Mexico City.- Venturing into the deep and intricate recesses of an organ as complex as the human brain would lead even the most skilled explorer astray.
From anatomical dissection, one of the oldest resources in medical education, historically attempts have been made to better understand those convoluted paths and territories, which now the neurosurgeon and expert in anatomical photography Daniel Ballesteros managed to map in an image titled “The Blue Brain.” .
“It is a very high definition map of the brain. That is the best description,” says in a telephone interview the Lasallian doctor with a specialty in oncological neurosurgery from the UNAM, author of this fascinating series of captures that now adorn the National Institute of Neurology and Manuel Velasco Suárez Neurosurgery (INNNMVS).
Unveiled at the end of February, within the framework of the 60th anniversary of said institution, where Ballesteros (Mexico City, 1991) works in the Laboratory of Experimental Surgery, the unique print shows a real brain sectioned into 17 coronal sections – with a face anterior and a posterior one -, each of which was photographed a hundred times.
“So, that image is made up of 1,700 photographs. Obviously, then all the cuts were put together in the order in which the brain goes so that this great mural was made,” says the INNNMVS doctor about this work made with the stacking technique. of focus, or focus stacking, and that if deployed each of the shots would reach a dimension of 5 meters long by 70 meters high.
“If we stacked each of these slices, a complete brain would be made,” adds the specialist. “It is a large format so that all the detail can be appreciated; if the photograph were smaller, it would be more difficult for you to identify certain things.”
Regarding the Prussian blue hue with which the organ was portrayed, it is not a filter, but is the product of a procedure called “Mulligan staining”, a series of chemical reactions to dye the gray substance and be able to differentiate it from the white , explains Ballesteros.
This allows us to distinguish, the doctor illustrates, brain structures such as the thalamus, the sensory distribution center of the entire body, or some that are found deep in the white matter of the brain, such as the basal ganglia – or nuclei -: the caudate nucleus. , the putamen and the globus pallidus.
“The different nuclei have different functions, and it is very important to be able to locate them,” says Ballesteros, not only referring to the need for doctors to know the anatomical substrate of brain function, but also to the precision with which procedures such as deep brain stimulation surgery, which improves the condition of patients with Parkinson's by placing millimeter electrodes in those basal ganglia.
“If you see a brain without this stain, it is much more difficult to identify certain areas,” adds the doctor, who traveled to Argentina to learn this procedure with neurosurgeon Matías Baldoncini, director of the Microsurgical Neuroanatomy Laboratory at the University of Buenos Aires.
“That's where we did that magnum opus; it was created there, and we finished it here.”
That was during the months in which the Qatar 2022 World Cup was being held, where Lionel Messi and the entire Scaloneta – the Argentine team led by Lionel Scaloni – were crowned champions, which was never witnessed by that Argentine man between 30 and 40 years old. who owned the organ portrayed in “The Blue Brain.”
The author of this anatomical photograph has referred to it as a tribute to the kindness of that man's relatives, who allowed his brain to be preserved so that neuroscience specialists can expand their knowledge about this organ that continues to be the subject of numerous studies to be able to decipher it. completeness.
“The fact that we can study the brain anatomically allows us to better understand this very complex situation of how our brain is connected (approach of a new discipline known as connectomics). The basis is knowing anatomy, anatomy that becomes increasingly more precise with help of technology.
“We can use this type of high-definition photographs to make maps, find coincidences between one brain and another, and see, for example, in the brain of a sick patient versus that of a healthy one, what differences there may be anatomically” , highlights the Mexican neurosurgeon.
With this as motivation, a smiling Ballesteros, accompanied by his family, his fiancée and INNNMVS directors, donated his image to the entity that he defines as “the highest house of study of neurosciences in Latin America.”
And the invitation to explore such abysmal and enigmatic paths remains open to all adventurers.
Passion for the camera and the body
Recognizing himself as passionate about photography, Ballesteros says that even before studying medicine he spent a couple of years taking photos with a teacher at La Salle University.
An additional passion would be added to this when, still as a resident doctor, he began to go to the laboratory to dissect brains to learn about their anatomy; “Especially us who are surgeons, because we have to know what we are operating on, where we are operating on it and how we are operating on it,” highlights the neurosurgeon.
“That was my first approach to doing brain dissection, it was something that I was very passionate about. When the pandemic hit there was a lot of problem for us to be able to operate on patients, due to the conversion of hospitals. That led me to return to the laboratory and do dissection with more precision.
Doubling down on the photographic work, it was then that Photobrain was born, an anatomical photography project by Ballesteros that people can follow through their Instagram and brain.
“We have had the opportunity to take high-definition photographs of cardiopulmonary blocks, that is, of both lungs with a heart; of hearts, of kidneys, even of an aborted fetus. Cytological photographs have also been taken to see sections where the neurons, the layers of the brain.
“The reality is that this can be applied to any medical specialty,” says the expert, with the pleasure of having reconciled his two vocations. “I can say that I was fortunate that two things that I am passionate about could come together. Let's say that one feeds the other.”
Among its objectives is to create an atlas of the human brain, aimed at both medical professionals and people without such training, and eventually extend it to the entire body. Make reliable snapshots of each organ and system for a better visualization than diagrams and illustrations provide.
“I can tell you that the diagrams that come in neuroanatomy books are a little far from what it really is. And when you see a real brain you say: 'In the tower! What is this? How am I going?' to orient if everything looks the same?' It looks like a coral where everything is spirals and grooves.
“I feel that that is what I am so passionate about, that you allow yourself to marvel at how incredibly complex, how incredibly beautiful the human body is, and how aesthetically beautiful the brain is,” estimates Ballesteros, who through his lens seeks to involve others in this same contemplation: “sharing those types of things that only very few of us have the privilege of seeing and touching.”
'A way to transcend'
In addition to the medical, scientific and artistic value of “The Blue Brain”, at the heart of this project stands out the importance of organ donation not only for transplants, but also for educational and research purposes.
“Unfortunately, one cannot donate a brain (to another person) because that is impossible, at least right now, but at least for research it can help us find new cures, break certain paradigms and open doors for that brain helps to perhaps cure a disease in the future,” Ballesteros emphasizes.
And despite the advance of the donation culture in the country, the doctor says that it matters little whether one has a donor credential – which can be obtained at www.dv.cenatra.salud.gob.mx/registrar.php -, if Such will is not expressed during life to family members so that they can respect it once one has died.
“It depends on the person wanting it, having expressed it in their life and, above all, the people who are going to make the final decision allowing it. Here in Mexico I can have my donor credential, but if my family member does not want to donate, my organs are going to waste. And I think that's terrible.”
According to the INNNMVS neurosurgeon, in addition to bad legislation, religious beliefs prevail in the country due to which family members usually deny the donation of a person's organs; “the fact that a body is not complete, obviously it is something that disturbs many people. They say: 'How do you think?! If they are going to disembowel it, it will no longer be able to reach heaven, or else He will not be able to be reborn or reincarnated, etc.,” he exemplifies.
“There are many ideas that are difficult to fight against, although, obviously, all religious beliefs are respected.
“But I don't think there is a greater privilege as a human being than being able to give the life of up to nine people for donating something that one is no longer going to use,” Ballesteros emphasizes. “From that to being eaten by worms or being incinerated in an oven… I think it's a way to transcend others.”
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