Gamma knife

1937109_105365107132_470020_nThe Gamma Knife Radiosurgery goes pretty much as promised. The Valium is really not enough to take the edge off, but I was not really feeling much edge anyway. The shots to numb the areas where the pins would attach the ring to my skull hurt like hell and I found myself, with tears in my eyes, using the Lamaze breathing that I learned in childbirth classes six years ago but have never had to call upon in my three Cesarean Sections. The shots are put in one by one and while I want to beg them to let me get my bearings between each one they made no such offer. Not wanting to appear weak, I stay silent.

There are four pins that attach the ring to my head, two on my forehead and two on the back of my head. The pin that they insert in the back left side of my head somehow misses its anesthetized mark and its insertion and residence there, although short, is excruciating. It seems the neurosurgeon asks me something about whether it is pressure that I am feeling and I am somehow able to communicate to him, although I am not sure that it is in English, that it is not merely pressure that I am feeling. He removes the pin, gives another awful shot, and reinserts the pin and somehow, once everything is installed, despite that awful looks of it the contraption isn’t the most uncomfortable thing that I have ever worn. I am surprised and pleased.

There is a CT scan to help them line up the radiation precisely and then I am given breakfast. One of the friends who waits with me had brought a banana and sweetly offers it to over and over in hopes, I’m sure, that it will make this all okay.

The procedure itself is painless but somehow brings out in me all the emotions that I should have been probably been working though in the weeks since diagnoses. Alone in the room, literally bolted to the table by my head, being moved this way and that from time to time by the mostly unseen techs; I am suddenly overwhelmed by the sad loneliness of it all. It makes me miss my mother. I want her here to hold me, to stroke my hair and tell me that it will be okay. And then I am sad anew because I realize that if this doesn’t work, my own children will lose that comfort from their mother as well.

I realize as the machine moves and whirrs that I am, at that very moment having things burned from the center of my brain. I understand why my friends have been so weepy and worried these last few weeks. I see suddenly that while it almost never happens, it has happened to me again and again: the tumors have come back and they have moved and they are now threatening the very thing that makes me me. I have a brain tumor and suddenly benign doesn’t seem so benign.

As they remove me from the machine and the Radiation Oncologist comes to remove the ring, a single river of blood runs from my left forehead pin spot to my eye and down my cheek. Although there was pressure the procedure was not painful, and yet is was all I can do to hold back my tears. Afterward, I am taken back to the family room where my friends, who have nothing in common except me and their dislike of one another, take turns mothering me; alternately wiping the blood from my face and trying to remove as much of the marker ink from the pin placement site as they can. No one offers to hold me or stroke my hair, but I have a feeling that if I asked they would quickly accommodate me. And I wish, more than anything, it could be enough.
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Home Again

We are here for a routine visit in a life that has become unroutine by most anyone’s definition. I am in the planning stage for my second six-week course of radiation for a tumor that I was once assured was nothing. It is now the nothing that will kill me someday and so we continue these huge treatments that are no longer huge to us.

I sit, fully clothed, on the exam table, the white paper crackling beneath me. My back is straight, my hands folded daintily in my lap but not because this is my way. Rather it is because I always imagine hidden cameras in these rooms and somewhere in the clinic a wall of monitors and groups of doctors and nurses laughing at patients picking their noses or rummaging through drawers and cabinets full of medical supplies. Sure, this is unlikely given the magnitude of their work here, but sill, I figure it can’t hurt to behave myself.

The doctor comes in unexpectedly and I know in an instant the news is not good. The MRI shows a mass on the back of the forebrain, he says. It is inoperable and now fills a space in my brain where cerebral spinal fluid once washed through unimpeded. They will do something called Gamma Knife Radiosurgery he tells me. Hundreds of separate beams of radiation will be directed into my head where they will intersect at the tumor, killing it. The remnants of this atrophied growth will then liquefy and be reabsorbed. The best case scenario will be an empty black spot that will forever show itself on the MRI like a pair of bunny ears placed over my head by some childhood peer in a class photo.

I sit, alone, on the edge of an exam table at the university hospital in the town of my birth. My husband and children sit out in the waiting room talking, laughing, oblivious to the fact that this appointment that was supposed to be about nothing has rapidly turned into something.

I am 35. I am sick, I am tired, and I am home. And yet, not home.

There are no barricades at the edge of town, no uniformed officers with waving arms signaling no entrance, but just the same, you can’t go home again.

I grew up here and driving back twenty years after having moved away the blue of the mid-summer sky is almost choked from view by crisscrossing tree branches. The town appears overgrown and slightly wild as if an abandoned farmstead instead of a vibrant college town. The twenty years of tree growth makes the town seem smaller somehow, more closed in, as if I have grown a great deal since I left even though, if anything, I feel smaller, worn down a little by life.

This lushness of this river town surprises me in the way that seeing a picture of my childhood home the year my parents bought it surprised me. In the photograph the trees I would climb in the yard are little more than saplings. This idea, that something exists without me, whether before me or in my absence, still gives me pause.

Sitting on the edge of the table, unclear about how much I might be about to lose, I am taken back to the time when I called this town home because when I lived here I lost everything and I’m not sure that I can do that again. I was seventeen when my widowed mother died and my family fell away from me as if my aloneness was something they couldn’t bother to fix and couldn’t bear to witness. The losses weighed heavily and the newness of them was sharp and ragged. I moved away from here then without the trappings of childhood but not at all as an adult. But even still, home has always emitted a siren song, seductive but painful. Come back, it says, there is something for you here. It turns out what is here for me now is the best hospital in the state.

But I can’t go back, barricade or not, because home isn’t here. It isn’t anywhere. While, like the river, so much of it looks the same it is not. Things have been carried away with the current to some far off, distant place. Things we can never get back. The things that remain are changed too: covered in layers of sediment or worn down by the passage to time and water over them. The once sharp edges of loss smoothed by that rush of water, the ache dulled by the joys of marriage and children.

The doctors work long and hard. There are tests and more tests. There is planning and counseling. There is medication given to take the edge off of the day that will include, among other things, four screws being attached to my skull and high-dose beams of radiation that will, if all goes well, kill the tumor.

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