Bullets on Gray Matters: A Biography of Brain Surgery

Cancer got its biography with the Emperor of All Maladies, and now brain surgery gets a similarly subtitled treatment with Dr. Theodore H. Schwartz’s Gray Matters: A Biography of Brain Surgery. I was a neuroscience undergrad until 2010, but didn’t keep up – this book is full of new findings and old anecdotes:

• Craniectomy bone flaps are often stored in the patients abdomen to preserve them until needed.
• Lobotomies made psychosurgery infamous, but it’s seeing a revival with more modern techniques and better knowledge of how to apply them. Modern psychosurgery is still often ablating parts of the brain.
• Dr Jose Delgado, a neurophysiologist, stood in the ring with a charging, stimoceiver implanted Córdoban bull. Delgado stopped the bull in its tracks via a neural shock.
• The Utah Array is a well characterized, long-lasting 96 electrode BCI (up to six are implanted) that was used starting in 2008 to enable paralyzed patients to control electronic arms.
• NeuralLink has 1024 electrodes across 64 threads, must be surgically implanted using a robot, and has been implanted in two quadriplegic patients in Canada. The first operation had issues with threads retracting, but there is little information otherwise.

Tyler Cowen will be doing a Conversation with Dr. Schwartz. I’d ask:

• How do you improve neurosurgical access for rural and developing populations?
• What is the most significant bottleneck limiting the progress of brain surgery today?
• Are we producing enough great neurosurgeons? And, if not, how do we produce more?
• In your experience, how does country shape neurosurgical practice?
• Do you still play music? Does it have a direct impact on your surgical ability?
• What are the economics of developing new neurosurgical procedures? Is there a pressure towards cost-efficiency in your own work?