All I know

It seems a good time to mention that I ditched Man A. I was becoming fond of him, and my head wasn't as together as I thought it was.

He was having an online flirtation with a woman far enough away so as not to be too much of a problem. Unfortunately, my brain and body reacted as they did when The Erstwhile Hub and The Erstwhile Pal got together; namely, I went berserk.

I figured it was too much to ask of an uncommitted person to stick with me while I worked my head out, so I dumped him. Badly and baldly and I miss him.

... ... ...

Glioblastoma multiforme is a type of brain tumor that arises from the structural cells that keep your brain from being one big pile of mush sloshing around in your skull. It's the most common and most lethal type of brain tumor. You don't get better with a glio.

Today I had a patient come in who'd had a glio, been given four to six months to live (the average, though sometimes we can keep 'em alive and functioning well for two years or so), and was back because she'd had a bleed. This is a common complication of glioblastoma simply because of how it operates:

It meshes normal brain tissue and cancerous brain tissue together so closely you can't take it out all the way.

Think about that for a minute. This cancer destroys, slowly and with your full awareness, your memories, your personality, and finally your most basic functions.

It is what I fear most.

So, anyway. This woman came in. It became apparent early on that she couldn't feed herself; the sight of a plate of food overwhelmed her. Besides that, her motor skills had declined to the point that she couldn't get a forkful of salad to her mouth unaided. So I fed her, and we talked. She thanked me for being understanding and not making her feel bad.

She told me, "I'm not sure how this is going to turn out. I mean, I know how this is going to turn out, but I'm not sure what it's going to be like getting there."

Then she said, "When the doctor told me 'four to six months' I wanted to say to my husband, 'Honey, let's not do this.' But we've been married so long and we're so devoted to each other, I couldn't tell him no. Even though I wanted to."

She looked me dead in the eye as she said that. I replied that maybe it was time to talk to her doctor and husband, if she really didn't want to do this ("this" being more treatment, more radiation, more steroids). I didn't know what else to say. It was borne in upon me at that point that maybe this was one of those things that might make me cry.

When you see people like this, the progression of the disease is fairly predictable: they lose short-term memory first, then function, then finally, before they end up dying, the only thing they retain is the awareness of who's most important to them.

But the ending always comes at last
Endings always come too fast
They come too fast
But they pass to slow
I love you and that's all I know.