Printer-Friendly
Email this Story
Post a Comment (0)
When life feels like an episode of 'House'
A week ago, I blogged about my son David, 19, who came home from college with a 6-cm. mass in his left sinus. I was breathing a sigh of relief because it seemed the Pathology Department at Georgetown University Hospital, in a preliminary report, had diagnosed the tumor as a benign schwannoma.
But that was just a pit stop on the roller coaster ride that we climbed into four weeks ago.
On Monday David, my husband Gene and I breezed in for a second-opinion consult with Dr. Chris Gourin, an otolaryngologist at Johns Hopkins. Her opinion? David's tumor is a rhabdomyosarcoma, or "rhabdo" for short – a malignant growth most often seen in children. The three of us were floored, and shaken.
We drove home from Hopkins in gray, pounding rain, feeling discouraged and depressed. That awful churning had started up again in my lower intestine. The only thing that kept us hopeful was Dr. Gourin's assurance that David's tumor was "inoperable but curable."
She arranged for us to return to Hopkins on Wednesday for a meeting with Dr. Katie Thornton, an oncologist and sarcoma specialist, and for a second CT scan for David.
But Tuesday Dr. Thornton's office called to say she didn't need to see us until we had Georgetown's final pathology report, which wasn't due until late Wednesday. She believed there was no reason to meet unless we were sure David's tumor was a sarcoma.
A couple hours later we got a second call, saying Dr. Thornton did want to meet with us. We took that to mean that Pathology had found a sarcoma, and our spirits dropped to new lows.
We headed back to Hopkins Wednesday morning and checked in at the Sidney Kimmel Comprehensive Cancer Center's outpatient unit. I was expecting to enter a dark, dreary room full of bald, vomiting cancer patients. Instead we were welcomed by a "hostess" to a pleasant, even cheerful, space resembling a large, modern hotel lobby. The colorful furnishings were tasteful, and the mood upbeat and friendly. And frankly, it was hard in most cases to tell which people were patients and which were friends and family members.
Eventually, we were called in to meet Dr. Thornton, whose warm, outgoing manner immediately put us at ease. Even better were her first words: "I don't think you'll be needing me."
She, too, had first thought David's tumor was a rhabdo because of his age and the location of the mass. But after further study, she decided it didn't behave like a sarcoma, which as a rapidly growing tumor would cause excruciating pain. David's pain has been minimal, which told Dr. Thornton that the mass was slow growing – more in line with a schwannoma.
She reviewed with us the treatment options for both a schwannoma and a rhabdo. We felt reassured that the treatment of both would be manageable.
Then Thursday evening Dr. Kenneth Newkirk, our Georgetown otolaryngologist, called with his hospital's final pathology report: The tumor appears to be neither a schwannoma nor a rhabdo. In fact, the pathologist isn't sure what it is.
"We're trying to fit the tumor into a category, and it's not fitting," Dr. Newkirk said. Pathology is calling it a "myofibroblastic tumor," which would fall somewhere along a continuum with schwannoma on one end and rhabdo on the other. The tumor looks like a rhabdo but acts like a schwannoma.
Meanwhile, Hopkins Pathology has undertaken its own study to see if it can come up with something conclusive. We should have those results next week.
In light of all this, I had to laugh watching the return of "Grey's Anatomy" last night. Meredith orders an MRI for a patient based on a few vague symptoms (impulsive behavior, loss of peripheral vision). She reads the films herself (where was the radiologist?), and without the benefit of a biopsy, concludes that the man's brain tumor is an invasive, difficult-to-treat glioblastoma.
Of course, up till now I've thought that's how doctors work – that almost everything is clear-cut. I'm learning that medicine is far more intuitive than I knew. It's as much an art as a science.
And more like "House," where actor Hugh Laurie, who plays a doctor on TV, takes on mysterious cases, exhausting every possible diagnosis until he and his team hit on the correct one.
If we don't have an answer for David soon, I'm pitching our story as an episode for "House"!
You must be logged in to post a comment.