美国国家公共电台 NPR Neurosurgeon: McCain's Recovery From Brain Surgery Might Take Weeks

 

ROBERT SIEGEL, HOST:

As we've heard, Senator John McCain is recuperating¹ from neurosurgery. He had a blood clot² removed from over his eye. And to learn more about the kind of surgery he underwent, its risks and what a recuperation might be like, we turn now to Dr. Peter Nakaji, who is director of the neurosurgery residency program at the Barrow Neurological Institute in Phoenix³. Welcome to the program.

PETER NAKAJI: Thank you, Robert.

SIEGEL: And we should say you are not treating Senator McCain. We're just calling you as someone who does this kind of work. Senator McCain's office describes the procedure as a minimally⁴ invasive craniotomy with an eyebrow⁵ incision⁶. What does that mean?

NAKAJI: So there are a lot of ways to get into the head, and some are more invasive, and some are less. And what that really means is that instead of making a large opening in the head and opening a large window through the skull⁷, we make a small one right over the eye through the eyebrow and open a little window and really make a direct route to whatever we need to get to, assuming it's right under that spot. So that's a less-invasive, easier-to-recover-from kind of surgery.

SIEGEL: The blood clot was described as 5 centimeters or about 2 inches. Is that average, relatively⁸ large, small? And what danger would it have posed?

NAKAJI: So as you point out, I'm not a treating physician, so I don't have all of the information. And the real key is 5 centimeters in which direction. So something which is 5 centimeters around is actually pretty big for the frontal lobe⁹, whereas if it's shaped like a pancake, it's not very big. So if the blood is outside the brain, it may not be that impactful. If it's inside, it may or may not be impactful. It really matters a bit more what it's caused by.

SIEGEL: But when you use the word impactful in this case, what kind of impact are you alluding¹⁰ to?

NAKAJI: Well, the left frontal lobe in most people is considered the dominant¹¹ one, meaning it's responsible for a lot of high-level thinking. And if you're a very high-functioning person like he is, a lot of things like judgment¹² and speech can be in that area. Happily, it sounds like he was out quickly and doing very well, so it may not have had a lot of impact. Draining a blood clot that expands like a balloon and then deflates like a balloon sometimes can be recovered from very well.

SIEGEL: Well, obviously much depends on the details here of the blood clot, but how long might it typically take, say, a robust¹³ 80-year-old to recover and be back on the job?

NAKAJI: Yeah, well, fortunately he is a very robust 80-year-old. He's in good shape, and that's where I like to start. I mean reasonably we would send someone home in a day or two, which nowadays for this kind of minimum-invasive neurosurgery is realistic. But I wouldn't counsel anybody to go back to normal activity for at least two weeks. And many people may take even four to six weeks to feel really up to snuff.

SIEGEL: Yeah. We're told that tissue pathology reports are pending¹⁴ within the next several days. What are the answers doctors are looking for there?

NAKAJI: Well, I think what we're all hoping to see for the sake of Senator McCain is that we don't see something underlying¹⁵ like the melanoma that we know is in his history. This is one of the tumors more likely to bleed in the brain. And we'd like to see that that's not it and that it's something else. But you know, pathology - we get it because we don't know what it'll show to be sure.

SIEGEL: After Senator McCain's melanoma, which was over 15 years ago, he said that he was being followed very closely. Would that mean regular scans? And would that mean that something grew to this size even despite his being looked at very recently?

NAKAJI: Yeah, surprisingly we do see bleeding in the brain. You know, the brain is not sensitive to pain, so you can see things expand without really seeing them happen, sometimes to rather alarming sizes. And we do see it all the time. So the fact that they would be looking a little bit more at him because of his history might have mean that they did pick it up and it did get to be very big despite all. But it is hard to say without knowing a bit more about it.

SIEGEL: The only thing I would ask - and I would respect your not answering if you chose. But I'm just curious to hear...

NAKAJI: Yeah.

SIEGEL: ...What you would say was. Not too long ago in his questioning of former FBI Director James Comey, Senator McCain betrayed a confusion in public. He later said, I was up late watching the Diamondbacks baseball game. Is there any link between confused speech or thinking and a blood clot of this size?

NAKAJI: Yeah, I mean I think in this case, it would be speculation¹⁶ because this might well have started after that for all we know. But if you had something in that location, I suppose it's possible - as I say, probably speculation at this point.

