Instant Genius - Life as a brain surgeon

Episode Date: September 8, 2024

Thanks to the years and years spent poring over textbooks to study the inner workings of the brain, the high level of manual dexterity required to perform operations and the mental pressures that come with taking patients’ lives in your hands, there can be little doubt the journey to becoming a brain surgeon is one of the most challenging any of us can embark upon. So, what exactly does it take to become a successful brain surgeon and what does the day-to-work reality look like when the years of training are finally complete? In this episode, we catch up Theodore H Schwartz, professor of neurosurgery based at Weill Cornell Medical Center, to talk about his new book Gray Matters: A Biography of Brain Surgery. He tells us about his own personal journey to become an in-demand surgeon, what it’s like to work in one of New York’s busiest hospitals, and the surprising crossover between brain surgery and learning how to play an instrument. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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combine handcrafted tradition with cutting-edge innovation and high-end materials, delivering digital precision with analogue warmth, so you can experience exceptional sound at home. Music just as the artist intended. Visit namea audio.com to learn more. Welcome to Instant Genius, a bite-sized masterclass in podcast form. Every Monday and Friday, you'll hear world-leading experts and scientists

talking about the most fascinating ideas in science and technology today. I'm Jason Goodyear, commissioning editor of BBC Science Focus. Thanks to the years and years spent pouring over textbooks to study the inner workings of the brain, the high level of manual dexterity required to perform operations, and the mental pressures that come with taking patients' lives into your hands. There can be little doubt that the journey to becoming a brain surgeon is one of the most challenging any of us can embark upon. So what exactly does it take to become a successful brain surgeon? And what does the day-to-day reality look like when the years of training are finally complete?

In this episode, we catch up with Theodore H. Schwartz, Professor of Neurosurgery based at Wyle-Cornell Medical Center, to talk about his new book, Gray Matters, a biography of brain surgery. He tells us about his own personal journey to become an individual. man surgeon, what it's like to work in one of New York's busiest hospitals and the surprising crossover between brain surgery and learning how to play an instrument. So welcome to the podcast. Thanks very much for joining us. Thanks so much for having me. I'm excited to be here. So today we're talking about your new book, Gray Matters, a biography of brain surgery. So obviously being a neurosurgeon is an extremely challenging occupation, you know, requires knowledge, both manual and mental dexterity,

an ability to endure emotional hardship, so on and so on. So why on earth did you choose this as a profession? You know, when I was in medical school trying to figure out what to do, my first thought was not to become a brain surgeon. There are some people who know right away it's what they want to do. I was not one of those people. I had majored in philosophy in English in college and I was very interested in how the mind and the brain are related. My father was a psychoanalyst, so I certainly was interested in the mind, but not so. much interested in the brain per se. And I went to mid school thinking I was going to do something in international public health, working in developing countries. But the minute I got into the neurosurgical operating room on a rotation, and I saw what brain surgeons do for a living, I was

flabbergasted and in awe of what I saw. And after being in that operating room a couple of times, there was nothing else I wanted to do except for that. And I was very intimidated by the workload and what I thought I would have to give up in order to become a neurosurgeon and be a neurosurgeon. But I had another experience where I was leaving the hospital one night at 9 p.m. And I saw one of the internists or maybe a gastroenterologist, he was leaving the hospital at 9 p.m. And I realized that he was there because he was working hard, taking care of his patients. And I thought to myself, it seems like no matter what I go into in medicine, if you want to be great at it, you're going to have to dedicate your life to it and make sacrifices.

And so you might as well do the thing you really, really want to do as opposed to maybe saying, oh, this might be too hard for me. So I made that decision, and I from then forward on, was less intimidated by the workload because I knew it was what I was passionate about. Is there a particularly moving story about a patient that you've taken care of that you'd like to share? There are so many, and it is sort of routine in what brain surgeons do, but there is one in particular that I wrote about early in the book that has really stuck with me.

It was soon after I finished my training, I was taking call at a busy trauma center where it had a helicopter pad that would bring patients in constantly overnight with head traumas. And I got a call about a little girl who was horseback riding. And she was wearing a helmet, but a motorcycle had gone by and made a noise and the horse reared up. And she was knocked off the horse and hit her head. And the helicopter her in. And I got the call. I was home, you know, starting my dinner, like, you know, the spoon about to go into my mouth. And of course, the beeper goes off and I drop everything and run in.

