opened her mouth, and then closed it because she didn’t know what to say. She’d read somewhere that people in a hospital needed an advocate to look out for them when they were too sick to do it themselves.
But mom isn’t that sick, is she?
Evangeline waited for her mom to speak.
Say something, mom. Say something—say something—please.
“Um, can you tell me, um, how you know it’s malignant?” Evangeline finally asked, her voice so soft that the doctors had to step closer to hear her.
“A brain tumor is deemed malignant not just because it consists of cancer cells, but due to its location,” the resident answered. “The skull is made of bone and it can’t expand to make room for even a small tumor growing in the brain. With a tumor as large as Ms. Theopolis’, it’s categorized as malignant due to its location, which can damage and destroy the brain’s delicate tissues. Ms. Theopolis complained of severe headaches and vomiting which tell us that she has increased intracranial pressure, or ‘IICP.’ These symptoms all factor into a diagnosis of malignant tumor.”
“Correct, Yuske,” Dr. Sullivan said. “What grade are we looking at Veronica?”
Veronica stepped forward, pushing thick, black bangs back so she could more easily peer at the scan. “Looks like a Grade Four.”
“What does that mean?” Evangeline asked, embarrassed to hear the tremor in her voice but terribly aware of her mom’s silence and the need for both of them to understand what was happening.
Veronica turned to face Evangeline and her mom. “Small tumors with distinct borders are Grade One,” she said gently, “which means they are the most easily cured. This tumor is quite large and the borders aren’t distinct. Ms. Theopolis’—your mom’s symptoms suggest that her tumor is already damaging her brain tissue because she has already experienced headaches, black-outs and delusions.”
Evangeline wanted to shout that only crazy people have delusions and her mom wasn’t crazy—but hadn’t her mom thought her teeth were falling out? And then her hair? What was going on? Evangeline said nothing.
Dr. Sullivan turned to another resident, tapping the scan. “What type of tumor are we looking at, Aaron?”
“Hard to say for certain without a biopsy, but we can narrow the field.” The resident scratched his patchy mustache as he thought aloud. “The most common adult brain tumors are metastic tumors, which we can rule out from the MRI scans we’ve already done, leaving Meningioma or Anaplastic Astrocytoma. My money is on Anaplastic Astrocytoma, and more specifically the sub-group, Glioblastoma Multiforme or ‘GBM.’”
“Please, wait! You’re going too fast. What’s all this stuff you’re talking about? What’s a GBM?” Evangeline asked the questions, even though she was certain—totally and one-hundred-percent certain—she did not want to hear the answers. What she really wanted to do was to run far away from this hospital and these doctors and their clinical diagnosis of the most important person in her life.
“GBM,” Aaron replied, “is a brain tumor made of several different cell types. This makes it difficult to treat because while one type of therapy works on a specific type of cell, another type is needed for each different cell. So we treat GBMs with aggressive chemotherapy and radiation. In Ms. Theopolis’ case the tumor is so large and in such an inaccessible area that we won’t be able to remove it all without causing severe neurological damage. The best we can do is attempt to keep it from growing and hopefully shrink it a bit to alleviate the headaches and other symptoms.”
“The option of surgery shouldn’t be entirely ruled out, though,” Veronica added, looking to Dr. Sullivan for confirmation.
“It’d create way too much damage,” Aaron countered, also looking to Dr. Sullivan.
Evangeline turned to her mother. This roller coaster was climbing way too high and someone needed to
But mom isn’t that sick, is she?
Evangeline waited for her mom to speak.
Say something, mom. Say something—say something—please.
“Um, can you tell me, um, how you know it’s malignant?” Evangeline finally asked, her voice so soft that the doctors had to step closer to hear her.
“A brain tumor is deemed malignant not just because it consists of cancer cells, but due to its location,” the resident answered. “The skull is made of bone and it can’t expand to make room for even a small tumor growing in the brain. With a tumor as large as Ms. Theopolis’, it’s categorized as malignant due to its location, which can damage and destroy the brain’s delicate tissues. Ms. Theopolis complained of severe headaches and vomiting which tell us that she has increased intracranial pressure, or ‘IICP.’ These symptoms all factor into a diagnosis of malignant tumor.”
“Correct, Yuske,” Dr. Sullivan said. “What grade are we looking at Veronica?”
Veronica stepped forward, pushing thick, black bangs back so she could more easily peer at the scan. “Looks like a Grade Four.”
“What does that mean?” Evangeline asked, embarrassed to hear the tremor in her voice but terribly aware of her mom’s silence and the need for both of them to understand what was happening.
Veronica turned to face Evangeline and her mom. “Small tumors with distinct borders are Grade One,” she said gently, “which means they are the most easily cured. This tumor is quite large and the borders aren’t distinct. Ms. Theopolis’—your mom’s symptoms suggest that her tumor is already damaging her brain tissue because she has already experienced headaches, black-outs and delusions.”
Evangeline wanted to shout that only crazy people have delusions and her mom wasn’t crazy—but hadn’t her mom thought her teeth were falling out? And then her hair? What was going on? Evangeline said nothing.
Dr. Sullivan turned to another resident, tapping the scan. “What type of tumor are we looking at, Aaron?”
“Hard to say for certain without a biopsy, but we can narrow the field.” The resident scratched his patchy mustache as he thought aloud. “The most common adult brain tumors are metastic tumors, which we can rule out from the MRI scans we’ve already done, leaving Meningioma or Anaplastic Astrocytoma. My money is on Anaplastic Astrocytoma, and more specifically the sub-group, Glioblastoma Multiforme or ‘GBM.’”
“Please, wait! You’re going too fast. What’s all this stuff you’re talking about? What’s a GBM?” Evangeline asked the questions, even though she was certain—totally and one-hundred-percent certain—she did not want to hear the answers. What she really wanted to do was to run far away from this hospital and these doctors and their clinical diagnosis of the most important person in her life.
“GBM,” Aaron replied, “is a brain tumor made of several different cell types. This makes it difficult to treat because while one type of therapy works on a specific type of cell, another type is needed for each different cell. So we treat GBMs with aggressive chemotherapy and radiation. In Ms. Theopolis’ case the tumor is so large and in such an inaccessible area that we won’t be able to remove it all without causing severe neurological damage. The best we can do is attempt to keep it from growing and hopefully shrink it a bit to alleviate the headaches and other symptoms.”
“The option of surgery shouldn’t be entirely ruled out, though,” Veronica added, looking to Dr. Sullivan for confirmation.
“It’d create way too much damage,” Aaron countered, also looking to Dr. Sullivan.
Evangeline turned to her mother. This roller coaster was climbing way too high and someone needed to
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