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Man 'plays' trombone during 'incredible' surgery on his brain

Patients are kept awake during the procedure so surgeons can test their movements.
Trombone player.
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A patient “played” his trombone while awake during a surgical brain procedure at the University of Wisconsin Health.

Brian Rust sought help at UW Health for hand tremors that were starting to impact his daily life.

UW Health said Rust’s career required him to type on a keyboard and he played the trombone in multiple bands as a hobby. But what really drew the line for him with the tremors was when it became impossible to hold his granddaughter.

Rust was diagnosed with an intention tremor, meaning when he tried to use his extremities they would shake uncontrollably. Blood pressure medication and anti-seizure medication — commonly prescribed to treat tremors — did not offer him a solution.

UW Health said after medication and therapy were deemed ineffective, Rust was given two options for surgery. One involved targeting a part of the brain with ultrasound, but UW Health said that would only treat his tremors on one side.

The second surgical option was deep-brain stimulation in which wires connected to an implanted battery pack and stimulator would be placed in Rust’s brain to deliver electricity to certain spots that would actively disrupt the tremors, UW Health explained.

Ultimately, that was the route Rust decided to take.

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The procedure is performed while the patient is awake, with the top of their head behind a plastic sheet in a sterile environment, UW Health said. The wires are inserted through small holes that are drilled into the patient’s skull.

Dr. Wendell Lake, the UW Health neurosurgeon who performed the procedure on Rust, said the patient is kept alert so they can ask them to do certain movements in order for them to ensure the wires are being put in the right place.

In the past, patients have been asked to do things like writing on a tablet to test their movements during the procedure. But given Rust’s musical talents, he had a better idea.

Rust brought in his trusty trombone and made the hand movements that would be necessary to play it to ensure the procedure was working, UW Health said.

He couldn’t actually blow into the instrument and make music because it could have caused bleeding in his skull or a venous air embolism, UW Health explained.

Nevertheless, the scene left the operating room in awe.

Rust was able to recover after a few months, with the battery pack and stimulator inserted in his upper chest and a specially designed smartphone that controls the device. UW Health said it has two settings, one for everyday life and one for playing his beloved trombone.

The “incredible” procedure was documented and published in the journal Anesthesiology by Dr. Whitney Fallahian, a UW Health anesthesiologist and assistant professor of anesthesiology.