Carol Edwards was 67 years old. When I first met her she appeared socially proper and refined, and she was dressed impeccably. Her husband, Thomas had been diagnosed with a brain tumor a year previously, and had undergone surgery at the Henry Ford Hospital in Detroit, Michigan. The surgeon was able to remove most of the tumor visible on the MRI scan and not surprisingly, Thomas recovered without any neurologic deficits. Unfortunately the diagnosis was that of a glioblastoma multiforme, which is the most malignant form of brain cancers. He received radiation and was started on chemotherapy and because he had done well and his follow up MRI did not show any tumor recurrence, he and Carol decided to come to Florida for the winter.
Shortly after arriving in Dunedin however, he began experiencing some neck pain. His doctor figured that he probably had some arthritis in his neck since he was 69 and suggested he see a chiropractor. Within a few weeks he also began experiencing some numbness and tingling in his arms and legs and began having difficulty walking. His doctor then ordered an MRI scan of his cervical spine and this revealed the presence of a tumor within the center of his spinal cord extending from just below his brainstem to the level of the sixth cervical vertebra. This most certainly represented a rare but not unheard of spread of the glioblastoma from his brain. He was sent immediately to my hospital for neurosurgical evaluation.
After I finished operating for the day I went to the emergency room that evening to evaluate Thomas and it was there I met his wife Carol and their daughter Audrey. I explained the location of this tumor was perhaps too risky for surgery and that most neurosurgeons in private practice, myself included only rarely see patients with tumors in this location let alone one that had spread from a glioblastoma in the brain. I prescribed a steroid medication to control the swelling in the spinal cord that likely would occur as a result of the tumor. I then offered to call his neuro-oncologist in Detroit first thing in the morning to inform him of the latest developments in Thomas’ condition and ask what he would recommend, since they were contemplating returning to Michigan for any additional surgery or treatment.
After speaking with the neuro-oncologist and explaining the location of the tumor he merely said palliative radiation would be the only course of action which Thomas could just as easily receive in Dunedin, Florida as he could in Detroit, Michigan. He thanked me and told me he would communicate that to Carol by email right away.
I stopped by Thomas’ room that evening and Carol told me they had decided to remain in Florida for the radiation treatment. I assumed that Thomas would be discharged the following day to carry out the radiation as an outpatient, so I was surprised to see he was still in the hospital two days later. I learned that the radiation oncologist was reluctant to begin radiation without a biopsy and so was arranging to have him seen by another neurosurgeon at the university teaching hospital in Tampa for the biopsy.
Two days later I printed up my patient rounding list and was surprised once again to see that Thomas was still in the hospital. I figured a course of treatment was in place and my assistance was no longer needed so I deleted his name of my list. I went about my rounds seeing my post-op patients and then proceeded to leave the hospital. As I was getting ready to walk out the door, I heard a voice in my head saying, “go back and see him”. I thought to myself, “why?” “Perhaps” I thought, “no one would do the biopsy so if it needed to be done I certainly could do it”. So I turned around and went back to the hospital ward on the second floor.
I arrived at Thomas’ room to see Carol sitting by his bed. She appeared a bit flustered and was hurriedly straightening out folder full of papers that undoubtedly she accumulated during this recent hospitalization. Thomas was sound asleep as he had been most of the other times I had stopped by. When she saw me, she relaxed. I asked her what was happening and she told me the doctors had performed a spinal tap and because cancer cells were identified, the radiation oncologist decided a biopsy would not be necessary and that Thomas had received his first chemotherapy infusion that day and would begin his radiation tomorrow.
I said, “OK, I just wanted to stop by and check in, to make sure everything was progressing, as far as Thomas’ care”. I merely expected her to say, “oh yes, thank you”, but instead she reached out for my hand, with tears in her eyes and said, “thank you so much for stopping by”. Taking care of a loved one who is terminally ill is such an enormous task and can be completely draining emotionally even for a normally strong-willed individual, such as Carol. It is at times like these that caregivers need as much care and support as the patients they look after.
As I left Thomas’ room and walked down the hall on Hospital 2, I realized how important those few minutes that I spent with Carol were. And once again I became convinced that voice inside my head was one of my ‘angels’ keeping me on the path that God put me on.
Gosh dad, every time I read one of your stories it never ceases to amaze me how in touch with the Lord you are and how well you listen. It's definitely something worth striving for. Love you
Posted by: Ashley Colbassani | 02/11/2010 at 09:37 AM
Simply amazing!! How real and touching~you are definitely connected with God in a very special way!! Love you very much!
Ro
Posted by: Rosa Corcoran | 02/11/2010 at 06:53 PM