Brain surgery neurosurgery:
A personal memoir.
of undergoing brain surgery.
Here online on this web page, posted on this cancer treatment home page, is an account of brain surgery done under a general anesthetic to extract a lymphoma tumor for biopsy. This brain surgery / neurosurgery text published online is a cancer patient's account of undergoing neurosurgery. The full text of this cancer patient's neurosurgery experience is available to read free online.
Hugh Cook underwent brain surgery in Auckland Hospital in the city of Auckland, in New Zealand, early in 2005.
This web page features an expert's succinct account of the operation followed by the start of the patient's personal experience. This cancer patient's full course of treatment is detailed on this web site.
The non-fiction narrative of undergoing neurosuergery which starts below, following on from the expert's account of the procedure, is part of the full text of the medical memoir "Cancer Patient" written by Hugh Cook. The full text has been published online on a free-to-read-online basis. This autobiographical non-fiction account deals with the author's initial health problems, diagnosis, and treatment with chemotherapy and radiation therapy.
The complete text of "Cancer Patient" is here on this web site but is also available for purchase from amazon.com as a proper printed paperback book. The full text may also be purchased as a download (a PDF file) from lulu.com for US $5. Go to lulu.com/hughcook
For a chapter-by-chapter breakdown of what's in the CANCER PATIENT book (in its online version, in the PDF version and in the paperback version), see:-
Table of Contents
by cancer patient Hugh Cook.
I had neurosurgery early in the year 2005, before staring a course of treatment for non-Hodgkin's lymphoma of the central nervous system (the brain and the spinal cord), a course of treatment which involved chemotherapy followed by radiation therapy.
At the time I underwent my brain biopsy, a biopsy done to extract a sample from the brain so the exact nature of my cancer could be determined, my concept of the operation was poor.
I had a rough idea of what was going to happen, but for some reason the surgeon did not stop by to explain the details of the operation, though I had been told that he would. Consequently, the explanation of the operaiton that I give in my medical memoir CANCER PATIENT is based on the things that other members of the medical team told me, fleshed out by surmise and guesswork.
Because I was planning to go to Japan following cancer treatment, and because I would need follow-up checks in Japan, late in 2005 I was kindly provided with a package of medical information.
This package included an expert's account of the procedure, which I reproduce below.
The spelling of the report is New Zealand spelling, which generally follows British spelling.
The "dura" (which I had to look up in the dictionary) is the outermost of three membranes covering the brain, and is also known as the dura mater, the literal meaning of which is "hard mother".
What follows on from the expert's account of the procedure is the first of the chapters of my medical memoir CANCER PATIENT. The medical memoir gives a patient's semi-informed (and sometimes uninformed) perspective of brain surgery, not a doctor's perspective.
The text is presented unchanged but paragraphing has been added to increase ease of on-screen viewing.
The expert's account mentions the "Stealth system". In the cours of the memoir that follows, I give my own conjectural idea of how this system works (in other words, I don't know, so what I present is just a guess).
Basically, the system works (I think) by surgeons watching the progress of a virtual needle on a display screen which is hooked up to a computer which has a copy of the patient's brain which was produced by an MRI scan, with dots on the patient's scalp visible both on the screen and on the patient's actual scalp.
For more about the dots, read on in the memoir, starting from Chapter 20, which starts below.
I still don't understand why there was a tumor, because my concept is that lymph is one of the body's fluids, and that lymphoma is a cancer of this fluid. And, if it's a fluid, how can it form a tumor? You can see cankers of one kind or another forming on trees, but it's hard to imagine a tumor forming in a stream or a flowing river.
Still, evidently there was a tumor, otherwise they could not have grabbed hold of it and hauled it out of the brain.
I was, I regret, unconscious throughout this procedure, and nobody subsequently provided me with video of the tumor being hauled out into the harsh bright illumination of the operating theater, doubtlessly kicking and squealing as it was wrenched out of the security of its comfortable lair.
From the tumor's point of view this was surely a horrendously traumatic experience, but for me as a patient it was, overall, okay.
