Friday, April 15, 2005

I should be tickled silly

Last night I had one of those moments. I realized that in a few hours' time, our lives could change forever. Why? Because this morning, my son had an MRI of the brain. He's had a constant headache for the past five weeks. His mother and his pediatrician both seemed ready to write this off as a particularly nasty viral crud, but I've seen too many kids with brain tumors. It didn't help that the mom of one of those patients came by to thank me last week. (Sure, it's nice when people do that, but it stirred the pot.) Nor did it help when I told myself that those other kids were a lot sicker than Jake. They had much worse neurologic symptoms (says I), they LOOKED sick, and so forth. That little creep in the back of my head (trust me, you want your doctor to own a creep like this) merely said, "It could STILL BE SOMETHING HORRIBLE. You can't drop it just yet." And so we got the head CT last week. Normal. Does that let Jake off the hook? No! Some of the nasties will only show up on MRI. So why do I bother with the head CT? Go figure. Last night, I thought about Life after Diagnosis: the mental distortion that comes from hanging on to hope, when the odds are so slim; the painful trifecta of surgery, radiation, and chemotherapy (what's worse: living through that, or watching your child live through it?) The loss of function. The dissolution of personality. We doctors are a fucked up lot. By this morning, I'd gone past that stage. As Jake's appointment neared, I found it more and more difficult to dwell on 'what if'. Now I was in Writer Mode, already assuming the MRI would be fine, mentally composing my daily blog entry. Realizing: asshole, this isn't about you. But writing, like medicine, is a fundamentally egocentric activity. (More on that some other time.) Well, Jake's fine, naturally. Otherwise, we'd be flying or driving to Portland right now. Next up is the neurology appointment on Monday in Ashland. Jake went through the MRI like a champ, by the way. He barely flinched when the tech injected the contrast, and weathered the nauseating flushing reaction that came with it. He saw the films afterwards and commented on what a nice looking brain he had. I looked through the films, too, with quite a different frame of mind (that fuzziness -- is that just volume averaging? And what's that dark spot -- flow void, or something else?) Obvious enough that there weren't any big gumbas, to use the technical term, but was there something subtle present that only the radiologist would see? Nope. The radiologist gave us a clean bill of health, too. So. I should be relieved, tickled pink, delighted. I am relieved, but I still feel tight. Really go figure. D.


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