When music teacher Dan Fabbio played a simple melody on his saxophone as he laid on the operating table after his brain tumor had been removed, music never sounded so sweet.
Fabbio was working as a substitute music teacher and earning his Master’s degree in music education in 2015 when he began to “see and hear things that I knew were not real,” according to the University of Rochester Medical Center.
Tests showed the musician had a brain tumor that was nearing the center of the brain.
“I was 25 at the time and I don’t think there is any age when it is okay to hear that,” said Fabbio. “I had never had any health problems before and the first thing my mind went to was cancer.”
Although the mass appeared to be benign, it was located in an area responsible for music function. Because Fabbio’s livelihood depended on his musical capabilities, a team was assembled to map the precise location of musical ability in the brain and preserve it.
Dr. Web Pilcher, chair of the Department of Neurosurgery at the University of Rochester Medical Center, and his colleague Brad Mahon, a cognitive neuroscientist, had developed a brain mapping program. Since 2011, they’ve used the program to treat all kinds of patients with brain tumors, from mathematicians to a bus driver.
“Removing a tumor from the brain can have significant consequences depending upon its location,” said Pilcher. “Both the tumor itself and the operation to remove it can damage tissue and disrupt communication between different parts of the brain. It is, therefore, critical to understand as much as you can about each individual patient before you bring them into the operating room so we can perform the procedure without causing damage to parts of the brain that are important to that person’s life and function.”
Fabbio, the team’s first musician, underwent many tests and brain scans over six months to see how his individual brain may be impacted by surgery.
“Everybody’s brain is organized in more or less the same way,” said Mahon. “But the particular location at a fine grain level of a given function can vary sometimes up to a couple centimeters from one person to another. And so it’s really important to carry out this kind of detailed investigation for each individual patient.”
The team also worked with Elizabeth Marvin, a professor of Music Theory in the University of Rochester’s Eastman School of Music who studies the ability of brains to remember and process music. Together, they developed cognitive musical tests performed during functional MRI (fMRI) scanning, such as Fabbio humming back melodies and verbally identifying objects. They used their findings to guide them through the surgery in the operating room.
To ensure they were successful, Fabbio’s saxophone was brought into surgery for him to play after the tumor had been removed. Marvin was present to let the surgeons know whether or not they had targeted an area that disrupted music processing.
For the ultimate test, Fabbio played a tune that could be played in shallow breaths, as long breaths could have put too much pressure on the brain. And it worked.
“It made you want to cry,” said Marvin. “He played it flawlessly and when he finished the entire operating room erupted in applause.”