SIEGEL: That's Dr. Peter Nakaji, director of the neurosurgery residency program at the Barrow Neurological Institute in Phoenix, Ariz. Thanks for talking with us.

NAKAJI: Thank you.

1 recuperating   

v.恢复（健康、体力等），复原( recuperate的现在分词 )

参考例句：

• He's still recuperating from his operation. 他动了手术，还在恢复。
• He is recuperating from a serious back injury. 他背部受了重伤，目前正在康复中。 来自辞典例句

2 clot   

n.凝块；v.使凝成块

参考例句：

• Platelets are one of the components required to make blood clot.血小板是血液凝固的必须成分之一。
• The patient's blood refused to clot.病人的血液无法凝结。

3 phoenix   

n.凤凰，长生(不死)鸟；引申为重生

参考例句：

• The airline rose like a phoenix from the ashes.这家航空公司又起死回生了。
• The phoenix worship of China is fetish worship not totem adoration.中国凤崇拜是灵物崇拜而非图腾崇拜。

4 minimally   

最低限度地，最低程度地

参考例句：

• Food spoilage problems occur with minimally processed, concentrated frozen citrus products. 食品的变质也发生在轻微加工的、浓缩冷冻的柑橘制品中。
• So, minimally, they are responsible for such actions and omissions. 所以，至少来说，他们要对这样的行为和忽略负责。

5 eyebrow   

n.眉毛，眉

参考例句：

• Her eyebrow is well penciled.她的眉毛画得很好。
• With an eyebrow raised,he seemed divided between surprise and amusement.他一只眉毛扬了扬，似乎既感到吃惊，又觉有趣。

6 incision   

n．切口，切开

参考例句：

• The surgeon made a small incision in the patient's cornea.外科医生在病人的眼角膜上切开一个小口。
• The technique involves making a tiny incision in the skin.这项技术需要在皮肤上切一个小口。

7 skull   

n.头骨；颅骨

参考例句：

• The skull bones fuse between the ages of fifteen and twenty-five.头骨在15至25岁之间长合。
• He fell out of the window and cracked his skull.他从窗子摔了出去，跌裂了颅骨。

8 relatively   

adv.比较...地，相对地

参考例句：

• The rabbit is a relatively recent introduction in Australia.兔子是相对较新引入澳大利亚的物种。
• The operation was relatively painless.手术相对来说不痛。

9 lobe   

n.耳垂，（肺，肝等的）叶

参考例句：

• Tiny electrical sensors are placed on your scalp and on each ear lobe.小电器传感器放置在您的头皮和对每个耳垂。
• The frontal lobe of the brain is responsible for controlling movement.大脑前叶的功能是控制行动。

10 alluding   

提及，暗指( allude的现在分词 )

参考例句：

• He didn't mention your name but I was sure he was alluding to you. 他没提你的名字，但是我确信他是暗指你的。
• But in fact I was alluding to my physical deficiencies. 可我实在是为自己的容貌寒心。

11 dominant   

adj.支配的，统治的；占优势的；显性的；n.主因，要素，主要的人(或物)；显性基因

参考例句：

• The British were formerly dominant in India.英国人从前统治印度。
• She was a dominant figure in the French film industry.她在法国电影界是个举足轻重的人物。

12 judgment   

n.审判；判断力，识别力，看法，意见

参考例句：

• The chairman flatters himself on his judgment of people.主席自认为他审视人比别人高明。
• He's a man of excellent judgment.他眼力过人。

13 robust   

adj.强壮的，强健的，粗野的，需要体力的，浓的

参考例句：

• She is too tall and robust.她个子太高，身体太壮。
• China wants to keep growth robust to reduce poverty and avoid job losses,AP commented.美联社评论道，中国希望保持经济强势增长，以减少贫困和失业状况。

14 pending   

prep.直到，等待…期间；adj.待定的；迫近的

参考例句：

• The lawsuit is still pending in the state court.这案子仍在州法庭等待定夺。
• He knew my examination was pending.他知道我就要考试了。

15 underlying   

adj.在下面的，含蓄的，潜在的

参考例句：

• The underlying theme of the novel is very serious.小说隐含的主题是十分严肃的。
• This word has its underlying meaning.这个单词有它潜在的含义。

16 speculation   

n.思索，沉思；猜测；投机

参考例句：

• Her mind is occupied with speculation.她的头脑忙于思考。
• There is widespread speculation that he is going to resign.人们普遍推测他要辞职。