specialized in doing and the 5 percent chance he will die and then the patient dies because of the operation and the family will be very cross they'll say you said there was a 95 percent chance of success and i said yes but i said there was a 5 percent shots of disaster zone with the way the full cost and they were wrong because all of the probabilities but from the patients point of view as patients and i've been a patient myself and my own son had a brain tumor we want certainty we want to know what will happen to me not a 95 percent this or a 5 percent that so there is a huge difference between the doctor's perspective and the patient's perspective we're going to actually swap roles and a little bit before we do that i know that you specialize in. brain surgery when local anesthesia yes i think they look patient isn't sleeping. what is the reasoning behind it because with is a new applies for certain sorts of jumah tumors which are actually part of the

brain in the brain so consisting in effect to bring tissue not of nerve tissue where the cells called lisl cells surround and support them kind of look off to the nerve cells and the tumor looks very much like the brain and feels like the brain it doesn't come with little dotted black lines in the pair of scissors saying cut head think cut. and if the tumor is in the very important part of the brain for instance the speech area most of us most of us have speech or movement here just looking at the brain with the patient a nice that doesn't tell you where to stop because the edge of the tumor looks like the edge of the brain. is the patient's awake you can ask the patient to do things you can also position to talk you can use electrical stimulation to work out roughly where you are so. you ever seeing a significant change in

a person's brain as you operate live so for say i gonna like yes and of kaizen there. was this common reason is something has an epileptic fit while you're operating and then they can become unconscious so paralyzed will stop talking things like that if if there's a problem with the operation and you actually start a new start damaging important brain the patient will start to lose the function of that part of the brains or occasion the patients to start to lose the ability to to or become paralyzed on the opposite side of the body if it's a real risk it happens very often they have what makes operating brain much more difficult and sensitive than operating something like hard or. 2 things 1st of all the brain does not heal in the way but the muscle in the skin

heals when you win you win every time you. cut the brain you damage it and he won't recover and secondly the brain is incredibly sent delicate if you can damage some parts of the brain you can kill the patient just by damaging it one or 2 millimeters of brain tissue other parts of the brain you can actually other parts of the brain can sustain quite a lot of damage in particular at the front on the right without the person's leaving to suffer in a home. but is very vulnerable it's very delicate it has it it is the consistency of. crean's is the main the main surgical instrument is a socket the minutes of action clean the brain surgery is horribly crude actually people think it's so terrible what is high tech but with actual reality is actually quite cool. rude compared to the incredible complexity of the brain you do have to

like cut the skull something right you know that's easy answer i mean it's that simple bits and that spits that you can do with the patient awake it like lancets in the skin the problems all start once you open the membrane that covers the brain injuries and that's where the trouble starts that's where it becomes very dangerous but i suppose like if someone has been doing this over and over again for years and years evan you know it is a job like anything else and you've said it yourself it's not the process is not a job like anything else because you're dealing in people's lives and if you make mistakes the consequence is a terrible. some surgeons and some doctors become very detached from their patients and it depends on the culture you work in i've worked in countries all over the world and in some countries. really seem to have minimal human emotional contact

with was better to be emotionally involved or to be that it's a question about and it's a question of what patients expect. in countries like don and nepal and dissidents and ukraine all of it china will the patients and certainly the patients families often do not want to move troops and they really don't want to be told. how bad the disease is. in england and in america on the whole patients and their families want to move the truth more on this but even then . with diseases like cancer where we can't cure if it's accounts we can't cure or to get the balance right between. giving the patient who can being realistic is very difficult and to get that balance right and you often fail you have to have some. you know we're all poor with the patients if you want to complete the code

detached technician you will not you will not handle these problems well but what about the process itself i mean if you had someone in your life that you really loughlin needed to get a brain surgery would you rather do it yourself oh no you couldn't you'll fall to him and my son had a brain tumor so that's what i really would ask of the drugs that i linked i was a jet i was doing general surgery and training at the time he was 83 months old and some people say who did you operate yourself missing that was you couldn't because all your oriel detached all your mechanisms of self preservation and the taps meant it was simply too anxious i once operated on a close personal friend that one of my daughters i'm godmother with a malignant brain tumor so unusual going to die and the operation was simply old school to biopsy confirm the diagnosis and a very very simple operations a bit reluctant agreed to do it because the family were very key and i should

