Neurosurgeon Thanksgiving

Giving Thanks is such a good thing. Anything that gets your focus off of yourself is a good thing, and I am hard pressed to think of anything to thank myself for. Being in the line of work that I am gives me much more to be thankful for than most, I think. During my month of Neurosurgery I have been able to meet many grateful and many devastated people.

Two weeks ago a woman in her mid 50's came in to us because we operate on the brain and she had a problem where the remedy matched our job description. It sure is nice to not need an advertising budget as all of your work comes to you. She had been complaining of worsening headaches and some mood changes. She went into the emergency department at her local hospital, fortunately for her because everyone who follows her example gets a CT of their head, and they immediately sent her to us.

I examined her and noticed she had a very flat affect. This is doctor speak for lack of emotion or expression. Her husband added that she had lost nearly all motivation for doing much of anything over the past bit, and was concerned her scan was related. The nurse and I looked at the scan and decided she needed surgery. She got an MRI because the surgeons need the MRI to better show the limits of the tumor that had entirely replaced her Right Frontal lobe... In essence she had a golf ball sized tumor in the front of her brain that was squeezing the living daylights out of it. Fortunately for her, there is not too much that goes on there that will let you know something is wrong. There is no motor or sensation control there, or even speech or anything, so you won't have much more than headaches and problems thinking and feeling (sort of like a functional lobotomy, really)emotion.

When we opened up her scalp and drilled out a wallet-sized chunk of skull so we could access the tumor we were impressed again with the size of the lesion. It was a dark grey mushy mass of tissue inside the ivory white brain tissue, and it took us quite some time to dissect it carefully away from the healthy normal brain tissue, especially since these tumors are so vascular (which means they bleed whenever you touch them). We did finally get her tumor out and filled up the hole with saline so her brain wouldn't collapse back into the hole. We carefully sewed back the layers covering the brain and then I got to screw the flap of skull back on and we closed her scalp.

To my amazement she was only a little nauseated when she woke up. Then when I saw her in the ICU the next morning, she actually smiled! Wow, she hadn't done that for some time. By the third day after her operation she was joking, planning out her holiday preparations and was trying to make up for lost time in the energy department. I am not sure if her husband will be thanking us or not since she lost her energy gradually so he could get used to it, but now she had it all back over the space of 3 days, which has to be quite the shock.

Makes me especially grateful for what I have and how blessed I am. Also makes me feel very safe and secure to know that I have a personal relationship with God, and that He is so steadfast and dependable. Living is so unpredictable in itself, with seemingly random tragedy and elation waiting for each of us around the corner. I sure do not depend on my body for satisfaction or function tomorrow. I can either be cynical and sour about not being able to know that I too won't end up under the lights with my brain exposed, or else I can just accept that uncertainty and take solace in the odds and put my confidence and trust and life in the hands of the Creator and see what it is He would like my body to be doing during the time it is here.

Another guy we took some brain tumor from won't be so blessed. He is pretty devastated and upset given the fact that his tumors, unlike the lady above, are not primary brain tumors but they are metastases from lung cancer that has not yet been located. He has a 10 or less percent 5-year survival and he is very much into his body. He did smoke for years and years until he had a heart attack. He then started working out with the same enthusiasm he used to smoke with, ate all natural stuff and paid close attention to his body. What he gets from that is metastatic brain cancer that will buy him radiation and chemotherapy and a very low chance of making it more than 2 or 3 years from now. Unfortunately he worshiped his body, so he is devastated about it.

I have been thinking about him some lately, and hope I get to see him again sometime as the time he spent in the hospital was very busy for us... I never got a chance to talk with him about God more than just passing one-line comments to ascertain his openness to the subject, which seemed to indicate he was as he has no family and only a few friends around here. I will keep praying he will come to know God in a way that allows him to place his life in His hands (as if it is not already, you know?).

Well, that is what I have been dealing with the past week or so, along with many other patients as well. My stretch of being on call has come to a close so I get to enjoy Thanksgiving at home with the family and even get this weekend off, except I have to go in tomorrow because we are opening up a few more brains and spines.

We hope you all have a good Thanksgiving and have ability to be thankful for the blessings you have undeservedly been given.

David