Neurosurgeon Would “Make the Same Call” for His Own Family

In March of 2022, then 28-year-old Tomoya Ogura, an Oakland-based software engineer, started having pain on the left side of his face – in his cheek, sinuses, and lower eyelids. Sometimes his face burned or felt numb. Occasionally, the pain was sudden and sharp and would shoot like a bolt of lightning from deep inside his head out through his face.

At first, the pain was intermittent. It would flare one day and then remit for several weeks. But by August, he felt it every day. It kept him up at night and stole his focus at work. During stressful moments in his life, he often turned to his piano for solace. He’d sit on the bench at the electric keyboard in his bedroom and move his fingers across the notes of Chopin’s Nocturne Op. 9 No. 2 - his go-to for peace and calm ever since he’d learned how to play it as a child.

But now, there was no comfort. Even while playing, he couldn’t escape from the pain. 

So he sought help. His primary care doctor prescribed pain meds, though they didn’t help much. After a month and a half of trial and error, his doctor ordered an MRI. Ogura knew that something was going on, but he never expected the results he got. He had a brain tumor pressing on his trigeminal nerve, the cranial nerve that provides sensation to the face. He still vividly recalls the difficulty of processing the news in the doctor's office.

“I had always been a generally healthy 20-something,” Ogura said. “I never smoked. I didn’t drink that much. It was really a surprise. In some ways, there was a twisted sense of relief for visibly seeing what was causing the pain for the past few months. And yet, I was washed over with feelings of uncertainty for the treatment options. I really had trouble fully absorbing all the details my doctor was sharing.”

Ogura then started researching tumor surgeons and found Michael Lim, MD, Chair of Neurosurgery.

Over Zoom, Lim proposed a unique approach to get at the tumor by going around the outside of the brain. And that wasn’t the only assurance Lim provided, Ogura said.

“Even though it was just over a Zoom call, I could tell that he really cared about every patient,” Ogura said. “There was something special about that.”

Ogura knew he wanted to have his surgery at Stanford, but there was a catch. The medical center wasn’t in-network with his health plan. If he wanted to receive his care at Stanford, he’d have to change health plans at the end of the year and schedule the procedure for early the following year. Given how much the pain had progressed in a short amount of time, he was hesitant to put off the surgery for so long.

“It would be a leap of faith that I was a bit afraid to take,” Ogura said. But again, Lim reassured him.

“He said he was very comfortable waiting and that he’d make the exact same call with his own loved ones. He treats his patients as if they were in his family, and that really stood out.” After his consultation with Lim, he took the leap of faith and scheduled his surgery for February 2023. 

The tumor was located almost in the middle of his brain. Lim’s approach was to get to the tumor through a corridor in front of the brain through a skull base approach. This approach created a narrow corridor behind the eye to remove the tumor with a microscope and image guidance. This helped avoid exposing the brain.

“Once we got into it, the nuance was that we had to figure out where the fibers of the trigeminal nerve were going over the nerve – to preserve it both for chewing and to save as much sensory fiber as possible,” Lim said.

Avoiding the critical nerve fibers, Lim used a device that deploys ultrasonic waves to break up the tumor and remove it from the brain with gentle suction.

“We can essentially core out the tumor with minimal disruption to the neighboring structures,” Lim said. “We got a gross total resection.”

It took a whole team to achieve this surgical success. Throughout his entire experience, he felt the support of the care team at Stanford.

“In addition to the surgical expertise we provide, I’m proud of our team and facility,” Lim said. “As soon as patients walk into our facility, they get extraordinary care and attention. We have a team that not only provides compassionate care but also are

trained to detect and notice issues quickly to minimize risks of complications. Hence our patients feel like they are in a safe place.” 

By the next day, Ogura was up and walking around the hospital. On day three, he was discharged. He was ecstatic for he could chew, the majority of his sensation in his face was preserved, most importantly, the pain was gone!

"My life is pretty much back to normal, except for one quirky detail—I can't feel my left nostril anymore. So, sometimes when I eat spicy food, my nose runs and I don't notice. My girlfriend has to point it out," he chuckled. "But considering the pain I endured before, this is a minor detail."

“Through this entire experience, I've gained a deeper sense of empathy for others. During moments of pain, I'd look in the mirror and see no visible changes on the outside. It made me realize that we often don't know what others are going through internally each day. As I share my story, I've heard from many people about their loved ones' battles with brain tumors or serious medical conditions. It makes me think those who may appear distant or irritable outwardly, could be grappling with unseen challenges. I am immensely grateful for the successful treatment I received and for encountering Dr. Lim and his team.”

Over the next few weeks, Ogura recovered at home with his family and girlfriend close by to take care of him when he needed it. He was playing his keyboard in no time. As he took a seat on the bench, he recalled the many sleepless nights he’d spent in pain in this same room over the last six months. Instinctively, his fingers found the notes of Chopin’s Nocturne Op. 9 No. 2.

“In just a couple notes, I felt the calm. Not having that pain inside my head – it gave me so much clarity.” –Sonya Collins