chapter 11: fast track

the soonest i could be seen by the chief of neurosurgery at USC was may 27th–more than ten days after my release from St. Joseph’s.  not exactly right away.  however, that wednesday following my discharge, USC called, and they were able to see me on Friday–a WEEK early.  this was great news.

i showed up at USC, with my images from the tests done while i was in the hospital.  i’d had a catscan, an MRI with contrast (with dye injected into me through my IV), and an MRI without contrast.  the doctor at USC looked at my discs and came back to tell me that my lesion was NOT a “suprasellar” mass, as i’d been told at St. Joseph’s.  it was, in fact, retrosellar (supra means above, retro means behind), and it sat between my brain stem and the base of my skull.  furthermore, aside from providing this basic information, my images were useless and inconclusive:  we were back to square one.  i may indeed have an aneurysm.  or a tumor.  or a cavernous angioma, which is a clump of malformed blood vessels which have become a mass.

of these possibilities, the aneurysm could be blocked or unblocked.  if blocked, that meant that the pain i had experienced on the 12th was from the aneurysm blocking itself.  according to the doctor, this was the best news i could hope for, because it essentially meant that the aneurysm had healed itself, and if so, i would have to be monitored by medical visits every 6 months.  if the aneurysm was unblocked, he would have to go in and block it.  this would be done by either brain surgery or through my groin artery, up into and through my heart, up through my carotid artery, and then into my brain.  if it was a cavernous angioma, well, he didn’t really say what would be done.  if it was a tumor, that meant that my pain was from the tumor hemorrhaging.  and if it was a tumor…

he described the procedure.  this was the first time i got emotional.  “this thing is as deep inside your head as you can get.  it sits near two big important nerves that move your left eye.”  now was the first time i felt my breath taken away…as he held up his hand.  “i will cut a hole in your skull…”  he held up his hand, with his forefinger and thumb together, illustrating the size.  at first, it was small; then he began to adjust in order to show me the exact diameter…  “i will cut a hole in your skull…the size of a 50-cent piece.”  my heart sank.  i felt emotion well up inside me.  “i will have to cut you from the front side of your head, to back and down around behind your ear…you will have a big scar…”  this was difficult to hear.  and so was something else:  “we will do some tests.  but the truth is, i may not know what is there, until i get into your head, and i’m looking right at it.”  again, i felt my breath leave me.  if you’re going on a journey to the center of my head, i would really like for you to at least know what you’re going in for.  this was so difficult to hear, and i felt unsteady.  i had dealt with everything fine up until this point.  WHY IS THIS HAPPENING TO ME????  AND WHY COULDN’T IT BE SOMEWHERE ELSE?  ANYWHERE OTHER THAN THE CENTER OF MY HEAD????  IT’S JUST NOT RIGHT THAT SOMEONE SHOULD HAVE TO OPEN UP MY SKULL AND TAKE A KNIFE TO THE CENTER OF MY HEAD.  JUST NOT RIGHT.  NOT RIGHT.  and the truth is, it will never be right.  and that is life.  some things happen that are not right, and will never be.  they will always be wrong.  and we will always be affected by them.  some people say “live with no regrets.”  i disagree.  life is a series of victories and defeats.  an unbalanced mixture of pride and embarrassment.  our regrets deserve the respect of being recognized for what they are:  faults.  it’s the undeniable reality that life is not perfect.  we aren’t, and so neither is how we happen to life.  and so it follows that neither is how life happens to us.  it’s chaos on both sides.  what we do, and what is done to us.  and that’s the toxic mixture that causes our deepest pain.  but there is no way to regurgitate the choices we’ve made, or the things that were beyond our control.  it’s inside of us.  a part of us.  forever.  and so in some way, for now, in this moment, i have to be this person.  in these circumstances.  and so i will be.  because it is what i am.  in this moment.  any day above ground is a good day.  and i will live this day.  and i will be thankful for the privilege of feeling misery when that is my only option.  i will be grateful for this heartache.  because it’s a reminder that my heart is still beating.  it could be worse.  much worse.

the doctor told me that i needed to have more tests done, that they could get clearer and more precise images than St. Joseph’s.  he also told me that the doctor at St. Joseph’s specialized in spinal issues, whereas he himself was an expert in brain issues.  he said that doing the surgery with the doctor and facility at St. Joseph’s would give him a surgical assistant who was also a neurosurgeon, which would be good, but depending on what the tests revealed, he may decide to just do the surgery at USC instead.  also, he told me that he does about 100 surgeries a year in this area of the head.  that spoke well of his expertise.

according to the doctor, if it was a tumor, there was a 20% chance he wouldn’t be able to remove it all.  and there was a 5% chance it was cancerous.  as for cancer, i hadn’t even allowed myself to consider that possibility.  and that is a policy i’m sticking to, for the duration of all of this.

the doctor said they would perform a catscan immediately, and then the following week an angiogram, which would require me to be in the hospital for half a day:  they would go thru my groin, all the way up into my brain, and take pictures.  six hours later, i would walk out of the hospital.  moreover, he wanted to operate in two weeks.  this gave me very little time for 2nd and 3rd opinions, and it also made me think that if i waited too much longer than a couple of weeks, the consequences may be severe.  but i needed other opinions, other tests, conclusive analyses, and then respondent research:  once i knew what i had and what needed to be done, i wanted to find the best neurosurgeon in the country for the job.  that would take time.  but was time something i had?  what if i tried to find the best person for the job, and waited and waited, and died before my surgery?  my life was in my hands, and as much as i didn’t want to give this issue my time and priority, as much as i wanted to just get on with my life, the reality was that my life wasn’t guaranteed to start with, and this was a threat to its continuance.  i would need to take care of myself in a way that wasn’t typical of me.  i would need to put this first, and everything else last.  even when i wanted to tell myself that i could go back to work and take my time to find out what’s wrong.  taking my time was not an option.  because time was not a guarantee.  and so neither was life.  i was no longer able to be a casual player on the field.  now i was the goalie.  and i’d better be ready.

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