WHAT HAPPENS DURING A CRANIOTOMY?

Nearly all operations begin with the creation of a bone flap so the doctor has an opening into your brain. This opening will be sealed shut at the end with wire or titanium plates and screws. Beneath the bone are the three meninges, connective membranes also known as the mothers: the dura mater (hard mother), arachnoid mater (spidery mother), and pia mater (soft mother). After we’re past that triple embrace—like the Moirai crones of myth that spin, measure, and cut the thread of life—we’re at the precious substance of thought. The blush of living brain has been described as resembling the inside of a conch shell or a crumbling marble quarry. To me, it’s like the revelation of brine and meat after shucking an oyster. Beyond that, what happens during a craniotomy depends on the type of surgery. A translabyrinthine craniotomy, for example, involves cutting away the whole of the mastoid bone and some of the tunnels of your inner ear.

IS IT TRUE I WILL HAVE TO BE AWAKE DURING MY CRANIOTOMY?

Some craniotomies require you to be conscious. When a tumor makes itself comfortable with a good book and a blanket in front of the fire of your eloquent cortex, which controls language or motor functions, we give you prompts indistinguishable from online banking security questions. Certain surgeons fancy themselves as early explorers, sketching out crude cartographies of the thunderous Badlands, the twists of the Amazon, the jagged coasts of Jutland brainscapes. I like to think of the organ as an ancient manor or primordial motel and myself a plumber, electrician, or stonemason reading a blueprint of where to find the stairways, hidden chambers, fuse boxes, boiler, septic tank. It’s a Versailles of the id and ego with a fleshy, well-manicured hedge maze.

WON’T I BE IN PAIN IF I’M AWAKE DURING MY CRANIOTOMY?

You will be awake for a short interval during the craniotomy. Also, there are no pain receptors in the brain. What you might undergo are moments of aphasia or synesthesia, like Kandinsky hearing his paint box hiss or Schubert visualizing E minor as “a maiden robed in white with a rose-red bow on her chest” when he heard chords struck in that key. The hallucinations aren’t as enchanting. You think you have it bad enough getting brain surgery, then suddenly the OR is covered in roaches. A woman once met her long-lost twin. She didn’t have a long-lost twin. There was also the estate lawyer who decided that his entire surgical team was trying to kill him and wouldn’t stop screaming, “You’ll never make me talk!” Reports of out-of-body experiences aren’t uncommon. I’ve heard it feels as though you are watching your own handwriting uncoiling from someone else’s pen.

WHAT WILL MY BRAIN BE LIKE AFTER MY CRANIOTOMY?

It will go on with its braining, provided we got all the cancer or your growth was benign. If you have a tumor that has seeded itself throughout your cerebrum like an aspen grove, however, or been diagnosed with a glioblastoma multiforme, you will have a different kind of recovery.