DBS patients such as Denise Bacon, above, are typically kept awake so doctors can assess their movements as they place electrodes into the brain and analyse their immediate impact. Photo / King’s College Hospital
The doctors prepared to carry out the brain surgery, their medical tools laid out.
Their patient, wide awake on the operating table, was given an instrument of her own: her clarinet, which she began to play.
Denise Bacon, 65, blew into the mouthpiece as doctors stood behind her, piercing holes into her skull to implant electrodes that would deliver electrical pulses to the brain in a bid to improve her motor skills.
The electrodes were connected to a pulse generator – a device likened to a pacemaker – which sent continuous pulses to modify the brain, helping her manage her symptoms of Parkinson’s disease, for which there is no cure.
Bacon underwent the procedure, known as Deep Brain Stimulation (DBS), in London’s King’s College Hospital in July.
The semi-professional musician was diagnosed with Parkinson’s in 2014 and its symptoms greatly impacted her ability to feed herself, walk, and play her “beloved” clarinet, eventually forcing her to leave the concert band she played for, the hospital said in a statement.
One of the goals for the procedure was to help her play again, said Keyoumars Ashkan, the neurosurgeon who carried out the operation, in an interview yesterday.
“If I can go back to playing clarinet, that will make a huge difference to my quality of life,” Bacon told Ashkan before the surgery, he said.
As the results of DBS are instant, the best way to assess the procedure’s success was to have Bacon play as doctors stimulated her brain, one electrode at a time, doctors decided.
Bacon was fitted with a type of stimulation device in her chest, which can monitor her brain activity and adjust stimulation when needed.
Parkinson’s, which affects an estimated 10 million people worldwide, causes brain circuits that co-ordinate movement to misfire, causing symptoms including tremors, stiffness and slow movements. Other common symptoms include difficulty speaking and issues with sleep, co-ordination and balance.
DBS patients are typically kept awake so doctors can assess their movements as they place electrodes into the brain and analyse their immediate impact, Ashkan said. Bacon was given a local anaesthetic to numb her scalp and skull; the brain itself does not have any pain receptors.
“You can, on the table, immediately see the effect of the surgery,” Ashkan said. In Bacon’s case, as soon as the electrode was placed, doctors witnessed her finger movement becoming “immediately better”.
The right side of the brain controls the left side of the body and vice versa, Ashkan explained, adding that when doctors placed the electrode on the right side of Bacon’s brain, her left fingers were “flying”.
The right fingers, which were not being treated, were not doing anything. “They were stiff and slow and couldn’t move,” he said.
Katherine Fletcher, research communications lead at Parkinson’s United Kingdom, said in an emailed statement that DBS offers those living with the disease “better control of symptoms when medications are no longer as effective”.
Speaking of Bacon’s procedure, Fletcher said it was “incredible to hear how this life-changing treatment is not only helping individuals with symptoms but regain the ability to do the things they love”.
In 2020, a violinist who learned she had a brain tumour after a seizure at a symphony played her instrument as doctors worked to remove it. That surgery also took place at King’s College Hospital, with Ashkan in the room.
“Images and videos of musicians playing instruments like a clarinet during deep brain stimulation remind us of the extraordinary power of modern therapies for Parkinson’s disease,” said Michael Okun, co-author of The Parkinson’s Plan and medical adviser for the Parkinson’s Foundation, in an interview with the Post.
Okun described moments like Bacon’s surgery as “not just medical feats” but “windows into the resilience of the human brain and spirit”.
It also brings hope and awareness to effective Parkinson’s treatments, Okun said.
“It’s a myth that Parkinson’s lacks effective treatments as DBS, medications and rehabilitation can all dramatically restore function and quality of life.”
Ashkan stressed that DBS is not a cure for Parkinson’s, but a “very effective” surgical tool that can improve the quality of life for patients who may have stopped responding to medication or are experiencing side effects.
“The first line of treatment for Parkinson’s disease is not surgery, it’s medical management drugs,” he added, though he pointed out that some patients stop responding to the drugs after years of taking them.
“At that stage surgery could potentially have a real role,” he said.
Ashkan said he hopes that Bacon’s story will offer hope to those living with Parkinson’s and also educate them about DBS as a treatment for their symptoms, which is offered free on Britain’s National Health Service. DBS surgery is also available in the US, according to the Parkinson’s Foundation.
After a DBS operation, patients are discharged for three or four weeks before returning to the hospital to have their stimulation device switched on.
“It’s a permanent system that lasts forever,” Ashkan said, adding that Bacon is getting more mobile each day and slowly returning to hobbies such as swimming and hiking.
“She’s finding quite a lot of improvement,” he said. “Hopefully she will sometime soon go back and play in the band again.”
Ray White, another member of the East Grinstead Concert Band in southern England – where Bacon played – said in an email yesterday that the group was “delighted” to see Bacon making headlines for bringing a little music to the operating theatre.
Though Bacon stopped playing because of her symptoms, he said she remained a “much loved friend”, sometimes attending the band’s events as their unofficial photographer. The band is “very much looking forward to the day when she can resume her place in our clarinet section”, White said.
Bacon could not immediately be reached for an interview but said in a statement that she was “delighted” with the outcome of the surgery.
Having noticed improvements in walking and playing the clarinet, she has another place she wants to test her regained mobility: the dance floor.
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