because we were close friends and even that i found almost impossible because i was so anxious because i was not detached it's just what's the hardest decision you had to me because i understand brain surgeries all are back to events world problems i had to make many difficult decisions i think some of the ones. many regrets. over 40 years of practice i think some of the most difficult decisions. when i treated people too much i should have stopped i operated really when there was no realistic hope and all i did was add to the patients and the family is suffering and i can think of quite a few patients where i did that on the other hand with surgeons who are cold and detached they'll do that and it doesn't doesn't trouble them so you've sat they will actually never know how the brain works but i think it's unlikely i mean the

whole point about the future is unpredictable so i think it's unlikely it will ever understand the brain and the way we can understand how a computer works or a clock works and i think is unlikely. somebody once said you can't cut butter with a knife made of butter. but i think nick with the present technology we have. m.r.i. brain scanning electret implantation in monkeys and a certain extent and human beings is very limited to how much it will tell us and we can't experiment on ourselves now so we can't we can't cut open our fellow humans brains and sit around them the experiments on them we can do a certain extent on chimpanzees and i feel rather sort of chimpanzees and who is becoming increasingly difficult ethical reasons so there are a major limits to what we can do this or actual scientific research we can do on

the brain so following that logic you never really actually know what a patient's brain will do after the surgery surgery and all that has to be well i you know you know it was stents because i mean. we understand how various parts of the brain more important to some times that we need the areas to speech. the vision schul they're all tied in together in the complicated ways we didn't understand. but they did with the old. have a pretty good idea what you want you can get away with speak without damaging the patient and went on. and we were going to take a short break right now when we're back we'll continue talking to one of the top sergeants dr henry marsh stay with us.

in this community there are people who believe that it's ok. it's really hard there are no jobs and you see that i've got kids. and as a parent. i can come up with lots of arguments there's a lot of conflict within the game between the teams most of the conflict i would say over balls around money and most of them money is made. close one on each of

those seen on each other is good business the state of california alone makes $6000000000.00 a year of prison complex just to get some point in your life where. you don't care anymore nobody cares about you so you don't care about anything. why a paradise with some ground into a round the experimentation field the agricultural chemicals we know that these chemicals have consequences they are major irritants there's no question otherwise why would that the chemical company workers themselves be geared up and suited up locals attempt to combat the on regulated experiments that often in day you have many of these people have one foot into the biotech pharma and the other foot in the government regulatory bodies this kind of collusion is reprehensible while the battle goes on the chemicals continue to poison hawaii and its people so one has to ask the question whether there is

a form of environmental research going on in hawaii whether these companies feel they can get away with this because the people have less political power. and we're back with dr henry marsh one of the world's top neurosurgeons henry how closely are nearest science and nearest surgery elated and in sense that discoveries in your science actually make advances and well not not very what's called functional neurosurgery where you put electrodes into the brain for conditions like parkinson's disease and things like that. and again and on very epilepsy surgery because it was quite literally involved you can take

a look cool record some single brain cells in the planning to do but in terms of the v.a. every day problems like operating on patients with hemorrhage is head injuries things like that people are near is a completely different the world away from the everyday world than yours so you don't think of a human brain quake near scientists think of the huge computer you know on the on the as a this is more like a plumber i mean the the diff the relationship between neurosurgeons and mirrors is rather like the relationship between plumbers and physicists who deal in the make the quantum mechanical properties of the metals in a way is a big gap so when you're operating on brains you can remove something great you can remove belated to tongue or to see you know or to hear you had something new at

