The probe is in place, the needle tip resting on the target. Gerry
wheels over the Frequency Lesion Generator, irreverently referred to as
the "cooking machine." It is the only gallows humor of the day. But it is
accurate.
The electrode is hooked up to the source of current. Gerry squirts
a clear gel on a tinfoil-covered rigid plate and inserts it under
Matthew's back. Then he runs a wire with an alligator clamp to the
retractor handles and hooks it up. "Grounding Matthew," he says to no one
in particular. "Grounded."
"In case something breaks," Uematsu explains.
11:43 A.M. "Set for seventy-five degrees for ninety seconds,"
Uematsu orders Gerry. The dials are set.
"Okay," Uematsu says, "cook." He forces a smile. No one returns
it.
Through the same hole, Uematsu positions the probe four more times
in the same plane to create four other tiny lesions around this first
central lesion. Some at 90 seconds, some at 45 seconds. All at 75 degrees
Centigrade. "Cook," he orders. "Cook," again. "Cook. Cook." The lesions
are less than an eighth of an inch apart, all on the right side. That's
Matthew's right, his right hemisphere, his right cingulum. It's close to
noon.
The right side is pronounced finished, and a new set of scans is
taken to confirm the lesions. "There," says Uematsu quietly, pointing to
a perfect circle of black blots. "All there. Perfect. Better than the
textbook. Now, ready to do the left side."
12:15 A.M. "Do you know how we learned how long to cook?" Uematsu
asks as he makes the second burr hole. "Egg whites. We picked egg whites
in 1967, in our first studies, to see how long and how hot to go through
egg whites and create a hole of the right diameter that would not close
up."
Over the next two hours, five more lesions are placed in the
cingulum on the left side of Matthew's brain. The air target studies are
again done to verify the placement, then they "cook," the heated tip
cutting the brain. Then more scans make sure the lesions are sufficient
and in place.
3:40 P.M. Steve Derrer has awakened Matthew and escorted him to the
recovery room. Uematsu and others have talked to Matthew's family.
"Perfect," Uematsu announces. "Better than the textbook." But they all
must wait now, to see if the "textbook" surgery was not just successful
in its execution, but also in its goal.
Matthew's neurologist is nervous. There's much that can still go
wrong, he says. Brain damage or return of the seizures that might have
found an alternative pathway for the abnormal electrical signals.
6 P.M. Matthew wakes fully and talks a "blue streak," but then
unexpectedly lapses into a stupor. He apparently is unable to talk, move
his limbs or arms. An angry, upset neurologist says, "It's not looking
good." They take Matthew back to the OR for an emergency scan. Everything
looks okay. The doctors hope the problem is temporary, from swelling that
will subside. Matthew's parents are with him all night.
Wednesday, November 28, 11 A.M., eighth floor of the neuroscience
wing: Matthew is propped up in bed in room 811, eating seedless red
grapes from a plastic bag, half watching a television set suspended from
the comer of the ceiling above his bed. His mother is all smiles; his
father grinning.
"God, we are happy today," his mother says. "I knew it all the
time. He's doing just great." Matthew has no pain, not even a headache,
but he is still somewhat stunned and slow to react. Full recovery from
the surgery is still days or more away, although he will return to Spring
Grove Hospital on Sunday if all goes as planned. After six months without
rages, they'll know if the cingulotomy has brought success -- peace and the
chance for a better life.
This morning, little more than a week after his operation, Matthew
remembers names and faces slowly, but he does remember. His arms and legs
and toes work. He can talk. "Rodgers," he says after his mother's prompt
of a visitor's first name. "Writing a book," he says. A moment later
there's a smile, which broadens when his father says quietly, "Perfect.
So far, perfect. Better than the textbook."
Over Memorial Day weekend, 1991, six months after Matthew's
surgery, his parents are still careful not to trumpet their hope. But all
the signs remain positive. Over the holiday, Matthew is spending most of
his time on a home visit with his family, and weekend leave from the
hospital is now regularly scheduled. Matthew's social worker has begun
the process of enrolling him in a special course at the hospital that
teaches independent living skills -- cooking fundamentals, washing
clothes -- because paperwork is under way to place him in a community-based
group home.
"There have been no rages since his operation," Matt's mother says.
"He's still having seizures, but no rage episodes at all. And he seems to
have much, much better control of his anger. It doesn't escalate into
chaos. He takes the time to calm down when he becomes angry. We think we
have a success here, but the doctors -- and we -- still don't know how long
it will last.
Tags:
bad reputation,
belief,
brain surgery,
dilemma,
horizon,
human brain,
human subjects,
lobotomy,
mental illness,
nam,
neurology,
philosophers,
pretension,
psychiatric disorders,
psychosurgery,
record keeping,
safeguards,
scientists,
strict regulations,
successes,
surgery,
worth the risk,
wretched excess
