WEBVTT

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Michael Balzer: Hola.
That's about the extent of my Spanish,

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(Laughter)

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but I learned one new word yesterday,
and that's cráneo, skull.

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I'm the guy who created my wife's skull

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to save her life, her eye
and even her soul. No, not really.

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I was part of a team of Pamela,
two surgeons and technology,

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kind of, as I call it, the healer,
the magician and the warrior,

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and together we defeated the pain
and suffering that was in her.

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We'd like to invite you into our story.

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Pamela Scott: When I was 16 years old,
my mother died of a brain tumor.

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And of course, this impacted me
very deeply.

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But it also left me
with a tremendous interest

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and passion in understanding
health and medical research.

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Now we live on a very small community
in the Central Coast of California.

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It's halfway between Los Angeles
and San Francisco.

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We have very limited
specialty medical services there,

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which is difficult for anyone
who has a serious illness.

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Major medical centers
are at least 4 hours away.

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Now, I'd like to talk to you
about my pain.

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Imagine having the worst headache
you've ever had.

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And imagine having that headache go on
24 hours a day, 7 days a week for months.

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In the summer of 2013,
this is what I was experiencing.

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I went to my primary care physician,
she had no idea what was wrong.

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I went to emergency rooms,
they had no idea what was wrong.

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So I was referred to a local neurologist

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who was very well thought of
and respected,

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and he diagnosed me with migraines,

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kind of classic
but severe migraine syndrome.

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So, he prescribed a very
complicated regimen of pills.

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I took so many pills.
I had trouble keeping track of them.

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I also had injections,
I had inhalant medication.

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But the headaches kept getting
worse and worse over the months,

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until finally I could not sleep at night.

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There were no imaging studies done,
nothing was ordered by the doctor.

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No MRI, no CT scans.

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And so we really never had
a very good idea

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what was going on inside my head.

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MB: So, she came to me and said,

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"Can you come with me
to see this neurologist?

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He's not listening to me.
I'm still having a lot of pain."

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So, I did and sure enough,
he was very adamant

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to keep the same treatment going.

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So, I had to tell him,

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"You know her mother died
at the age of 53 of a brain tumor.

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Humor me, let's do an MRI."

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He paused. I guess
he was somewhat surprised

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that I would say that.

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And he relented and ordered the MRI.

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PS: Now there are two types of MRIs.

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One is a standard MRI
which is fast and easy,

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but it doesn't give very much information.

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The other one is a better MRI,
and it's done with contrast dye.

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My doctor only ordered the first MRI
even though he said, with that,

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there was absolutely
no reason to do it,

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no clinical information
that he thought would be important.

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We did that MRI and I got a report
back from the radiologist

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that indicated there was something wrong
in this part of my skull.

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The radiologist recommended
that we have the second type of MRI

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in order to determine
more specifically what that was.

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My doctor, the neurologist,
refused to do this

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and said I should continue the medication,
all the pills that weren't working,

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go home and come back
to see him in a year.

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This was entirely unacceptable to me.

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So, I went back to my primary care doctor,
and she looked at the report,

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and she ordered the better MRI
with contrast dye.

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And, to my surprise it did turn out
that in fact I had a brain tumor.

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MB: This is the report.

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It's difficult to read but essentially
it identifies the size of her tumor.

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To put it in perspective,
this was the size of the tumor.

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About the size of a golfball.

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This was lodged
between her eye and her brain.

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There's also some other
medical jargon here,

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but I'm somewhat of a visual guy.

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So I created this
to help me understand it.

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I took my own measurements;
I circled the area where the tumor is.

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Now this is an MRI, bone does not
show up in MRI, it's dark.

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If you notice right above her left eye
is a very dark space that's the tumor.

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But it also indicates the type
of tumor, a bony tumor.

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PS: I think we all are uncomfortable
when we think about our deaths,

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but there's always been something
that has frightened me more than death.

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And that's the thought
of having brain damage:

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no longer being myself

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because that's what had happened
to my mother.

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The problem with the location
of this tumor

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was that it was under the frontal lobe
of the brain.

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Now, the frontal lobe
is where we have our intelligence,

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our reasoning, our memories,
it's the seat of our personality,

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it's what makes us unique.

