intergalactic stereotactic

Life’s Malarkey

2/ 25/ 14

Rocket science and brain surgery remain the standard up to which the luminosity of the rest of our wittedness is to be held.  As in, “You dolt, it’s a grilled cheese sandwich, it’s not . . . exactly rocket science;” they remain the earmark by which the knuckled-protrusivity of the rest of our headedness is to be compared. As in, “You inveterate mome, it’s cheese toast, it’s not exactly . . . brain surgery. Brain tumor biopsies are both.

I’m not saying the rest of us are moronic (though a few of us do seem to be aggressively so) just that most of us undoubtedly apply our unique geniuses to other boggling pursuits. It’s like a great poster once said: “Do not worry about your difficulties in mathematics. I can assure you mine are still greater than yours. Albert Einstein.” Or, put less myopically-- forthcoming physics-wise--by a nearby nail-clinging kitten: “Hang in there, kid, you and I are going places.”

I'm saying that the science and the surgery combined astound me.

My first biopsy opened this wonderment when it opened my skull. I was apprised of this surgical necessity but not as prepared for its aftermath as I would have liked. Or so I though at the time. In retrospect, who knows how petrified I'd have been if more prepared, how much more resolutely resisting the fog settling in my cranium when the time came for alphabet recital?

"OK, wise-guy, now backward," this up from a rabbit hole, echo-ey.

"Backways around?"

"Right. Starting with Z,Y,X . . ." from a teapot, itty-bitty-ily.

"Got ya. Z,Y,X, four, three, turquoise . . ."

It's called craniotomy. It requires scalp-slitting, skull-splitting, and staple-fitting. And trauma. First came the typical post-op misery. A monumental thirst made more miserable for the  assurance there was no quench in the offing— in case they needed to go back in. Shoot, for some ice chips you can go back in now. Next, an epic journey into delirium through nausea down into the abyss of head-lessness, and back up into redoubled thirst.

"Now ice chips?" from a desolate soul.

"Not yet," from a soulless soul. "How bout these little minty thingies you can chew on that they say works pretty good."

"They say it, do they? Well, if they say it . . . stock me up!" from a realm nearly black beneath an undulating awning of bat wings, filled with the anguished moans of tortured janjiis.

Then, the first of four ICU seizures. It seemed to immediately follow a series of beeps from my monitor. Nurses arrived with fitting concern. Kept me safe from myself, made some notes, went wherever it is they go. The second verse, same as the first, the beeps a little bit louder and the convulsions little bit worse.  The nurses arrived from wherever it was they went.

My mother arrived from thin air. Already praying and massaging my racked left-side. As the episode abated, not when it ceased (be it known), mom had questions for the nurses. My mother gathers no moss down the path of getting to bottom of things.When the third seizure struck, my sundry team of medical professionals did not panic, but did allow that they maybe should get more meds and a longer white coat involved.

Two of the nurses left my bedside, my mother presuming, I presumed, en route to two red phones--one labeled "meds", one labeled "longer coat"; for her part, she picked up her ever-blinking gold phone and resumed her prayers. The third nurse jotted on my chart in a calm, conceivably pantomimed manner.

My body settled by slow degrees. Mind and muscles were exhausted.  The room narrowed and dimmed to yellow gray as my eyelids fell, unresisting. Time passed. I'm sure of it. I felt it moving from all sides, from all times--a post-seismic miracle with which I’m familiar though of which I’m not the least comprehending. Time passed soothingly forward, smoothly back like a farmhouse porch-swing; it levitated like a leaf in a gentle updraft and descended on its crackly umbrella of dead veins. Time passed when it passes, or passes when it passed. I'm sure of it.

But when the beeps beep, first in a frenzy from the grog, then in piercing, staccato ricochet off the walls . . . rude.

I think I had decided back then, but right now I cannot remember [how to spell remember] if I appreciated the warning beeps or if I’d have rather taken my shocks in the customary way—in the natural course of life’s malarkey. I've never had the “aura” or the metallic tastes which many epileptics talk about preceding an episode—their beeps, so to speak—so I still can’t say for sure; though I suspect an occasional heads-up would be nice. Especially while eating good BBQ or about to be discommoded while en-commode, so to speak.

Comparatively, my second biopsy was a delight. For starters, it sounds cooler: stereo-tactic needle biopsy as opposed to craniotomy; it evokes a pretty nifty Star Trek vibe whereas craniotomy smacks of Hannibal.

Of course the “needle” prospect is off-putting. Gums and needles. Veins and needles. Brains and needles. Pines and needles, now that's the stuff you're looking for. Pins and needles, worst case scenario.

As it turned out, the prep for the operation was the most “painful” part of the ordeal. I use the quotation marks because I've had knee surgery, appendix surgery, epididymus (I'll let Google do the heavy lifting on that) surgery, and the cranium one. Call it uncomfortable. Because in order to perform stereo-tactic biopsy the surgical team needs precise coordinates to access the target tumor and in order to do that they need real time images of the target brain and in order to do that they need the target human to keep his head still and (last one, I promise) in order to do that the surgical prep team must bolt a metal cage to the target head. I have pictures somewhere. Neo-Frankensteinian, classically ridiculous.

Next, after the AMA mandated hour minimum between set and go, I was on my way to the operating room, rehearsing my ZYXs, lightly sedated and only locally anesthetized. I knew I was not to be fully knocked but had forgotten the implications--drill, needle, bore, resect, retract. Awake with the option to banter. A miracle with which I was utterly unfamiliar.

But it's just like an erudite T-shirt of mine once told me: “One may say that the eternal mystery of the world is its comprehensibility. Albert Einstein.”

P. S.

Yes, rocket scientists and brain surgeons possess lofty minds, but never underestimate the unique genius of a perfect-cheese-sandwich maker.