some of their press and they are and this has been there been sort of fashions for implantation maybe using fetal brains from feet to fetuses the stem cells. but none of this really work to get in terms of literally compliance not really i mean there are there are there are various computer brain interfaces where you put a lick troops on the brain i mean it's been you. some people can paralyzed and then some of them can then by thinking can actually move a reporting robotic arm i've read this crazy magical surgical records where it's at that human brain can be cut in half well it partially because in them that they don't have a name for that was brenda cold callous or to me exactly brain is famous the research done of a 19 eighties gets an eager and spirit for certain sorts of epilepsy

dividing part of the brain in the middle the 2 cerebral hemispheres the joint the 2 halls of the brain up here which then joined together with like the trunk of a tree the brain stem is the trunk you can't touch that if you touch that people die or left to be disabled but then the trunk splits into 2 main hemispheres like that and they're joined. i think all the copas collision which is billions of nerve fibers connecting the top of the right side of the brain the top of the left side of the brain and if you cut part of that it can help certain sorts of epilepsy in particular a form of epilepsy where people as full on the ground called a drop attack and these people appear normal if you met them you wouldn't know a part of their brain had been cut in half but you can carry out experiments on them where. there's a sort of barrier which divides the view what they're seeing the visual field so

the right side of the brain can then you see things on the left and the left side of the brain can and see things on the right and supposedly they also suffer from split personality well really do in the sense yes because i mean sort of with this special experimental set set up it's thought to separate people in to a certain extent the same area so it out back in the other i think you got but the story is told of one man who had a split brain operation and lost his temper with his wife and wanted to hit with his left hand which was controlled by the right hemisphere and then his right hand pulled it back that may not be true but it's an illustration of the way you end up with this sort of split personality so let's just roll forward i know you don't like this whole science fiction but we're not there yet i'm tired of something else

. let's say we do have this crazy technology to achieve it where 2 people it's a you and i we want to swap won hands here with another is it possible that. no way they were ok there are. 85000000000 nerve cells in the human brain if you took one cubic millimeter of the serval cortex the surface of the brain that can contain up 210-0000 nerves and 1000000000 electrical connections that is seriously complicated complicate what is the a radically. theoretically i mean i didn't i didn't believe in the humans so i believe lives in you and i thinking and feeling at the moment is generated by their activity of our brains but we really don't. i mean yes we can we understand a certain about but vision movement but how consciousness arises how pain arises.

and there's no way it happens it definitely for most people like myself. within the knowledge of the brain. thought and feeling all physical physical phenomena but the fact of matter is contemporary science even the political of quantum mechanics cannot explain it which means there's a big. there we very there's a huge gap in our sun to figure on the standing of the world or of you by the time wonders if where we're understand that's where evolution of human race ends probably to that's why we don't know much about it anyway as you told me don't watch much t.v. so i don't assume you've watched this series altered carbon no it's pretty much about how you can take one person's brain and transplant it into another one sensor like shockley i'm sure you were at hand. this is funny it's there's no way we can

ever achieve well the way that i'm not not in the foreseeable future more than the fools who. likewise the idea that some people have we can download all brains on the computer that's what it was in moscow saying or say that you can and hans human brain with that spirit that's variously because they're saying they already experiment in on this to this very to a moat saying it's impossible but our present level of mirrors and technology there's no way we can do it so this whole new fashion of maybe becoming immortal where we're trying to miss yeah yeah. it's fairytales. fear of death written in another form of giving people of lost we have a deep fear of death we have is the need to feel will live forever which until the modern age took the form of religious belief in an afterlife the need for that

belief is still there but not as some people dress it up in suit pseudo scientific terms all i'm saying is that when we seen 2 days in medicine how people are being rather test for for me it's like you can replace an organ when artificial already well so then you're asking yourself maybe someday in theory it's possible i won't say it's impossible but 85000000000 cells trillions of connections between them it's quite quite difficult so that like put this cyber port in your brain that's like not happening and there's sensors and sensors so tell us something if we do understand how memory is stored in a brain or in a very little there's no way we can remove what we don't want from the brain or i mean we understand some of the. limited understanding put it this way we know which bits of the brain if they get damaged where we lose the ability to make new short

term memories in particular parts of the brain called the hippocampus in the form of these so called experiments of nature you see people who've had damage either from a head in real from an operation they can't make short term memories or long term memories which is what eventually we lose without sinus disease and dementia seem to be more to do with the brain as a whole row than any individual points but maybe he can they've kate. a memory in the brain there having said that we know that maps. to the hippocampus is a famous study done on london taxi drivers you have an m.r.i. scanning which a london taxi drivers you have to pass this examination called the knowledge they have made the entire road map for london and not just the layout which a one way road which is the quickest way of getting from know from belsize park to

