Dr. Beverley Orser was featured in the Winter 2023 edition of UofTMed Magazine. The following excerpt was adapted from a piece written by Lauren Vogel. We encourage you to read the original article.
Forgetful. Distracted. Dazed. Struggling to find words. Trapped in a constant state of déjà vu. A brain in slow motion. A head stuffed with rags.
People with brain fog vividly describe a common constellation of debilitating impairments in memory and executive function — the basic mental processes required to prioritize, focus, and follow through on thoughts and tasks. But brain fog isn’t a clinical diagnosis as much as a colloquial catch-all for the cognitive difficulties that cut across a wide range of conditions — from cancer to long COVID. And despite growing recognition, these cognitive difficulties can be poorly understood by clinicians who lack adequate testing or treatments to tackle the problem.
“In patients with breathlessness, we might look to the lungs, or with a painful calf to blood clotting,” writes Laura McWhirter, a consultant neuropsychiatrist and clinical research fellow at the University of Edinburgh, in a 2023 study. “But where in the brain might we look for the source of a fog?”
Research at the Temerty Faculty of Medicine is cutting through the haze — from pioneering work tracing the cognitive fallout of anesthesia and chemotherapy to the hunt for treatments for Alzheimer’s disease and long COVID.
Beverley Orser (PGME ’87, PhD ’95), like many of her peers in anesthesiology, initially struggled to believe that the same miracle drugs that block the pain of surgery could have lasting cognitive impacts on patients.
“For decades and decades, we’ve known that sometimes our patients weren’t quite right after surgery,” says Orser, the chair of Temerty Medicine’s Department of Anesthesiology & Pain Medicine. Yet, it was widely assumed that any effects of anesthesia cleared once the drugs left the body. Perioperative neurocognitive disorders — ranging from short-term delirium to lasting cognitive decline — affect roughly one in four surgical patients one week after surgery, and one in 10 patients up to three months later.