By the time I got to the hospital, she was already under anesthesia because it was such an emergency. And she had something called an epidural hematoma, which is a blood clot that can build between the skull and the brain and push on the brain. And if we didn't operate on her right away, she would have died for sure. She was probably eight years old. And we took her in and opened up her skull and took out the blood clot and the surgery went beautifully. But you never know if you get there fast enough. You never know if the clot has already done so much damage, she won't recover. And I went out into the hallway. I had not met her parents. And I saw a woman pacing with a worried look on her face, her clothes somewhat disheveled. And I knew it was her mom. And I walked over and told her we did everything we could as fast as we possibly could. But I really didn't know if her daughter would recover or not or if she had suffered brain damage. And I would round on this little girl every day and see her every day. And her mother was literally in bed with her, you know, curled up, spooning her. And the girl just didn't wake up for probably about 10 days, didn't move, wouldn't.

breathe on her own above the ventilator. And I came by one day and her mom was in tears. And I said, what's going on? Why are you so upset? And she said, well, one of the other doctors said that if my daughter hasn't woken up by now, she probably won't. And I was very frustrated with that because I had seen an MRI scan that looked okay. And I thought, you know what, there's still hope here. Like just give it a little more time. She's young. She may recover. And sure enough, you know, the next day, she started moving her finger a little bit. And the day after that, she started wiggling her toes a little bit. And eventually she made a full, complete recovery. And she walked out of the hospital on her own. And within a year, she was back in her own grade. You know, she had made a complete

recovery. And her mom, to this day, still sends me Christmas cards saying, you know, this is what my daughter's doing. She never would have reached these milestones that are normal milestones without you and your work. And I can't thank you enough. And I remember after I did that operation going back and talking to my wife and saying, you know what, if I never do another surgery for the rest of my life, this one operation would have made all the sacrifice getting here. I remember I was like 34 years old at that point. It trained for, you know, 15 years would make it all worthwhile. And I would do it again just for this one operation. If they told me I could never operate again. So we have cases like that, you know, where you just make such a big difference in someone's life that we carry with us as surgeons

and we think about them. And they remind us why we do what we do, particularly on. on days that are difficult for us and give us hope and keep us going. And we have a lot of those saves, you know, in our memory banks as surgeons that we treasure. So having said that, what qualities banks are successful brain surgeon? You know, I'd like to say that there's only one thing that we all have in common, but obviously human beings are very diverse and different. And, you know, there's many things that make a great brain surgeon. But there are a couple things that we all share. I would say that first and foremost, you have to care about other people because ultimately it is a service profession. You know, you're giving up a lot of your own life and free time to take care of other human beings.

And as much as it's a technical discipline that requires a lot of confidence and a lot of practice, ultimately, you know, you're taking care of another human being. So I would say that's the first thing. The second thing has to do with the ability to focus for long periods of time and block out the external work. world because a lot of the surgeries we do last for hours and you really have to be in it completely, wholeheartedly with all of your mind and all of your soul in order to do a really good job. So I think those two qualities together are very important for being a great neurosurgeon. So in the book, you mentioned sort of different, I guess, subtypes of people that tend to become neurosurgeons. In your background, you said it's being a musician, which I thought was fascinating.

There are a lot of musicians who go into medicine, and I think surgery in particular, to be accomplished at an instrument, first of all, requires you to have a certain amount of manual dexterity, right? You're holding this thing in your hands, and you're touching it with your fingers. And so your brain and your fingers have to be connected in such a way that you enjoy that touching. But also, to practice an instrument requires an enormous amount of focus and concentration, and ability to sort of lock yourself in a room for several hours and just work on something again and again by yourself. And neurosurgery really is that. I mean, you're in a room. You're not by yourself, but there's really only one surgeon who can do the most intricate parts of any operation. And you have to be able to focus on that for long periods of time. And neurosurgical operation is very much like a performance.

You want to be flawless from start to finish with every one of those little tasks that you have to accomplish with your hands. So let's have a bit of a look at the training then. So obviously there's an awful lot of book study, but how do you move from the books to the operating theatre? That's a very big transition that we all have to make. I remember being very nervous when I chose neurosurgery as a specialty because you know you're good at studying and memorizing things because you've gone through college and med school, but you don't really know that you're going to be great technically as a neurosurgeon. And you have to dedicate another seven years of your life to that training. I didn't finish until I was 33 years old.

