“Dr. Gordon, your preliminary diagnosis of my wife’s condition catches me completely off guard. For some reason, she’s told me very little of the distress she’s been experiencing. I’ve been heavily involved with my work at the University, and I can only assume that she’s not wanted to be disruptive. Her pregnancy was difficult, and … well, I did anticipate an extended recovery period. But up until now, I’ve been unaware of any unusual health problems.”
Dr. Gordon leaned back in his chair, placing the tips of his fingers together while his elbows rested on the arms of his desk chair. He was cordial but authoritative as he spoke of his findings. He made it clear that his diagnosis was not preliminary, and that the data was conclusive. His eyes were riveted on the young man who sat before him. Though he knew very little about him, his intuition told him much. The doctor consciously couched what he had to say, so as to leave no question as to the necessity and urgency of the procedures he had scheduled that very morning.
“Mr. Kirkham, your wife has a brain tumor. We have no way of knowing how long the condition may have existed, but the size of the tumor is worrisome. I believe that the problem has existed for some time, perhaps even predating her pregnancy.”
Dr. Gordon now withdrew a medical referral form from the folder in his hands. “Your wife was examined initially by Dr. Schindler, a family practitioner here in Ann Arbor. Apparently, Dr. Schindler did not treat your wife during her pregnancy?”
“That’s right. There were several reasons for making other arrangements, and her neighbor, Lucy Bartlett, had recommended Dr. Schindler.”
The doctor nodded, then turned his attention to a number of X-ray negatives which he withdrew from a large envelope on his desk. “Let me show you the X-rays Dr. Schindler ordered following his initial visit with your wife.” He walked to an X-ray viewer mounted on the wall and Paul followed. Dr. Gordon clipped two negatives in place and turned on the back-lighted illumination.
“These skull X-rays show some displacement of the pineal gland,” he said, pointing to the irregularity with his pen. “Normally, the outline of the gland should be here at the midline of the skull. Though inconclusive, this suggests the presence of a tumor.” The doctor then removed the negatives and clipped two additional X-rays in place, side by side. “Yesterday, we took an angiogram of your wife’s skull. This involves an injection of iodine dye, which is visible in X-rays. We took a number of serial photos as the dye moved through the blood vessels. Here you will notice a displacement of blood vessels, which gives fairly conclusive evidence of a tumor’s presence. There are also abnormal vessels here, inside the tumor area. These photos, together with the symptoms your wife is reporting, all indicate the need for immediate surgery.”
Dr. Gordon removed the X-rays and the two men again seated themselves as the doctor continued to speak. “The outcome of this kind of surgery is somewhat unpredictable. The location and size of the tumor is of some concern, but still, if it proves to be benign and if there are no complications, it is likely that your wife will fully recover and lead a normal life.”
Paul was visibly sobered by the doctor’s tentative prognosis. “And what is your personal assessment? Do you think this is a benign tumor?”
“I honestly don’t know what we’re dealing with. The data does not allow me to be conclusive on that point.”
“If the tumor is malignant …?”
“We would hope that it might be a case of meningioma, which is typically a non-aggressive and non-invasive tumor. This would allow for a fairly clean removal. On the other hand, if it is something more aggressive and more invasive, our job will be considerably more complicated. Growth tentacles are sometimes hard to identify, and naturally, the more tissue that is removed, the greater the risks involved.
“Post-surgical problems can range from mild difficulties with speech, movement, or sensation, to profound disturbances in these areas. There is also a possibility of significant personality alteration. One additional concern has to do with the post-surgical swelling of brain tissues. We do our best to control this problem, but where we cannot, patients do not survive this period of post-surgical trauma.”
Paul sat silently as the full impact of Dr. Gordon’s prognosis registered. His vacant gaze went past the doctor and his thoughts were elsewhere. The doctor continued in a less official, more personal manner. “I know this is a bitter prospect for you, but it would be wrong for me to sidestep the reality of things. I’m an optimist. I think we should be positive about the outcome. Certainly, there is room for hope that the surgery will be routine and completely successful.”
Dr. Gordon now leaned forward and spoke in a slow, searching manner. “My immediate concern is your wife’s frame of mind. Her outlook on things is pretty bleak. She was terribly anxious as we visited yesterday – almost irrational. Then, as we began to prepare her for the tests, her fears got the best of her and she completely broke emotionally. The woman who brought her to the hospital, Mrs. …”
“Lucy Bartlett”
“Yes, Mrs. Bartlett. She was very helpful in calming your wife. Have you been aware of your wife’s precarious emotional state?”
Paul spread his arms and, gripping the front corners of Dr. Gordon’s desk, he reclaimed his assertive role in the discussion. “Dr. Gordon, what you saw yesterday is, unfortunately, typical of my wife’s tendency to overreact to stressful circumstances. She has been emotionally unstable since the early days of her pregnancy. Quite frankly, I have assumed that her physical complaints and her volatile emotional state were interrelated. I believed that once the challenges of her pregnancy and the difficult delivery were past, her emotional state would level out. As you can see, this has not been the case.”