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I went to two local neurosurgeons,
and both of them said

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that I really should consider
the tumor inoperable

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because in order to remove it,

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they would have to do
an ear-to-ear craniotomy,

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so cutting my skull open,
remove a piece of the skull,

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and then, because of the location
of the tumor, apply traction

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to try to lift it or move the brain aside
in order to reach the tumor.

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Now, by doing that, both doctors said
there was a very high possibility

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I would have brain damage from this.

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One doctor said
I may never be functional again,

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I may never be normal,
I may never leave the ICU.

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This was not acceptable to me.

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The other problem was
that if I did not remove the tumor,

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the tumor could continue to grow

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and would grow up
into the frontal lobe there.

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So I would have
the same outcome ultimately

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although we don't know how soon.

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I needed to do something different.

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I was anxious, yes.

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So, I went to the Internet

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which of course
we have to be careful about.

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It comes with the caveat
because how much information,

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particularly medical information,
on the Internet is good information?

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I'm going to guess about 10%.

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90% of it - Facebook, no;

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forums, no -
not good information.

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But I discovered that all major
medical centers have websites

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that you can go to
and find so much information

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you can read about the newest techniques
in treating so many different diseases,

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and they talk about the special
treatments that they have,

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along with providing links to videos
and other information that is reputable.

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So, this is what I did,
and I learned so much.

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I also learned that there was something
called a "distant patient program".

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I had never heard of this before.

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And many of these
university medical centers

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will do an evaluation of your case
by looking at your records

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that you can send to them.

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So you don't actually have to go there

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and their team of physicians
will go over your situation,

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discuss it together,
develop a provisional diagnosis

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or their best guess about what it is
and then determine the best treatment

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that they would have to offer
at their clinic or their hospital.

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And then they would call you on the phone,
and discuss that with you.

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So I thought this was
a wonderful thing to do,

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and that's what I began doing.

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MB: Now, everybody handles
anxiety differently.

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Pamela handles it with research,
research and more research,

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and she would come to me
with this research.

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"Can we get this?"
"Can we get that?"

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I have a IT background,
so I accumulated a lot of information.

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In fact, we had a white binder
about 10 centimeters thick

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of documentation, reports, scans
that I created that she would take

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to all the local surgeons, physicians
throughout California.

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However, we also needed
to send this information

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throughout the rest of the country.

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So it was my responsibility
to use email, facsimiles

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even the web portals that somebody's
medical systems put together

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in order to present this information.

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But I also do something else.


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I started a 3D print company.

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I also started a podcast.

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In one of my episodes, I had talked
about a Malaysian neurosurgeon

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who printed a 3D skull and brain,
and used that for practice surgery.

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Now [in] Malaysia, [they] can't use
cadavers, it's illegal,

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so I could understand
the reasoning for that.

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Coincidentally, ironically,
Pamela had a brain tumor,

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and I thought to myself,

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"Wouldn't it be neat
if I could apply these skills

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that I have just learned
to be able to help her?"

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So, I went to work but immediately
I ran into roadblocks.

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This software is horrendously expensive,
and it's also for the medical community.

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One, I'm not in the medical community.

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Two, I don't have a lot of money.

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So, like Pamela I used the Internet
and did a lot of searching.

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And I came up with two open-source
research programs

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that allowed me to do what I needed to do.

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One of them was from Brazil,
part of their Technology Center.

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The other one was from a research company
on the East Coast.

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Through the two of these things,

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after a couple of weeks of training -
that I trained myself -

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I came up with this.

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This is a 3D volume render.

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On the right hand side
you see a bunch of slices.

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These are CT scans.
Bone shows up very well in these.

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There's about 300 of them.

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All together they rendered
this skull here.

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Now, the skull by itself is great
for Halloween, but nothing more.

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So, there're other powerful tools in here.

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They're called ROI
or "regions of interest,"

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and they virtually allow me
to slice the skull in half.

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And I did it right over the left eye,

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and you can see not too clearly the tumor,

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and I'll highlight it a little bit here.

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As you can see there is the tumor.

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Now the magic behind this kind of software
is that I can rotate it,

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so here's an animation
where I cut it in half

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so that I can look inside this skull.

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A few years back
I would have had to kill Pamela

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in order for this to happen.

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No, I'm trying to save her.

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So because of technology, I now
have the ability to look inside there.

