The gripping story of a patient’s faith — and a surgeon’s skill.
“Early that morning a barber came into my room and shaved my head so that it resembled a large billiard ball. Then my bed was wheeled into the hall where Dad and my sister kissed me, trying hard not to cry. “Don’t worry,” I said. “I’ll be back.” My feeling was, “Today is the beginning of the end of my 30-year war against epilepsy.”
In the X-ray room, a doctor said to me with a smile, “This is a big day for you.” In one hand he had two wires, each about a meter long; in the other a glass of water. “I’m going to insert a wire in each of your nostrils. I want you to take a drink and swallow when I tell you to.” The wires were to go down into my stomach. Each time the doctor said, “Swallow,” a few more centimeters would disappear, until only about 40 centimeters remained in view. Then the doctor took an X-ray to see if the wires were in proper position. Three times, they were not, and he would say, “Let’s start over.”
Finally the wires were in place. As he taped the ends to my chest, he explained that these electrodes would provide a reading of stomach movement — the sensation I often experienced with the onset of an attack. When electrical stimulation of the brain came close to the point from which my attacks originated, the stomach sensation would be produced.
Now my bed was wheeled into the anaesthesia room. I knew that I was to remain fully conscious throughout the operation so doctor could be guided by my reactions. The anaesthetist was to give me injections to deaden the feeling in my face and scalp.
He asked me to open my mouth and, with his thumb, located the hinge bone connecting the upper and lower jaw. Into it, he inserted a needle — so far upwards that it seemed to reach my skull bone! I felt a searing pain. But these injections were the only way to deaden the feeling in my scalp and facial skin.
Each time he picked up another needle, I glanced at the remaining pile. It seemed to grow larger instead of smaller. Dr now entered, and I could feel him tracing a design on my scalp. “This is the skull opening I want,” to the doctors with him. One replied, “Yes, a full butterfly flap.”
The anaesthetist said, “She is about ready for the operating room.”
“I’m not afraid, but do me a favor. When my skull is about to be opened, will one of you tell me a joke?”
I thought it would help to mask the moment of intense pain I anticipated.
Out in the hall the doors of the operating room opened to allow my bed to pass through. I had reached the point of no retreat.
Inside, I looked at the wall clock: 8:05 am. I could see the glassed-in-gallery where doctors, nurses, and students were waiting to observe. Each of the six doctors who were to take a part in the operation wore special glasses, for the room had ultraviolet lighting instead of glaring overhead bulbs. “We’ll be lucky if we get out of here by suppertime.”
A doctor behind my head said, “This will sting. I’m going to paint your head with iodine.” The anaesthetist told me to lie flat on my back and turn my head to the left. Towels were placed around my neck firmly but not uncomfortably. In fact, I hardly noticed them after a few minutes.
Now doctor was standing at my head, a tray of instruments besides him. With foot or hand controls he raised my head to the proper position. It was up to me not to move; no sandbags or straps restrained me, except one to keep me from falling off the table. Doubtless the impact of w hat was about to happen had given me the chills.
I’m going to inject several needles at the base of your skull.” This will eliminate as much pain as possible, but you know I can’t deaden it entirely.”
He began inserting the needles. As he worked, doctor occasionally consulted his associates, and sometimes dictated notes to a secretary in the gallery, through an intercom.
I thought: Imagine doing a delicate operation like this — and dictating at the same time. He told the type and amount of medication in each injection, reviewed my case history, and explained what he believed to be the cause of my seizures: a brain injury, damage resulting from an interference with the circulation of oxygen-carrying blood to one side of my brain, at the time of my birth.
Each needle felt as if it would come through my mouth. I finally lost count of the needles. “How many more?” “Not many. Try and bear it longer,” the doctor would answer.
I glanced at the clock. It seemed impossible but it was already 11.20 am. Now I felt the pressure of what I was certain was a scalpel against my scalp. No pain; just the sudden warmth of liquid trickling down my cheek. When I realized it was my own blood. I said, “I’m going to throw up.” A pan was held close to my face. My mouth felt parched. A piece of ice was placed between my lips.
