Five weeks after the stroke, the neurosurgeon says it’s time to put Mom’s head back together. He tells us that he will re-attach her skull using 4 millimeter screws and some metal plates.
“Will you be using a power drill on my head?” Mom jokes to the neurosurgeon, her voice soft and raspy. “I’m not entering any beauty pageants anytime soon so it should be fine.”
She alternates between humor and bouts of deep sadness that escalate as she becomes more aware of her physical limitations. At first, she could not even open her eyes or speak, so we held her eyes open while she used markers and a dry erase board to communicate. But with occupational, speech, and physical therapy, she went from bedridden to walking with a four-footed hemi-cane in a matter of weeks.
After her first brain surgery, Mom began taking blood thinner medication, which helps prevent blood clots, but also increases the risk of bleeding. As a result, her blood thinner medication is reversed before her second brain surgery, restoring her blood’s natural ability to clot. As a pre-caution, a radiologist places a small umbrella-like device called an inferior vena cava (IVC) filter in her abdomen to catch blood clots until she heals from surgery and resumes her blood thinner medication.
“The filter is in her abdomen, in the major highway known as the vena cava,” the radiologist explains. “We come up through the femoral veins, the major veins in the legs, which make a fork in the road and bifurcate from the vena cava, the main vein that empties up to the heart.”
Leaving only a minuscule incision, the radiologist positions the filter via tiny cameras and small catheters, all so Mom won’t pass another clot while they are screwing her skull back on. Doctors can now thread tiny catheters and devices through veins and arteries, transforming open heart surgery into minimally invasive procedures like angiograms, angioplasty, and stent placement, yet cerebral edema can only be treated by cracking open Mom’s skull and cutting out part of her brain. Modern medicine contains surprising juxtapositions of old and new, invasive and non-invasive.
After the surgery, she is awake, but groggy. Iodine is lightly smeared on her right cheek, mixed with blood. She wears a turban of gauze. She says she can’t find her thinking brain.
“This brain says bad things,” she tells us.
“Like what?” I ask.
“That maybe it should be like ‘Million Dollar Baby.’”
I think for a moment and then explain the allusion to Dad. “It’s a movie about a boxer who asks her coach to euthanize her after she becomes paralyzed.”
We are quiet.
Despite tremendous physical healing, I can’t help but think that another type of healing—much more elusive, hard to treat, and slow to heal—has hardly begun. With physical rehabilitation has come a devastating awareness of her physical limitations. We have been well trained in the use of wheelchairs, hemi-canes, and leg braces, but we are unable to deal with our own grief. I fear random, unpredictable things, like the brain not having enough room to swell, or a clot smaller than the tip of a pencil causing a stroke. When it comes to mortality, we have a natural suspension of disbelief, and mine had been forever shattered.
As we try to chase her bad brain away, on the other side of the curtain dividing Mom’s room, an oncologist is telling Mom’s elderly roommate, the primary caregiver for her diabetic daughter with kidney failure, that she has terminal liver cancer.
