Neurosurgery- A quantum art.
The tumor was truly intimidating. It was almost occupying a fourth of the entire cranial cavity. The relatives as usual asking the same old questions that assume I'm in total control of the eventual outcome.
What's the guarantee of success? Will our patient be able to lead a normal life after the surgery?
Visions of torrential bleeding from that vascular meningioma flashed across my eyes as I gave them the same old answers.
I was really worried, and yet had to project an omnipotence, a calm confidence, that was in sharp contrast to what was going through my mind.
Can I simultaneously be worried, and confident? Am I Schizophrenic?
The surgery gets underway. The first thing I noticed after I have opened the cranium is the tense brain. It makes me far more tense. Those gray convolutions of the cerebral cortex are thinned out by that monster lying underneath. I'm cramped for space. I have to plead, with that overlying brain to relent a bit to give me access. I have to be firm, and yet gentle as I endeavor to retract that stretched, tensed tissue. Firm and gentle at the same time? Schizoid. I eventually make some headway and catch the first glimpse of that reddish brown tumor. It doesn't look too happy to see me. As I touch it with my bipolar forceps, it erupts very sanguinely. The tumor is very vascular and firm. It's going to be a tough nut to crack.
I coagulate a 2 cm strip on the tumor and incise the capsule. It bleeds mercilessly.
I grab my bipolar forceps, coagulate the raw area, almost apologetic for my indiscretion.
This alternate "attack and apologise" schizophrenic dichotomy continues for the next few hours. I'm blessed to have a CUSA at hand. This device liquefies that firm gritty tumor, reducing it's egoistic unyielding demeanor to a compliant subservience. But it is a slow process. I then decide to zoom out and have a birds eye view of the tumor. The operating microscope tends to tunnel my vision. I need to have a Schizoid admixture of tunnel vision as well as a comprehensive birds eye vision. I get to the point of having debulked a sizeable portion of the tumor.
Now comes the most critical part of separating it from its adherence to the adjacent brain and the vital blood vessels, that course over the dome.
I gently push a cottonoid between the tumor and the compressed brain, and simultaneously exert gentle traction on the capsule of the tumor. A bloody dangerous game of pulling and pushing at the same time. This is really getting more and more Schizoid.
Eventually, after about 5 and half hours, I have separated the capsule from all around and I gently tease it away from the base.
I'm done. I ensure the integrity of all the adjacent blood vessels, and structures and finally wash out, leaving the closure to my assistant.
As I deliberate on the surgery whilst having a cup of coffee in the Surgeons Room, it strikes me like a flash.
I have to be in a similar state as that of the photon. A wave and a particle at the same time. Quantum physics believes completely in that dichotomy of 'And'.
It renders the "either - or " philosophy of classical physics to an extinct anachronism.
I pride myself on the quantum state of "worried and confident, gentle and firm, attack and apologize, pulling and pushing, tunnel and birds eye views". I'm not Schizoid. I'm in a state of quantum superposition of being in multiple states of mind at the same time. The surgical exercise becomes a symphony of ebony and ivory and all the shades in between. The ultimate quantum superposition of course - being human and God at the same time. Human with all my limitations and God for the patient.
Dr. Deepak Ranade.
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