Awake: A Journey Inside the Human Brain and the Art of Neurosurgery
“Even though its common knowledge these days, it never ceases to amaze me that all the richness of our mental life – all our feelings, our emotions, our thoughts, our ambitions, our love life, our religious sentiments and even what each of us regards us his own intimate private self – is simply the activity of these little specks of jelly in your head, in your brain. There is nothing else” – Vilayanur S. Ramachandran
Awake is the story of the neurosurgeon Christian Brogna and his most famous operation: a ten-hour brain surgery performed while the patient was awake and playing the saxophone.
But the book is much more than that.
The operation itself serves as a filo conduttore, a narrative thread that holds together a series of flashbacks from Dr. Brogna’s life: his medical studies, his discovery of awake surgery, his determination to travel abroad to learn from the best, and eventually his return to bring this technique to Italy. In an era full of doubt and uncertainty, his story feels like a reminder that passion, curiosity, and courage still matter.
Throughout the book, Dr. Brogna explains why awake surgery can achieve things that are impossible when the patient is asleep. Being awake allows the surgical team to stimulate specific areas of the brain with electrodes and identify which regions support essential functions like language, memory, or movement, ensuring that these are preserved.
One of the most fascinating phenomenons he talks about is “acute neuroplasticity”: the brain’s ability to form new connections in nearby areas to support the same function through subtle and relatively fast local adjustments. During awake surgery, these dynamics can be monitored in real time, allowing the surgeon to remove a tumor safely.
Dr. Brogna also emphasizes how awake surgery allows to take into account the desires and essence of the person. In the book, the saxophonist undergoing surgery is a musician who could not imagine life without playing. He also describes the surgery of a translator for whom speaking multiple languages was everything. During awake surgery, the team actively engages with patients, having them play, speak, or switch languages, to ensure those abilities remain intact.
The message is clear: the goal of awake surgery is to place the patient first, safeguarding not just survival but the abilities that define who they are and the essence of their life.
Awake is a captivating read for everyone and shows what can be achieved when science and empathy work hand in hand.
For now available only in Italian, but I think and hope it will soon be translated into other languages.
📖 Resource:
Awake. Il magnifico viaggio nella mente umana di un neurochirurgo che opera i suoi pazienti da svegli. Christian Brogna e Claudia Zanella. 2025.
