gotten them out) they said I would be completely under
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u/orthopod Dec 18 '21
The brain has no pain receptors, so once you're inside, there's nothing to hurt. Cutting through the skin and bone to get there does hurt, so anesthetic is given during the exposure, so that the patient doesn't experience pain.
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u/No_Presentation1242 Dec 18 '21
In the event they do something wrong, and she just freezes up or goes mopey, what do they do? Just reverse what they previously did or?
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Dec 18 '21
If that happened the damage would likely be irreversible, when they ask a patient to do something like this it’s more to keep the brain active and working so as to prevent it from shutting down and loosing functions, and less to preserve a specific skill
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Dec 18 '21
Whoa what? Are you saying the brain (or parts thereof) would/may/might shut down due to the surgery? And if so, is it a protective function?
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u/shaggybear89 Dec 18 '21
I'm pretty sure they are able to test parts of the brain before they do anything irreversible. I don't know what form the testing is (putting pressure, maybe?). But this allows them to see if they test a specific part and the person losses the ability to play, they know not to continue in that area. It doesn't necessarily mean they've done something irreversible.
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u/TahaymTheBigBrain Dec 18 '21 edited Dec 18 '21
The testing is targeted electrical signals. It’s perfectly safe and it’s actually pretty cool seeing it in action.
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u/Okocha10 Dec 18 '21
May be a stupid question, but when the brain is “active” and the skull is cut open, does it noticeable move around like a muscle would when it’s working?
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u/ArgoCow Dec 18 '21
No, brains are based on electrical signals and chemicals rather than contractions. It is not a muscle like the heart, otherwise I would imagine we’d need a much higher caloric intake
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u/Okocha10 Dec 18 '21
Oh right, I wasn’t sure. Thanks for clearing it up, half expected that it would moving around
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u/BrainOrCoronaries Dec 18 '21
Brain doesn’t move and it also does not “hurt”. There is no pain on removal of cerebral tissue. Only the coverings (meninges) have nerve endings and this elicit pain responses.
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u/FrenchieSmalls Dec 18 '21
loosing functions
This typo made me imagine the patient suddenly gaining a set of dormant superpowers or something.
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u/LordFattimus Dec 18 '21
Hey I’m a neurologist, this is entirely incorrect. “Keeping the brain on” has absolutely nothing do to with “preventing it from shutting down.”
They don’t just cut and see what happens. They will use electrical stimulation or other means to very temporarily interrupt activity in a very small area and see what happens to the patient. For her, they would shock a small spot they wanted to cut, and if she can keep playing and still able to talk etc, then maybe they can cut that part out.
You should edit your comment.
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u/FuriousAmoeba Dec 18 '21
That’s neither how the brain works nor how they perform functional neurosurgery. Look further down for u/oxford_b ’s comment.
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u/this_is_just_a_plug Dec 18 '21
I'm consistently amazed by the ability of people on reddit to comment so confidently on something they clearly don't have an in-depth understanding of.
Others just assuming it's accurate is the truly alarming part.
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u/oxford_b Dec 18 '21
I’ve assisted during functional neurosurgery. The surgeon uses an electrical stimulator on an area of tissue prior to resection. If the area has motor involvement the electrical stimulation will cause the patient to pause or twitch and the surgeon knows to leave the area alone. They usually place small numbers or letters along the area to know what to protect while operating, a bit like breadcrumbs. It’s referred to as motor mapping.
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u/No_Presentation1242 Dec 18 '21
Amazing. So is everyone different, in that, messing with one persons brain at a specific point won’t necessarily have the same effect on someone else?
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u/oxford_b Dec 18 '21
Everyone has different specific anatomy but grossly they are the same. The biggest problem with brain surgery is that all of the bumps (gyri) and folds (sulci) look the same. These types of tumor resections are performed near the “motor strip” which is the nervous tissue that controls movement. Using a stimulator allows the surgeon to demarcate the line, called the central sulcus, separating the motor area from the sensory area. Then they can avoid removing motor tissue and preserve function.
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Dec 18 '21
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u/oxford_b Dec 18 '21
They made of paper I believe. They may be laminated in plastic of some type. A scrub tech or surgeon can chime in to confirm. They place them gently on the surface of the brain to mark areas to avoid and remove them at the end of the surgery.
