SA muso gets through brain op with the help of his guitar
No fretting for musician awake in theatre as doctors operated
A heart monitor beeped in the background and the fragile chords of an acoustic guitar filled the theatre at the Inkosi Albert Luthuli Hospital in Durban as a team of neurosurgeons removed a tumour from Musa Manzini's brain in a procedure known as "awake" craniotomy.
The procedure is fairly standard, but this was the first time medical staff had a musician on their table, playing an instrument as they worked.
A month later, Manzini - a jazz bassist and former music producer for local soapies like Generations and Backstage - is on the mend and hard at work preparing for his stage comeback in Angola in June.
"I felt no pain at all, but it felt like two blowtorches inside my head," said Manzini, who was awake for four hours during the six-hour operation last month.
The "awake" craniotomy technique allows doctors to operate on delicate areas of the brain - like the right frontal lobe, where Manzini's tumour was situated - without causing damage.
A video of the surgery went viral shortly after the operation.
Manzini, 47, well-known in jazz circles, discovered his tumour after returning to SA from Indonesia last year to take up a teaching position at the University of KwaZulu-Natal.
He had undergone two operations previously to remove the tumour.
"I was living in Indonesia for four years. The university offered me a teaching post in February. Out of the blue, I felt like my left hand was numb.
"I was supposed to be operated on in June but was penalised by my medical aid because I was out of the country and rejoined. I had no choice but to go to a government facility," said Manzini.
"The doctors have been amazing. I am so grateful just being able to breathe and still be here to tell my story," he said.
Describing the procedure, Manzini said he was put under general anaesthetic for about two hours while the team opened his cranium.
"And then they woke me up. I stayed awake through the rest of the operation.
"We talked throughout the procedure. I was just strumming the guitar. The most important thing was for my fingers to keep moving.
"I had a better chance of not being paralysed if I stayed awake during the procedure."
At some point Manzini could hear the bones of his skull being pushed back into place.
He admitted he was afraid.
"I was faced with a situation where I really didn't have an option, I was either going to die with the tumour in my brain or have it removed in the way the doctors did it."
This week Manzini was given a clean bill of health by his doctors. He is focusing on his return to the stage and lecturing.
Dr Rohen Harrichandparsad, head of the hospital's clinical unit, and Dr Basil Enicker, head of neurosurgery, were part of the surgical team that conducted the operation.
Harrichandparsad said: "His tumour was situated in the right frontal part of the brain. It was encroaching on an area called the motor cortex, which controls all the movements on the opposite side of the body.
"Musa's was on the right, which controlled his left-side function. Particularly where this was, it would have been responsible for his left-hand movement.
"Him being a musician, we wanted to make sure we preserved that area.
"The procedure is a standard procedure done in selected medical centres worldwide and in SA.
"But what was unique was that we used his background as a musician and his ability to play the guitar to conduct the operation," said Harrichandparsad.
The surgeons used small electrodes to stimulate different parts of Manzini's cortex, to test which areas were functional in a process known as cortical mapping.
"The ability to produce music is not situated in one particular area of the brain, but a number of different regions that allow a person to make music," Harrichandparsad said.
"By allowing him to play, we could get real-time feedback that all these areas were working and that we hadn't damaged anything."
Harrichandparsad said the team was happy with Manzini's progress.
"We removed about 90% of the tumour. The part we left behind was in a critical area which we couldn't remove, so we will follow that up in the long term.
"It's a benign tumour, so it's a very slow-growing tumour and not to be too concerned with. His hand function is intact."
OTHER AWAKE CRANIOTOMIES
• In 2014, a tenor in the Dutch National Opera, Ambroz Bajec-Lapajne, sang Schubert's Gute Nacht as doctors removed a tumour.
• In 2015, saxophonist Carlos Aguilera read music and performed during an operation in Spain.
• Last November, a patient in India, Hulasmal Jangir, was made to recite a sacred Hindu chant for hours while doctors performed surgery to remove a tumour.