News conference following first human surgery with a free-electron laser beam

A news conference was held on Monday, December 20th, 1999 on the Vanderbilt campus three days after the first human surgery using a free-electron laser. Following are excerpts from the comments of Virginia Whitaker, the patient who had a tumor removed from her brain, and Michael Copeland, the neurosurgeon who performed the operation.

Mrs. Whitaker:

I feel fine, I feel good, and I love these people. I have so much confidence in them. I knew, about 30 minutes after I talked to this man that I would do this. And I just hope it does help other people and other doctors.

Well, it feels like I am looking outside on someone else. I have never been anybody important, you know, and for me to be sitting here talking to you people, it doesn't seem like it is me. I am watching someone else do this, but I am glad it is me.

I was never scared, before God, I wasn't. I was apprehensive, because I had a brother who had to have brain surgery twice, but it was from an injury in the Navy, but no I really wasn't afraid. I knew [Dr. Copeland] would save my life. He wasn't going to let me die, was he?

Do you want to see my head? I look like a real goon.

There is only one bad thing about [the successful operation]: I can't blame every mistake I make on the tumor any more!

Michael Copeland:

The unique thing about the FEL here, is that unlike conventional surgical lasers which typically only have one static wavelength of light that they produce, the FEL has essentially an infinite number of wavelengths of light that it can output. -So really it was the only laser that could be used for this operation. However, the trick was figuring out, -out of that infinite number of wavelengths which one do you choose as the right wavelength. So the hard part was figuring out that 6.45 micron radiation minimizes collateral terminal injury, in other words, the tissue right next to your incision has the least amount of injury to it….

We feel this is a break-through, in that we can vaporize tissue and have almost no ill effects on the tissue immediately next to it. So the advantage of this laser, when it is fully utilized and fully exploited, is that we can make incisions in normal brain infrastructures or remove structures such as tumors … without injuring the adjacent brain. In some parts of the brain a millimeter is like a mile and can make the difference between doing well as a patient or having a devastating injury. It may seem like just a millimeter, but in the brain stemwire and speech cortex, that is a mile.

The scalpel has a lot of mechanical problems. The brain is a lot like jello really and if you have ever tried to cut jello with a knife, you just can't do it without tearing it up. The other tool that we have at our disposal is bipolar forceps, which create an electrical charge between the tips of the forceps and create heat. That's four millimeters of thermal injury to the brain. We have conventional lasers, which also produce collateral thermal injury, so there is either mechanical injury or heat injury with all the incision tools that we have now. So [the FEL] adds another weapon to our armamentarium.

That doesn't mean that everyone will need to have an FEL. What we are trying to establish is what wave length has properties that minimize collateral thermal injury. Once we have established that, then the industry can create, hopefully, a tabletop laser that cranks out 6.45 micron radiation and that can be an inexpensive way for everyone to take advantage of it.

We couldn't have had a nicer person to start with. We are trained in medical school to keep an arm's distance from your patients because sometimes you make an unpopular decision and you don't want to get clouded...This was such a delightful woman that it has been real easy.