The voice of the 75-year-old patient passionately narrating a scene from Pradeep Ranganathan’s 2025 hit ‘Dude’ cuts through the silence of the SIMS Hospital operating room. But the surgeon carefully working on sections of his skull does not for a moment seem perturbed.“It’s a standard procedure to keep some patients awake during tumour resection surgeries and quiz them, asking them to name days of the week or months, recall family members’ names or identify objects from pictures. But this can exhaust doctors and patients. It’s easier to get them to talk about movies they’ve seen,” says SIMS senior neurosurgeon Dr K R Suresh Babu. “We tested movie narration during 38 awake brain surgeries over three years, and published the results as a letter to the editor in ‘Clinical Neurophysiology Practice’.”In nine cases — nearly 25% — narration spotted word-finding pauses, character-naming failures, narrative tangents or grammar slips, prompting refined tumour resection near eloquent zones.Dr Babu says that doctors use electrical stimulation on exposed brain areas while patients perform tasks. If stimulation disrupts a task, such as speech halting or stammering, it signals an impact on the zone controlling language, motor skills, or sensation. “The process is tailored to each patient and procedure. Depending on where the tumour lies and what stage the surgery has reached, we may switch between testing language and monitoring motor function.” We get musicians to sing or play an instrument during surgery, children to play video games to map motor skills, coordination and dexterity, says intraoperative neurophysiologist Dr Nishanth Sampath. “But we found that most people are shy about singing but are at ease talking about movies.”Unlike isolated tasks such as counting to 10, narration demands real-time integration of comprehension, memory, sequencing and expressive language through dialogue. “For instance, when they count numbers or say alphabets, we don’t know if their ability to retain intonations or connect incidents,” says Dr Babu.Guided story retelling of a favourite blockbuster reveals subtle language slips, allowing doctors to screen fluency. “It helps us see if the surgery is affecting their ability to select, organise info, or adapt. It tests not just speech but social communication and cognition,” says Dr Sampath.The process did not work in four patients because they weren’t familiar with movies, were anxious or spoke only a few sentences. Doctors used traditional methods to minimise risks for these patients, says Dr Sampath.