. brompton road or something they take this to look and the hippocampus in these london taxi drivers runs a pos the test a bigger than the ones of people who failed the test likewise you know the professional pianists have bigger hand in the movement there of the brain than the norm in nonprofessional pinnace so i don't know if you've operated any real time geniuses but what their brain be any different from not what you can see i mean as i go as idea of an a lenin's brain was kept and einstein's brain was cut into slices this is a very simplistic show but by definition everybody's brain is different because we are all different we are all brains every time we think a thought that is a physical process in our brains so an awful lot of current mirrors take the.

cognitive neuroscience which is what psychologists call themselves is really does saying well yes when we think certain thoughts certain parts of the brain a more active than that individual explain anything because you know already but everything we think and feel is a physical process in our brains so you're a man of science i don't suppose you believe in anything like the afterlife or it so what it will put it this way i think it's unlikely that you can't prove it or disprove it but it seems. unlikely to me and and why is the nearest seems unlikely because i see. and have seen many many people who suffered damage to the front part of the brain which is where all social behavior and moral behavior seems to be organized because people have suffered particular head injuries and suffered damage to the front of the brain they suffer a personality change they saw a personality change in terms of the behavior towards other people is also almost

was for the worse they become crude of. course disinhibited and you can reverse it any way and and if if the moral is what we think makes us particularly human can be omitted by physical damage to our brain well when our brains die i reckon we die well i don't necessarily mean the moral part is more like a religious part but i'm just saying it could be anything but what would that mean that those billions and billions and billions of nerves that are connected to each other and their existence the minute person's heart stops to be well. there are some rather alarming work done recently in america looking at dead pigs brains where they went to an average. prison took some brains out of pigs that have been killed if you. can show that some of the brain cells are still alive they'll die in time and what it means goodness knows likewise you knew some patients in what's

called persistent vegetative state because life without moving have to be fit in is a they were a new live because a medical treatment some of them is seen as a some kind of activity in their brains that we don't know what it means. all right gary thanks over israel so it is very strange but still thanks a lot fresher at least some light into this strange world is framed near surgery costing lives is to say even more and most. from the door and then you finally noodles on the of a side to religion it's the other way rudd is a closed door and that all the christians are all was you also to question your own aunts and then the whole of the new questions of him that's what's so interesting i suppose that's how life works in general. as we get older it kind of. anyway spankings are like ironical chads any plainer touch and good could light over

everything thank you very much right. to eat. yes. in this context i'm almost glad that asked for the last 70 and seen and done today

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that sound caught up with. the finish still so small. if you got on the. ball. say. to pull. from. the swarm see the blue of them so morning. and good your school local was before. much of those who heard the preview it was few other movies to see him with the north we will we're going to. move. move.

move she didn't look beautiful little i mean it's going to look her good. more muslim also these girls will give you films for good girls. go to shows a look look your simu believe this will be story to you should go. to startups to. get to meet until they were a little misty they'd say look it is it's. your stash them understand statistics it's their mashed old truck stop the president and please introduce more to constituents. as we have produced a toast in this world to slip a time when you look as good as the girls are with you sir your supporters to your insurance through sure sure mr you should put all through one of those don't do the

request. i i. hundreds of people in the central russian city of surat have demand that even murder suspects be put to death after the body of a 9 year old girl is discovered. yet which could. lead to something the president. also this hour vladimir putin talks turkey's offensive in syria warning that may escape abroad in there as a result of the operation. ukrainian m.p. publishes documents he says were real career.