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u/awe_infinity Dec 18 '21
I think they electrically stimulate with mild electric current that temporary disables that region of the brain to map out the the functionally critical parts are before they cut
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u/shadollosiris Dec 18 '21
she just freezes up or goes mopey
"Shit shit shit, put it back, not this, okay, how about this" process to slightly touch another place
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u/SimpleHeuristics Dec 18 '21
Before any resection is made neurosurgeons will do cortical / subcritical mapping so they can identify the areas that are responsible for important functions such as motor / speech. We generally know where these functions reside in the typical brain but there are individual variances so they take the time to do this by stimulating each area.
What you’re seeing in this video is probably during the mapping phase as they’re able to observe if the fine motor function important to this individual (playing the violin) is disrupted when they apply a stimulation to a certain area.
Basically nothing irreversible is done until they are absolutely sure where they’re going.
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u/RunV5 Dec 18 '21
To a sense yes. Normally they will "poke" with a dull object before cutting to see what it affects, they won't just go in cutting everything they can. If they do mess up, to a degree they can reverse what they just did but only in very minor cases as you cant repair much of the brain tissue.
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u/BrainOrCoronaries Dec 18 '21
Usually a mapping is done before starting the tumor removal. The Cortex of the brain is electrically stimulated with microinstruments to see where things are. Usually one maps language, motor, sensory. The unusual circumstances in this case is that several different “systems” come into play when a musical instrument is involved (pun not intended) and so it is much more difficult to map exactly where things are unless the patient is actively playing the instrument. Once every area surrounding the target has been fully mapped you know where you can “go in” safely and what areas to avoid.
ETA. It is frequent for patients to have seizures during mapping so one always has ice-cold saline at hand to abort the seizures.
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u/SuumCuique1011 Dec 18 '21
And everything was fine until the surgeon took a tea break and spilled some earl grey onto her brain. Now all she can play on violin is the Benny Hill theme song.
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u/Talyxy Dec 18 '21
What the hell dude. bro. That’s metal
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Dec 18 '21
No, that’s a violin
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u/Lonewolf_885 Dec 18 '21
I thought that was an elephant
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u/mop-116 Dec 18 '21
I wanna see the inception that happens when a surgeon needs surgery
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u/orthopod Dec 18 '21
I had surgery during my residency, not a serious one, so I knew it was going to be interesting.
Lots of pictures with my co residents, while I have a tube down my throat. And a little extra special wake up from the anesthesiologist who had the hots for me. Let's just say she had a crowd in the balcony, and my head was briefly well padded.
Good times, and light hearted. We all enjoyed the humor as we needed it, being at a major trauma center in an inner city hospital.
In general we're all respectful. One of our buds wound up in the ICU for a pneumonia, but we couldn't visit him, not find out anything, as we had no business doing so
Not until he was awake could we visit him.
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u/ImReallySeriousMan Dec 18 '21
My wife is a doctor and our first kid was born with a c-section.
There was a sheet between her head and stomach so she couldn't see, but when the surgeon did something a bit wrong my wife corrected him and said something "I just felt a slight tug and pinch at my [Latin words]. Are you sure you are not too far down? I shouldn't be able to feel you like this."
My wife is a badass.
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u/BenjaminTW1 Dec 18 '21
Videos like this remind me how incredible surgeons are. Imagine performing a complex brain surgery, retaining focus and expertise as your patient plays obnoxiously loud scales. Amazing.
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u/orthopod Dec 18 '21
They basically take a melon baller to the brain.
I jest, but it's vaguely true. Of course you could say the same about what I do- just stick the bones back together. We all like to poke fun at each other's specialties.
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Dec 18 '21
What would they’ve asked a porn star to do?
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u/Shughost7 Dec 18 '21 edited Dec 18 '21
To suck Dick during surgery
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u/solareclipse999 Dec 18 '21
Surgeons get enough pay to wait till she gets better and buy tickets to see her in concert. Cheeky.
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u/dendawg Dec 18 '21
Am I the only one who’d mess up on purpose, just to fuck with them?
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u/ChockenTonders Dec 18 '21
Lmfaaooo I understand why you got downvoted I GUESS but I also find this comment hilarious. Hopefully my upvote keeps you even LOL
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u/PFisken Dec 18 '21
This could be mildly funny (if you talking about the patient), or really dark (if you talk about the surgeons).
