Violinist has risky surgery, ready to run again

During his 40-year tenure with the Minnesota Orchestra, Roger Frisch has played many of the world's great concert halls, bringing Beethoven and Brahms to life through his 250-year-old Italian violin. Yet the most memorable performance of his career came under the cold spotlight of an operating theater at the Mayo Clinic, before an audience waiting to hear him coax just one note from a cheap, squeaky instrument.

Frisch lay bolted to a table with a hole drilled in his skull, awaiting his cue from a surgeon implanting two electrodes into his brain. Doctors hoped the electrical impulses would calm the uncontrollable tremor in his right hand that threatened his livelihood — and to guide their placement, he had to play during the surgery.

"The margin of error is smaller than a pinhead,'' Frisch said. "And the challenge was to get the tremor down to absolutely zero.''

With one long draw of his bow, Frisch produced two sweet sounds: a clear, steady tone, and a round of applause from a room packed with medical professionals. Sunday, the Plymouth resident will celebrate the neurostimulator that preserved his career by running the TC 10 Mile as one of Medtronic's Global Heroes. Frisch, 63, is among 25 people representing the medical-device maker in the 10 Mile or Sunday's Twin Cities Marathon, demonstrating technologies that have allowed them to continue working, playing and running.

The violinist and concertmaster has run for 30 years and completed two marathons, as well as many 5K and 10K races. Sunday's race will be his first since his surgery in 2010. When he hits the streets with 22,000 others participating in the two events, he won't be focused on speed, but on his ability to persevere — a trait strengthened by his two-year ordeal.

"For a violinist, this was devastating,'' Frisch said. "I've been given a second chance, a second beginning for my career. Not many people have that. And I do not take that for granted.''

Frisch's condition, essential tremor, is believed to be hereditary. It affects him only on his right side, and the shaking is most pronounced when he is playing the violin.

His device is implanted underneath the skin on the right side of his chest, connected by wires to the electrodes placed deep inside his brain. When Frisch activates it — with a control that looks like a garage-door opener — electrical impulses block the faulty signals in his brain that cause the shaking. When he turns it off, the tremors return within seconds, with such severity that he can barely raise the bow to the strings.

The trembling began in 2008 on a concert trip to China. Frisch wrote it off to fatigue from the long flight, but it did not subside. Over the next two years, he hid the condition from his Minnesota Orchestra colleagues as a dozen doctors tried to diagnose its cause.

Risky choice

Neurologists at the Mayo Clinic finally discovered the answer, but the cure would prove trickier.

"They told me I could live with it and do nothing,'' Frisch said. "We could try medication, or as an extreme option, there is surgery, which would mean drilling a hole in my head and putting wires in there. OK, that's not going to happen.

"But the medication turns you pretty much into a zombie, which is not real cool for someone who's basically doing a high-wire act in front of 2,000 people. So I started doing my own research on deep brain surgery, and I thought, 'Maybe this is not so far-fetched.' ''

As his tremors grew progressively worse, Frisch had to contort his body into all manner of odd positions to steady his bow hand as much as possible. It became clear that surgery would be necessary to save his career, but success was not guaranteed. In addition to the general risks of brain surgery, the procedure typically reduced but did not eliminate tremors — which would not be good enough.

Mayo neurosurgeon Dr. Kendall Lee thought Frisch would be the ideal candidate for a new technique. His medical team bought a $75 violin on eBay and connected it to computers; when Frisch played, it would guide the surgeon to place the electrodes in just the right spot.

Sweet music

Because the brain has no pain receptors, Frisch did not have to be anesthetized. With Frisch's head in a halo, bolted to the table so it would not move, Lee inserted the first wire and saw the tremors subside. Then he placed the second. "That violin sounded like a sick mosquito,'' Frisch said. "But the tremor was gone, like magic.''

Frisch's wife, Michele, principal flute for the Minnesota Opera, rejoiced as well.

"The idea of surgery was frightening,'' she said. "But the result is a miracle, and I don't use that word lightly.''

To prepare for the TC 10 Mile, Frisch has been running 20 to 25 miles a week. His time on the roads and trails has long provided an escape from his busy schedule of performing and teaching. Sunday, running will remind him of how dear the musical life is, and how grateful he is to play on.

"I am really happy to get the story out, if it can help one person or five people or 10 people to know there is life beyond this [condition],'' he said. "There is an option out there.''