good afternoon as a neurosurgeon I treat
two very different groups of patients
and I will tell you a story it’s typical
for patient in each of those groups let
me start with mark mark is 25 years old
and he has suffered from epilepsy since
the age of 10 he’s very afraid to go out
in public because he doesn’t want to
have a seizure there he never finished
high school he has never had a job in
his life
and he lived with lives with his parents
but he has a type of epilepsy that we
can maybe cure him from the surgery this
has about a 70% chance of succeeding I
talked to him about this he opts for
surgery I operate him and I talked to
him two years later he’s completely
seizure free and I asked him about the
rest of his life unfortunately he still
lives at home with his parents he’s
still afraid to go out he still doesn’t
second patient John John is 58 years old
he has a great life he has a nice family
a nice house a nice job but one day he
has an epileptic seizure we make an MRI
scan and we see that he is suffering
from a malignant brain tumor people who
have this disease typically live ten
months without treatment and if we
operate and he does other treatments
like chemotherapy and radiotherapy we
can maybe extend his life with another
six months I tell him all of this he
opted for surgery it does always other
treatments he gets operated again he
does other treatments and in the end he
ends up living one and a half years
after he dies I talked to his wife and I
asked her how was this whole process and
she said we were very grateful for that
all the treatments that were available
it was but it was also very hard
we went from treatment to treatment from
MRI scan to MRIs
and it was very little time left to
actually live life and Joan was always
talking about his treatments but we’ve
rarely talked about anything else and by
the time there were no treatments
anymore he was already not John anymore
and he slipped away in a coma and he
died so if I tell you about my work in
this way I think you will probably feel
two things the first thing is this
always seems rather futile are these
really good treatments and I think the
second thing you think is these are not
very good stories these stories will
never be turned into movies or into
successful novels and I argued that the
this is actually the same thing a futile
treatment is the same as a bad story and
this has always interested me like why
are these two things so intimately
connected to each other and it also made
me wonder like what is a good story then
and this is something we know a lot
about because there are many people who
analyze stories that are popular and
successful if you look at movies that
grows a lot of money they always follow
the same storyline and the storyline
goes something like this there’s a
regular guy or a regular woman who lives
in a regular world and is called to
adventure and at first this person does
not want to go on the adventure but the
adventure is their faith they have to do
it so in the end they go on the
adventure and the end up in a special
world in the chaos in the unknown where
they have a lot of trials adventures and
in the end a big battle with their
biggest enemy and if they win that
battle
they gain something of value and they
take it back to the community they come
from and they are revered as a hero for
what they have done and they are called
the master of two worlds having gained
the power to live and the power to die
and this is not only the storyline of
popular stories if you look at religions
if you look at the story of Jesus Christ
or at the story of Buddha they have the
same storyline so even our religions are
built on this story and there must be a
very deep reasons for this and the
reason can actually be seen in our brain
I think if you look at our brain we have
two hemispheres two halves of the brain
left side right side and scientists have
argued for centuries about the
differences between left brain and right
brain the left and the right hemisphere
and there is this new idea emerging that
the left brain is actually giving us a
reality of what we know we look out into
the world and we separate it into all
kinds of different things we give them
names and we understand the
relationships between those things and
it serves as well we build reality out
of the parts like a virtual reality and
we can work with it but when
circumstances change when new things
occur or when there are new
opportunities or new dangers this note
does not serve us anymore and we need to
use our right brain our right hemisphere
and the right hemisphere looks at the
world in a completely different way it
sees the world as an undifferentiated
field everything is connected to
everything in space and time and when we
move into the right hemispheric domain
we try to make sense of what’s going on
about we try to make sense of this new
situation we try to wrestle with it a
bit a little bit we fight it and when we
win we understand it we can cut it up
into pieces name the pieces and
understand the relationships and this is
what we do all the time we move from the
left hemisphere domain to the right
hemisphere domain and back to the left
hemisphere domain and when we understand
something we talk about it with other
people
so the heroes amongst us are the ones
who are best capable of this process of
moving from left to right back to
and talking about it with other people
the great communicators the leaders the
scientists these are our heroes and this
is something we find extremely
meaningful and I think there’s even a
deeper reason for that I think it gives
us an evolutionary advantage I think
communities that have valued people that
have this ability and individuals that
have the disability are better at
surviving and from the evolutionary
level this has built our brain the
anatomy of our brain has been built on
that we love this process and we build
stories that show the same process and
we build religions around that this is
what creates meaning but when we look at
medicine we fail to do so and we make
two mistakes first of all the patient
has the disease it’s his call to
adventure but what we do is we take the
disease away from the patient we say you
don’t need to suffer give it to me I am
the surgeon I am the doctor I will treat
it and the second mistake we make is
that we fail to recognize that the
disease and the suffering and death is
not our enemy
they are inevitable facts of life the
enemy is lack of meaning so the worst
thing we can do is to fail to use the
disease to create meaning and if we look
at the story of Mark and John we can
tell it in a completely different way I
could have told mark look surgery is not
the end it is the beginning of a long
journey and you have to make the journey
think of where you want to go you can
build a bigger life out of this surgery
even if the Epilepsy returns this can be
your call to adventure your call to
action think about this what do you want
to do with your new life and in the case
of John I could have told him this you
are terminally
this is the last chapter of your life
think carefully of what you are going to
write in your last chapter because last
chapters are very important for the
quality of the whole book and if you
figure out what you want to do with your
life with the little life that you have
left I can give you a little bit more
time and this is what medicines you do
so sometimes
dying is terrifying and sometimes living
is terrifying but lack of meaning is
always the enemy and we can only beat
that enemy if storytelling and medicine
come together thank you [Applause]
