Trying to decide whether to have brain surgery.

Health and medicine explained.
Sept. 14 2009 12:19 PM

Head Case

Trying to decide whether to have brain surgery.

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Allowing myself to be scared made me realize that I'm not a person who can live with a tumor in his head, benign or otherwise. If the world breaks down into two types, I'm in the camp that would prefer not to learn what hydrocephalus feels like, even if that means a difficult operation and months of recovery. If I don't do it, I'll ascribe every ache and pain to the massive tumor no doubt swallowing my brain.

It's never a great time to have your noggin cut open by a Harvard man, but avoiding it won't make the procedure any easier in the future, though it could make it harder. Coming to this decision has provided welcome relief, though I still have to face the knife. More importantly, it has freed up mental space for the really important choices, like whether to shave my head Travis Bickle-style before I do this and what my first recovery room wisecrack will be. It's a tossup between "Actually, it was brain surgery" and "I needed that like I need a hole in the head."

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My brain after the surgery

The preceding was written while I still had a brain tumor. On Aug. 10, my wife and I drove to New York Presbyterian Hospital at dawn. As with international travel, I was ordered to arrive three hours before departure. Just before 8:30 a.m., I was wheeled into an operating room by a gray-haired orderly who assured me Jesus would be watching. I was happy to have the extra attention.

The last thing I recall is signing the consent forms, though my surgeon insists that I asked about the vacation from which he'd just returned. Six hours later, he informed my family that the surgery had been a success: They removed the entire tumor, it did not involve the brain stem, and it appeared to have been a benign choroid plexus papilloma (which was later confirmed via a formal pathology).

I'd been cured.

My first night was a fever dream of blunt head pain, monitor beeps, distant screams, a parched throat, and the numbing effects of an opioid 10 times stronger than morphine. But three evenings later I was home, having spent fewer than 85 hours at the hospital. Based on what I witnessed during my brief stay in the neurological ward, I made it out relatively unscathed.

As I continue my recovery, I'm baffled by how normal I have felt. There is minor residual pain, and I'm still aware of the 5-inch scar (which bisects the back of my head from the neckline to the crown and looked, with the stitches, like a deflated football), but it'll soon be covered by hair. And while I'm not quite back to fighting form, my brain feels exactly as it did before the operation. I have, in other words, the same unremarkable mind I started with, albeit one that appreciates life a little more.

So did I make the right decision? Given the near perfect outcome (and the fact that I'm fortunate enough to have health care coverage), absolutely. In my view I was going to have to deal with this at some point, and I chose not to wait until it was made more difficult by growth. While there is a very remote chance the tumor might never have changed in size, I did not undergo voluntary brain surgery. I simply happened to have a half-day craniotomy and tumor removal at a moment when the circumstances were favorable. There's no better time to do something as complicated as brain surgery.