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416: I was drowning in memories when my life flashed behind my eyes. Voila: this book.

417: This is about how our miniature dachshund Latte might have saved my eyesight:

    I am awakened at 3 a.m. on my knees, stunned, pain ascending, blood. I’ve fallen out of bed. I’ve crashed my head into the corner of the side table. Erin tends to the cut near my eye and declares, “You need stitches.” We make sure Latte’s water dish is full and leave her with the usual “Watch the house.” The emergency room at St. Luke’s is relatively calm. The intern confirms I don’t have a concussion and stitches me up (after first getting permission from a resident). He is about to release me when he glances at my paperwork. “At your age, protocol calls for a CAT-scan in case something got shaken loose. It’s up to you. I’m pretty sure we won’t find anything.”

    The CAT-scan confirms my brain is intact, but a suggestion of a shadow hints at a pituitary tumor. “Only way you can tell for sure is with an MRI,” the intern says. “Don’t lose any sleep over it—they’re almost always benign—but do call your doctor soon.” The prospect of an MRI terrifies me. Take Xanax, a friend advises, but that is another of my fears. Turns out the two work nicely in tandem, especially with the Beatles piped in and Erin holding my foot.

    The MRI confirms what the CAT scan suspected, and my internist refers me to Dr. S. at Langone, a specialist in skull-base tumor surgery who, research reveals, is “world-renowned,” “a pioneer,” and a New York Magazine “Best Doctor” (I always wanted one of those).  Dr. S. and I admire each other’s fountain pens, then he shows Erin and me the image of my brain laid bare, pointing to a white mass. “Is that my pituitary?” I ask. “No,” he says, “that’s the tumor enveloping your pituitary.” He points to where it wraps around my carotid artery, and to the short—but safe, for now—distance between the tumor and my optic chiasm.

    The benign tumor will keep growing slowly, so no need to do the surgery—which has risks—until it almost abuts the optic chiasm. “What about the carotid artery?” I ask, imagining a tiny snake suffocating me at the source. “The carotid adjusts,” Dr. S. explains. Erin and I feel total confidence in Dr. S, and we like him, a gentle spirit harboring great power.

    After several MRI follow-ups over two years (Xanax, Beatles, foot-holding), Dr. S. points to the tumor encroaching on the optic chiasm. “Now we know what it’s trying to do,” he says, and we schedule surgery for September 18. Two weeks before the surgery, on a blustery Friday evening, we walk with Latte along the West Harlem Pier, where we come across what may be saddest Bingo game ever: a Parks volunteer calling numbers to two players. It is our humanitarian duty to play, and, before long, I forget my pituitary and focus on B-55. BINGO!—give that man a straw hat.



    There will be another surgeon involved, Dr. L., an otolaryngologist specializing in endoscopic transnasal skull base surgery, including “the management of cerebrospinal fluid leaks.” Our visit to Dr. L. is assuring—he smiles easily, keeps up with my banter, and precisely explains how he will create the pathway for Dr. C. by removing part of my septum. He assures me that we have way more septum than we need. (The septum, like the carotid, adjusts.) Oh, and about the possible spinal leakage. If it happens—as it sometimes does—he will be the one to patch it. “We’ve teamed up on far more complex procedures.” (When Erin said earlier to Dr. S., “So this one is easy for you,” he rejected easy: “One must stay humble.”)

   I recommend being the first surgery of the day. The 5:30 a.m. cab ride with Erin from 125th and Riverside, down the FDR—especially on the verge of the autumnal equinox—is lovely. I have not taken any preemptive Xanax, but passing the 59th Street (groovy) Bridge induces a sweet flashback of Beatles and foot-holding as we pass through the United Nations Tunnel.   

    My biggest anticipatory fear has been the possibility I could be rendered unconscious and never wake up (what could that possibly feel like?). Waiting for the wheel chair, I tell Erin I am still in control—we could still leave and get breakfast and come back another time. Instead, I am being wheeled, my life, perhaps for the rest of my life, in the passive voice. I am handed off to an OR nurse and parked outside the OR door. “We’re waiting for the surgeon.” I distract myself by imagining that the last words I will hear, cutting through the dark tunnel as I approach the golden light will be: “On my count…” “No, on my count!” “Why is it always on your count?” “Because I’m always the first to say, On MY count!!” “Damn, now see what you’ve done?!” (Now, I must make it through.)

    The OR nurse notices I am still wearing my wedding ring. I tell her we weren’t able to get it off (after thirty years) and I signed a waiver allowing them to cut it off during surgery if my hand swells. She insists that we remove the ring now: “We wouldn’t want to pause the surgery to cut off your ring.” Then comes a scramble for the right equipment: folks in scrubs being sent off in search of a mini-saw and tiny pliers, followed by several minutes of drilling and pulling, which draws a small crowd, including Dr. C., who smiles when the hallway procedure is successful and the excised gold is whisked away in a jar.

    The surgery starts late and takes longer than expected due to a minor cerebrospinal fluid leak, patched by Dr. Lebowitz with fat from my belly. Erin and my sister get progressively more nervous. Then an aide brings in my severed wedding ring—with no explanation—and they start to panic, until the sublime Dr. S. appears to tell them all’s well, he got it all and my carotid and optic chiasm are unscathed.

    The United Nations has just started their session, leaving the area around the hospital in perpetual gridlock. It takes Erin hours to get home to feed Latte. I remember that exactly 57 years ago, driving on the way home from a ballgame, we passed under the U.N. Tunnel and I was awed by the notion that Castro, Khrushchev, and Eisenhower were above us. Of course I was oblivious to the thousands in surrounding hospital rooms.

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    After three days in intensive care, being intensively cared for and monitored by an array of kind and capable nurses and doctors, including 48 hours supine because of the spinal leakage, I am released and reunited with Erin and Latte. Which gets me to how Latte might have saved my eyesight.

    Mine was an “incidental” diagnosis, common in pituitary tumors. If I hadn’t fallen out of bed and banged my head, eventually I would have experienced vision problems, and, if I got diagnosed in time, required even more of Dr. S’s considerable talent. This was the fifth or sixth time I’d fallen out of bed in the last few years. But I never needed a trip to the Emergency Room. I attributed the falls to Latte—nine pounds of horizontaldachshund-length nudging me to the edge, so one false step in a dream and over I’d go. Could Latte have been trying to nudge me to a CAT scan? I know of no evidence of dogs being able to sniff benign pituitary tumors, but I have not fallen out of bed since that night.

418: If I am able to maintain this snail’s pace, I am comforted to know I will never run out of things to write.

        

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