(In a future age, an age in which political correctness has developed to the point where there is a well-evolved concept of "tumor rights", this cold-blooded indifference to the fate of the tumor will doubtlessly seem barbaric. In excusing myself to the tender-hearted future, I can only say that we are all creatures of the world into which we were born, and I, shaped by my society as I have been, lack even the slightest shred of sympathy for the deceased tumor.)
of the Procedure
The patient was taken to the Operating Theatre and placed under general anaesthesia. He was placed in a supine position with his head fixed in pins.Editor's note: the "rubbery" is a nice piece of tactile detail, helping to convey an impression of authenticity, but there are no sound effects. To take us there, it would have been nice to know about the sound that the tumor made, if any, upon extraction. Did it come squelching out of the brain? Or did it ooze out silently, slug-fashion? Surgeons know these things, and the world would be better informed if they shared with us.
I once spent a year or so living in an apartment in Seafield View Road, an apartment with a view out of the back window to the Medical School, which has the distinction of being the most hideously ugly building anywhere on planet Earth. I never in my remotest dreams imagined that a part of me would one day end up being vivisected inside that building.
CANCER PATIENT Cancer Treatment Medical Memoir
Brain Surgery Neurosurgery
The author is admitted to hospital for brain surgery and finds that he is regarded as a potential carrier of an unkillable superbug, methicillin-resistant staphylococcus aureus. The author meets various people associated with his upcoming operation and constructs a fantasy about his eventual return to his former life in Japan. The fantasy requires, of course, that he survive.
I was admitted to Auckland Hospital for brain surgery on Sunday 16th January 2005.
* * *
2005 January 16 Sunday.
Looking recently at my schedule diary for 2004, I was amazed at the demented ever-busy lifestyle it showed.
For me, 2004 was the most stressful year of my life, the year in which I had to be teacher, writer, webmaster, husband, father and breadwinner, the year in which I could not, must not fail. The year in which I had to be invincible, all-mastering, immortal.
In the last desperate months of that year I thought to myself, "Wow, I'm really mastering the art of organization!"
But, in retrospect, the "push it to the red line and then a little further" organization of my days was, really, a kind of insanity. I don't know if this insanity has a formal name, so let's call it "lymphoma rigidity".
Somewhere along the line I stopped listening to music. I don't know if this is a symptom of a problem but I suspect that starting to listen to music again might be a symptom of a cure. So, when I finally get back to Japan, one of the first things I aim to do is to dig out one or two of my favorite CDs, sit down with a cup of tea, and listen to some music.
Yes, do that first.
Today's big conceptual discovery about my disease is the notion of this roughly kidney-bean sized lode of something existing in my brain. I'd conceptualized the lymphoma as a disease of the lymph fluid, without, so to speak, a home base.
Well. Said goodbye to my wife at about 2 p.m. today, and now she'll be at home with my parents in Devonport, and tomorrow she'll be getting on an early flight to Japan with our daughter, who will ride in a bassinet, a sturdy metal and canvas structure strapped to one of the airplane's bulkheads.
Flying out, there was a nice German couple sitting beside us, with a German baby in their bassinet. And then there was us. With our baby.
And one of these babies went to sleep precisely on schedule and slept for exactly the right amount of time, then woke refreshed and ready for another productive day of learning and socializing.
But the other baby (I'm not saying which one) kept sleeping for short intervals then popping up from the bassinet in a state of demented excitement, looking around as if to say, "Oh, gee, oh, wow, isn't it wonderful! The whole world is vibrating!" And then, toward the end of the flight, that baby, having worked itself up into a state of complete exhaustion, collapsed into screaming hysteria.
Fun and games on aeroplanes!
* * *
Late in the evening of January 16th, the Sunday on which I was admitted, the night nurse came round and told me I was done for the day. Nobody would be disturbing me until morning. I told her that, actually, a doctor would be dropping by to put some dots on my head. This was what I had been told (by someone), but the night nurse seemed to think that I was in error. She departed, leaving me alone with my delusions.
Midnight came and a new day started, Monday January 17th, 2005. I planned to get to sleep, but was waiting until the dots had been done. Finally, twenty minutes after midnight, a doctor by the name of Sheik came into my room. I had been right and the nurse had been wrong.
I learnt two things while I was in hospital. One is that the staff member you happen to be dealing with doesn't necessarily know what the plan is, regardless of whether that person is a nurse or a doctor. The other thing is that the plan has a tendency to change.
I was fascinated by Sheik, who was very dark and obviously Not From Here. Where was he from? Not Africa. Bangladesh? My guess was that he was from somewhere on the Indian subcontinent. It was conceivably possible that he was from Bangladesh but I never found out because I never asked. I wanted to ask but I was too inhibited.