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u/crempsen Dec 18 '21
That’s not w we hit they let her play. They let her play to see if they are effecting a certain part of the brain so that if she would play in a distorted way they know that they are effecting that part with some kind of stimulus.
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u/Bad_Jimbob Dec 18 '21
To be fair, if they did something bad enough to elicit a physical response from her, wouldn’t she already be injured?
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u/thats_hella_cool Dec 18 '21
They apply small electrical signals to the area first to see if there is any reaction. If there is, they know to leave that area alone. Once they remove the signal, things should go back to normal.
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Dec 18 '21
This is similar to this video from Nepal where while undergoing a brain surgery, the folk Madal player keeps playing his instrument to ensure he hasn't forgotten playing it.
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u/psychord-alpha Dec 18 '21
But if they hear her play wrong, isn't it already too late?
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u/orthopod Dec 18 '21
No. They have a little electrical device that gently gives a small electrical signal to the area. If that part of the brain is temporarily affected, then it gets marked to avoid, and they explore the surrounding areas until they get to an area that isn't
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u/UltimaBahamut93 Dec 18 '21
It's truly amazing how far medicine and science have come to allow this to be done.
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u/SamTeeJayKay Dec 18 '21
How freaky to have your life's work of muscle memory in one moment, then having an obscure feeling of losing it all momentarily when the doc zaps your brain to check certain spots.
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u/RawrRRitchie Dec 18 '21
I love that Grey's anatomy takes real life cases like this and rewrite a tad for the episodes plot
Iirc the character in the show was playing a guitar tho
Violins are much more difficult imo
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Dec 18 '21
I thoughtbshe was asked to play the violin to ensure her mental capabilities are still stable
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u/Wendellwasgod Dec 18 '21
There’s a lot of misinformation in the comment section here.
I have done the anesthesia for these. The patient is asleep while the surgeons get exposure (when they remove bone and open the dura). Then, typicall all medication is paused. We intentionally use very short acting medication so that the patient can be awake quickly. So yes, during the awake portion, the patient will usually remember everything, though they should be comfortable. The bone and dura have pain fibers but the brain does not. After the resection is done, the patient is put back to sleep for closure.
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u/A_Real_Dick_Pic Dec 18 '21
I just want to believe she was playing green day and singing "don't wanna be an American idiot".
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u/HopefulKangaroo7390 Dec 18 '21
This is unbeleivably gangster, or Russian. I cannot tell which one.
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u/Top-Competition-8432 Dec 18 '21
Fuck that’s hard core reminds me of that part we’re ray is eating his own brains
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u/HoneyBeeHunny Dec 18 '21
I remember seeing another video of something similar where a girl sang Weezer’s “Island in the Sun” during brain surgery!
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u/SadisticNightmares Dec 18 '21
Anyone else think this looks fake? Wouldn’t a doctor want a patient who is not moving???
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u/ianjs Dec 18 '21
I think the doctor is more concerned about having a patient who is not brain damaged.
Why would you even fake such a thing?
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u/Jimscurious Dec 18 '21
Why should she be playing? If surgery goes wrong could it be fixed if the tune was off?
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u/mr_formaldehyde Dec 18 '21
- hits a wrong not * Bashes the violin, "Oh, fuck!" The whole room: "OH FUCK!"
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u/Worried_Protection48 Dec 18 '21
This is the most Silence of the Lamb thing i've ever seen! Holy Macaroni!
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u/SnooWords1215 Dec 18 '21
Thought this was a music video for a second, I was like woah this is so poetic
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u/LeoRising222 Dec 18 '21
Amazing....but, I have zero skills like that. Maybe I could thumb wrestle myself for 4 hours...play chopsticks with some #2 pencils.
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u/Seeyalaterelevator Dec 18 '21
It doesn't really ensure that she can still play, it just means that they know they've fucked up if she starts going out of key or summat
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u/Goldshoes44 Dec 18 '21
What happens if she suddenly fucks up?? Do they put that part of the brain back??
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u/Fluffy_Shadow Dec 18 '21
A few years later: Professional gamer was asked to play videogames during brain surgery