And I thought, oh, my goodness, what if I finish? And I realize I'm not very good at it. Wouldn't that be awful, you know, at 33 to figure that out? But the truth is, neurosurgery is a combination of a technical ability, but also judgment is incredibly important. So you do have to learn the technical parts of it. And you do that by doing literally thousands of operations during your training where you're assisting and you're tying knots.

and you're making all the moves with your hands and you're learning how to move your fingers appropriately and how to manipulate tissues that can be very, very delicate and sensitive, but you're also learning the judgment. And that judgment part goes on for decades. I mean, I am still getting better after doing neurosurgery for 35 years. I'm better at it today than I was 10 years ago, 20 years ago, and 30 years ago because I'm still learning that judgment part of it. My hands can do what I need to do. I can accomplish what I need to accomplish technically, but my judgments are getting better and better. So let's have a look at the surgery a little bit then. So what are the sort of tools of the trade, so to speak? Yeah, most people think of brain surgery as something that you do in a quiet room,

maybe with a little classical music playing in the background, you know, and everybody is very focused on what's going on, you know, in the brain. And that is true for a portion of the operation. But what many people don't realize is you basically, you have to get into the brain. brain first, right? So you have to pass through the skin and you have to pass through the skull. The skin is very bloody and you have to cut through it. The skull is very thick and strong and you have to drill through that, which makes a lot of noise and there's bone dust going up into the air. It's a little gruesome. But obviously, once the brain is exposed, everything changes. So you go from being a carpenter to being a watchmaker. So you have to kind of have both of those skill sets,

you know, as you get in there. Once we're under the microscope, and that was really the part of brain surgery that I loved the most was when I was in college, I thought I would become an astronaut or go into astrophysics or do something where I'm traveling to a world where a few people get to go to. And I get to do that in neurosurgery, but I'm traveling to a little microcosmic world, almost like going into the quantum world, where I'm, you know, spending my whole day focusing on an area of the sides of a postage stamp. And we sit in a special chair, so almost like in a cockpit with our arms resting on farm rests to reduce our tremor. And we're looking through microscopes often,

which are these enormous pieces of equipment that allow us to see deep into the brain, spending hours, you know, voyaging into these landscapes that are remarkable, mysterious, beautiful, you know, like traveling to the moon and going to a crater that you've, you know, studied on a map and never really seen until you take a step off your, you know, airship and walk around.

What was it like, I'm sure you remember, the first time that you saw a living human brain. I mean, few people have seen that. Yeah, I never have forgotten the first time. I mean, I literally can see the picture of it and see in the operating room. When I first saw the human brain, I was doing a rotation where I walked into a neurosurgical operating room

in Boston and saw the brain exposed. And I'll be honest with you, I have never lost that sense of amazement and wonder every time I peel back the Dura and I see the brain. I still have that momentary gasp of astonishment at what I'm looking at. I mean, that's a beautiful thing because, you know, I get to see that seven or eight times a week when I'm doing my brain surgeries. And I also love having students with me, you know, and I'll have high school students and medical students who've never seen the brain before come into the operating

room and I'll take them through that experience. And I'll know that I'm providing with them with that same astonishment that I felt when I first saw the brain. And I love shepherding them through that experience, because I know it's something they're never going to forget. So let's stick with surgery for a while, then. What are some of the most common procedures? So the truth is, the most common procedure that a neurosurgeon will do is a spine surgery, at least in the United States, and I'm sure it must be true in the UK as well. 70% of what neurosurgeons do is spine surgery, and about 30% is brain. However, there are some of us who focus only on brain surgery, and then within brain surgery, there are subspecialties,

So the most common thing I see is a brain tumor, and about half of them are benign, and half of them are malignant, and I take out, you know, all varieties of brain tumors. I also treat a lot of epilepsy. That's something I do. But there are other surgeons who do vascular neurosurgery, who treat aneurysms and arteriavenous malformations, and there are other neurosurgeons who do pediatric neurosurgery, and they sort of do a lot of developmental abnormalities in children. And then there's other neurosurgeons called functional neurosurgeons,

and they're the ones who treat Parkinson's disease and move. disorder and epilepsy as well. So I can't say what the most common is per se, it depends on your practice, and it depends on what it is that you've focused on, because what we've realized over the years, you know, back in the old days, a neurosurgeon used to do everything. There was just one neurosurgeon because before that there were no neurosurgeons, right? The first dedicated neurosurgeon was only in 1905, a guy named Harvey Cushing. Before that, general surgeons would try to do what they could, and the mortality was about 50%. So now neurosurgeon's subspecial. and don't try to do everything because it's very hard to be great at everything.

