The Halo

He was hit from behind. He was only driving about 45mph, and being 91, I guess we should forgive him that. I don't know any of the rest of the details about what happened to him that day, and I don't want to. From the looks of him now, it was the horrible beginning of a horrible end.

He is hooked up to a ventilator, strapped down to the bed, his swollen and disfigured head rigidly fixed in place by a collar designed to prevent him from moving his broken neck. It's been days since his accident, but he is still crusted with blood and dirt. We want to get him off the ventilator, because he has developed pneumonia, as many on ventilators eventually do. But if we lift his sedation enough for him to breathe on his own, he will be in excruciating pain because of his many fractured ribs, so we called Pain Control to come and place an epidural. I came back from lunch to find four strapping Anesthesia residents standing outside of his room, shaking their heads. Neurosurgery had nixed that idea, they said. They had been told that the patient's neck was too unstable, and that he could not be rolled onto his side for the epidural placement in his spine. Instead, Neurosurgery would come (when?) and put screws into his skull to attach him to a rigid armature that should stabilize his neck enough to place the epidural. The apparatus is called a Halo. Once we're done with this poor man, it won't be the last one he wears.

In case you missed it...

An article about me appeared on the front page of the LA Times. Click here for a link to the article, and here for a link to the photos.

One year anniversary

I had totally forgotten, until my mother called in a celebratory mood: today I have been cancer-free for one year! It is the anniversary of my "heroic" surgery, so named because the best doctors in the country agreed that it was the only thing that could cure me, even if they weren't sure that it would work. We had a wonderful conversation, talking about all the things that have happened since then, and how amazing it is that I am not only alive, but doing so spectacularly well. I feel altogether unreasonably healthy, and perhaps not coincidentally, the CT and blood work done earlier this week show no evidence of disease!

A three year long torrential flood of events has carved new channels and created new beaches on the riverbanks of my psyche. And while the flood has abated, the previously glassy flow of events is now swirled aside into unexpected eddies of doubt, and thunders up against new boulders of understanding, and spreads out onto fresh floodplains of reflection. And while I would not wish my disease on anyone, my life has been made so much richer by riding these waves. Every day, many times a day, I encounter situations that resonate with me differently because of my illness. Life has been and continues to be wild, and drenching, and scary, and exhilarating. What more could I ask for? Dayenu!

I have been busier than ever before. Yesterday was the last day of my Surgery rotation, which is famous among medical students for the absurdly long hours spent at the hospital, kowtowing to the established sado-masochistic hierarchy, all the while having stunning opportunities to engage with countless people during the most critical moments of their lives. There is so much to write about, but it must wait: I have an exam to study for!

In the Vascular Surgery Angiography OR: The number of pagers carried is inversely proportional to one's importance.

The Newborn Nursery

In 1979, some variation of the following probably occurred.

A medical student, his hands quivering, placed his hands behind my shoulders and picked me up from a rolling basinet. He gasped as my unsupported head rocked back, seemingly threatening to roll right off my neck. He was quite relieved when it didn't. He placed me under a heat lamp, and then fuddled with the dial, trying to figure out how to turn the thing on. He measured my head with a paper tape measure, picked up his pen to record the data, and then wondered to himself for the first of many times if he was supposed to take off and change his gloves between doing this and doing that. He decided no. He searched a poorly mimeographed form for the right box in which to write this number. There were hundreds of boxes on the page. While searching, he forgot the number, and went back to re-measure. He sweated under the heat lamp. He did not even try to contain his surprise when I grasped his latex-covered finger and jammed it into my mouth, WAY in there, and began sucking on it. He had never felt anything quite like that before. He didn't imagine it tasted all that good, but I apparently didn't seem to mind, so he let me - at least it had gotten me to stop crying. He scratched my foot and made my toes fan, he flipped me over on my stomach and made me wag side to side by tapping up my back, he pulled my arms down and watched as they sprung back up. He gently squished my testicles between his fingers. I didn't like that at all. He decided that now would probably be a good time for a glove change, before picking up his pen again.

That head would grow curly blonde ringlets, then straight brown hair, then curly brown corkscrews, then fall out. Those lips would go on to speak French and kiss girls. Those reflexes would be incorporated into innumerable layers of recurrent neural subroutines, and be orchestrated to throw curveballs and fill out forms. Those testes would grow cancer. He documented what he could, but he had only the faintest idea what might happen to it all.