I spent 24 hours in the same energy field of a man on a mission to rid the world of brain cancer. In the year that has passed my head is still spinning, noticing stuff. I was fortunate for the privilege of observing neurosurgery with Australia’s most talked-about brain surgeon. There is a lot going on at any one time in his operating room. All at once(!) and in slow motion, backwards and in sequence – elegant and complex and subject to change.

The how’s and why’s to answer the obvious question: what was I doing in neurosurgery with Charlie in Sydney? are as redundant as I was in theatre. This is not a clinical manuscript. As a fan of the central nervous system and a born observer, aka ‘pest’, I’ve settled on this answer to the obvious question: I was put there to notice things. To Charlie and his team, to the anonymous donor who facilitated this experience – in fact to all of the people who have gone out of their way to satisfy my neural curiosities over the years, I’m very grateful. Had I not received the welcome I did from CT’s team on this day, or been indulged by so many over the years, I would not have had the temerity to ask all of the questions I got away with. 

Stuff I noticed 1: Paradox.

The OR is icy cold and very dark, except for the spotlight under which CT toiled and the omni-angled projections emanating from CT’s instruments and his P.O.V, suspended from dozens of ceiling monitors. The visuals are deafening and inescapable. To see this patient so intimately was a reverential experience of the beauty alive and deep within us all. The second living brain I see will a) hopefully not be my own and b) definitely look nothing like the brain I observed that day. We are non-fungible expressions of the same essence. This brain was my favourite; I determined, I liked it from the moment I met its pia mater. Charlie introduced me to each new structure as it emerged.

The familiarity I developed with a soul I would never meet over hours where I was physically distant and gloved/ scrubbed/ masked etc., it all defied logic. There are members of my own family I would not recognise if they sat across from me at dinner tonight. The host of this brain, however, could fly into my city and I would sense their proximity, yet I never saw their face or learned their name.

Deadly serious circumstances call for lightning-fast comedy. In CT’s OR, humour is supplied as reliably and abundantly as the judiciousness of the team’s probity and care. In extreme situations if you can’t laugh, you’ll internally combust and splatter everywhere (the neurosurgery OR is an unforgiving environment for lack of self-containment, I learned)  and so I  was reminded of one of my best friends, MN, a lawyer I came to know during undergraduate studies. People like MN can laugh you back to life and save your butt, making them an unlikely ally in a neurosurgical procedure. Nevertheless, in the spirit of collaboration which is genial to CT’s surgical and research approach – I asked the universe for MN’s vibes to assist the team that day. Bring a lawyer, cosmically, to neurosurgery? It was that logical a notion it seemed like nonsense, ergo, perfect. I channelled MN’s light from the dark periphery.

Stuff I noticed 2: Nothing goes unnoticed.

CT, in open warfare with a rapidly growing tumour, armed with an instrument almost as fine as a strand of hair. Me, head darting left and right, processing everything at high speed (e.g., Charlie’s progress on suspended screens, the anaesthetist’s corner, my own pulse in case I fainted from sensory overwhelm) and willing myself to learn by osmosis. CT addressed the hostile tissue of the tumour in terms non-conciliatory. I shuffled under a new screen for a fresh perspective. I asked muffled questions of a German physician, who later turned out to be an expert sommelier, and listened intently.

As I scrawled something illegible in my notebook in the dark, several strands of my own hair had escaped my surgical cap. A Filipino nurse who I’d been introduced to and who stood metres away beside CT, had also spotted these keratinous offenders at just the moment I had. Without leaving her station or flexing a compound muscle of her 45-kilogram frame, the dynamo had rugby tackled me through a series of heavy doors that were all locked and seriously guarded from both sides. She had spoken two words, “Kate” and “hair”, at a fairly low decibel for a force that ejected me across country. I’ve been granted access to roughly half the places I’ve been kicked out of. Persistence is key in science. Learn the lesson, adapt your methods, keep showing up.

I ‘found’ some surgical adhesive outside theatre and bolted to the change rooms. I wrapped the tape around the crown of my head, then added a few extra rows at odder angles for good measure. Had a disposable razor and sufficient time been available I would have deforested everything north of my collarbones to get back to my task of noticing things. Having resterilised myself with new scrubs and gloves and extra surgical caps to conceal my DIY headgear I got back into theatre. The nurse smiled at me. I would have smiled back but could not form any facial expression whatever; to do so audibly ripped hair straight out from roots on forehead, cheeks and neck. Wincing, I resumed my position next to the best man to stand next to when you’re in pain, the anaesthetist. I checked the patient’s propofol consumption/ blood pressure and sent them vibes “my sleeping friend, we’re really in this together now, we can do this”.

 

Stuff I noticed, 3: Really, nothing goes unnoticed.

My feet felt heavy. CT remained hunched over my sleeping friend, moving without breathing, directing without speaking and being characteristically, well, reptilian. As I stood in the anaesthetist’s corner and charted the coordinates of the patient’s vitals of interest (my interest, no one else’s in particular) I felt the beginnings of internal alarm.

In the time it had taken me to glue my hair to my head and return to the OR the rhythmic trajectory of X, Y, & Z had altered off course. I looked for the anaesthetist. He wasn’t in the room. Yikes. CT continued his ministrations. I noticed a shadow in a glassed-off room – the anaesthetist stood with the histologist and other attending neurosurgeons. I pointed to a monitor and gesticulated a question mark when they glanced in my general direction. He gave me a thumbs up. The screen was triplicated, and he was also (believe it or not) monitoring those same coordinates from where he stood. Much was explained in detail to me seconds later. The coordinates of my face, set in adhesive stone, were not able to reassemble to convey my wonder. Great. I had become facially reptilian. I stepped a few inches farther back from Charlie and wriggled my toes.

Stuff I noticed, 4: Pay attention to what gets noticed.

I write of my experience in neurosurgery to remind me what to notice and what to hold fast to. In the course of 24 hours (a fundraiser, a wrong-way trip over the Sydney harbour bridge, a major surgery, a solo skateboard adventure, an elaborate dinner which boiled down to TWO instances necessitating my wearing high-heels and two cocktail dresses get-out-of-here-this-scientist-did-not-commit-to-formal-attire) I was lit up, again, with the energy of Charlie Teo and the spirit of his fight. Charlie has previously and successfully operated on people I love and know. That I had the opportunity to observe this particular surgery was, I reiterate, an incredible privilege but one that did not shield me from the savagery of despair that brain cancer wreaks in the lives of all who suffer the consequences of it, personally or indirectly.

I notice criticism when it is offered from a constructive source. This involves discernment – rigorous and ongoing investigation into who is saying what. I have noticed antagonism bounce around both nationally and globally on the topic of CT; it doesn’t warrant my attention. Feedback that is constructive, feedback intended to realise self-actualisation for the recipient- I notice and have gratitude for. I stand with all people and creatures, happening to find extra stamina for omni-considerate creatures – CT being one of these. Not many people want to work themselves OUT of a job. I’d like to do the same, but with Parkinson’s Disease.  I notice his acts of kindness and sacrifice. In my personal and professional endeavour for harmony and alleviation of suffering, I am very grateful for what I’ve been allowed to notice, e.g., CT’s team that works in collaborative harmony. I notice, apply, emulate and keep showing up.

Thank you to everyone for holding space for a neuroscience student. I’m not satisfied with what little I know now, knowing just how little that is. I will never be satisfied but I will get exhausted, be sustained and keep questioning!

==