“Oh! You’re strong!”
The neurological registrar’s head flashes past my shoulder and comes close to headbutting the wall. It’s clear my paramedic wild swimmer superpowers remain in the right arm at least.
Not so in the left, which is slightly weaker so that when I pull him towards me the neurologist remains upright.
It’s during this examination I realise that my face is numb down the left side, along with my left leg and arm to the elbow.
“I don’t think it’s a stroke, I’m going to send you for an MRI scan. You’re not claustrophobic are you?” Erm, well a bit depending. I’ll be fine.
The MRI is much smaller than expected; I lie on the slab and the radiographer has to put my left hand into my pocket because it keeps dropping off the table.
I plump for easy listening music, as the mask is placed over my face. The radiographer is smiley, friendly, chatting about the noisy aspects and durations of the scans, and places an alarm in my right hand so I can shout if I need her.
There’s a small mirror at eyeline in which I can see my supine body, and to the rear, a red-brown painting of slightly slanted wide brushstrokes. I start by trying to work out what it is: leafless trees? A squadron of Mr Hanky the Southpark Christmas poos? I’m plumping for the poos.
The music plays, and the echoing voice of my radiographer warns me this scan will be noisy and take a couple of minutes. Noise isn’t quite it. There’s clunking, whirring, banging, and the music oozing around. Vibrations work their way through the very cells of the inside of my head, neck and chest. It’s the kind of physical experience you get by standing by the speaker at a gig, only coarser and more discordant than most musical genres, maybe a bit Nick Cave? Or PJ Harvey.
I think of the Carpenters, a young and beautiful Karen, mutton-chop sleeves and maxi skirts, big hair, trying to stay at the back drumming while they push her to the front to sing as she disappears again with anorexia, all the while pouring forth that calorific chocolate voice. That’s her in the MRI, reasserting her drumming self in poltergeist form. I hope she’s having fun.
What can they see inside my head?
A dark grey silhouette appears, my brain in fashionably drab wall colours. Aside from being a woman with a love of colour, I could never live with a wall where I can’t see spiders. Can’t see the spiders on my brain chart either for that matter, so I turn it orange, then aquamarine. Definite improvement.
I start from the top and name the areas of the brain I can remember as I go. Then I return my cartoon map to orange, and start from the inside, working out, scrabbling for functions. Why am I seeing my brain in textbook form? It’s not something you usually think about, invisible yet ubiquitous, omnipotent…
I walk into the farm building. He’s lying on his back, 12 bore shotgun resting along his body from thigh to chin, a dark, petechial-looking rash of shot sprayed up, over what’s left of his nose, upper jaw and cheek.There’s a whiff of earth and death. His hair is quiffed with blood and brains, dark and sticky, drying in the warm air. There’s a mess from the exit wound that’s blown the back of his head off, almost black and shiny in contrast to the dusty earth floor. I look for signs of life, but know there are none. I grab my stethoscope to listen for heart and breath sounds before setting up the 3 lead ECG. My job here is only to note and remember the details for my records, recognise death, then complete the paperwork for the police. Then I’ll go and check on the people who found him, have a chat, make sure to contact the local surgery so they know there are people who might need support.
I go to move the man’s shirt, and notice the hunks of brain, satsuma to grape sized, dropped casually as if from the sky across his chest like a Masterchef plate. Greyish, alien, certainly not perfused with blood or alive, but unmistakably brain. Above his shoulder is a larger chunk that wobbles as I move my foot to squat over him; that’s why you won’t often see an experienced paramedic kneeling.
Brain, body, soul. One of the clear categories for not starting advanced life support for a paramedic confronted with a recent death is ‘massive cranial destruction’. That’s what I see here, and the death of the body is evident in any case. Brains are something else, the control centre, the mind, the self. I wonder what this man was like, how his voice sounded. Did he have a sense of humour? What drove him to this? What was he thinking as he pulled the trigger, how did he keep the barrel straight, not flinch? How did his brain let him die?
A new scan starts.
“Lynne, we’re just going to pop a cannula in and inject some dye so the doctor can get some more definition. Is that okay?”
Uh oh. There’s something there then.
Cannula in with a sharp, welcome physical pain, dye in, poltergeist Karen returns.
