between life and Death.
Crisis followed crisis now in a series of savage ups and downs. The flap, which we called the Bulge or the Bump, got slowly, mercilessly bigger, until it was almost the size of a tennis ball sticking out of his head. “Oh—it’s the way those things go after X-ray,” we tried to explain it away. He accepted this—perhaps—and was cheerful and determined. Meantime we came to learn a new medical word that pursued and haunted us for almost a year—papilledema. This means, to put it roughly, a forward protrusion of the optic nerve, which is an extension of the brain itself. When pressure exists inside the skull, causing damage to the optic nerve, the amount of injury may be calculated with an ophthalmoscope. When the eyes are normal, the papilledema is zero. Then degrees of injury are measured in an ascending scale to 10 diopters. The higher the papilledema, the worse the situation. Before the operation Johnny’s papilledema was a full 10; when we left the hospital, it had dropped to 2. Now it hovered between 4, 3½, and 4 again. Always the first thing a doctor did was to measure this wretched papilledema. Another frightening factor was that though most of the cranial nerves were still normal, there had come a slight lag on the left side of the mouth. Also Johnny had lost a shocking amount of vision. His eyes were more or less all right when he looked straight ahead, but what are known as the visual fields had become sharply restricted, and he could not see well to the side. The doctors called it “a left homonymous hemianopsia.” It was as if he had an invisible blinker on the side of each eye.
Nobody should get sick in or near New York in July or August. Putnam and Mount were both on holiday. On July 12 I brought Johnny in to Traeger for a check. Traeger did not like the look of the bump and sent us to Masson, who had taken Putnam’s place at Neurological. Masson would not see Johnny that day, which meant that he had to undergo the exhausting business of a hundred-mile drive back to the country, then into town again, and then back once more. Then Masson took one look and said flatly that Johnny could not live more than a couple of months. That ugly analogy came up again—his brain was like an apple with a spot in it.
On Wednesday, July 17, 1 was back in town. At about mid-night Frances called from Madison. The bump had opened and was leaking pus.
From that day until a month before he died, there was never a single day in which Johnny—patient, brave, humorous—did not have to go through the laborious nuisance and ordeal of having his head dressed and bandaged.
This leak in the bump was not in itself serious; it was a “stitch abscess” caused by a couple of tiny stitches left in the original incision. But it worried our local doctor in Madison, and Johnny began to take penicillin to avert infection in case the wound should widen where the bulging scalp was stretched thin and taut, or in case there should be another ulceration. We prayed that this would not happen. It happened, though. The bump burst open in another place. I got another hurry call from Madison at noon on the twenty-fourth, drove out at once, and Johnny was back in Neurological that evening. He was not worried much; only annoyed that his work was being interrupted. But he was skeptical when we said that he would be hospitalized only for a day or two. “Once they get me here,” he declared, “they keep me.”
We had heard, meantime, about a magician named Wilder Penfield in Montreal. Half a dozen folk had suggested that we get in touch with this renowned surgeon who, like Putnam, has international rank and who, like most great brain surgeons, is a poet. Traeger tracked him down, and he agreed to come to New York to have a look at Johnny. It was interesting to notice how impressed Neurological was with Penfield. The manner of the whole sixth floor abruptly changed. Previously Johnny had been a hopeless case; now he
Crisis followed crisis now in a series of savage ups and downs. The flap, which we called the Bulge or the Bump, got slowly, mercilessly bigger, until it was almost the size of a tennis ball sticking out of his head. “Oh—it’s the way those things go after X-ray,” we tried to explain it away. He accepted this—perhaps—and was cheerful and determined. Meantime we came to learn a new medical word that pursued and haunted us for almost a year—papilledema. This means, to put it roughly, a forward protrusion of the optic nerve, which is an extension of the brain itself. When pressure exists inside the skull, causing damage to the optic nerve, the amount of injury may be calculated with an ophthalmoscope. When the eyes are normal, the papilledema is zero. Then degrees of injury are measured in an ascending scale to 10 diopters. The higher the papilledema, the worse the situation. Before the operation Johnny’s papilledema was a full 10; when we left the hospital, it had dropped to 2. Now it hovered between 4, 3½, and 4 again. Always the first thing a doctor did was to measure this wretched papilledema. Another frightening factor was that though most of the cranial nerves were still normal, there had come a slight lag on the left side of the mouth. Also Johnny had lost a shocking amount of vision. His eyes were more or less all right when he looked straight ahead, but what are known as the visual fields had become sharply restricted, and he could not see well to the side. The doctors called it “a left homonymous hemianopsia.” It was as if he had an invisible blinker on the side of each eye.
Nobody should get sick in or near New York in July or August. Putnam and Mount were both on holiday. On July 12 I brought Johnny in to Traeger for a check. Traeger did not like the look of the bump and sent us to Masson, who had taken Putnam’s place at Neurological. Masson would not see Johnny that day, which meant that he had to undergo the exhausting business of a hundred-mile drive back to the country, then into town again, and then back once more. Then Masson took one look and said flatly that Johnny could not live more than a couple of months. That ugly analogy came up again—his brain was like an apple with a spot in it.
On Wednesday, July 17, 1 was back in town. At about mid-night Frances called from Madison. The bump had opened and was leaking pus.
From that day until a month before he died, there was never a single day in which Johnny—patient, brave, humorous—did not have to go through the laborious nuisance and ordeal of having his head dressed and bandaged.
This leak in the bump was not in itself serious; it was a “stitch abscess” caused by a couple of tiny stitches left in the original incision. But it worried our local doctor in Madison, and Johnny began to take penicillin to avert infection in case the wound should widen where the bulging scalp was stretched thin and taut, or in case there should be another ulceration. We prayed that this would not happen. It happened, though. The bump burst open in another place. I got another hurry call from Madison at noon on the twenty-fourth, drove out at once, and Johnny was back in Neurological that evening. He was not worried much; only annoyed that his work was being interrupted. But he was skeptical when we said that he would be hospitalized only for a day or two. “Once they get me here,” he declared, “they keep me.”
We had heard, meantime, about a magician named Wilder Penfield in Montreal. Half a dozen folk had suggested that we get in touch with this renowned surgeon who, like Putnam, has international rank and who, like most great brain surgeons, is a poet. Traeger tracked him down, and he agreed to come to New York to have a look at Johnny. It was interesting to notice how impressed Neurological was with Penfield. The manner of the whole sixth floor abruptly changed. Previously Johnny had been a hopeless case; now he
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