The Twinkling of an Eye. Sue Brown
twelve-year-old boy that his symptoms sound like he has suffered a stroke. My son’s first line of defence against his own anxiety is trying to turn the doctor’s appraisal into a joke.
We progress to an officious casualty officer, who says, perhaps a little put out by the orders from the neurologist: ‘I am sure this is just Bell’s Palsy. But, just to be sure, we’ll do the scan.’
I am irritated by his patronising manner, but choose not to contradict him with the infinitely more terrifying reality in front of my child. I know that the scans will all too soon prove him wrong, but I am feeling too emotional to trust myself not to cry if I say so.
Craig is wheeled on a trolley along deserted passages to the dimly lit cavern of the radiology department. Soon to close up for New Year’s celebrations, the radiographers are in festive spirits. They congratulate their patient for wearing a black T-shirt featuring a brightly sequinned Baby Milo monkey, inadvertently matching their own ‘Black and Bling’ dress code for the day.
His head and shoulders are tightly clipped into a special head cage as he slides into the claustrophobic MRI tube. He has strict instructions not to stir. A panic button is in his hand in case he needs help. I put a hand on his leg, where it protrudes from the machine, and we are left in the dim chamber as the machine begins its knocking and banging. Electronic arpeggios impassively sending the all-important images of Craig’s brain to the monitor outside.
The radiologist comes in after the first series of pictures. He is poker-faced, but his manner is gentle as he supervises Craig being slid out of the tube and released from the cage, and injects contrast medium into his elbow vein.
They’re about to begin the next series of pictures when I see Craig’s chest heaving – he is soundlessly vomiting while pinned on his back in the head cage.
‘That was horrible!’ he manages, shaking his head, when the staff immediately release and help him upright. My heart aches at Craig’s pale boy torso, now stripped of his soiled, Baby Milo monkey T-shirt – and, with it, his brave armour – as he leans over pulled-up knees in otherworldly light.
After Craig’s hair, face and neck are wiped as clean as possible, the radiologist urges his team to complete the scans quickly. He stands deferentially aside as the porter arrives to push Craig’s trolley back to casualty, saying only that a neurosurgeon will discuss the results with us in person.
It’s a tacit confirmation that the news is bad. Terrified of hearing the prognosis, I do not ask, running away from the inevitable for just a little longer.
Neil arrives to meet us. His eyes are question marks. The casualty officer, now a little wide-eyed, too, concedes there is indeed ‘something on the scans’.
There is a white board at the heart of the casualty ward, which, over numerous rubbings out, lists the names of the specialists on call. As Craig wheels past, I am relieved to see ‘Dr Farrier’ next to ‘neurosurgeon’ – a highly respected name in the field.
This very surgeon’s late father had been our much-loved Methodist minister – the man who married Neil and I nineteen years ago. The one who had held my infant son, who made the sign of the cross on his forehead, who baptised him.
It feels right that, if anyone should now cut into that same, precious head, it should be his own son.
AULD LANG SYNE: HUGS IN SCRUBS
We are not necessarily doubting that God will do the best for us, we are wondering how painful the best will turn out to be.
– Letters of C.S. Lewis by C.S. Lewis
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It is late afternoon when Craig is transferred to the almost empty paediatric ward. He is wheeled into his own, sunny room, and immediately sets about charming his flurry of sympathetic nurses with stories of persistent proposals from his friend’s sister – perhaps more survival tactics to escape his anxiety.
‘We will have to put a restraining order on her!’ declares Nurse Crystal. She is rewarded with a broad grin from the right side of Craig’s face, but the marked droop on the left makes me feel desperate for him.
Having completed a lengthy operation upstairs, our tired-looking neurosurgeon quietly enters the room sometime later. Dr Farrier is slightly built with fair, straight hair, glasses and something of the contained presence I remember in his father.
He nods an acknowledgement at Neil and me, but he directs his gentle greeting at his patient, who looks up anxiously from his pillow on the bed’s raised head. While he quietly appraises Craig’s clinical condition in the context of the scan’s results, I sense that he has been briefed by the radiologist.
He picks up the large, white envelope lying at the foot of the bed, untouched – I have been too afraid to open it.
Sliding out the plates, he holds them to the light. I perch on an armrest. My legs might not hold me if this doctor tells us there’s nothing he can do.
Standing out plainly, in stark contrast to grey shades of healthy brain tissue, is a white, golf-ball-sized shape – somewhere near the middle of Craig’s head, and just to the right.
The doctor nods gently, calmly turning to Craig to say: ‘You have a tumour here, and I am going to need to do an operation to get it out. Is that okay with you?’
Nodding slowly in response to this respectful request, my son’s sage reply is: ‘Yes ... this thing has caused me a lot of trouble.’
Leaving Craig to enjoy the warm and friendly attentions of the New Year’s Eve nurses, Neil and I step out with Dr Farrier to the parents’ room. The room is marked by a circle of black La-Z-Boy armchairs, worn brown carpet and a faint smell of souring milk – perhaps forgotten in the little fridge by other parents once their own, lonely wait was over.
The surgeon slumps heavily into his chair opposite the two of us.
The tumour is 4–5 cm across, he says. It is not possible to say how long it has been there, but he would guess two years – at least. My own head is processing this information very slowly: I voice the silly question – would this account for Craig’s behavioural problems and deteriorating schoolwork?
Dr Farrier patiently replies he is actually surprised at the level of functioning Craig has managed to maintain.
In addition to exerting pressure on the brain, the tumour has more recently obstructed the flow of the cerebrospinal fluid – the liquid that bathes the brain – at the place where it should be able to drain away from the third ventricle. He shows us this darkly distended ventricle, pointing out how much bigger it is than the same, healthy space to the left.
This fluid build-up has caused enough pressure to shift the dark midline between Craig’s brain hemispheres towards the left. Two recent, small bleeds from the growing tumour would have caused the sudden headaches and vomiting.
I feel guilty about being so angry with my son over his behaviour. But I also recognise in myself a twisted relief – finally I understand what is wrong with my son; that he is not a horrible child, on the contrary, a desperately ill one.
Based on the information Dr Farrier received from the radiologist, he had initially braced himself for an emergency shunt operation – to relieve the pressure caused by fluid accumulation on the brain. But on assessing a no-longer-vomiting and rather cheerful patient, Dr Farrier prescribes high doses of cortisone syrup instead, until the tumour removal can be performed. And, when he learns he can have his supper, a hungry Craig cheers up.
The proposed surgery, we are cautioned, will require two neurosurgeons and specially trained theatre staff – a tall order during the festive season. The tumour is tucked away at the furthest reaches from the surgical instruments’ capability – in the ‘tiger country’ of the brain, as I’ve heard it called.
Picturing my son’s unopened head, I want to know where he will be cut.
‘Just above his fringe on the right.’
The