Dr said, “We are about to make a few holes in your skull.” The drilling began. There was a period of dull pain, and a dull grinding sound. There were to be, I knew, five to seven fairly large burr holes. After an interminable interval everything was still, almost morbidly so. Then I heard the sawing of bone. I waited for the pain I vividly remembered when the skull had been opened in my other operation two and a half years back before. I finally asked how much longer it would be before they would break through my skull. Someone patted my hand and said, “It’s already done.”
THE CLOCK SHOWED 12 noon. A nurse held a cup of something steaming-soup perhaps and doctor drank it through a straw.
I heard, more than felt, the awful sensation of liquid being squirted over my brain. When the brain is exposed, the air dries its surface quickly, and it must be continuously moistened. At 1.30 pm, doctor said, “Turn the machine at this angle.” I knew he was referring to the machine he would use to stimulate the electrical activity of my brain cells.
Pictures were taken, both in black-and-white and in color. Then doctor spoke to me quietly, from here on I will need your full cooperation. We are going to stimulate your brain, and I want you to tell me exactly what you feel and where.” Was I ready? I said I was.
A few seconds later I felt a light current go through my body. I said, ” I feel as though I am about to fall off the table to my left.” He answered, “That’s fine. We’ll try it again.” This time the current was stronger. I said, “My left leg feels as though it is about to fall off the table.” Moments later I felt someone lift my leg back on to the table. Then I heard the doctor say, “I want a few more color pictures, please.”
MORE BRAIN STIMULATION: “Doctor, that felt as though my left forefinger pointed inward.” Doctor repeated the experiment, then said, “Let me hear what you said during the stimulation.” I heard my own voice and realized my words were being recorded. Immediately after, Doctor said, I am going to remove a small section of your brain which is causing you some of your trouble,”
Then I heard words which I shall never forget: “Remember, just so much is in my hands.”
A few minutes later came the clicking sound of metal as he put down the instrument he had used, and I knew the excision had taken place. I looked at the clock. It was 2.30 pm. How much longer?
Dr said, I’m going to stimulate again. Please tell me what you feel.” I felt the current, and at that instant I felt my left eye turn inward. It was repeated. Then doctor said, “I’m going to remove another small piece of brain.”
At that crucial point I said, “Doctor, I have a funny feeling I’ve never had before. I’m afraid I’m going to have a seizure.” Metal clicked as he laid aside his instrument. A few moment later I had the seizure, a small one.
“What kind of reading did you record?” Dr asked an assistant. The answer came, in medical terms.
Once more I felt the stimulating current go through my body. And this time I had a familiar, sickish feeling int he pit of my stomach.
Once again the doctor said, “I’m going to remove another affected bit of brain.” And, speaking to his assistants, he explained how far into the brain he was going. He said that the previous surgeon at precisely the right spot, but had not gone this deep, fearing he would leave me paralyzed.
For the first time I felt true cutting pain momentarily. When it ceased I said, “If anybody ever says again there is no feeling inside the brain, Doctor, don’t believe him. I know better.”
I kept saying, I’m tired, doctor. Please put me to sleep.”
“I’ll bet you a quarter you’ll fall asleep within the hour.”
Then he said that he was a bout to make his third excision, and now he would touch the section of the brain that controls vision. For the first time, I said a silent prayer.
Then I heard put him down his scalpel. I could still see the anaesthetist clearly — and I thanked God.
Dr said, “Still awake? I guess I owe you a quarter.” The recording shows that I replied weakly, “Deduct it from my bill.”
I was so tired I could hardly hear the voices around me. After a while the doctors began testing the reflexes of my arms and legs.
Dimly I heard them say. “All four extremities have good reflex actions. No paralysis.”
The anaesthetist spoke: “Hold your arm steady, while we locate a vein.” It meant that the operation was over. Now t hey would put me to sleep to close my skull.
Exhausted, I glanced at the clock as I felt the needle going to arm: 4:30 p.
“No paralysis,” I heard.
All was well.”