In retrospect, I can see that, initially, I was a little inhibited in asking not just personal questions but also questions about plans, procedures and gadgets. One thing that changed during the course of my various hospital admissions that I became increasingly ready to ask questions, any kind of questions, the reason for this being that the response to the questions that I did ask was consistently positive.
In that encounter shortly after midnight, Sheik shaved away little patches of my hair and stuck a bunch of dots on my scalp in preparation for the next day's MRI. Each of the dots had a little circular slug of something solid at the center of a small dome of some kind of flexible material.
As midnight had been and gone, and the day of the operation had started, I was not supposed to eat anything or drink anything. In fact, I think I had been fasting ever since finishing dinner. Sheik having departed, I found myself unable to get to sleep, and started thinking about the hours ahead, which promised to be fairly busy.
I wrote in my diary:-
"The night nurse plans to wake me at 0600, my sister plans to visit at 0700, the ward round is at 0730, and at this stage I go to the MRI at 0830 or thereabouts and into theater at perhaps 1130, so I'm going to be one tired boy by this evening."
Still unable to sleep, I began to construct an elaborate step-by-step fantasy of my return to Japan. At that time, this fantasy was very important to me, and I played and replayed it in my mind. It was my connection to a future which I was hoping for but was not promised. A key point about this fantasy was that it was an imagined journey into a world from which stressors had been eliminated. Other human beings are, inevitably, a source of stress, and there were none in my fantasy, which is featured below.
* * *
2005 January 17 Monday.
I have been fantasizing about (well, more exactly, planning) my return to Japan. Get a flight that arrives at Narita early, about 0630. Immigration, customs, bus to Yokohama then a train home. At Hamayama Station, our home station, buy bread, buy sashimi, buy a papaya. Wander home.
Pick up the mail, go inside, set three cups of rice to soak. Go upstairs, find some CDs, come downstairs, make a cup of tea, put on the music.
Sit back and listen to the music.
Cook the rice, have sashimi with rice and sake, then take a long hot bath. A bath or a shower. Then go down to the supermarket and buy the makings of dinner. I will cook fish. And two boxed lunches for the next day, pork and sausages.
This is my dream.
Rule: I will not touch the computer the first day.
* * *
At the time, I thought this was a very relaxed fantasy, a mental exercise in total looseness, rigid and overplanned. The instruction to myself to "come downstairs, make a cup of tea" looks casual but was part of a very serious and inflexible wargame.
I had figured that if I made a cup of tea before going upstairs, then one of two things would happen. Either I would leave the cup of tea downstairs while I went up to my personal room to hunt for CDs. And then the tea would get cold. Alternatively, I would take the cup of tea upstairs with me, meaning I would possibly spill it, and the last thing I wanted to do was to begin with a domestic catastrophe.
(I was having this fantasy at a time when I'd recently smashed a number of things in my parents' house by dropping them, my brain-damaged control center having lost confident control over my fingers.)
The reason for planning to cook three cups of rice was that I would not be able to eat more than a cup of cooked rice at one sitting and the other two cups would do for dinner. (Our high-tech rice cooker can keep rice warm for hours, or even days, though it does tend to get just a little bit dry if left in the cooker for a couple of days.)
The prohibition on touching the computer was because I could all too easily imagine myself getting immersed in a world of computer problems right from the start and working myself into a state of ragged exhaustion, downloading e-mail, updating virus definitions, uploading stuff to my web site and so forth.
My fantasy was a journey into a world of total familiarity, totally free from stress. A world in which, conspicuously, those stressors known as human beings were missing.
The text on this page is part of the cancer memoir "Cancer Patient" which has been posted online. All the chapters of this book are on this website and can be read for free online. However, the text is copyright - all rights reserved. For permission to use this text or any portion of it contact Hugh Cook.
This personal memoir of the writer's encounter with cancer (non-Hodgkin's lymphoma of the large B-cell type) attempts to cleave to the truth. However, the text may contain information that is wrong, outdated, incomplete or otherwise misleading.
This memoir has been written in a time of illness by a cancer patient who, though he feels sharp enough, must admit to sometimes misinterpreting things, forgetting things, or, on occasion, quite simply not hearing things.
This memoir is designed to communicate the writer's personal experience and is not intended as a source of medical information. Got a medical question? Ask your doctor.