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Notebook Medicine

A steady hand

Roger Frisch (Christopher Loren Ewers/PBS)

Medicine

A steady hand

Innovative surgery stopped a violinist’s tremor, allowing him to continue in his calling

Roger Frisch had it all. A lengthy career as violinist and associate concert master of the acclaimed Minnesota Orchestra. A supportive, talented wife, Michele, principal flutist of the Minnesota Opera. Three adult children successfully launched. A fulfilling teaching post at a local Christian college.

But in 2007, at age 56, Frisch’s right arm started involuntarily quivering on a music ministry trip to China. He recalls, “It came on quickly. It progressed quickly. Real panic set in.”

Two years of deteriorating steadiness and more than a dozen doctors later culminated in a visit to neurologist Joseph Matsumoto at the Mayo Clinic in Rochester, Minn. Within 30 minutes, Matsumoto diagnosed him with essential tremor, a benign but progressive neurological disorder that could eventually render professional performing impossible. 

When medication didn’t work, Frisch knew any hope to extend his career entailed the radical next step: brain surgery. 

Renowned Mayo neurosurgeon, Dr. Kendall Lee, told me he’d been in Asia and saw a Japanese surgeon stop a patient’s tremors by lesioning, or damaging, part of the brain. Lee wanted to stop Frisch’s shaking by implanting electrodes to interrupt the tremor-causing impulses without harming tissue, a technique called deep brain stimulation.

Frisch recounts how in December 2009 he lay strapped to the operating table, his head propped up and immobilized by a bolted-on halo. He remained awake for the entire surgery, violin and bow in hand. 

The surgical team planned to measure precisely Frisch’s tremors while he played by using an oscilloscope attached to a first-ever “accelerometer” that Mayo engineers had innovatively created from inner workings of a Wii game accessory toggled to a $75 violin from eBay.

Lee drilled a small hole in Frisch’s skull and manipulated a lead with an electrode down into the correct region of the thalamus. He directed Frisch to draw his bow across the strings. Frisch complied, trembling noticeably less, but not enough to play smoothly.

After checking with Frisch, Lee in a surgical first inserted a second electrode on the same side of his brain. Frisch again drew his bow and pulled a long, steady, beautiful note, and then another. The tremor had disappeared.

Mayo Clinic video

Frisch plays through his brain surgery. (Mayo Clinic video)

Michele Frisch recalls that day: “We had a huge prayer team all over, but I had lots of time to think about what could go wrong.” 

The revolutionary surgery included implanting a controllable pulse generator under his collarbone. It allowed Frisch to play nine more years with the orchestra. He and Michele have taken numerous overseas ministry trips, especially to Ukraine, performing and sharing their faith.

Frisch says, “Performing gives us credibility to speak.” He paraphrases what Itzhak Perlman said: “‘I’m just a dumb violinist. If I want people to listen to me, I have to play first.’” Frisch considers playing beautiful music his spiritual calling card to share Christ. 

Last August, after 44 years with the Minnesota Orchestra, the same length as his marriage, Frisch retired. He anticipates God presenting more music ministry opportunities overseas and perhaps in the Twin Cities. Michele likes to cite Olympic runner Eric Liddell’s quote: “‘I feel God’s pleasure when I run.’ That’s how Roger and I feel. … We feel God’s pleasure when we play.”