Stephen Sparrow
The neurologist continued writing and without looking up asked what my plans were. I can’t remember how exactly I replied but the next thing he asked was, “Are you intending to be out of town in the near future?”
“Well. My wife and I are flying up north for a holiday on Sunday.” I replied.
He put down his pen and looking directly at me said. “I would be unhappy about that. I want you in hospital Monday morning.”
My mouth was starting to drop open a little.
He continued. “I’ll make the arrangements.” He held up the x-ray print I’d brought with me and jabbed his finger at the top of the vertebra just under my skull. “That’s where the problem is. The squishy stuff in the middle.” He meant my spinal cord. “We need to see inside there and we can only do that with an MRI.” (Magnetic Resonance Imaging scan) “Are you going home now?” I nodded. “Good, good. My secretary at the hospital will phone you later to confirm things.” He leaned over and patted my knee. “We don’t want you in a wheelchair now do we.”
I paid the bill and walked to the car. It was still before 9.00am so I called in to hear Mass on the way home. It was something I’d been in the habit of doing since finishing work two years previously. An hour later the Neurology Department secretary rang and told me to report to Christchurch Hospital by 8.00am on Monday; and to be prepared to stay at least one night. After lunch Anne arrived home from her job as a doctor’s practice nurse and I told her our holiday plans were on hold. In a way it was a relief since for the last month I’d sensed something was wrong and deep down I didn’t want this holiday. I imagined what it must be like for a wounded cat to remain holed up in its lair.
Four months previously things had kicked off with a stiff neck. I thought it was some muscular thing and tried using different pillows for sleeping. The symptoms didn’t go away but now I began to drop things from my left hand without realizing it. I would carry a cup of tea across the room and half of it would be in the saucer when I got there, and I hadn’t been aware of it spilling. I began to lose feeling in my left hand and found difficulty separating magazine pages, and with my right hand I couldn’t tell hot water from cold. Dealing with shirt buttons became a problem; I developed a funny numb patch on the back left quadrant of my head and when walking, I would occasionally and unexpectedly stumble as if my left foot couldn’t figure out where the ground should be; and if that were not enough, I was tired all the time. Loading rubbish on a trailer, something that normally took only ten minutes now took forty and at the end of it I needed to lie down and rest. All of these symptoms were gradual; so gradual in fact that family members put it all down to my having lifted some heavy object the wrong way leaving me with a pinched nerve; or that it was postural, having spent too much time at the P.C. keyboard. I protested they were wrong but secretly began to think maybe they were right. A visit to the doctor supported the family’s ‘diagnosis’. Three weeks later and things had deteriorated further but still the doctor wasn’t too concerned. He prescribed some exercises. Another three weeks, another doctor’s consultation and this time a neck x-ray was advised. No problem there so over the phone the doctor suggested a brain scan; I had one and still nothing showed up; nothing wrong that is. The family were starting to take things more seriously and so was the doctor. He gave me the name of a neurologist and I rang for an appointment only to be told there was a ten week wait–going privately! I made the appointment anyway and said I would take a cancellation if one came up. One did and two weeks later I got a call asking if I was available the next morning. I grabbed it; after all we were only four days away from taking off on holiday. The first thing the neurologist did was ask me to list my symptoms which he methodically wrote into a pad, and then, putting me on a bed he carried out various strength and sensory tests using hammers, pins, vibrating forks and hot and cold objects. After about five minutes of testing he murmured that a pattern was emerging. A short time later I was again fully dressed and sitting listening to the neurologist’s assessment. It was serious all right but needed further investigation to determine the exact cause – hence the trip to hospital.
The weekend was more than a little subdued. We told close friends and extended family and Father John Noonan from Halswell took time out of his busy schedule to spend an hour with us. Later I watched a video of The Sound of Music and listened to some favourite CDs. Nostalgia was definitely in the air. Here I was at sixty and suddenly living with the knowledge that something was seriously wrong. Not knowing what it was; that was the hard part. A copy of the specialist’s report to our GP came in Saturday’s mail. From a lay perspective it looked scary. All those medical terms. A quick sweep on the Internet did nothing to clarify anything or allay fears. While consulting the specialist I told him I’d been able to keep track of what Anne had been thinking the problem might be by periodically checking the computer history list. Sites on Parkinson’s Disease, M.S., Motor Neurone etc had received plenty of hits. The specialist smiled and said that the Internet was an unreliable source for lay people to find good information on medical matters. Much of it was out of date and of course there were sites maintained by absolute medical charlatans. Best to stay out of it; advice we should have taken.