And you want to be great when you're dealing with the brain and another human being. So we really try to subspecialize and only treat certain types of diseases. Peak pollination season and my business is scaling fast. To keep the nectar flowing, I need a phone plan with top priority data speeds. That's why I chose GoogleFi wireless. My connections stay strong even when the hive is buzzing. Plus, unlimited plans started $35 a month. Now that's a deal that doesn't.

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It matters where you stay. Hilton, for the stay. This podcast is sponsored by Name, Audio and Focal. With over 100 years of combined expertise, Name and Focal have been bringing music to listeners just as the artist intended. Since day one, this mantra has shaped every innovation in Hi-Fi design, and acoustic engineering, balancing craftsmanship and tradition with pioneering thinking. Name Audio pushes cutting-edge technology to ensure digital precision whilst sustaining Pratt,

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Everyone makes the same decisions, but that is so far from the truth. And we always hear about the art of medicine. And there is also an art of surgery first in the judgment as to what to do and then the performance. Both of those are artistry in a way and will vary from human being to human being. So I do write a bit about how we make decisions as to who to operate on. And I use the meningiomas as an example because it's a benign brain tumor that slowly grows in the brain that can be treated in one of three ways. We can observe them and do nothing if they're not causing symptoms. We can radiate them if we want to stop them from growing and we can surgically remove them. And it's very common for me to see a patient in the office with a meningioma who will say,

well, I saw this surgeon, he told me to do nothing. I saw this surgeon and he told me to do radiation. And I saw this surgeon, he told me to do surgery. So I'm really confused. And the question is, why would you get three different opinions from three different experts on exactly the same tumor? And the answer is that there's a lot of areas in medicine. And I give the example in brain surgery that are gray areas.

We don't really know. We can't predict the future. And the risks and benefits that we weigh in making the decision whether to operate or not are going to vary dramatically based on the age of the patient, the location of the tumor, the size of the tumor, where exactly it is. And then also your technical abilities. There are some surgeons who are just better at taking out tumors than others. And if you see one who's very good at taking them out, they'll say, well, you should have surgery. Because in my hands, you're going to do better in surgery.

And another surgeon who might not be as good at removing tumors in that particular area, or maybe the last one they did happen to have a complication and it's weighing on their conscience, they'll say, you know what, I think we should do radiation for you, or we should just follow you and observe you because they don't want to take on that difficult operation. So those opinions are going to vary dramatically based on who you see. Yeah, so we're talking about removing tumors. So we're removing parts of our brain. Well, tumors are not parts of the brain, right?

So tumors are extraneous to the brain. What we try to do is we remove his little brain, healthy brain, possibly can, right? And that's really the trick to brain surgery, right? We want to take out the bad stuff and leave the good stuff. The hard part is when the bad stuff is buried deep in the brain or under the brain, and then we have to figure out how do we get there and damage as little brain as possible. And sometimes you do have to damage a little bit of brain in order to accomplish your task. So you have to make very careful decisions as to how the brain is organized and what I can possibly sacrifice in order to get the benefit of the surgery.

to remove the tumor. And sometimes we do have to sacrifice a little bit of normal brain that we think will not damage the person's personality, behavior, movement language in order to get tumors out. So that's the chapter in the book that you titled, The Hardest Thing is Knowing When to Stop. Yeah, it is very true. That also comes down to a different decision. So often in brain surgery, and this happens a couple hours into an operation, you're faced with a moment where you have to make a very critical decision. Imagine that there's a tumor that's very deep in the brain. It's surrounded by blood vessels. It's surrounded by nerves that are stuck to it. And you're trying to take out as much of the tumor as you can. You're trying to preserve all the blood vessels and the nerves that are

stuck to it. And you may get to a point in the operation where you've taken out some 70 or 80% of the tumor. And you realize that there's a little bit that's left, but it's very stuck to an artery or a vein. And you have to make a decision. How aggressive do I want to be to try to dissect that artery, your vein or nerve off the tumor and take that last bit out and risk damaging that artery, which could cause a problem that could be anything from, you know, mild weakness to the patient never waking up again, right? There's all the whole gamut of complications that you can face by sacrificing different parts of the brain. And that's a decision that you have to make at that moment in time. And sometimes the right thing to do is to stop and to say, you know what, it's going

