Devin Galligan only had one fear on Dec. 17 as Vanderbilt University Medical Center surgeons prepared to remove a malignant tumor from his brain.
He was afraid to wake up.
It wasn't the disoriented, groggy sort of waking up after a normal surgery that scared Galligan. It was the idea of waking up during the procedure that really got to him but it was something he knew he had to do. So he did.
Galligan's "awake craniotomy" procedure is a special form of brain mapping surgery paired with sophisticated anesthesiology techniques. The patient is in a deep sleep during the first phase, but is awakened later during the surgery to perform a series of tests to help guide surgeons through the rugged pathways of the brain.
"They basically put you to sleep, cut your skin, take the bone flap out, then wake you up," the 24-year-old Nashville resident said. "I was terrified thinking about waking up in the OR and saying 'whoa, where am I? What's going on here?"
But instead of fear, Galligan felt like he was simply waking up from a restful nap.
"I felt like I had just been napping, but it might affect other people differently."
He chatted with the surgical team, who asked him questions as they removed pieces of the tumor. They asked him to count to 20. He counted in French.
Today, Galligan is recuperating well from the successful surgery and began chemotherapy last week. Inspired by the success of his surgery, he is now offering his services to the Department of Neurosurgery as a volunteer patient counselor.
He has already spoken at length to 32-year-old Jamie Bridges of Glasgow, Ken., who underwent the same procedure last week to remove a recurring brain tumor, and will make himself available for any other patient who wants a first-hand report. He also plans to prepare a patient handout about the procedure.
"He really helped Jamie," said her husband, Kerry Bridges. "This is her second surgery, but she wasn't awake during the first one. She talked to Devin for a long time."
Galligan said he hopes to share some of his confidence with Bridges. He visited her in the hospital last week.
"I came out of my surgery with an amazing confidence," Galligan said. "I came out feeling like I had been part of something and helped accomplish something very important. The surgical team relied on me to help and I did. I hope in some small way I can help ease some fears of future patients."
Galligan's awake craniotomy surgery is fairly new to VUMC.
Neurosurgeons are basically navigating through areas of the brain where one small slip could lead to devastating problems.
After being awakened from a deep general anesthesia-induced sleep, a local anesthetic numbed sensation to Galligan's skull as he was brought back to consciousness. Dr. Robert J. Maciunas, associate professor of Surgery, talked to Galligan and stimulated portions of his brain with very fine electrodes and recorded his response.
Areas crucial for speech, motor function and sensory perception were located and charted on an interactive three-dimensional computer map which the surgeons used for guidance, allowing greater precision in the removal of Galligan's tumor.
Galligan is a well-educated patient, making him more than qualified to counsel other patients, said Susie Dengler, clinical nurse specialist and a case manager for Neurosurgical patients.
"Devin has done a lot of research in the library about the procedure and his condition. He is extremely well informed. He's helping patients and it's also very good for him. He is able to give back," she said.
"I think many people get very frightened by the thought of waking up during surgery," Dengler said. "I can say 'you'll do fine,' but I've never gone through the procedure. It makes a lot more sense to hear Devin say 'been there, done that.' It can be very soothing to the patient. It was very reassuring for Mrs. Bridges."
Galligan, who hopes to eventually go to medical school, said he has formed an "incredible bond" with Bridges.
"It's amazing that you can feel such a bond with someone who lives 100 miles away, someone you've never met. But we have both gone through this life-threatening experience and I told her she needs confidence that she will pull through like I have."
Since his surgery, Galligan has spent much of his time at VUMC. He volunteers in the emergency room at night and spends some portion of his days studying about brain tumors in the Eskind Biomedical Library.
"If you read a lot, the statistics will scare the hell out of you. I just try to keep a positive outlook, do what I have to do, and hope that technology will keep coming along."
Galligan said he would also like to write articles about his experience.
"I just want people to know. It's an amazing thing to have happen."©2014 Vanderbilt University Medical Center