Sunday, November 1, 2009

PROLOGUE - LIFE IS...Full of strange moments in time.



Prologue


LIFE IS…

Full of strange moments in time. Moments which become suspended in time, slowed down to almost exaggerate the intensity of what you’re about to experience. Moments which are similar to the dreams where you are trying to run but can’t get your legs to move. That brief second before the accident where the whole scene goes frozen for an instant, silent and you think to yourself, this is going to be bad. Then everything goes into fast forward and the crunching sound of metal spinning through the air as the truck flips over and all you see is the ground rushing up to collapse the hood of the cab before it crushes down on top of you, spitting you out the side and onto the ground. As you stare at the ground in disbelief about what you just survived, you are strangely focused on the gravel. Why am I just staring at the gravel? Get up!

So I survived, somewhat broken, but alive. Thanking God that I had been spared. Crazy, uncontrollable body shakes as the body releases the adrenaline dumped into the system, as if I’d just come out of an ice bath. But none of these kinds of life moments could have prepared me for what was about to happen.

We were having an early gift opening for our family Christmas before leaving on a ski vacation, just the four of us. My wife, Patti, my teenage son Kamden, my teenage daughter Kjersti and myself. Sitting around a warm fire, sipping a glass of wine and enjoying the brief quiet before the storm of finishing our packing. The kids are all excited about opening their gifts, but more excited about leaving in the morning for a winter adventure. I ask my wife a question, and I think I mishear her answer. I ask again, and I get the same strange response which makes no sense. I shake my head, look at the kids and they are as puzzled as I am. I cock my head a bit to the left like our little white bijon friche who tries desperately to understand what we’re saying, but just can’t seem to get it. The kids and I both think she is making a joke or kidding around with us, but when it happens again I get an immediate knot in my stomach. I know something is wrong…I just didn’t know how wrong. I call my sister, an orthopedic surgeon, and describe what we’ve just experienced. She tries to keep me calm, but I quickly grasp the gravity of the situation. After asking my wife who the current President is, and with a straight face as serious as can be, she disgustedly tells me, “geessh, purple cows can’t so there’s why I can tell you the President.” After randomly sampling the responses from a few other questions, my sister tells me that my wife is having some kind of brain attack and to get her to the Emergency Room…immediately.

It was one of those times when all of sudden everyone knows something is terribly wrong. The kids begin to cry in fear, not knowing what’s happening to their mom. We quickly load everyone into the car and drive a few short miles to the local ER. My wife is objecting the whole time, half the time making sense and arguing that she’ll be fine, the other half talking gibberish. The intake nurse is quick to recognize the urgency of the situation and immediately gets my wife on a gurney and back into the ER. I sit the kids down and make sure they are situated. Then I join the group of doctors working on my wife back in the triage area. As they start to do testing and asking her questions, I see a blank stare come over her eyes and she stops responding. Like a tidal wave rolling in, the gran mal seizure starts as her eyes roll up into her eye sockets and her body becomes overwhelmed with what’s going on inside her brain. The doctors immediately recognize the onset of the seizure and do their best to assure me that they know what they are doing. How can you know what to do for something as awful as this? The doctors are amazed that we were lucky enough to get her to the ER before the seizure began, as most victims usually lose consciousness and fall down. The first few seconds of the seizure are marked by complete rigidity in every muscle in her body. She stops breathing completely. I cannot fully describe the grotesque contortion that happens to the body when it goes into this state where every limb is seemingly completely hyper-extended, but yet in total constriction. Shortly after the complete rigidity comes the convulsion, violent and rhythmic. All of her extremities are slapping wildly against the gurney, pretty much like Darryl Hannah having a death seizure in one of my all time favorite movies, the Blade Runner with Harrison Ford. I will never be able to watch that movie in the same way ever again. The experts can only watch and make sure her airway is open and that she doesn’t bite her tongue. This is when it hits me that this is why they call it “practicing” medicine, as they have no solution for this. The seizure lasts for what feels like an eternity, but in reality is probably about 3 minutes. The convulsion weakens and just like a submerged diver coming up for air, her respiration starts again with a huge gasp as she gulps for fresh air.

As she stabilizes, they wheel her off for X-rays, CT scan and PET (positron emission tomography) scans. I learn later that PET is a major diagnostic imaging modality used predominantly in determining the presence and severity of cancers. It is currently the most effective way to check for cancer recurrences and it offers significant advantages over other forms of imaging such as CT or MRI scans in detecting disease in many patients. Being an engineer and always wanting to understand root cause, I learn that for the PET scan she is given a radiopharmaceutical, such as FDG (fluorodeoxyglucose), which includes both sugar (glucose) and a radionuclide (a radioactive element) that gives off signals. She is injected with these contrast elements, and the emissions given off are measured by a PET scanner. A PET scanner consists of an array of detectors that surround the patient. Using the gamma ray signals given off by the injected radionuclide, PET measures the amount of metabolic activity at a site in the body and a computer reassembles the signals into images. Cancer cells have higher metabolic rates than normal cells, so they show up as denser areas on a PET scan.

I will never forget when the radiologist and medical oncologist called me into a small room lined with little white light boxes all around the walls. They turned off all the lights in the room except the light boxes and then jammed the slides up into the metal clips to hold the scans. This is when it happened again, that out of body slow motion experience just like the accident. I was literally floating up in the corner of the room, watching this bizarre scene unfold in front of me. I looked down at these two lab-coated geeks and said to myself, that poor bastard is going to get some really bad news. As I said that to myself, it hadn’t even hit me yet that the dude was me. When I realized that was when everything went into fast forward high speed mode. It was like my whole life flashed before me and all I could do was sit there in shocked silence. I vaguely remember hearing the doctors talk to me, sort of like how the adults talk to Charlie Brown or the other kids in Peanuts with a “wa-waa-waaa” muffled voice sound, but not intelligible. I do remember crystal clear the sentence, “You see that little black node in her frontal lobe? That is a brain tumor. You need to put your wife’s affairs in order because she will not be here in a year.”

You cold-hearted bastards! Didn’t anyone teach you bedside manner in medical school? Are you such a social retard that you have lost the ability to have any compassion whatsoever? What ever happened to just the politeness of saying, “I’m really sorry, I’ve got some bad news which is going to be really hard to understand. Would you like anyone to be here with you as we talk about this?” This was like these guys were the purveyors of bad news as sport, just trying to see how callous they could be. I knew a guy like these guys before, a forensic pathologist who dealt with death all day long. A life that was tainted by the gore of seeing every imaginable type of death and figuring out how to survive without being scarred for life. The reality was that dude was twisted by his profession. How could you not be affected when you’re the person pulling body parts out of the plane, train and auto wreck or trying to figure out how a man could kill himself using a trapeze hung above his bed and a sharpened fence pole nailed to the wall and impaled up his rectum? That is some twisted stuff. But to be fair to this pair of dumb and dumber, I’m sure it was just a reflection of their own badly honed coping skills, or more realistically their denial of having to interact with real human beings. How could someone survive in a profession where every day you are telling people their loved ones have cancer and are going to die? It’s no excuse for these idiots, but at least I can rationalize why they were such moronic communicators.

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