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And I'll circle it here,
again, there's the tumor,

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Now I said earlier that I 3D print,

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so I wanted to take this
to the next level.

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It's great to be able to look
at this stuff on a computer,

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but wouldn't it be great
if I could actually touch it?

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So I went to work, the same software
gave me the ability to create a model

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that I applied to a printer.


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So, here is a time-lapse image.

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Obviously if you've ever worked
with a 3D printer, they're not this fast.

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It took about 8 to 12 hours
to create this skull.

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Now this is kind of creepy,
kind of reminds me of the Terminator.

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However, this is that 3D printer,

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and this, a year and half ago,

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is the time-lapse that I created,
and this is the skull.

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Don't you think it kind of looks like her?
(Laughter)

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I like the cute little nose here.

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Now, the reality is we want to look
inside of it , so here is the tumor.

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We can actually touch this tumor.

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I was extremely excited about this,
so I ran to her and said,

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"Look, I've got your skull here!
Here's your tumor."

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She greeted me with a look of horror.


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I thought to myself, "Why?"

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but then it dawned on me,
for the first time she came away

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with what was inside her
causing her all that pain.

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But what does Pamela do?
Research.

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PS: I had found something miraculous

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and something that most doctors
were not familiar with,

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and had never heard of.

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There were 2 major medical centers

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on the East Coast,
so across the country from us,

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that have developed
a new surgical technique

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for the kind of tumor that I had.

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It was perfect.

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One was Johns Hopkins Medical Center,

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the other one was the University
of Pittsburgh Medical Center.

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In this procedure, groundbreaking,

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there would be a team of a neurosurgeon
working with an oculoplastic surgeon.

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They would make a tiny incision,
truly tiny in the crease of my eyelid,

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and then the neurosurgeon
would go over the eye

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and directly into the tumor
to remove it in very tiny bits,

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small increments,
over the course of several hours.

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Thus I would have no craniotomy,
no movement of my brain,

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and this would eliminate
the risk of brain damage.

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I was very excited about this,
and I really wanted it done.

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Now UPMC could get us in
within a few weeks,

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so I went ahead and scheduled
the surgery there as soon as I could.

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MB: So a few weeks later,
we got on a plane,

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and we went to Pittsburgh, Pennsylvania.

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The next day she had some labs done,
and we had an opportunity

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to talk to the surgeons, in particular
the neurosurgeon Dr. Gardner.

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So I asked him because I had sent him
one of these skulls,

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and said, "What do you think of it?"

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He kind of chuckled, he said,

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"We passed it around
in one of our meetings."

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He said, "We thought it was extremely cool
how we can look at something, touch it,"

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because normally all they had
was some images and some text documents,

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so they were able to touch it,
now we had a fellow with him, he said,

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"The huge potential of using this
for education is enormous

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because now we can take data
from a patient immediately

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and apply it into a tangible model
and use that

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as the Malaysian neurosurgeons
use for practice."

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PS: My surgery was very successful.

00:14:47.786 --> 00:14:51.858
This photograph was taken
10 days after the surgery.

00:14:52.122 --> 00:14:55.892
The surgeon had encouraged me,
to get up and walk every day,

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and so I was walking a little bit
and Mike's idea on day 10

00:14:59.776 --> 00:15:02.560
was that we would go a half mile
and walk to a museum

00:15:02.560 --> 00:15:04.621
and then walk around the museum.

00:15:04.621 --> 00:15:05.899
So this is what we did.

00:15:05.899 --> 00:15:07.676
MB: It was a great museum.
PS: It was.

00:15:08.163 --> 00:15:09.778
And you would never know

00:15:09.778 --> 00:15:12.018
that I had had brain surgery
10 days earlier

00:15:12.018 --> 00:15:15.592
unless you peeked
under those big dark glasses,

00:15:15.592 --> 00:15:18.059
and then you might think
that I had an affinity

00:15:18.059 --> 00:15:22.885
for purple eyeshadow on just one eye,
but no one had any idea.

00:15:22.885 --> 00:15:26.037
And 5 hours after this photo was taken

00:15:26.037 --> 00:15:28.437
I was back on a plane to California,

00:15:28.437 --> 00:15:32.633
and 10 days after that,
I was back at work in my office.

