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Part I:


Warning Shots




Sent: June 13, 2004

Subj: What could be more fun than a brain tumor?


The Continuing Adventures of Tom and His Entertaining Band of Tumors:


What a spring it has been!  Sometime in April, I noticed a small lump in my soft palate.  I had a delightful surgery on May 4 to remove a small, charming radiation-induced cancer (apparently completely cured by surgery).  I am told that the surgeon warned me that the stitches would come out by themselves.  What he definitely did not say was when--2 days later.  He wanted the wound to heal open (by "second intention" as we doctor-types say).  So, a few days later, I was standing in the emergency room talking to another resident when what should happen but the roof of my mouth pops open.  Needless to say, this did wonders for my bedside manner.  I frantically called the surgeon (henceforth to be known as Dr. Communication*) who was unsurprised.  Thanks.


Next, I made the mistake of getting an MRI of my head and neck.  Well, I should have known better.  After all, if you don't want to know the answer, don't ask the question.  So, on the Friday of Memorial Day weekend, Dr. Communication calls me up and says, "Your MRI looks normal [I sigh with relief]. . . except there is a small mass in your left temporal lobe.  It's probably a meningioma.  You should talk to a neurosurgeon."  This news detracted somewhat from K's graduation from law school, which took place later that day.  I have decided it's my personal mission to cast a pall on every family event this year.


So, on Thursday, I went to see the Jedi Master, who is the Superman of neurosurgery.  He was very pleasant, but necessarily blunt.  He said that I almost certainly have a radiation-induced meningioma, which is more aggressive than your everyday meningioma.  It will grow.  I can wait to do something until I'm a gibbering, seizing, drooling, incontinent freak show, or I can get this removed ASAP (actually, I'm reading between the lines on some of the details).  So, I will probably get this thing removed on July 30 (my birthday!) or sooner depending on the results of a PET scan (to be announced on June 25).  True to form, I chose to receive this news just before my brother-in-law’s wedding, adding extra sparkle to the event.


Now, to put this all in perspective, it is smaller than a pea, so as brain tumors go, this is a peewee--not even a true tumor, a mere nodule.  And, as brain surgeries go, this is a walk in the park. (I'm told that walking around the Fenway at night can be equivalent to a craniotomy.)  If all goes as planned, I'll get a month's vacation, one hell of a headache and more sympathy points than I can cash in for a year.  (Also, I will get all sorts of TLC from my wonderful wife and hang out with the delightful Little Lord Chaos (LLC) (my son, one year old at the time).


So, without further ado (not to mention adieu), here are my top ten thoughts on my cute li'l' brain tumor:


10. I can no longer count to ten.

9. I need this like I need a hole in the head.

8. What's the big deal?  It's not like it's rocket science!

7. There is no number 7.

6. I was 2 for 2 on tumors, so I had to go for the hat trick.

5. Symptoms?  Me symptoms no got have.  Roogala, roogala, roogala.

4. That's just how the CIA gives me my orders.

3. I got a brain tumor.  What's your excuse?

2. It's actually my legal education.  It only looks like a tumor.


and number 1 (drum roll, please). . .s


1. It's all in my head.


Peace, love, and may all your brain tumors be as itty-bitty as mine,




* To be fair, overall, Dr. Communication turned out to be a very dedicated and compassionate guy who came through for me in bad time--in addition to having plucked a potentially deadly tumor out of me and ordered the scan that showed another.  But fairness isn't funny.




Sent: July 11, 2004 

Subj: Tumoriffic!


Greetings and trepanations!*


And the fun never ends!  Tomorrow, I go into the hospital for brain surgery.  That's right, brain surgery!


It has been another eventful couple of weeks since our last installment.  My little soft palate tumor has hit the big time.  It's so weird, it was featured at the Ben and Jerry’s Tumor Board Conference.  But was I invited?  I think not!  It was upgraded to 'intermediate grade.'  Now that my tumor is famous, he never calls.


