Asking a patient to hum piano melodies and play an instrument while undergoing brain surgery may sound like a strange request from a doctor. However, that is precisely what a team of brain specialists, led by University of Rochester Medical Center’s Web Pilcher, requested Dan Fabbio to do as they were removing his tumor.
The chain of events that led to this unprecedented medical feat began in 2015, when the then 25-year-old professional musician was diagnosed with a low-grade brain tumor. Though the swelling was benign, it was located in the part of the brain known to be active when people listen to and make music. "Removing a tumor from the brain can have significant consequences depending upon its location," Pilcher says. "Both the tumor itself and the operation to remove it can damage tissue and disrupt communication between different parts of the brain."
Fabbio, therefore, feared the surgery would cause him to lose his musical ability, which was not just his means of livelihood but also his passion. To prevent that from happening, Pilcher and his colleague Brad Mahon, a cognitive neuroscientist, spent six months mapping the functional and structural organization of the musician’s brain.
They devised numerous tests, including asking Fabbio to listen to piano melodies and hum back the tunes during MRI scans. This enabled the physicians to pinpoint the region that is crucial for music and language processing and create a three-dimensional map of Fabbio's brain.
Though that was a great starting point, it was not a foolproof way to prevent Pilcher and his medical team from inadvertently impacting the area responsible for the young man’s musical talent. The only way to do that was to keep the patient awake and ask him to hum piano melodies during the surgery so that the surgeons could identify the areas to avoid. To ensure Fabbio was accurately repeating the tunes being played to him, they asked Elizabeth Marvin, a professor of music theory at Rochester University's Eastman School of Music, to score each cognitive test in real-time.
While the surgery went without incident, the real test came when Fabbio was asked play a song on his saxophone. The tune had been modified to ensure that it would not require too much exertion and cause harm to the stitches in the brain. "He played it flawlessly, and when he finished, the entire operating room erupted in applause," says Marvin. "It made you want to cry."
The researchers, who outlined the procedure in detail in the September 11, 2017 issue of Current Biology, say that a year after the groundbreaking surgery, Fabbio’s musical abilities are as good as they were before the tumor formed. The young musician can once again hear melodies in everything — even his electric toothbrush!
Resources: NPR.org, Current Biology