to be too dangerous for me to do this. It's better for me to leave a little bit behind, even though the MRI scan afterwards is going to show that you didn't take the whole tumor out. And maybe you said to the patient, hey, I'm going to try to take your whole tumor out. And then you have to tell them, you know what, I couldn't take your whole tumor out because I didn't want to damage this, that, or the other. Then you second guess, well, maybe another neurosurgeon could have done a better job than I did. Maybe they can take it out. Maybe I should try harder.

I should push myself to take this out. And so we do this internal psychological battle during an operation that most people may not realize goes on in a surgeon's head. You know, you want to imagine they know exactly what they're doing at every moment in time. time, but obviously like any human being, we're making a lot of decisions and there's so many things that go into making those decisions. And ultimately, what it comes down to for me is what would I want my surgeon done if I were the patient lying on the table at this moment in time? And you have to kind of remove yourself from surgeon and put yourself in the patient's shoes and say, all right,

what really is the right thing to do? It's not about how the MRI scan looks after surgery. It's not about what you can tell your colleagues. It's about how this patient's life is going to go on and what alternatives you have to treat if you do leave some tumor behind. So sometimes the hardest part is knowing when to stop and sometimes you have to forcibly stop yourself from operating because you're at that moment where you may do more harm than good. So let's say, unfortunately, we have gone a little bit too far and we've removed some healthy brain tissue. What happens? You know, can the brain recover? Well, there's always a little bit of possibility for some recovery. So the answer is yes, but there are some things that we can damage

that will never recover. If you transect a nerve that moves the eyes in a particular direction, that is never going to recover. If you remove a part of the brain that's important for speech, they will never speak normally again. If you move part of the body that's important for movement, they may regain some movements, but they will never move normally again. So the ramifications of our errors and our decisions are dramatic, profound, permanent, and affect another human being's life forever. And it's one thing to say, well, you know, if you make a mistake in neurosurgery, you're not the one that suffers, right? It's the patient that suffers. But the truth is, we do suffer. And I also want to make that point that, yes, we don't suffer as much as the patient,

100%. And obviously, all sympathies go obviously to the patient. However, there is a profound psychological burden on a human being who knows that they made a decision that led to an adverse outcome in one of their patients that they have to live with and carry with them the guilt, the burden, and we do carry that with us. And we think about that with every subsequent patient that we operate on. How can we prevent this from ever happening again? Because we see not only how devastating it is to our patients, but we see how devastating it is to us. And we have to carry on. You know, we have to face the next patient sometimes in the same day and go back in there and focus and give your best and your all to take care of that patient.

Yes, I was going to ask about that. So, like, personally, in my profession, perhaps the worst thing I can do is spell someone's name wrong. Not all that bad, right? I can live with that. But do you get specialist mental health support? So that support is available. The hospital does provide it.

The hospital's aware that there is physician burnout, you know, that physicians can get overwhelmed with workloads and the psychological burden of having to take care of other human beings. I have never availed myself of that. I have a wonderfully supportive family. I have a lot of hobbies and other interests. My father was a psychoanalyst, so maybe I'm psychologically fairly well adjusted. Luckily, he didn't screw me up too much, which maybe is unusual. But if I really felt down, I would absolutely do that. You know, I have no shame in talking to some professional about mental health, you know, particularly coming from

the family that I did. But I have not had to do that as of yet. I've just sort of found ways to deal with it. And what surgeons talk about is the concept of emotional armor and emotional flexibility. So you have to erect emotional armor to deal with problems and to close things off when you're in the operating room or when you have to deal with seeing patients, you know, dying and patients who have horrible diagnoses and how do you not just collapse and cry? And we do collapse and cry, by the way, sometimes. And I talk about that. But that you also have to have emotional flexibility so that when you need to be a human being and you're You need to be there present for people and sensitive to their needs.

