Chapter 7

THE ELEPHANT ON THE CLOTHESLINE

“What surprises me,” said Dr. Bederson after he had laid out the Good Friday scan plan, “is how you are walking around with this tumor. Do you have headaches?”

“Terrible ones,” I said. “But I do have five kids.”

“She’s been complaining about headaches for months,” Jim offered.

I shrugged. “I thought it was allergies.”

“Do you have breathing problems?”

“When I lie down in bed at night I have a coughing fit,” I admitted.

“She gasps for air in her sleep,” Jim confessed.

“I do?” I looked at him angrily. “I didn’t know that!”

“You told me you had allergies,” Jim replied.

Dr. Bederson nodded. “That’s from the pressure on your brain stem when you lie down. Your cranial nerves are severely compromised. What about your balance?” Oh my God, the heels. It was like the Seinfeld episode, but mine would be called “It’s Not Shoes, It’s Me,” and feature me stealing a wheelchair from a helpless grandma because of a wardrobe malfunction. Also, those dizzy spells and head rushes when I stood up. I recalled a curriculum night when I had to hang back in the classroom while the rest of the parents exited to the auditorium because I had the spins for no reason at all. I was mortified that I had been neglecting these things, and now my husband and kids were going to suffer for it. Of course, over the past few years it had crossed my mind more than once that it was not normal to get head rushes all the time, but who goes to the doctor for a head rush? I thought I would put it off until I was older. Only old people got sick. To me, admitting I was not feeling great was like complaining about being old. I guess I felt like I could force myself to stay young if I didn’t complain about my health.

Dr. Bederson gave me some tests that I can only describe as the same tests you would get if you got pulled over by the cops because you weren’t driving your car straight.

“Hold out your arms to both sides, then one at a time try to touch your fingers to your nose.” I tried and I missed my nose by a mile. “Can you stand on one foot?” That would be easy. I used to do yoga every day. When I had one kid. How long ago was that? I lifted one foot behind me. I almost toppled over. Dr. Bederson moved his finger in front of my eyes. “Can you follow my finger?” I felt like I could, perfectly, but he noticed a major delay with one eye.

“Are you going to give me a DUI?”

“How’s your spatial perception?” I thought for a minute. I’d walked into doorframes more than once. I thought I was just clumsy. I was baffled by my lack of self-knowledge. How could I have not noticed any of this? And wait a minute, why had a giant tumor grown in my brain anyway? Was it from my iPhone? I felt like Jim and I were ignoring the eight-hundred-pound gorilla in the room. I had to ask: “Is it cancer?”

“I don’t think it’s cancer.”

“Why?”

“Cancer cells grow really rapidly, and if this tumor grew rapidly, we wouldn’t be having this conversation right now.”

“When will we know if it’s cancer or not?”

“After the surgery, we will send the tissue to the lab to get the pathology. It will be about two to three weeks after the surgery. We won’t know until we get the lab results, but judging from the characteristics of this tumor, I would say that there is an 80 percent chance that it’s not cancer.” I chose not to focus on the other 20 percent, but truth be told, what I really wanted to hear, what anyone would really want to hear, was that it was 100 percent not cancer.

“How long have I had this?”

He explained that judging from the size, and in conjunction with how functional I was, it was likely the tumor had been insidiously growing for years, and that my nerves had found ways around it, suppressing any serious symptoms that would have caused immediate alarm. Leslie explained it this way: It’s like if you put an elephant on a clothesline, the clothesline will obviously break. But if you slowly, over time, keep pinning small items onto the clothesline, eventually it will stretch lower and lower to the ground, until, ultimately, you can put an elephant on it and it won’t break. For those of you who can’t follow the large animal metaphors, the clothesline was my brain, the elephant was the tumor, and the eight-hundred-pound gorilla had a 20 percent chance of being cancer.

An eight-year-old’s medical diagram of the brain adapting to a tumor.

“Can you get it out?” I asked. Dr. Bederson took a deep breath.

“One of the things I am very concerned about,” he began as Jim and I leaned to the edge of our seats, noticing the shift in his tone, “is that your facial nerve is running right through the center of the tumor. There’s risk that one side of your face will become paralyzed.”

“I don’t care!” I blurted out. At this point I could be a head in a jar as long as I could raise my kids. I’d just be that mom with the paralyzed face. What did I care—I already had a husband.

Leslie would handle scheduling the full day of scanning that would begin early the next morning. A word about Leslie and PAs (physician assistants): Being a surgeon is obviously no small task. You want the brain surgeon focusing all of his attention on the surgery. Leslie dealt with everything else. It was a relief knowing someone was handling all the hospital logistics who was knowledgeable about every aspect of what was going on and able to field the never-ending questions from people like me and Jim, who were obviously not brain surgeons. Dr. Bederson was the star out on the stage. Leslie was coordinating the whole production. Leslie was the Jeannie Gaffigan to Dr. Bederson’s Jim Gaffigan. With the team of Leslie and Dr. Bederson, we had hit the jackpot. Leslie is one of the most incredible people I have ever met. She is like six feet tall and drop-dead gorgeous. A former basketball champion in the NCAA college league at GWU and overseas on the Israeli Olympic team, she has a brilliant mind, is the master of Dr. Bederson’s schedule, and still keeps a million other balls in the air, all while being nonstop charming and genuine.

She explained that the MRI scans, the CT scans, the angiograms, and the ultrasounds would be integrated to render the brain’s anatomy in a virtual reality 3-D scenario. This new type of augmented reality surgery, blending digital images with physical structures, was the most advanced way of removing tumors in a procedure where even the slightest miscalculation could cause irreparable damage. This “CaptiView” system overlaid data and 3-D models to the eyepiece of a surgical microscope and combined rare technologies that were being used individually by only a “handful of experts.” The first doctor to use CaptiView in neurosurgery? As luck would have it, Dr. Joshua Bederson. The pioneer. Guess we barged into the right office.