Promptly at 8.00am Monday Anne dropped me off outside the hospital admission office and after completing some paper work and putting on an I.D. bracelet I was off to the Neurology Ward and placed in an eight bed room. I was quickly aware of being the subject of much curiosity among medical staff who singly or in pairs came to test my uneven limb strength and query the unusual symptoms. Anne came back and sat with me and we learned that an MRI scan had been scheduled for later that evening. After tea Anne returned with Alice, William and Will’s girlfriend Sara Jayne and together they helped wheel me down four floors for the MRI and waited while it was done. I spent more than an hour inside that impressive looking cylindrical piece of machinery while with many loud hammering noises multiple angle images of brain and upper vertebra were obtained. Afterward not only did the nurse help me off the sliding table but the Radiographer bounded out of his booth to help as well. The next day I understood why.
Tuesday was almost a repeat of the previous day with inspections by more ‘professionally’ curious medical staff. The chief surgeon came and said he would see Anne and me together around teatime. He had that air of being extremely busy and yet apparently unphased by it all. Teatime came and went and Anne sat with me until a nurse announced that the surgeon was waiting in a room down the corridor. On the wall against a backlit panel were numerous MRI images. Even a layperson could see what they represented but my eye was drawn to several images of the vertebra top where inside C 2, a striking white spherical mass dominated the space forcing the spinal cord around and behind it like a thin piece of ribbon. The surgeon pulled an illustrated medical book from a shelf and without emotion explained the problem in clear lay terms. The tumour was in an awkward spot being wrapped around the front of the spinal cord and additionally it had a spur growing out through the foramen magnum, the opening in the front of the vertebra, which carried the phrenic nerve and controlled all breathing. If the tumour was not removed the result would be tetraplegia. I would end up like actor Christopher Reeve, in a wheel chair and breathing via a ventilator. The surgeon patiently answered questions and made further explanations. Was it life threatening? No, but during the operation there was the possible risk of damage to the spinal cord and phrenic nerve leading to serious disability or paralysis. Well at least we now knew, so without hesitating I signed the papers showing that I was aware of all possible outcomes and giving the surgeon authority to operate. The operation was scheduled for Friday morning, first on the list.
Wednesday started with my being the subject of a full ward round. About fifteen medical staff of all kinds from students and up looking and listening while the surgeon outlined the symptoms and the cause. Later one of my nurses cheerfully informed me that Mac (the neurosurgeon) has a spring in his step – he enjoys a challenge – he’s looking forward to having a ‘go’ at you. After tea an anaesthetist came to check me out. Just as he was leaving he put his head back through the door and said, “You do realize don’t you that where we’re going on Friday is tiger country.” The rest of the day was filled with numerous visitors plus phone calls from Matt in Japan, Sarah Jane in London and Bec in Wellington and at the days end home leave; just one day on the clear understanding that I’d be back in the ward Thursday evening. And Thursday! That was sheer bliss; sunny, warm and a few visitors and after tea a slow amble (shuffle really) through part of the Botanic Gardens before returning to the Ward.
Friday morning at six I got up showered and slipped into one of those funny gowns that fasten behind. Then an hour later the gang from home returned and with much mild wisecracking and grinning, wheeled me down to theatre where the nurse checked my identity before wheeling me inside and onto a theatre bed parked beside a large collection of stainless steel gadgets and tubing and gas cylinders all manipulated by two cheerful technicians. The two anesthetists now did their final checks before one gave me a wee jab in the arm and asked me to count backwards. I remembered nothing more before waking briefly to see the assistant surgeon smiling down and saying. “We got nearly all of it.” I must have drifted off again because it was late afternoon when I really ‘came to’, this time in the high dependency unit. The anesthesia had lasted nearly four hours and I had slept for a further four.
I was lying in bed with a drip attached to the back of my left hand. I was breathing unaided, no ventilator in place. I tried wriggling my toes; ‘Yes, I could.’ I reached out and put the back of my hand against the jug of ice water on the bedside cabinet. It felt cold. I pulled a magazine toward me and found I could separate the pages using the fingers of my left hand. Well so far so good. The specialist told me before the op that all going well he expected me to regain about half the strength and sensory acuity I had so far lost and I couldn’t argue on that score, but the back of my neck felt rigid as though it contained a steel implant. It didn’t, it was just the sutures and the large dressing. Basically I felt pretty good and cheerful. A half hour later Anne came in all smiles. Of course she knew more than I did after all the surgeon had phoned her immediately he finished.
Twenty-four hours later the drip was out, I was off the steroids, using only mild painkillers and back in the ward proper. Lots of visitors and cards and lots of sleeping followed; I was feeling great, until, post op day three when I hit the rocks. All cheerfulness evaporated and with it went my interest in food. Later in the day my nurse encouraged me to get up and shower and I also ate a little and started to feel better and within another thirty-six hours was pretty chirpy once more. From then onward progress was rapid, the sutures came out and I could make it to the loo without hanging on grimly to the ward corridor handrails. Thursday the assistant surgeon told me that because I appeared to have a good supportive family (intuitive guy wasn’t he?) they would discharge me the following day, exactly one week after the op.
