One of a suite of blog entries about the aftermath of chemotherapy and radiation therapy, including brain damage and eyesight damage; a survivor's account of the aftermath of cns lymphoma, non-Hodgkin's lymphoma of the large B-cell variety, in the author's case cancer of the brain and the spinal cord.
THIS IS A PICTURE OF YOUR GOD:
A HUGH COOK READER.
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 operation 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". My understanding of this is that 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.
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.)
EXPERT'S DESCRIPTION STARTS
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.EXPERT DESCRIPTION ENDS
The Stealth system was calibrated.
A curved incision was made in the right frontal region. A craniotomy was then fashioned over the lesion itself and the dura was then opened in an 'X' shaped fashion.
The tumour was then removed in its entirity.
It was rubbery in nature.
A section of it was removed and taken for frozen pathological section which revealed it to be consistent with a lymphoma, although we will await the final pathological section. The rest of it was sent for permanent section as well as to the Medical School for research purposes.
The bed was lined with Surgicel and the dura was closed. Surgicel was placed. Miniplates were used on the bone and then the scalp was closed in a multi-layer fashion.
The patient tolerated the procedure well.
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.