Your next job: Brain-computer interface surgeon


There's a lot to like about brain-computer interfaces, those sci-fi-sounding devices that burrow into your skull and convert nerve signals into software commands. Experimental BCIs help paralyzed people to communicate, use the Internet, and move prostheses. In recent years, devices have also become wireless. If mind-reading computers become part of everyday life, we will need doctors to install the tiny electrodes and transmitters that make them work. So if you have steady hands and don't mind a little blood, becoming a BCI surgeon may be a job for you.

Shahram MajidiA neurosurgeon at New York's Mount Sinai Hospital began work in clinical trials for a BCI called StentRode in 2022. (That's a “stent” in the form of a tube that often sits inside a vein or artery.) Here he talks about a not-so-distant future where he's performing hundreds of similar procedures per year.

brain-computer interface Have been in existence for a few decades, and various types of implants now exist. Some have electrodes attached to your brain with wires coming out of your head and connecting to a computer. I think it's great as a proof of concept, but it requires an engineer sitting there and a big computer next to you all the time. You can't just use it in your bedroom. The beauty of a BCI like Stentrode, which I've worked with, is that nothing is coming out of your brain. The electrodes are in the blood vessels next to the brain, and you get there through the patient's throat. The receiver is placed under the skin in their chest and connected to a device that decodes brain signals via Bluetooth. I think this is the future.

This is a minimally invasive surgery. You don't need to open the skull. You don't have to violate the anatomy of the brain. Placing a stent in a blood vessel in the brain is something I've done thousands of times for other procedures, but this time I'm implanting a device that will record specific signals coming from a very specific location in the brain. In order for it to work properly, I had to make the most precise delivery of the implant that I have ever learned. From the time we enter the room to the time we complete the surgery and check the devices, it usually takes less than three hours.

The patients we enroll in these trials are severely disabled. They are paralyzed by diseases like ALS. They are tied to the bed; Even getting them to the hospital can be a huge task. So I'm able to visit all of my BCI patients in their homes to talk about the device and how it works. This is an exciting moment for patients and their families, but you also need to set expectations.

The surgical planning that occurs in BCI implantation is very sophisticated compared to other daily procedures I perform as a neurosurgeon. Before surgery, my team and I practice on a model to make sure we understand all the steps and protocols. In fact, the scope for mistakes is very narrow. (Neuralink is building robots to install its BCIs, but I'm not worried about robots coming to do my work. You'll always need human surgeons and scientists to advance the field and perform precise procedures.)