Speaking of unfair, I just saw Spider Man 2.  It made me think.  Peter Parker gets bitten by a radioactive spider and gets spider powers.  I get exposed to radiation, and what power did I get?  I grow tumors!  Yippee!  I'm Cancer Man!*


On the bright side, while I have had a number of pre-op appointments this week, I have gotten to see a lot more of LLC and K.  Many wonderful people I don't see often have visited.


Meanwhile, showing wisdom beyond his year, Little Lord Chaos has been a mighty pillar of strength.  No matter how bad the news I brought home, he never let it get to him.  He would smile and say something reassuring, like "Goo."  He has also helped me physically prepare for surgery.  I carried him to daycare every day in a backpack.  Whenever he yelled "Go!" (or "Goo!" or "Ga!"), I had to run.  That boy was one tough coach.  And no matter how tired I got, he just laughed at me.


So, as I was saying, tomorrow is the big day.  I will likely be under for 4-5 hours.  Dr. the Jedi Master will use an innovative method called 'MRI-guided' surgery.  Instead of cutting a big hole in my head, he will cut a small one and watch what he is doing using a specially-designed MRI machine.


After the surgery, I will probably be in the hospital until Thursday.  I am unlikely to be up for visitors until after I get home.  The total recovery period should be 2-4 weeks.  In theory, I would love to see any of my friends and family, but I am told that my energy levels will be low, so please e-mail to this address to see how I am doing.  K will check e-mail if I'm not up to it.


Well, wish me a happy craniotomy.




*Some contributions from friends




Sent: July 23, 2004

Subj: Tumorless Tom?


Hello everyone.


I'm doing remarkably well.  Sorry it has taken me so long to write an update.  I was asleep at the time, but people tell me the surgery went smoothly.  The illustrious Dr. the Jedi Master was able to remove the thing without cutting any brain.  They just had to push some aside a little bit.  (I envision my left temporal lobe flopped over my right ear.)  My only complaint is that those neurosurgeons need barber lessons.  They did a real number on my carefully styled hair.


The first week after the surgery was a little rough.  Although I was healthy enough to come home 2 days post-op, I was grumpy, tired and stupid for several days more.  It was just like being post-call all the time.  I had remarkably little pain and was not at all tempted by the Percocets the neurosurgery resident offered me.  (Another opportunity to make good money thrown away.)  I was deeply moved by the help I got from my family and many friends.  Notably, the food-bringers, the chore-helpers, and especially those friends who came and hung around for a few days to keep me company and watch me in case I had a seizure.  I also want to thank David and Robin, brain tumor veterans who warned me what to expect and also referred me to a wonderful new primary care physician.  (I have been unable to reach my old PCP during this whole affair.  I just left messages to get referrals for doctors I found.)*


The stitches came out a couple of days ago, and nothing has fallen off yet.  (I take that as a good sign.)  I get to wash my hair again.  I have a wicked cool scar going from about an inch in front of my left earlobe, up, over and down the other side.  Who knows?  It may become stylish.  It's no stranger than tongue-piercing.


In general, I feel almost completely back to normal.  As of 3 days ago, I am allowed to drive.  The heaviest thing I am allowed to lift for a month post-op is LLC.   I'm told that heavy lifting increases intracranial pressure. (If I see a little disk of skull flying off like champagne cork, I'll know I've overdone it.)  I can't chew very well since they had to cut some muscle, and I can barely lift my left eyebrow but that will come all back.  The pathology report is not bad at all, but just ambiguous enough to make me very glad I elected to have the surgery when I did.  All that is indicated is careful observation.  I'll be back at work early next month.  I'll just have to be careful not to play football without a helmet.


Thanks everyone for your concern!




* If I have forgotten to thank someone, just blame on the brain surgery.  It's got to be good for something.



(March 30, 2007) And so, cured of all my tumors, I rode off into the sunset and lived happily and healthily ever after.  I completed my residency without further incidents, and went on to a successful fellowship in Infectious Disease medicine.  All was right with the world.




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