By late morning Friday I was home to a smiling sun drenched back yard with flowers, singing cicadas, monarch butterflies and Rupert our large confidant ginger moggy curling around my legs: but, best of all, venison sausages for lunch. Each time in hospital I looked at that wholesome bland food, I dreamed of being home and eating a decent sausage. I was still pretty tired and shaky on my feet but I was home and was going to be okay. The O T people at hospital had lent me various gadgets to make life easier. One of them was a long handled grabbing device for picking up objects from the floor and the first thing I did after getting out of the car at home was to slowly walk to the peach tree and reaching up with this thing, pick a trio of succulent peaches. Yes, I was going to have a use for it after all.
And the public hospital system? Something I have nothing but praise for, especially the professionalism and dedication of the staff; from surgeons right down to the tea lady. One aspect reminded me of National Military Service and that was that apart from hospital staff, nobody else was there by choice. Health misfortune was the patient’s common lot; the thing that leveled each of us, in many cases forcing us together and out of ourselves to forge new if temporary friendships. And there’s nothing like a two-week stint in a neurology ward to deliver a proper jolting and with it a new outlook on life; to be thankful for both the good and the bad. I recalled a G. K. Chesterton quote; “the problem for the atheist is when he wants to express gratitude and has nobody to thank?” Well, I’m no atheist and I’m sure full of gratitude.
Post Script 1
While waiting in the ward day room for Anne to collect me after being discharged, another couple in their fifties entered. We were the only three there and the woman, a pleasant chatty type quizzed me on why I was there. She went on to explain that she was from a smaller centre about three hours drive away and worked in a busy office. Three weeks previously she had had a brain X-ray and been diagnosed with a deep seated and inoperable tumour. However her local hospital had sent the records to Christchurch where the surgeon who operated on me had advised her to come for an MRI scan to really sort things out and she was there that day for the follow up consultation. She went on to tell me that when her condition became known at work none of her colleagues could face her let alone even talk to her. She put up with this nonsense for two days before impulsively standing up in the middle of the office and saying loudly. “Listen you lot. How many of you can prove you’ve got a brain? I can. I’ve got a photograph of mine. Have any of you got a picture of your brain?” Well that broke the ice and the difficulties dissolved in laughter right there and then. Soon afterward, Anne came to collect me and take me home so I never discovered that courageous woman’s name or what subsequently happened to her. I do know that within nine months of my stay in hospital several of the other patients I had come to know were dead. But that is the nature of brain and allied organ tumours. A week after my discharge I received a visit from a dear friend to whom I incautiously said, “Well John, I’m a lucky man.” To which he responded. “No Steve, you’re not lucky, you’re blessed.” From that day on I’ve endeavoured to eliminate the word ‘lucky’ from my vocabulary. Blessed are we all indeed no matter what happens. Everything is grace.
Six weeks after the operation in company with two of my children, Bec and Alice, I successfully walked up steep bush covered Mt Richardson an hours drive from home. I was tired at the end but I had done it. Since then I have undertaken a six-week trip through Southern Europe by backpack and train: and yes I visited Lourdes and Lisieux and Rome. And now (April 2005) my subsequent MRI scans and hospital checkups have been extended from annually to every eighteen months. The tumour remnant is non-malignant and slow moving.
Post script 2
My situation was monitored with regular MRIs and early in 2008 it was decided that the meningioma had regrown to where my neurosurgeon Martin MacFarlane said it was time to “whack another divot off it.” – meaning that this would be a regular thing every five years. So on June 23rd 2008 I was readmitted and operated on the next day and two days later discharged to recuperate at home. Three months later I returned to Outpatients for the post-op consultation. The first man I spoke to was the assistant surgeon – Joseph Wang from Taiwan. He spoke in very correct professional terms. “Well now Mr Sparrow and how are you?” Me (without thinking) “Actually, I’m a box of birds.” A momentary look of puzzlement crossed his face, but unfazed he went on to tell me that Mr MacFarlane was satisfied that he had removed the entire tumour and didn’t think any follow up monitoring would be necessary but that he personally wasn’t so sure and if I waited he would quickly talk to Mr MacFarlane and make sure that that was the case. He returned a minute later with the man himself who shook my hand warmly and said, “Well I got the lot – no need for any more MRIs – I’m discharging you from further hospital care.” As I walked away down the hospital corridor I suddenly realized it was October 1st – the Feast Day of The Little Flower . I smile when sometimes I wonder about an imagined conversation later that day between Joseph Wang and Martin MacFarlane. JW. “Mr MacFarlane, I have a question. What is a ‘box of birds’?
© Stephen Sparrow: November 18th 2003. About a stay in hospital early Feb 2003 to deal with a close encounter with Brown-Sequard Syndrome. Published with permission.
Carlos Caso-Rosendi 