One crazy month

Almost exactly a month ago I got two calls almost simultaneously. One was a job offer, the other a diagnosis.

There is a lot to say about the job situation, but alas that is not for this dispatch. But I’ll say that everything that has happened over the last month has been colored by the opportunity and acrimony that are sometimes a part of changing jobs.

So, I had first gone to an Ear/Nose/Throat doctor after noticing hearing loss in my right ear.  He thought it was probably ear-wax buildup; he removed some and said to come back in a week if I still had problems with my hearing. I did and we did some testing which showed significant hearing loss in the right ear. The doctor thought it was probably a virus that had gone to my ear and damaged the nerve; he could have offered steroid therapy to counter-act the virus, but only if I had come in right away, and I had gone months before going to the doctor after noticing that I couldn’t speak on the phone on my right side (and after around a year or so of feeling a faint under-water feeling occasionally in my ear). Nothing really to be done in that case, but the thought was let’s do an MRI to make sure it’s not a rare tumor that sometimes grows in the nerve of the inner ear.

The MRI revealed an acoustic neuroma, a tumor that is fortunately benign but was nonetheless growing inside my head and affecting my hearing. He said it could affect my balance and other things and I should see a specialist to discuss options.

There ensued the rapid series of decisions that have me on the cusp of surgery as I write this.

I met with several leading specialists (fortunately I live in New York City) and learned that an AN is a slow-growing tumor (they estimated by its size—2.5 centimeters by 1 centimeter—that it was likely in my head for 6-12 years) and among the options I could consider was to just leave the thing alone: it’s not cancer and that option would allow me to head to the Caribbean for a scuba-diving trip, as I had been dreaming about for weeks, carefully planning my job search to provide me with a nice amount of time off before starting after labor-day. I actually pulled it off, got the job and the time, I just got a tumor instead of a vacation.

The other options were for radiation or surgery. Highly focused gama-radiation does an effective job of killing the tumor and leaving it at its current size, but essentially dead. It is also a quick out-patient procedure, no overnight-stay in the hospital needed. The problem is it is about 80% successful, and if you’re in the 20% of it not working doing surgery to treat the area, which is sensitive scar tissue after the gama-radiation, is far riskier in terms of damaging other nerves, in particular those that deal with facial function (my most feared scenario in all of this).

The doctors I met with all agreed that surgery was the way to go for me. If I was at a significantly later stage of my life wait and see would be an acceptable approach because I may not be around for that much longer. But I’m only in my mid-30s and this thing will continue to grow so it quickly dawned on me that the best thing to do was to get it done as soon as possible. Fortunately I was able to schedule surgery quickly, with doctors I have faith in, and I have every belief that I will make a full and rapid recovery, aside from the loss of hearing in my right ear, which will likely be complete after the surgery. I’m also fortunate that I have the time off to recoup for starting the new job, and an employer that is very supportive about the procedure and flexible about the start date.

It’s been strange to tell people about it, to witness the various reactions of sympathy, strange to be someone who has never had a health scare to suddenly be someone who is telling those close to him about a tumor and upcoming skull surgery.

But I’m feeling pretty calm about the whole thing actually. I’ve thought about it in recent days, and while I’m sure a bit more anxiety will creep in as the big day is upon me, I realized that it’s out of my control and all I can do is be calm. I was faced with a series of choices when I got the diagnosis: surgery now or later, which doctors, health insurance issues, recovery plans, etc. But now those plans have been made and all I have to do is get on an operating table, allow them to insert an IV, and then go under for around 5 hours. I won’t know a thing until afterwards, and by then it’ll be over.

And what if it is totally over and I don’t wake up? I had been thinking ever since I bought this apartment over the winter that I should have a last will and testament. So this experience finally got me to get my affairs in order. I’ve had the necessary discussions with friends and loved ones. The risks of mortality for this procedure are miniscule, but you can’t deny that they are going to open up my head and poke around, things could go wrong.

And I’ve been thinking about the recent spirituality junta because thinking carefully about death made me realize that I don’t believe in heaven and hell. I realized that if I don’t wake up from the anesthesiologist’s dream then I’m just gone. Maybe I’m willing to entertain the idea that some part of me—some kind essence or energy—may live on, after all they say that energy is never destroyed. Maybe there will be some nebulous feeling out there, some patch of energy that exists outside of time and with people that I’ve been close, and when they think of me maybe I’ll actually be there in some real way, something like that. But probably not. I talked about the John Barth book I read, Nothing to be Afraid of, at the spirituality junta. He wrote about how he has old photos of his long-deceased parents, but it occurred to him that there are no moving images of them or recordings of their voices. They are still beings captured in photos, more alive in the minds of their sons, aged themselves, who will pass away in the not too distant future. Will those pictures of them live on? Only perhaps as curiosities to their future relatives. Unless you’ve achieved rare fame, we’re all ultimately forgotten.

And I’ve actually found all that comforting rather than disturbing. All we have to live for is right here and now. It doesn’t mean to me that because I don’t believe in an after-life that life is point-less and there’s nothing to look forward to. Quite the contrary, I think it’s essential to live life as best you can, to live it richly, to value the relationships you have, to make each interaction with another person as meaningful as it can be. And it’s hard to do that, but I think part of this experience is realizing that for me in way I was aware of but now I really know.

At one point during the last month I said to myself, “I’m going to turn this into a positive experience”. That might be a bit too far—hard to fully spin a tumor in your head as a good thing. But I can find positive             things to take from it. I look around, 4 and half years after I came back from China, on the verge of a new job, with a lots of great things going on my life. I just got have to get past this one thing.

So early morning tomorrow (Wednesday, 8/17) I’m going in to the hospital, I’ll lay down on the table, close my eyes, and around 6 or so hours later I’ll wake up and start getting better. A friend called (one of the positive side-effects of this experience: quality conversations with people I care about) when I was writing this and I told him my feelings about being calm, about it being out of my hands. He said it reminded him of how he feels every time he flies—you trust your safety to the pros flying the plane. That’s what I’m doing. And I’m almost ready for take off.



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