Chapter 5. "That Was a Good Procedure"

Glioblastology, the Book

Friends, Thursday is chapter release day! Can you believe we’re already at chapter 5?! According to the book outline, this chapter concludes the book's first part, “Inside My Head.” Part two, “Encounters,” picks up the story after discharge. I’d love to get a live stream going with the community, so stay tuned for that! We also have a topic request from a reader who’s reached five referrals! I hope you’ve enjoyed the first five chapters. I’d love to hear your feedback in the comments! xx. <3 -a.

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“That Was a Good Procedure”

Whitney and I and our three boys are crowded in our second-floor condo. There is a pass-through from the kitchen to the great room, a split-floor plan layout. On one side of the pass-through is our small kitchen, on the other, a bar-height counter. The stools, purchased on the cheap and assembled by me, had long since given out. Besides, I read somewhere that standing to work is better than sitting. The vantage point allowed me to spin my head in a hurry to perform a risk assessment of the wrestling, always on the border of bodily harm, which is life with three young boys, our youngest only eight months old.

The counter was always littered with my laptop, legal pads and retractable Pilot G2 pens in blue or black, graduate school texts, the marked-up draft papers left to complete for classes, and the stained rings of red wine bottles that had been placed on the counter in haste. I turned my phone face up to check notifications, and I am reminded that the evening before I silenced a call from an unknown number. The mystery caller left a voicemail.

Here, I stood at the counter, listening to my neurosurgeon.

After presenting my scans to the tumor board, a meeting of surgeons, oncologists, and other specialists assembled to review medical cases and recommend plans of action, the consensus opinion among his colleagues was to perform the craniotomy (brain surgery) and surgical resection of the tumor, while I am kept awake to complete functional mapping of my brain in real-time while removing tumor. I need to remain conscious to report sensory and motor responses and respond to commands from the surgeon. In effect, to mitigate harm to the eloquent functions of my brain.

(Of course, you readers know all about this!)

“We all agree this is the best way forward to protect the maximum amount of motor and sensory function,” explains my neurosurgeon in the one-way transmission of voicemail communication. “The head OR nurse and the anesthesiologist will call you tomorrow to prep you for surgery. We will not adjust the timeline; your surgery is still scheduled first thing Thursday morning.” I look up and lock eyes with Whitney; she is standing in the kitchen.

“Babe, I am going to be awake. They are going to do my surgery while I’m awake.”

Noting the voicemail was left the preceding night, “tomorrow” means that I would receive calls from the OR nurse and anesthesiologist today. I learn of my awake procedure fewer than twenty-four hours before brain surgery! The lesson of this story is to not screen telephone calls within thirty-six and forty-eight hours of major surgery.

Before surgery, I wondered if my heavy eyelids would gently close and never open again. The closing of my eyes became ceremonious, ritualized, rehearsed, and well-practiced. I closed my eyes to usher in death. What would this be like? Whether I would be aware of death, whether my body would sense my slowing pulse, my labored breathing, or would the heavy eyelids be the only signal of death?

These thoughts were somewhere close to the surface Thursday morning when I gripped the back of my hospital gown to pull it closed and shuffled to the bathroom in the pre-op wing of the hospital to be prepped for surgery. I passed other rooms where other patients were prepped by other nurses. I received an IV line. My clothes and possessions were removed and placed in an evidence bag like I was spending a night in the drunk tank. Surgeons, OR nurses, residents, family members, and the chaplain marched in and out, drawing the curtain open and closed with dramatic theatrics. Maybe this was a dress rehearsal. The actors entering and exiting the stage. The curtain opens and draws close. When it was time for my performance, I squeezed my wife’s hand.

Curtain opens.

Exit stage left.

Break a leg.

The fluorescent lights passed overhead as my gurney wheeled down the OR corridor. Hypnotically, these lights clicked by like streetlamps. I was surprised that doors to other operating rooms slid open like a gas station, half expecting a bell to ring. I wondered if those same patients I hid my modesty from earlier were now laid bare on the OR tables as I sped by. The white lights washed out the details. Soon would be my room. My eyes squint from the white fluorescence of the operating room. My eyes gently close. I feel my pulse. I feel my breathing. I am alive. I am prepared. I am comfortable with the craniotomy we must now perform.

“Adam. You have a decision to make.”

“I do not want to make the wrong decision and end up back in this room in a year,” I told my surgeon, with his hand reassuringly gripping my right shoulder.

“Do not make a decision based on what could be the case in the future. Make a decision based on your quality of life today.”

I have three young children. Paralysis is not compatible with wrestling around on the floor and playing with our boys.

“Let’s stop the procedure.”