Dr. Gordon was thoughtful as he weighed Paul’s statements. He was confident that this bright young man was oversimplifying some very complicated circumstances, but he also sensed a closing on Paul’s part against any further intimate probing. “I have placed your wife under fairly heavy sedation. That should help in keeping her anxieties under control for the time being. We’ll be operating sometime tomorrow. The hospital will notify you about the specifics.”
Dr. Gordon closed the files on his desk, and then, as a seeming afterthought, addressed one final item. “Oh yes, before I forget, someone from the business office stopped by earlier in the day and asked that I pass their memo on to you when you arrived.”
Though he sensed the reason for the memo, Paul asked the question that would allow him to make an uncomfortable but necessary explanation to the doctor. “Is there some concern?” he said, as Dr. Gordon handed him the small envelope.
The doctor undoubtedly intended to emphasize Paul’s responsibility as a husband. After all, he had obviously been reluctant to face those duties the preceding day. “Mr. Kirkham, there will be considerable expense associated with your wife’s surgery. Financial arrangements are normally handled at the time of admission, but in your absence, and because of your wife’s emotional state, the business office deferred normal procedures and admitted her on a provisional basis. I think they merely want some clarification as to your plans for meeting the financial obligations involved. Apparently your wife’s intake forms fail to indicate any insurance coverage.”
Paul leaned back in his chair and seemed to stiffen as he responded. There was cold formality in his voice. “I am in the middle of a doctoral program at the University. Even though I am employed as a graduate assistant in the Psychology Department, things are tight for us. … I had hoped that arrangements could be made for protracted payment, perhaps a deferment of the lion’s share until I have completed my program. I will also explore the possibilities of a medical loan.”
Dr. Gordon nodded thoughtfully. “Why don’t you stop at the business office on your way out and you can discuss the matter with them. Ask for Mrs. Helms. She will have your wife’s file.”
The doctor stood, then walked from behind his desk to Paul and extended his hand. “It’s good to visit with you, Mr.
Kirkham. Please be assured that we’ll do everything we can to help your wife. I’ll plan to meet with you again tomorrow following the surgery.”
Paul moved towards the door, then stopped. Turning back to Dr. Gordon he posed one additional question. “Do you think my wife’s pregnancy and the tumor may be related?”
“You’re asking if the pregnancy could have been a causative factor?”
“Exactly.”
Dr. Gordon surmised that the query might have reflected something far more than medical curiosity on Paul’s part. “I’m sorry, I can’t answer that question. To presume such a relationship or to rule it out would involve sheer speculation on my part.”
Unable to visit Cathy because of her continuing sedation, Paul returned to his modest living quarters in Ypsilanti. Again he was alone with his thoughts as he waited in grim anticipation of the events that would fill the next day.
It was early the next morning when Cathy picked up the phone and waited for the switchboard to respond. She spoke quietly to the operator so as to avoid awakening Elizabeth, the woman occupying the other bed in the room. She asked if there were a gift shop in the public area of the hospital. Indeed there was and the operator routed her call accordingly. Despite the early hour there was an answer on the other end of the line. Cathy now made an unusual request of the proprietor who had come in early to organize floral bouquets that would likely be purchased during the day. She was a good-natured woman, and after a brief explanation on Cathy’s part, agreed to help. Since the shop was not yet open to the public, she offered to personally come to Cathy’s room with the requested items.
While Cathy waited she mentally rehearsed the life-altering experience that had knit her life to this unusual woman who occupied the bed next to her. Though a stranger, the distance between the two woman was quickly bridged as Elizabeth engaged her in the kind of conversation she desperately needed. Throughout the night Elizabeth had taught Cathy things she had never understood before and had exuded a kind of love and comfort she had never experienced previously. Elizabeth had taught Cathy how to pray that night and her prayers had not gone unheard.
Within a few minutes of making her early morning call, Cathy saw the manager of the gift shop enter her room and approach her bed. She had brought two empty, tissue-lined flower boxes, a long piece of red ribbon, a pink scarf, and a pair of scissors. “There will be no charge,” said the woman. “Someone will come by to pick up the scissors and the scarf later in the day.”
Cathy now busied herself with the project she had conceived during the early morning hours. Carefully she gathered her long-flowing blond hair together from one side of her face to the middle of her back and began to work the strands together in a braid as she had done when she was a little girl. Having completed the braid, she tied the end with a piece of red ribbon. Then, securing it at the top with another ribbon, she cut the braid free from her head. With this artfully and lovingly accomplished, she nestled the braid within one of the flower boxes. She then repeated the procedure with a second braid, and wrapped the scarf about her head, now shorn of the long hair that had been her crowning beauty since childhood.
Her project completed, Cathy moved to the other side of the room and laid one of the boxes on the utility cabinet to the side of Elizabeth’s bed. She was hopeful that this newly found and beloved friend would treasure her gift of remembrance.
When Elizabeth awoke there was no time for any postscripts to their lengthy conversation of the previous evening, as the morning hospital regimen commenced immediately. While breakfast was served to Elizabeth, the nursing staff began monitoring Cathy’s vital signs. Her surgery would be performed as scheduled. The staff, likewise, visited with Elizabeth about her discharge from the hospital which would occur in the early afternoon following a final visit from Dr. Gordon, coincidentally the same doctor who would perform Cathy’s surgery.
