“Are you nervous?” I ask.
We’re sitting in the preoperative holding area. Just me, my patient ― a 20-year-old woman ― and her parents. It’s 7:15 in the morning. They’ve been up since 4:00 — not from anxiety but because I’d asked them to arrive a few hours early to get a new MRI scan of her brain. I’ll put that updated scan into the operating room’s computer system, which I will soon rely upon to help me navigate safe passage to her tumor.
But who am I kidding? They’re terrified. It’s so clearly written on their faces. I’d have to be a robot not to notice the nervous laughter and her dad’s stale jokes ― a desperate attempt to lighten the mood and hide his own mounting panic. Hadn’t he always told her he’d keep her safe?
A few hours later, I finally reach the point in the operation that I always knew was coming. It has taken me a good hour just to expose the darn thing, working under the microscope dissecting a passable corridor above her cerebellum. The tumor, a benign but expanding rubber ball of cells the size of a chestnut, couldn’t have sprung up in a worse place, smack in the center of her brain. The central part, its core, has come out easily. Luckily, it was soft. But now I’m face to face with what’s left ― a bit of the capsule, which is stuck to the adjacent basal vein of Rosenthal, a thick blood vessel coursing along the back of the tumor remnant.
So here we are ― me, that last bit of tumor, and the vein, which I know is draining all the blood from her thalamus. If I accidentally damage this critical vessel, her thalamus — a cluster of neurons the size of a walnut — will probably swell up like a plum and she’ll never wake up. Related
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