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12. The Surgery
The brain's thalamus is centered in the brain deep to the surface cerebral cortex. In a vertical slice of brain it could be identified as a 4 centimeter (c.1.6 inch) diameter right & left gray matter body deep to the cortex gray matter and attached to the thalamus is its underlying white matter. Microscopically it is thousands of neurons in groups called nuclei with input and output to and from every other part of brain. It works like a switchboard that connects body senses and muscle control with the outside world, and memories and emotions with the cerebral cortex and with consciousness. Within and around right and left thalamus are control centers for feelings and emotions. The one of interest here is for anxiety - in practical terms, fear and worry. Anxiety is the ill-at-ease feeling, a feeling that may get attached to many ideas or to external objects and become a terrible worry about a real event. The anxiety center is just beneath the thalamus; in right-handed persons like Joe Pro, it is on his left side.
First is to expose an approach to the anxiety center for electric probing to locate it; then, paste over it a small silver disc that will transmit magnetic pulses.
The location is an internal surface, the side wall of the central brain ventricle space. Now, Leo Davidoff, through his operating microscope that has binocular viewing for assistants, starts his surgical approach to un-roofing the ventricle.
Intern Goldberg observes the action intently as he assists.
First, the front-to-rear cleft that separates left and right halves of brain is gently pulled apart and 2 small vises are set to hold it apart without harm. Then, Davidoff deftly does a 2.5 cm (c.1 inch) cut into the floor of the cleft that is roof to the ventricle. He deepens the cut and enters the ventricle. He now directs Goldberg to hold the 2 small surgical vises that pull apart the cut, allowing him to view inside. Now he is positioned to do the experiment because the left inside wall of the ventricle is the inner side of the left thalamus just beneath which he will move his electric probe.
It is 3 minutes so far; 3 silent minutes because Davidoff works silently - his assistants - Nurse Sheila and intern Goldberg - follow his finger prompts. Now, he pauses, inspects inside the ventricle-cavity and comments to Goldberg.
"The pineal gland!" He indicates with probe. "It normally hangs down into the ventricle. But, note, the tumor is a cyst. He points to a plum-like body in rear of the fingertip-size pineal-gland. Goldberg sees it is clear and water-filled.
Davidoff says, "It is blocking drainage from the ventricle. There we have the source of Mr Provenzano's headaches - the pressure build-up of fluid."
Suddenly a new voice - the patient, Joe Pro. "So what you gonna do, Doc?"
Davidoff, unfazed by the voice of his surgical patient from the operating table, replies, "Mr Provenzano, this is the best news. It is just a water cyst. I shall make it disappear now." With tip of his scalpel he incises the cellophane-thin cyst and like a punctured balloon it collapses, clear fluid ejects, and Davidoff suctions off the fluid; then, with a few quick motions of scalpel and tweezers, he strips off the cyst wall and applies a brief heat to stop any bleeding.
"Mr Provenzano, you are cured. From now, no more headaches except the usual."
"T'anks, Doc! You da greatest! And you too Gol'berg! When I get outa here you comin' home wit me and eat my mamma's spaghetti. And, Doc." (Now he is speaking to Davidoff) "Go 'head, expereement. I be a good Guinea but no pig." He laughs at his double meaning.
To continue, click 13.13 The Experiment
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