CHAPTER SEVEN

Doctor Doogie Howser

THE DAY OF MY APPOINTMENT WITH DR. NUSSBAUM ARRIVED TOO quickly. I’d soon have to make decisions that would affect everything. I have a high regard for the brain, particularly my brain. My primary fear was that if the aneurysm burst before or during surgery, I would become disabled. I worried I would become like my father—a burden on others. How could I keep my job if my memory and problem-solving functions were reduced or destroyed altogether?

Dr. Nussbaum’s Minneapolis office was located in a green-tinted, glass-encased, seven-story building near Lake Harriet. How ironic, I thought, that Linda, Leaf, Taylor, and I had blithely walked around the Minneapolis lakes countless times over the years, passing the building where my brain surgeon had his office. Was this some kind of cosmic joke? The building had what appeared to be a metal sailboat perched on its roof, as if steering the building into a lake headwind. Even though sailboats dotted the lake each summer season, the artsy version of a sailboat looked out of place to me.

With so much out of my hands, I worked to keep some aspects of life under my control, including knowing where I would be going for an important appointment. I decided to scout out the doctor’s office the day before our visit was scheduled. Upon arrival I found that the building’s signage only contained the name of the neurosurgery center, not the doctor’s name.

The following day I dropped off Leaf at his doggie day-care center. At least I had the assurance that he’d be looked after while we were at an appointment to determine my future.

Linda and I slowly walked toward the building’s side door. I took a quick look at the familiar city lake. How I wished to be walking around its choppy blue water on this gray day with my pup light on his feet and not a care in the world.

The moment we entered the ground floor of the building, I smelled fresh coffee and muffins wafting from the coffee shop.

“Muffins?” I asked, trying to tempt Linda.

“Maybe on our way out,” she replied unenthusiastically.

Normally I would have a tough time passing up such a treat. But today, we reluctantly continued our trek, with me leading the way.

Linda became quieter. I needed to give her some space.

As I pushed the elevator button to the floor for Dr. Nussbaum’s office, anger rose like bile in my throat. I wanted to blurt out, “What am I doing here? This is all a mistake!” My next thought was where is all the emotion coming from? What happened to my reasonable, Spock-like approach to the situation? The elevator door opened, and we entered—one quiet and one very angry person.

The hallway outside the doctor’s fourth-floor office was under construction. Large plastic sheets lined the halls, and floors exposed bare concrete. No one was working, although unsettled sawdust swirled in the sunlit air. I had noticed construction materials and the stripped-down floor on my scouting mission the day before but was still taken aback at having to make my way through it now. Was this a sign of what I’d find inside? Sloppiness, unfinished business, poor attention to detail?

I opened the door to Dr. Nussbaum’s office and let Linda enter first. I almost closed the door behind her. Couldn’t I just stay in the safety of the hallway? Couldn’t I wait out in the car while she talked to the doctor?

The young receptionist was businesslike and expressionless. She handed me a clipboard and asked me to fill out a form for gathering basic background information. Linda and I found two empty chairs together and sat down. I quickly filled out the form and returned it to the receptionist. I looked over at Linda. Her eyes telegraphed that she felt frightened. We usually chatted about almost everything. But now we sat in silence, taking in the sights and sounds of the office lobby.

When I’m feeling nervous in a new situation, I sometimes take my mind off what I’m about to do by mentally redecorating the environment. The first thing I noticed in the reception area was its nearly naked walls and sparse furniture. I imagined adding a few paintings of dogs, cats, and nature scenes. While indulging in this game didn’t make me feel better about being there, it allowed me not to immediately focus on the unnerving details of other patients in the room.

When I did let myself observe the people around me, I noticed that some wore baseball caps or head coverings. Others showed long scars across their skulls. The sight of shaved or bald heads, visible wounds, and the sounds of whispered speech forced me to remember why I was there.

I looked at Linda and touched her hand. She shared a nervous smile and handed me a brochure about Dr. Nussbaum that she picked up from the reception desk. I had done some initial research, but this brochure made it clearer that the man who would hold my life in his hands was more famous in the world of brain surgery than we knew.

