When he’s getting brain surgery, Taylor Hartsfield isn’t a very good singer.
As he mumbled the words to the 1980s Journey hit “Don’t Stop Believing,” the nurses and surgery staff laughed and gently ribbed him.
“You would not win ‘American Idol,’ dude,” said his surgeon, Dr. Ricardo Komotar.
In mid-April, Hartsfield, 30, underwent a craniotomy to remove a fist-sized brain tumor — while he was awake. The tumor was located near the part of the brain that controls movement and language, so surgeons had to keep him singing, talking, counting and wiggling his arms and legs throughout the hours-long procedure at the University of Miami Hospital to make sure they weren’t damaging his brain.
This complex surgery isn’t new, but it’s only performed at select medical centers with dedicated brain tumor centers.
A few weeks later, Hartsfield was back in Komotar’s office with his wife, Davina, and their two children. He dipped his head and parted his hair to show a small, neat scar — the only sign that the athletic, grinning real-estate agent had ever been sick.
At first, when Hartsfield started feeling the symptoms of the tumor, his doctor chalked them up to situational anxiety. Hartsfield didn’t want to work out or talk to friends or leave the house anymore. He was snappish and easily irritated. And sometimes he talked about “dumb stuff,” like how the sky should be green instead of blue.
Looking back, Davina calls this alternate personality “Tumor Taylor,” even though the couple didn’t know that was the cause at the time. It wasn’t until the day their son, Rocco, was due, and Hartsfield’s car broke down that he had a grand mal seizure as the tow truck pulled up. He woke up in a hospital in Naples, where the couple lives, almost a full day later.
“The scariest part was waking up in the ICU,” he said. “I thought, ‘Oh my God, you’re going to tell me I have like six days to live.’ ”
That wasn’t the case. Doctors sent Hartsfield from Naples to see Komotar at UM, where he helms the university’s Brain Tumor Initiative. Three days after his seizure, Hartsfield’s son was born. The next day, he was in surgery and telling his doctors about his dream concert (Phil Collins, Huey Lewis and the News, and Journey).
In Komotar’s office weeks later, his wife ticked off all the old habits her husband has picked back up: exercising, socializing and even cleaning the whole apartment — two days after surgery.
“I think you’re back to your old self,” Davina said, smiling at her husband.
Hartsfield credits his rapid recovery (and how quickly he was seen by a doctor) to the staff at UM’s Brain Tumor Initiative, which encompasses the departments of neurosurgery, neurology and radiation oncology from UM hospital, Jackson Memorial Hospital and Sylvester Comprehensive Cancer Center.
That kind of smooth and speedy recovery is exactly the experience Dr. Komotar and his team shoot for.
Komotar, 40, was recruited to UM in 2011 from New York’s Memorial Sloan-Kettering Cancer Center to build “the best brain tumor program in the world.”
“I know it sounds crazy, but I think it’s very achievable,” he said.
Komotar is wiry and bursting with energy, especially when he talks about the growth his center has seen. From the time he started to 2016, doctors working with the initiative quadrupled the amount of surgeries to about 1,000. More than 300 of the surgeries were the work of internationally renowned surgeons Dr. Jacques Morcos and Dr. Roberto Heros.
At the nearby Baptist Health Neuroscience Center, one doctor handled 96 brain surgeries in 2016.
The walls of his UM office are lined with degrees from the elite class of brain tumor centers he wants to join: Duke University, Columbia University Medical Center, Johns Hopkins University and Sloan-Kettering.
Komotar doesn’t just adopt the elements he admires from other organizations, he also recruits their doctors, including Dr. Macarena Delafuente, a medical neurooncologist from Sloan-Kettering; Dr. Antonio Omuro, an internationally known brain tumor doctor from Sloan-Kettering, and neuropathologist Dr. Hugh Gultekin from Oregon Health and Science University.
“A brain tumor center is so much more than the healthcare. It’s the research, it’s the training, it’s the clinical trials,” Komotar said.
His team of researchers — Dr. Nori Kasahara and Nagi Ayad — study solutions ranging from immunotherapy to new drug cocktails.
After tumors are surgically removed, Ayad analyzes their genetic makeup and drug sensitivity to figure out how to stop them from growing back. He sometimes even implants part of the tumors in mice brains to study symptoms, growth and cures.
One of the surgeons from the Jackson Memorial wing of the program, Dr. Mike Ivan, recently made headlines when his team removed an egg-sized tumor from a pregnant woman’s brain, restoring her sight.
Although that woman was from Miami Beach, the center serves patients from throughout the Caribbean, Latin America and throughout Florida.
Komotar said the initiative makes changes based on patient input — like the creation of a support group. One patient, who lost her husband, felt there was a need for a patient coordinator at the initiative and funded the position. Eileen Torres, the coordinator, works as the go-between for loved ones and doctors for what Komotar called “one of the scariest diagnoses you could have on the planet.”
If Torres isn’t the one making the call, text or email to patients and doctors, it’s usually Komotar.
“This thing is always on,” he motioned to his buzzing phone.
Hartsfield’s wife, Davina, said the text updates as her husband underwent surgery made the experience less stressful.
Inside the operating room, Hartsfield had a much better experience than his worried wife. With a little bit of local anesthesia and a great soundtrack, he didn’t remember much of the surgery, which he compared to the trippy Star Gate scene from the end of “2001: A Space Odyssey.”
“It was actually kind of fun,” he said.