‘I did not think about the fact that somebody was standing over me with a scalpel’

Because of the location of the tumour, Neil Foster was told his best option would be to have brain surgery - while conscious.

Neil Foster during surgery. Courtesy Neuro Spinal Hospital

DUBAI // Neil Foster was happier than you would expect a top company manager to be when he was able to answer a simple arithmetic question.
Why? Because at the time he was lying on an operating table and a neurosurgeon was removing a 1.5 centimetre tumour from his brain.
"You have a logic test in the middle of your operation so I did not think about the fact that somebody was standing over me with an actual scalpel," he says.
Mr Foster was operated on while conscious to minimise potential damage to to speech, movement and memory functions.
Dr Ahmad Bitar, his neurosurgeon, said being under general anaesthesia carried a 13 to 27 per cent risk to important body functions.
"Imagine this patient, the manager of a very important company, if I damaged the area of mathematical function, for example, he will not understand what is one plus two," said Dr Bitar.
"He would lose his job, his life."
Awake brain surgery reduced this risk to below 2 per cent, he said.
Since the operation Mr Foster's tumour has regrown and he is on a second course of chemotherapy, but his "awake" surgery in February last year saved his life.
Mr Foster, 46, a British expatriate father of two and a manager with Inspectorate International in Jebel Ali, had collapsed after suffering a fit. Tests showed he had a cancerous tumour rooted in his left parietal lobe.
Because of the location of the tumour, Mr Foster was told his best option would be to have brain surgery while conscious.
"They explained, because of where the tumour was located, there was a procedure that was able to make sure there was no damage to the actual brain tissue itself as a result of being able to do awake surgery," said Mr Foster.
"At the time it came as a shock but basically I thought I had to remove the tumour anyway. I said 'just get rid of it'."
Two days later he was being wheeled into the operating theatre.
Lying on the trolley, knowing he was to be awake during the surgery, was surreal, he said. However he remained surprisingly calm.
"I honestly cannot remember what I thought apart from that it sounded like a very good, sensible approach. The operating surgeon and the team were very calm so I didn't really give it a second thought."
Mr Foster was sedated and given a local anaesthetic.
Once at the critical stage of surgery, he was woken and given a series of cognitive tests.
"It was a unique experience. You don't understand that somebody is actually manipulating your brain while you are giving these answers. It is amazing really," he said.
The test involved simple mathematical questions and pictorial quizzes. "It could be as simple as two times three or to name what the object was in the picture."
Mr Foster remembers being shown a picture of an ashtray and being unable to name the object - despite being a former smoker.
He could not tell you how long his surgery took.
"I remember going in. I can remember waking up to take the logic test. I remember talking to the people. And then they put me straight back to sleep again."
The recovery time was short. By day two he was home and by day three he was back at work.
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