‘Then our mouth was filled with laughter,
and our tongue with shouts of joy;
then they said among the nations,
“The Lord has done great things for them.”
The Lord has done great things for us;
we are glad’
Psalms:126:2-3
I pray for many things. The thing of it is that what I pray for isn’t always what I need’s God’s help for. Fortunately He is merciful enough to help me anyways…and my realization of this shows me He has sense of humor too!
Quite a while back I operated on a gentleman, Grant Lisset, who had a brain tumor. Unfortunately the surgery did not go as I had planned. At the time of surgery I encountered an unexpected degree of brain swelling which prevented me from removing the tumor completely. Not only that but postoperatively, Grant, my patient, who entrusted his life in my hands developed paralysis on his right side and an inability to speak.
After his initial recovery he gained back his ability to speak and a significant amount of strength in his arms and legs to the point where he was able to walk with assistance.
Ultimately, a second surgery resulted in removal of the remainder of his tumor, although I had felt guilty…no, remorseful that I wasn’t able to completely remove his tumor the first time without complication. What had transpired during his first surgery likely would have happened to anyone else who might have operated on him but I, still, felt personally responsible.
The thing of it is that my approach to a difficult case is directly influenced by my experience with the one that preceded it. So, when Barbara Nelson came to my office with a similar tumor to what Grant had, I hesitated, initially, to even do the case. However, the tumor had increased by 40% over a year and a half period so despite her age of 81 years, it had to be removed.
What made the decision somewhat easier was because of her advanced age I knew I didn’t have to achieve a complete resection. This was because radiation could be administered following surgery and would, in all likelihood prevent it from recurring during her remaining lifetime.
In addition the tumor was right on the surface of her brain and from a technical standpoint would be (relatively) easy to approach surgically and remove. Nonetheless, I prayed hard for God to guide my mind and hands that I might successfully remove Barbara’s tumor.
The tumor was located essentially in the back of her head on the left side, just above the occipital part of her brain which is responsible for her vision. The only difficult part of the surgery would be exposing the tumor because it was right up against the superior sagittal (venous) sinus which runs in between the two hemispheres of the brain.
Essentially, the arterial blood which carries oxygen and nutrients is transported to the brain by the carotid arteries. After the arterial blood passes through the brain it becomes venous blood and drains into the superior sagittal sinus on its way back to the heart. Should any damage occur to this venous sinus the build-up of arterial pressure in the brain can cause a major hemorrhage or worse, death.
So it was critical for me not damage the superior sagittal sinus as I removed the skull overlying it to expose Barbara’s tumor.
As it turned out the surgery was ‘textbook’. I completely removed Barbara’s benign tumor and she was on her way to the recovery room less than four hours after I started the procedure.
The irony of my day in the OR, however, lay with my next case, where I would need every bit of God’s answer to my prayers!
It was by every indication a routine case. On Wednesday, the week before Deborah Grant had come to my office complaining of severe pain that started in her neck and radiated down her right arm into her hand. She described the pain as ‘a searing type pain that felt as though it was deep within the bones of her arm’ and nothing she did, not the medication, the therapist nor the chiropractor had lessened the pain a bit.
In addition her index and middle fingers were completely numb and when I examined her, the muscles of her right arm were severely weak as well. When I looked at her MRI the reason for her signs and symptoms was clear. She had a ruptured disc between the 6th and 7th vertebra that was literally squashing the nerve up against the bony opening through which it normally passed easily.
Having successfully removed Barbara Nelson’s tumor earlier in the day, I was feeling quite confident (perhaps even a bit prideful) so I figured correcting Deborah’s cervical disc problem would be a ‘walk in the park’ by comparison. In fact what happened couldn’t have been further from the truth!
I had just finished removing the majority of Barbara’s disc and with the use of the operating microscope I was closely inspecting the back part of the disc for a small tear in the ligament that separated the disc itself and the nerve root. Ninety-nine percent of the time I would have expected to find a fragment of the disc that had torn and ruptured through this ligament to put such excruciating pressure on the nerve traveling into Barbara’s right arm…but I found nothing.
Immediately I had a sense of dread come over me…I must be at the wrong level! Quickly I looked at the x-ray I had just taken…1, 2, 3, 4, 5… 6 and 7. No, I was at the correct level. But where was the herniated disc! I turned to review the MRI scan. Yes there was the fragment on the scan but why couldn’t I find it surgically?
In most cases a cervical disc will herniated more towards the central part of the spinal canal but in Barbara’s case it was far out to the side. Just beyond this was the vertebral artery which is similar to the carotid artery but it travels close to the spinal column to the base of the brain. Once, many years ago while performing a cervical disc surgery I punctured the vertebral artery and I had never witnessed such extensive hemorrhage before or since.
And I didn’t want to ever see that kind of bleeding again.
But I really had no choice at this point in Barbara’s surgery. I had to make a cut in the ligament to see if the fragment of disc was hiding beyond my surgical view. So I took a deep breath, said a quick prayer and then taking a micro-surgical instrument I separated the fibers of the ligament until I punctured through….
Fortunately there was no bleeding but what I did see created a sigh of relief…the fragment of disc I had agonized over not finding for the past 20 minutes! In fact as I probed out along the nerve root I found several large fragments.
As I stood there peering through the oculars of the surgical microscope it occurred to me I needed God’s help on this case a whole lot more than I did with Barbara’s brain tumor. And it was that case that I was way more fearful of doing in the first place. I really had to laugh at myself over that one.
God really does have a way of getting our attention. And I guess this day He reminded me that even the most ordinary, every-day, run-of the-mill events of our individual lives can be the most important or possibly the most treacherous if we take them for granted.
