In Brain We Trust: Virtual Reality, Augmented Reality and the Future of Neurosurgery

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Seven years ago, I hustled to the Museum of Modern Art to test drive a “new” virtual reality (VR) gadget, the Oculus Rift.  The bulky Oculus headset, which resembled a luge helmet, was cabled to a pulsating tower computer like a life support system. As I took my spot in the long line-up, we crushed forward, revved up by an unending series of “ooohs” and “ahhhs”.

Under the influence of the Oculus, one person dropped to her knees as if in a religious trance. Another sounded like he was on a psychedelic trip, shouting “rad” and “outtasight” until he tripped over the cable. When my turn came, an art intern placed the vise-like contraption on my cranium. I felt my brain pressure rise in anticipation, then plummet in disbelief wondering if the Oculus was broken. The 3D visuals were flat, cartoonish and humorless. The graphics were a virtual joke.  Disenchanted, I quickly handed the heavy helmet and tether back.  For the first time since I entered the room, the line was in silence.

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The next year, I begged Google to take my $1500 so that I could try Glass and experience augmented reality (AR).  After a few months though, I realized it was another gag.  Walking around straining to see a stamp size screen in the right upper corner of orange framed goggles made me feel like an uncool Jetsons character. I wrote an unpopular review about Glass, suggesting its only use was for monocular vision training in amblyopia.  Its short battery life was matched by how swiftly I relegated it to basement storage. I kept my set for sentimental reasons.

Recently, in late 2020, after reading a Wired review on the Oculus Quest 2 (OQ2) that claimed it was a revolution in personal VR as the first headset to go wireless, I ordered it. I couldn’t resist the allure of the add-ons that popped up on my screen, like the “supreme” carrying case, ear buds, special face guard, the whole kit. This was all worth it, I told myself, even the unstable silver display stand that collapsed the first time I placed the OQ2 on it, nearly shattering the lens.  The 3D graphics were so rad and outtasight I almost cried, that is until the motion sickness kicked in;and then, I almost vomited. 

Although much improved, the OQ2 is claustrophobic, hot and for the vestibular challenged: nauseating. Because the headset restricts your visual field to what is  displayed on the lens, it transports your brain into an immersive, dizzy place. Pushing past the headaches, I can now saber fight and box virtually, but the luge remains shaky.  My avatar’s friends in Spatial assure us that by next year an updated version will be available, and my OQ2 will be in the basement with its predecessors.

VR and AR are more than a fetish.  Although adopting this technology into neurosurgery will initially be awkward, knowing that our brains will acclimate, I choose to see the IV bag half full. Take it from my avatar who seamlessly traipse in the virtual world, to trust in the brain power that fuels the game engines.  They will build an operating room we cannot yet imagine, where nothing is real but everything is safe. Until then, let’s welcome VR in its current form and pray for a better headset.

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