Guitarist’s awake craniotomy video strikes a chord with drummer facing similar diagnosis

When Adrian Rivas needed brain surgery, his doctors suggested he not only be awake in the middle of his procedure but that he also play the drums while they removed the tumor. Adrian was stunned. 

“My initial thought was ‘I’m not going to agree to do this’ because I just can’t imagine how it would be possible for somebody to be awake during that kind of procedure,” Adrian says.  

He had astrocytoma, a type of brain tumor that grows from cells in the nervous system.  

“I didn’t have any major symptoms or family history,” Adrian says of his unexpected diagnosis. “I went for a run and, when I got out of the shower, I had a seizure.”

Seizures can be a sign that a tumor is growing in a critical location. In Adrian’s case, the tumor was in the part of the brain that controls motor function and, more importantly, his hands. 

Adrian works from home and relies on his fingers to type, so keeping this function was essential for his job. And, as an avid drummer since age 12, he didn’t want to lose his ability to play. There is no known musical part of the brain, so that made it difficult to pinpoint exactly how surgery would affect it.  

In cases where patients like Adrian have tumors near parts of the brain that control speech and movement, doctors suggest an awake craniotomy. This is where the patient is woken up during surgery to help locate and test critical functions in real-time to reduce the risk of neurological injuries and paralysis.  

Now, neurosurgeon Sujit Prabhu, M.D., wanted Adrian to wake up mid-surgery so he could play his drums.  

This had only been done once before at MD Anderson. And the previous patient’s story would come to change Adrian’s mind.  

MD Anderson’s first awake craniotomy with an acoustic guitar

In 2018, Robert Alvarez played his guitar in the operating room while undergoing brain surgery. 

Up until that day, none of the 80 to 90 awake craniotomies performed at MD Anderson each year had included a musical instrument in the operating room. But Prabhu had wanted to try it with Robert to map out parts of his brain as he and his team of neurosurgeons probed the areas surrounding the tumor while Robert played his guitar. Like Adrian, Robert had wanted to ensure he could continue to play music after his brain surgery.  

The surgery went smoothly, and Robert’s musical ability remained intact.

A change of tune about an awake craniotomy

At the time, MD Anderson had produced a YouTube video chronicling Robert’s surgery, which has since received more than 27 million views. Perhaps one of the most important was Adrian’s.  

When Prabhu shared the video with Adrian, it struck a chord. He saw the surgery through the eyes of someone with a similar passion for music and a similar fear of losing that ability. That made going through with his own awake craniotomy an easy decision.  

“I saw how easy it was and how everything was well planned out,” Adrian says. “Robert seemed calm and comfortable, and Dr. Prabhu made the music a priority.” 

On Sept. 1, 2022, Adrian underwent the 6-hour surgery.

“As soon as I got there, I didn’t feel a thing,” he recalls. “I woke up and had the practice pad in front of me, and it just felt like a regular day.” 

The neurosurgery team paid close attention to Adrian’s rhythms while removing the tumor. 

Paying it forward after an awake craniotomy

More than a year after surgery, Adrian is doing well. He’s working remotely and has set up a recording studio in his home. He hopes his story will inspire others.  

“I’m just hoping my case can help improve surgeries and also help somebody else that might be going through this,” says Adrian, who often gets asked what it was like to play during brain surgery. “It’s not until these functions are gone that you realize it could all be taken away. Robert’s story certainly helped me, and I’d like to pay it forward. That’s really the goal for me.”  

And Robert is grateful his experience has helped improve people’s lives. “It’s hard and it’s scary,” he says. “But music is my soul, and I’m glad my experience motivates people like Adrian to do something positive.”  

A harmonious meeting

Now fully recovered from their awake craniotomies, Adrian and Robert recently met in person. It gave Adrian a chance to get to know the man who made an enormous impact on his decision. 

It was also a chance for both of them to thank the care team who helped preserve their talents.  

When they met on Feb. 13, 2024, Adrian and Robert had a jam session at MD Anderson. For Prabhu and the entire neurosurgery team, seeing Robert and Adrian perform together reinforced the importance of their work.  

“It’s wonderful to see them thriving and persevering in their passions. It brings me back to why we’re doing this and whom we’re helping,” Prabhu says. “These guys are my rock stars.”  

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