What would be best? Stroke, maybe. I’m not in a majorly bad state, considering. I’d settle for that. If it’s a clot, though I’d have to take warfarin and won’t be able to eat broccoli or drink pink grapefruit juice. MS? It’s in my family; my uncle died from complications in his early 50s. I’ve already discussed that with the lovely neurologist who says that a genetic link isn’t established but that the MRI will pick it up. I’ve had no visual disturbances either, and those tend to go with MS. There are plenty of other degenerative diseases of the nervous system which I decide to ignore. The various forms of dementia keep nudging, and I know that’s my worst nightmare. Losing my mind. Brains chunked all over the floor of my life.
Tumour? I try to blank that one. But it might be a small, benign tumour, treatable. Might not. I’ve been to people who have the nasty type, read up on them afterwards. I like to know, to understand the workings. If I have galloping dementia I won’t be able to do that so maybe there’s a bright side.
“There is an abnormality there” says my neurologist. I know that already. We’re sitting back in our little room in the AMU. The nurse – a proper Plymouth chap full of muscular banter and warmth, who looks to have dropped in from a passing frigate, has a serious face on for the first time today.
The scan appears on screen, as the neurologist selects the picture he wants.
“There? It’s a tumour”. He’s looking me in the eye.
I think I say “Oh”, then “do you know what kind?” It resembles a misshapen foetus but I reject that image at once, think of nuts instead.
“The white area around it is where the dye has been taken up, so that’s the blood supply. A blood supply usually means it’s malignant.” I know that all cells need nutrients and oxygen to grow, and cancers set up their own supply lines in the body, muster their troops.
“It might be a primary brain tumour, or it might be a secondary from another cancer somewhere else. So we need to do a whole body CT scan to check. There’s a large area of swelling, where the tumour is irritating your brain. That’s what’s causing you the problems so we’ll give you a course of steroids starting now.”
I had breast cancer in 2010/11, culminating in bilateral mastectomies. I think of myself as one of the lucky ones, because my cancer was supposedly not invasive, and was discovered almost accidentally. It turned out to be far bigger than expected when removed, and so the mastectomy became the best option. But there were good margins of clear tissue. My un-diseased breast mastectomy was my prophylactic choice based on my mother’s breast cancers on both sides, and my outdoor lifestyle and hatred of bra wearing. I got my histology reports and researched what I had, and felt I had a good idea of the risks. Plus I wanted rid. There turned out to be a risk factor for cancer in that breast too, so I felt entirely vindicated. Mastectomy also meant no radiotherapy which was a bonus.
So this is potentially a bit of a shocker, though of course it might not be relevant at all.
So there’s a wait, and then the CT scan.
The nurse asks me if I want a private room, but I choose the recliners in the treatment area where there are people. I watch him as a more traditional-looking female nurse glides by smiling. I love the contrast, the variety of styles and approaches. They all work together, doctors, nurses, care assistants. I’ve just had a chat with the cleaner too. It’s a team, where they fill in the gaps, relate to their patients who all need different things. No corporate bland for the NHS, despite the pictures along the corridors spouting mission statements and branding.
I don’t want to be alone. I’ve called Dad who’s gone to fetch Mum from the prison where she works. I call two friends and tell them, just to make it real and have some contact with voices I love. I haven’t cried or wobbled, I just feel stunned.
“Thank god for the NHS” I say to Kari.
“You greedy cow! You’re getting all our money – won’t be any left for the rest of us once you’re done!”
Alongside me to my left rests a young woman, recovering from a lumbar puncture. I ask her how it was and explain what CSF is when she wonders, admiring her funky bag. Then I tip my cup of water all over the floor next to her, narrowly missing the gorgeous bag.
The nurse has bought me a refill of water. I pick it up and spill it over the table.
“I’m so sorry” I tell the young woman.
“It’s fine, I overheard you telling your friend, don’t worry.” She smiles.
The nurse reappears, this time with a towel, and mops up the growing puddle.
“It’s not your fault, don’t you worry”. I want him to call me ‘Bird’ but he doesn’t.
He brings the steroids and more water. I pick it up.
“Right hand!” warns my young neighbour, giggling.
Bless her. Young, probably scared and relieved the nasty bit is over, and confronted with the damper random effects of my brain tumour.