Though this bustle of activity left few private moments for the two women, the effects of the intimate bond that had been forged between them was mutually apparent in knowing glances, snatches of small-talk conversation, and reciprocal smiles. Their exchange during the foregoing evening, the many hours of prayerful contemplation that followed, and finally the flood of understanding that had filled Cathy with peace were all of profound significance on this eventful morning, which had now lost its frightening aspect.
In the course of the morning’s activities Elizabeth had discovered the flower box. She looked inquisitively at Cathy who said, “Wait until later.” From this Elizabeth sensed that the gift was to be opened after Cathy had been taken into surgery.
Suddenly, Paul stood framed in the doorway to the hospital room. Glancing at him Elizabeth noted his handsome features. She had thought much about him during the night as he had been a topic of much conversation between the two women. Inexplicably, she sensed that, in time, the two of them would experience a significant personal relationship. Despite his efforts to convey self-assurance as he entered the hospital room, there was uncharacteristic awkwardness in Paul’s manner – unusual for this man who prided himself in being the master of every situation.
He eyed Cathy’s scarf with curiosity but said nothing as he walked to her bedside. There was obvious hesitation as if he were deciding how to handle a difficult situation, then he leaned over and lightly kissed Cathy’s cheek. To his surprise, her arms were immediately around his neck in a tight embrace. His response was instinctive, and sitting next to her on the bed, he took her in his arms. They kissed with warmth that had not been present between them for many months. It was as if the two of them were engulfed in some healing influence, bridging the enormous distance that had come to separate them. They held each other tightly, willing the embrace to go on and on. Then, at length, Paul withdrew slightly from Cathy and glanced in Elizabeth’s direction. Sensing their need for some measure of privacy, Elizabeth had closed her eyes and convincingly feigned sleep. Again Paul embraced Cathy. “I’ve missed you,” he said softly.
“And I’ve missed you and needed you for months,” said Cathy in response.
She might rightly have replied, “The distance between us was of your making, not mine,” but she had no disposition to do so. Instead, she laid her cheek against his and said, “Life without you is a nightmare for me.”
Paul now looked again at Cathy’s pink scarf and said teasingly, “What is this – a new fashion statement?”
Cathy flushed slightly. “Anything but that. I’ve had a haircut already this morning and didn’t want you to see the damage. They’ll be shaving the rest of it off just before they take me into the operating room.”
Cathy’s mention of the operating room brought both of them back to the grim realities that lie ahead of them that day. “And how are you handling everything this morning?” asked Paul with concern.
“I’m all right. I have done a lot of thinking since last night, and I believe I’ve got a grip on things.” Now she led their conversation into new territory for the two of them as she spoke words he would never forget. “If I am completely honest,” she continued, “I’m more worried about you than me.”
Paul reacted with surprise. “What do you mean by that?”
“I’ve reconciled myself to whatever is going to happen, but I doubt that you have.”
Paul said nothing, uncertain where this was leading.
“Things will be different for us after the surgery, Paul. I may never be the same person again. There is the possibility that I may never be able to think or move or talk as I have up until today. There is also the possibility that I may die, Paul.”
Cathy’s observations came like an electric shock to Paul’s feelings. Certainly he had considered such possibilities, but her reference to grim realities were unwelcome; they made impossible demands of him. Indeed, he could not accommodate them. He had set his will against this possible outcome, just as he had rejected the inevitable when Cathy announced her pregnancy. Though he was an exponent of rational thought and an advocate of analyt
ic problem solving, he was unequal to these circumstances that now complicated his life. He felt compelled to deny their existence or to redefine them in a way that was less threatening to him personally. Anger flashed through him as he considered Cathy’s words, for anger was the easiest response. It required no painful analysis. Moreover, it effectively mobilized his emotional defenses against feelings of guilt he could not abide. Still, there was the delicacy of the present hour – circumstances that demanded self-control. Nor was it possible for him to easily dismiss the tender feelings they had both experienced moments earlier.
In turmoil, Paul rose to his feet, took several steps away from Cathy’s bed, then stood motionless – his hands in his pockets and his back towards Cathy. “I’m not up for tragic drama this morning,” he said. “Please don’t do this!”
Undaunted, Cathy continued. “There are things we must talk about, Paul, and we have to talk about them this morning; right now. You must not push them aside.” There was a tone of urgency in Cathy’s voice, also a quality of self-assurance that was unusual for her.
Paul turned to face Cathy. “You’re in one of the finest hospitals in the country. Your doctor is recognized as a capable neurosurgeon. Let’s just leave things at that and trust that the outcome will be positive.”
“What would you do,” said Cathy, ignoring Paul’s mandate, “if you had to face a challenge you couldn’t handle? – things that were beyond your ability? Could you admit something like that? Would you be able to ask for help? And if the problem were of your own making could you admit that you had made mistakes along the way?”
Paul was unaccustomed to this kind of assertiveness from Cathy. “What are you trying to say?” he said with a tone of accusation in his voice.
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