He was recognized worldwide for being an expert in a highly effective procedure for closing off blood flow in the brain. It involved the traditional clipping of the artery that feeds the aneurysm, thereby eliminating the risk of a rupture. He had done so many of these procedures that he was considered the best. His book on the subject was in bookstores. An entire wing of a hospital was dedicated to his neurosurgery patients.

I felt better after reading the brochure, but it gave birth to new worry. My research had indicated that there were two ways to go with brain-aneurysm surgery. One would be to have invasive surgery with clipping. The other alternative was a less invasive procedure of intravascular entry and then filling the aneurysm from the inside with material that would block blood from entering the area.

I wanted to make sure that after the doctor had answered my questions about the two options, I stayed neutral about which type of surgery to choose. My decision needed to be based on facts and not an emotional preference. I did not want to build a case in my mind for one procedure over the other. I just wanted the facts.

I clutched the large brown envelope containing images of the X-ray CAT scan that Dr. Nussbaum’s superefficient nurse Jody Lowary had told me to bring to the office for my first visit. “It is all in here,” I said to Linda as I held up the envelope. It was a bit surreal that the package contained brain images that could determine my destiny.

A cheerful woman in her late fifties, wearing a colorful-print medical smock, walked out to the waiting room and loudly called, “Allen Anderson.”

I would have preferred that she call me “Mr. Anderson” so the world, which at the time was everyone in the waiting room, would not know such personal information as my first name. I still clung to the idea that the diagnosis was a mistake, a misunderstanding, and I didn’t belong here anyway.

In the consultation room I carefully examined the large chart on the wall. It displayed well-rendered drawings. They depicted perfectly formed red and gray unruptured aneurysms ballooning from arteries. Each aneurysm had a well-defined neck. I wondered if mine looked that way. If I could have one request in this experience, I wanted my aneurysm to have a well-defined neck. It would be easier for the doctor to clip and make the less invasive surgery an option.

When the esteemed doctor entered the office, I kept my facial expression neutral so it wouldn’t register surprise. He introduced himself, turned away from me, and took a seat behind his desk. While he had his back to us, I looked at Linda. She mouthed words, but I couldn’t make out what she said. Later she told me that on first seeing Dr. Nussbaum, all she could think of was the fictional television character Dr. Doogie Howser—a sixteen-year-old brilliant physician who works as a hospital resident.

I stared at Dr. Nussbaum’s hands, thinking about the requirements for his profession. I reassured myself that younger people tend to have steadier hands. In this respect, surely his youth would be a plus while doing delicate brain surgery.

Nurse Jody joined us in the office. Dr. Nussbaum pulled out the CAT scan images to view. I briefly wondered if Nurse Jody played Dr. Watson to his Sherlock Holmes. Holmes was the mastermind of any mystery. In an effort to cheer myself up, I decided that Holmes would be my nickname for Dr. Nussbaum.

The doctor patiently answered each of the questions from a list I’d prepared. When I asked, “Which side of the brain will you enter?” he looked surprised at the question. He evaluated the CAT scan again and told me he would open my skull on the right side. “Check. Drill right side of brain,” I wrote on my list.

I glanced over at Linda. Her eyes had glazed over. She sat with lips frozen in a grim line. Her hands clasped together tightly in her lap.

Dr. Nussbaum posted the CAT scan on the wall so we could all look at it. An unfocused blob lay where only an artery should be. It looked nothing like the nice, easy-to-see, colorful drawings on his office wall chart. “I don’t see a well-defined neck to the aneurysm,” he said.

Disappointment slapped me in the face. The surgeon was not giving me the answer I wanted to my one request.

“I need for you to have an arteriogram.” He explained that the test would provide a more detailed picture of my brain.

“If an aneurysm does not have a well-defined neck, is it harder to clip?” I asked.

“I can clip anything,” he answered with confidence.

I was beginning to like this guy.