Living Life Fully Again
"Good morning, Dr. Hsu!"
The eldest sister energetically entered the consultation room. Compared to her previous two outpatient visits, she appeared more relaxed and composed.
After inspecting the surgical wound on her head and finding nothing unusual, I asked, "How have you been recently?" The patient replied, "I've been sleeping better now, the wound doesn't hurt, and I've started radiation therapy." I said, "Yes, today we can stop taking steroids, so you should be able to sleep as well as before." The patient said, "I feel much better. I used to be so fatigued and didn’t want to do anything. My limbs were also not very agile...but after the surgery, I can wash dishes and do household chores."
"It's like you're living life fully again," I said, and we shared a smile.
For the past two weeks, this patient had been experiencing decreased appetite, lack of energy, and an unsteady walk that led to frequent falls. Family members described her as having regressed, acting like a child. The day before her hospital admission, she experienced headaches and felt sleepy. Upon examination, it was found that a brain tumor was compressing her brainstem. Steroid treatment stabilized her condition, and after consulting with internal medicine, surgery was considered. At that time, I already had two routine brain tumor removal surgeries scheduled. Considering her condition, the availability of the operating room equipment, as well as my own capabilities, I decided to perform surgery to solve her problem.
During the craniotomy to remove the brain tumor, I aimed to achieve a clean removal. If I successfully performed a slightly complex procedure, I'd feel very content, as if I've overcome a major challenge, and it boosts my confidence for more intricate surgeries. Post-operative MRI scans showed complete removal, elevating my sense of accomplishment. However, the real reward often comes days later, when seeing the patient recover smoothly in the clinic, showing cognitive and physical improvements. It's usually on my way back to the office after consultation that I tell myself, "You've done something remarkable."
I once read, "Witnessing a patient recover is the most precious reward for a healer." Although I agreed, I didn’t quite resonate with the sentiment initially. But as my experiences accumulated,, seeing patients gradually improve from complications— from being paralyzed to sitting steadily by themselves, from being non-verbal to recognizing family members and answering simple questions—I could feel that all the hard work was worth it. The sense of accomplishment isn't influenced by the difficulty of the surgery or the sophistication of the technique used; it's simply real.
In cases of malignant brain tumors, whether primary or metastatic, careful evaluation is crucial. Considering both personal and team capabilities, and ensuring proper equipment, even if we can't change the inevitable progression of the disease, there's an opportunity to delay its course with the patient, improving neurological functions and preserving their quality of life. It's akin to allowing them to truly live again.
Author: Dr. Tsu-Jung Hsu (Neurosurgery)