00:15:32.633 --> 00:15:37.716
Pain-free, no impairments whatsoever,
driving my car and absolutely fine.

00:15:37.716 --> 00:15:40.941
MB: This is an object that rotates.
So I did 2 things.

00:15:40.941 --> 00:15:46.172
I did 2D resolution images,
and I also did a 3D scan of her head

00:15:46.172 --> 00:15:49.160
and sent that to them,
so they can rotate it,

00:15:49.160 --> 00:15:51.828
zoom in on it, look at it
from different angles.

00:15:51.828 --> 00:15:54.902
This allowed us not to ever
have to go back to Pittsburgh

00:15:54.902 --> 00:15:58.521
because they and all the information
at their fingertips.

00:15:58.521 --> 00:16:02.108
I see huge potential in this:
long distance surgeries

00:16:02.108 --> 00:16:05.749
and long distance postoperative checkups.

00:16:06.650 --> 00:16:12.026
PS: Now, this is a close-up photograph
of both my eyes, 2 months after surgery.

00:16:12.026 --> 00:16:15.772
There's no photoshop,
no make-up, completely natural.

00:16:15.772 --> 00:16:18.595
Can you tell which eye
had a brain tumor removed?

00:16:18.595 --> 00:16:20.903
MB: That one.
PS: You're always wrong.

00:16:20.903 --> 00:16:22.173
(Laughter)

00:16:23.763 --> 00:16:27.811
Now, I am a psychotherapist by profession,
dealing with people

00:16:27.811 --> 00:16:31.415
who are going through difficulties
going through traumas and stress.

00:16:31.415 --> 00:16:34.812
They often ask me,
"How do you cope? What do I do?"

00:16:34.812 --> 00:16:37.972
I like to use a metaphor
of inner archetypes,

00:16:37.972 --> 00:16:42.026
the characters within us
that are through mythology and literature,

00:16:42.026 --> 00:16:44.276
and I always talk about
having an inner healer,

00:16:44.276 --> 00:16:46.784
having an inner warrior,
having an inner magician,

00:16:46.784 --> 00:16:50.388
and how do we bring
those resources up out of ourselves.

00:16:50.388 --> 00:16:53.225
And there are times perhaps
when we're too depleted

00:16:53.225 --> 00:16:55.799
and we have to seek
those resources externally.

00:16:55.799 --> 00:16:57.909
And this is a wonderful thing to do.

00:16:59.169 --> 00:17:05.485
Now, Mike and I obviously dream big,
and I like to think of my life as a book,

00:17:05.802 --> 00:17:08.858
and I am the author of the story.

00:17:09.169 --> 00:17:12.178
It's an adventure story,
and it's not always fun,

00:17:12.178 --> 00:17:14.894
but it's always a very interesting story.

00:17:15.206 --> 00:17:19.477
And I hope at the end of my life
that I can hold up this book and say,

00:17:19.477 --> 00:17:22.460
"I am very happy with the way
this turned out."

00:17:22.460 --> 00:17:26.400
MB: I hope I'm a protagonist in your book
and not an antagonist.

00:17:26.400 --> 00:17:30.075
However, in my book
she is one of the heroes.

00:17:30.461 --> 00:17:33.363
She went through a lot
of pain and suffering.

00:17:33.363 --> 00:17:36.106
I was not going to cry so soon -

00:17:40.567 --> 00:17:42.557
(Applause)

00:17:43.155 --> 00:17:44.475
thank you -

00:17:47.345 --> 00:17:51.554
but she persevered
where other people have not.

00:17:52.444 --> 00:17:55.008
She is a warrior to me.

00:17:55.364 --> 00:18:01.396
But I also want a special note
to the two surgeons, notably Dr. Gardner

00:18:02.044 --> 00:18:05.276
and the technology
and the people behind it.

00:18:06.686 --> 00:18:11.775
CT scans just came out, 
MRIs were still on the drawing board

00:18:12.934 --> 00:18:16.435
that's when her mother fell into a coma.

00:18:18.775 --> 00:18:24.335
They determined that it was a brain tumor
from the CT scan, but it was too late.

00:18:25.358 --> 00:18:29.162
I wonder today
how that story would turn up.

00:18:29.829 --> 00:18:31.128
Thank you.

00:18:31.128 --> 00:18:32.964
(Applause)