You can take down that emotional armor that you use to protect yourself and make yourself emotionally vulnerable and open to your patient. So you're constantly bouncing back and forth between, you know, erecting and deconstructing your emotional armor. So you mentioned there about Cushing in 1905. So it's a really new field. So what's happened over that time, you know, and what can we look forward to in the future?

future in terms of technological advances. Yeah, there have been some revolutions in neurosurgery, and I talk about them. The first one was really Harvey Cushing. So, you know, in 1900, when he starts taking on the task of saying, I'm going to devote my life just to neurosurgery, the mortality rate is 50%. So half of the patients that he operates on will die on the table. And all the surgeons around him are saying, this is ridiculous. Like, why would you want to go into this field?

It's such a sad, depressing field. The skull should not be open. We shouldn't be messing with the brain. So he takes on the challenge. And by the end of his career, 1930s, 1940s, his mortality rate is down to about 8%. So he has made brain surgery safer. We're now well below 1%. I don't want to scare people with this conversation that neurosurgery is dangerous.

It is extremely safe. And the majority of our outcomes are really, really, really good. We bring a lot of joy and happiness and health to the society. So the next big revolution in the 1950s was the introduction of the operating microscope. And there's a neurosurgeon in Ghazi, Yashir Gil, who is, you know, know, a mythic status in our field, technically excellent, brought the microscope in, allowed us to see what we needed to see, to make surgery more effective and to make it safer. And now we're in sort of the computer age, where we're using robotics and computers and

minimally invasive approaches so that we basically are trying to put ourselves out of business in a way. So I talk about several different revolutions that have occurred and instruments that we use. The goal being to get in and out of the head with the smallest footprint, possible. And sometimes we can even affect change in the brain without opening up the head at all. So we can focus radiation in small areas in the brain without opening up the skull. And we can even focus ultrasound waves by sending basically a thousand different small ultrasound waves, high frequency sound waves, into the brain. So they all hit at one little point. And we can take someone who has a tremor and their hand is shaking all over the place and put them in this machine

and they emerge later, 20 minutes later, and their tremor is gone, and we haven't even opened up their head. So that's truly remarkable. We also now treat aneurysm instead of opening up the head and dissecting down to the brain under the microscope, we can treat aneurysm or a stroke just by threading a catheter up into the blood vessel and working from within the blood vessels as opposed to from the outside end. We can work from the inside out. There have been numerous revolutions like that that have made neurosurgery much less invasive and much safer for our patients. The most exciting one at the moment, I think, is the brain computer interface. And I've been involved with that technology and also followed that field very closely. And of course,

with Elon Musk's company, Neurrelink, it's very much in the news. And he's developed a remarkable device. And there are other companies that are developing competing devices with different strategies, because at the moment, we don't know what the best strategy will be. But We can now take information out of the brain with electrodes and put that information into a computer to allow a human being just by thinking about doing something to affect change miraculously. It's essentially telepathy and telekinesis that has been made real with through science by moving a cursor on a screen, typing, writing, speaking, their thoughts. If they want to speak them, those words can come out of their minds and go directly onto a

computer synthesized voice that can speak for them. We can move robotic arms and legs and we can create exoskeletons for paralyzed people to move them around. So there's just so much that we can do now with computers that has allowed us to harness the power of the brain and to really change the nature of the evolution of the human mind and the human brain. So it sounds like good things are happening in neurosurgery. For sure. And we're the gatekeepers of all of these things, which is what's so much fun. There's so many different diseases we can treat, and there's so much new technology that constantly comes in to make what we do better. And it also, you know, you have to stay agile. You can't just keep practicing neurosurgery the way you practiced when you train. For example,

with the majority of the surgeries that I do, I never learned how to do. I'm only 23 years out of my training, and the majority of the operations I do. I'll operate up through the nose, through a little incision in the eyelid or the eyebrow to take out these tumors that are difficult to reach. When I trained, we would open up the side of the head, dismantle all the bone, take down all the muscles, dissect around the brain to get there. And I really don't do that very much at all anymore because we just have better, newer operations that allow us to do us through smaller and smaller incisions. Thanks for listening to this episode of Instant Genius, brought to you from the team behind BBC Science Focus. That was Professor of Neurosurgery, Theodore H. Schwartz.

To discover more about the topics we've just discussed, check out his book, Grey Matters, a biography of brain surgery. If you liked what you just heard, then please do consider subscribing to Instant Genius on your preferred podcast platform. The current issue of BBC's Science Focus magazine is out now. Pick up a copy wherever you buy your favourite magazines or download us on your app store of choice. You can also find us online at sciencefocus.com. This podcast is sponsored by name, audio and focal.

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