two very different groups of patients
and I will tell you a story it’s typical
for patient in each of those groups let
me start with mark mark is 25 years old
and he has suffered from epilepsy since
the age of 10 he’s very afraid to go out
in public because he doesn’t want to
have a seizure there he never finished
high school he has never had a job in
his life
and he lived with lives with his parents
but he has a type of epilepsy that we
can maybe cure him from the surgery this
has about a 70% chance of succeeding I
talked to him about this he opts for
surgery I operate him and I talked to
him two years later he’s completely
seizure free and I asked him about the
rest of his life unfortunately he still
lives at home with his parents he’s
still afraid to go out he still doesn’t
second patient John John is 58 years old
he has a great life he has a nice family
a nice house a nice job but one day he
has an epileptic seizure we make an MRI
scan and we see that he is suffering
from a malignant brain tumor people who
have this disease typically live ten
months without treatment and if we
operate and he does other treatments
like chemotherapy and radiotherapy we
can maybe extend his life with another
six months I tell him all of this he
opted for surgery it does always other
treatments he gets operated again he
does other treatments and in the end he
ends up living one and a half years
after he dies I talked to his wife and I
asked her how was this whole process and
she said we were very grateful for that
all the treatments that were available
it was but it was also very hard
we went from treatment to treatment from
MRI scan to MRIs
and it was very little time left to
actually live life and Joan was always
talking about his treatments but we’ve
rarely talked about anything else and by
the time there were no treatments
anymore he was already not John anymore
and he slipped away in a coma and he
died so if I tell you about my work in
this way I think you will probably feel
two things the first thing is this
always seems rather futile are these
really good treatments and I think the
second thing you think is these are not
very good stories these stories will
never be turned into movies or into
successful novels and I argued that the
this is actually the same thing a futile
treatment is the same as a bad story and
this has always interested me like why
are these two things so intimately
connected to each other and it also made
me wonder like what is a good story then
and this is something we know a lot
about because there are many people who
analyze stories that are popular and
successful if you look at movies that
grows a lot of money they always follow
the same storyline and the storyline
goes something like this there’s a
regular guy or a regular woman who lives
in a regular world and is called to
adventure and at first this person does
not want to go on the adventure but the
adventure is their faith they have to do
it so in the end they go on the
adventure and the end up in a special
world in the chaos in the unknown where
they have a lot of trials adventures and
in the end a big battle with their
biggest enemy and if they win that
battle
they gain something of value and they
take it back to the community they come
from and they are revered as a hero for
what they have done and they are called
the master of two worlds having gained
the power to live and the power to die
and this is not only the storyline of
popular stories if you look at religions
if you look at the story of Jesus Christ
or at the story of Buddha they have the
same storyline so even our religions are
built on this story and there must be a
very deep reasons for this and the
reason can actually be seen in our brain
I think if you look at our brain we have
two hemispheres two halves of the brain
left side right side and scientists have
argued for centuries about the
differences between left brain and right
brain the left and the right hemisphere
and there is this new idea emerging that
the left brain is actually giving us a
reality of what we know we look out into
the world and we separate it into all
kinds of different things we give them
names and we understand the
relationships between those things and
it serves as well we build reality out
of the parts like a virtual reality and
we can work with it but when
circumstances change when new things
occur or when there are new
opportunities or new dangers this note
does not serve us anymore and we need to
use our right brain our right hemisphere
and the right hemisphere looks at the
world in a completely different way it
sees the world as an undifferentiated
field everything is connected to
everything in space and time and when we
move into the right hemispheric domain
we try to make sense of what’s going on
about we try to make sense of this new
situation we try to wrestle with it a
bit a little bit we fight it and when we
win we understand it we can cut it up
into pieces name the pieces and
understand the relationships and this is
what we do all the time we move from the
left hemisphere domain to the right
hemisphere domain and back to the left
hemisphere domain and when we understand
something we talk about it with other
people
so the heroes amongst us are the ones
who are best capable of this process of
moving from left to right back to
and talking about it with other people
the great communicators the leaders the
scientists these are our heroes and this
is something we find extremely
meaningful and I think there’s even a
deeper reason for that I think it gives
us an evolutionary advantage I think
communities that have valued people that
have this ability and individuals that
have the disability are better at
surviving and from the evolutionary
level this has built our brain the
anatomy of our brain has been built on
that we love this process and we build
stories that show the same process and
we build religions around that this is
what creates meaning but when we look at
medicine we fail to do so and we make
two mistakes first of all the patient
has the disease it’s his call to
adventure but what we do is we take the
disease away from the patient we say you
don’t need to suffer give it to me I am
the surgeon I am the doctor I will treat
it and the second mistake we make is
that we fail to recognize that the
disease and the suffering and death is
not our enemy
they are inevitable facts of life the
enemy is lack of meaning so the worst
thing we can do is to fail to use the
disease to create meaning and if we look
at the story of Mark and John we can
tell it in a completely different way I
could have told mark look surgery is not
the end it is the beginning of a long
journey and you have to make the journey
think of where you want to go you can
build a bigger life out of this surgery
even if the Epilepsy returns this can be
your call to adventure your call to
action think about this what do you want
to do with your new life and in the case
of John I could have told him this you
are terminally
this is the last chapter of your life
think carefully of what you are going to
write in your last chapter because last
chapters are very important for the
quality of the whole book and if you
figure out what you want to do with your
life with the little life that you have
left I can give you a little bit more
time and this is what medicines you do
so sometimes
dying is terrifying and sometimes living
is terrifying but lack of meaning is
always the enemy and we can only beat
that enemy if storytelling and medicine
come together thank you [Applause]
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