Medicine: Half a Brain

Two, three or four times a year a young woman living in Ohio threw fits. This went on for ten years. Finally she felt paralysis creeping upon her, suffered from headache, vomiting, blurred vision. Examination disclosed that she had neuritis in both eyes as the result of some pressure on the brain. With eyes closed she could not tell where her left hand was, or her left foot. On the left side she was insensitive to pain, heat, vibration. These left-hand symptoms indicated trouble on the right side of the brain, since the control lines are laterally crossed. Diagnosis: brain tumor. Dr. William James Gardner of Cleveland opened her skull, cut out the right cerebral hemisphere—i.e., half her brain.

The doctor who first observed this patient was Neuropsychiatrist John Daniel O’Brien of Canton’s Mercy Hospital. Dr. O’Brien kept track of her after the operation, reported her case last week in the American Medical Association’s Journal.

The half-brained patient made a remarkably good convalescence, went back to her family, capably took care of the house and children, gained weight and strength. Some paralysis and dullness of sensation remained on her left side; her face was lopsided. She could hear with only one ear, smell with only one nostril. Nevertheless, her friends noted no mental deterioration or personality change. She read constantly. Her sense of distance and perspective seemed unaffected.

Four years after the operation she tripped, fell 20 ft. down a stairway. Soon she grew apathetic, dullwitted, unable to feed herself. A sample of fluid from her spine showed traces of blood. Her doctors concluded that a blood-filled tumor had developed on the outer layer of the brain. The skull was trephined, clotted blood removed from the left side of the cranial cavity, bloody spinal fluid from the right. Later, the patient seemed like a person with no brain at all. Bedridden, apathetic, twitching spasmodically, she died.

Had ordinary hemorrhage caused her death? Or had the fall stimulated a new growth of the old tumor? An autopsy would have settled the question. Despite the most fervent pleas, the woman’s family refused to permit one.

Nevertheless Dr. O’Brien last week awarded her a place of distinction in medical annals. “Excision of the right hemisphere,” he wrote, “is not a very common procedure; it is an operation of great magnitude. From what I can gather in medical history this patient survived longer than any who have undergone a similar operation; in addition, it provided this woman with almost five years of happiness with her family. Her death . . .leads one to wonder how long she might have lived had the accident not occurred.”