"The Terrible Beauty of Brain Surgery"

"Then Xhumari placed the scalpel two inches above the ear and pushed it hard, down through the skin. Blood oozed up through the cut and ran down along the side of the head. Xhumari drew the scalpel in a semicircle across the crown. Petrela used a suction device to suck up the blood that was seeping out. Then, with a flat instrument that he inserted into the incision, Xhumari folded back the skin, along with the flesh beneath it and the sinews that fastened it to the skull. Inch by inch, the scalp loosened from the bone of the skull. He partly cut, partly pushed and scraped it loose from the underside, while simultaneously pulling it backward from above, as if he were peeling an unripe fruit, the skin of which still clung to the flesh. When he had finished, he folded the scalp over to the side and quickly covered it with gauze pads, which immediately turned red with blood.

The skull, now laid bare, was yellow-white, with thin stripes of blood trickling in all directions. Xhumari brought out a shiny metal instrument, shaped like a baton or a large soldering iron, with a bit at the end. He placed the bit against the crown and started to drill. A hard, buzzing sound rose faintly through the operating room. A small pile of finely ground bone formed around the bit as blood flowed down over the hard skull. When the drill had gone through the bone, Xhumari pulled it out; the result looked like the hole for a screw in a piece of plastic furniture. Xhumari made two more holes just like it. Then he took up another instrument, also made of shiny metal, and inserted the tip into the first hole. I realized that this was the saw. It, too, buzzed hard and intensely, and seemed to get louder as the work got heavier. Xhumari dragged it slowly along toward the second hole, while Petrela sucked away the blood and the bone dust. A narrow crack grew slowly behind it, as when you cut a hole in the ice with a saw. When the saw had come full circle and reached the first hole from the opposite side, Petrela lifted the top of the skull like a lid and held it up into the air in front of me.

Every brain surgeon, at some point in his career, drops this on the floor,” he said, laughing. He handed the bloody lid to the nurse, who placed it on a dish and covered it with a green plastic sheet.

Under the opened skull lay a wet, blood-tinted membrane. “That’s the dura mater,” Petrela said. “The outermost of the meninges.” Xhumari cut into it with scissors, creating a flap. Its underside was white and resembled a piece of soaked cloth. He gently pulled the flap back, exposing the brain. It pulsated slowly and looked bluish in the sharp light of the lamps. “Now we sew it up again,” Petrela said. “And we’re all set for the operation tomorrow.” The whole process was reversed. They sewed the meninges back down, and the nurse handed Xhumari the lid of the skull. When he pressed it into place, blood oozed up, as if he had put the lid on a cup that was overflowing with thick cranberry juice. They fastened the lid with metal clips, then stitched the scalp back together.

Not once had it crossed my mind that it was Hasanaj they were slicing into."

http://www.nytimes.com/2016/01/03/magazine/karl-ove-knausgaard-on-the-terrible-beauty-of-brain-surgery.html?smid=fb-nytimes&smtyp=cur&_r=2&referer

Honestly, I found the writing here a little annoying - it didn't need to be first person from the author, it felt like he was being cocky to cover up how much he didn't really know what he is doing - but there were some moments. Like the giant quote I pulled.

This feels particularly relevant because I sort of just had this experience. I'm taking a neuroanatomy class, and we are using human brains in the lab practicum. Or, in a bigger and more real description, we are handling the brains of people who recently died at the hospital across the street. We are pushing our fingers down central sulci that are the border between frontal and parietal lobes that were used for thinking and sensing by a human person (whose first name we know; for some reason the first name is the only information provided to us about these donated organs, as though they are pets). Soon, we will move to the medial structures and that means that we will be cutting into the brain, physically pulling it apart even more than we already have (removing the dura mater and other meninges, pushing around the temporal lobe so that we can see some of the important auditory-processing structures in the crevices called 'sulci').

The brain is beautiful, and it feels important to hold it and to explore its form and to think about what that form is able to do and to see how finely it is structured. And it's an interesting question: how can we hold that in our minds while also holding the fact that these cells allowed a person with a name and a community to experience love, and that person is now dead?