Endoscopic Third Ventriculostomy, or How I met my own brain and my own plasticity

[Spoiler] This is a story about how a Tinder date ended in brain surgery.

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In September 2015 I began my PhD in the French department at King’s College London, researching how contemporary French philosophy engages with current theoretical neuroscience.

Despite this interest in philosophical conceptions of the brain, I had never really thought about my own brain. I never thought I would ever get to see my own brain, or that I would ever come face to face with the questions of neural vulnerability and transformation that I was reading about in theoretical texts.

From Tinder to Neurology

On Thursday 10th December 2015, just months after starting my PhD, I was beaten up in a homophobic attack. I had been on a date with a guy at a pub in Holborn. His name was Shaun, and we had laughed and drunk too much and talked about whether animals drink the milk of other animals or not. Shaun had performed a song about this. At the end of the date, we had a snog outside the pub just next to The Lion King. A group of men had walked past, shouted abuse at us, and then punched me in the head. Hakuna matata.

Unconscious, I was taken St Thomas’ hospital, with my date bundled into the back of the ambulance with me. I remember being asked what year it was, how old I was, what my name was, and struggling to answer any of these questions.

At the hospital I had a CT scan and a doctor came to speak to me.

“So, the scan shows that you have some concussion and a bit of bleeding on the brain… that’s to be expected. But — and, err, nothing to panic about just yet — we found that you have a pre-existing brain tumour…”

My tumour, it seemed, had nothing to do with the attack, and was sandwiched right in between the third ventricle of my brain and the forth ventricle, meaning that fluid could not flow out of my brain normally and my brain was swelling up like an GMO melon. This is a condition called hydrocephalus, which means water-head.

Following a long week of extra tests, watching Loose Women in the day room, and wondering around in one of those hospital robes where your bare bottom shows at the back, I underwent brain surgery to relieve my water-head of all its excesses.

Endoscopic Third Ventriculostomy

I remember entering the surgical theatre, seeing all the instruments laid out for me like the implements of torture in the final scene in Braveheart, and the anaesthetist tapping the table as if to say “hop on, now, there’s a good boy!”

The operation was an Endoscopic Third Ventriculostomy. Here is a video of one on Youtube as seen from the camera at the end of the endoscope; the inside of the ventricles look like underwater caverns explored by a diver. Whilst the consultant hadn’t been too worried about my tumour itself – it looked “pretty friendly”, thank God, and he was happy to leave it where it was – the extra fluid did have to be redirected. The surgery was to make a small hole at the bottom of the third ventricle in my brain, allowing the fluid to escape another way. The operation was describable only in plumbing terms, it seemed. All about blockages, cisterns, squirts, and bypasses.

Benjamin Dalton and friends
The post-surgery visitation: morphine, nudity, and DVDs.
Benjamin Dalton post brain surgery
My mom lovingly reattaches my earrings after they had been brutally banished from the operating theatre.
brain
My brain, before and after surgery.

The operation was a success, and I woke up to find my extremely composed and endlessly handsome neurosurgeon by my bedside. He was happy.

Then they gave me an injection of morphine and I felt it race round my body’s contour – round my head, up my left arm, down my left leg, over to the other leg, and back up, like you might ice the outside of a gingerbread man at Christmas. Then I was wheeled back to the ward where my friends and family took photos of me with my bottom hanging out of my robes, and watched My Big Fat Greek Wedding on DVD.

Neuro-vulnerability and Plastic Stories

My own encounter with my brain taught me a lot about both neuro-vulnerability and neuro-resilience: the brain is at once impossibly fragile and impossibly hardy.

I had been extremely lucky in that what had happened to my brain – both before and after surgery – had not incurred any perceptible changes in my cognitive or motor function. Many of the patients on my ward, however, were suffering from brain injuries or pathologies that that radically changed their mental function, some unable to tell where they were, speak, or recognize family members.

Whilst plasticity refers to a resilience (the ability of the brain to transform and persist and survive), this very transformability is also its most intimate vulnerability: the neural self is always on the verge of transforming into something else, something unrecognisable, as the result of the most banal of material occurrences.

These people’s ability to put themselves into narrative – to communicate a cohesive, linear phenomenology of identity, trauma, and transformation – was, thus, radically hindered: an incapacity for narrative that had direct impact on their ability to negotiate agency with regards to decisions of care and treatment when met with a clinical team that only has the resources to engage with one type of (non-plastic) narrative.

In this project, “Narrating Plasticity”, the neuroscientists collaborated with Amanda to determine how much the conception of plasticity differed as it passed between the plastic arts and the plastic neurosciences; over months of workshops, making pots, looking down microscopes, talking, it emerged there are – and indeed must be – many forms of narrative necessary for communicating different forms of plastic change and transformation.

Imagine the ethical and clinical potentialities and innovations within hospital and therapeutic spaces and many others that might come from plastic narratives. It is my contention that in order to connect with our plastic bodies in plastic times – in order to offer these plastic bodies new forms of therapy, new forms of experience, new forms of community and help or mutual-aid – we must recognise all plastic forms and transformation as forms of life, precisely in innovating new forms with which to put plasticity into narrative.

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Plastic narratives are already all around us, often in the most unlikely places. For how my brain surgery got me into B movies, and how I came to find neuro-exploitation cinema therapeutic, see my article for The Still Point journal here.