Wednesday, August 27, 2008

Week 4: Goose

The 17 year old boy, who had a benign tumor in the middle of his left cortex and had to go through an open brain surgery, came to clinics for follow ups. The surgery the boy went through was the first craniotomy I have ever seen. I was in fact so shocked at how traumatizing the procedure was--perhaps the tears of the boy and his mother before the surgery began had also elevated my emotions. However, today when I saw him, I was quite surprised at the results. Although the boy seemed to be responding somewhat late to the questions Dr. Souweidane asked, he was perfectly normal. He walked straight without a problem with symmetric facial expression as well as full control over every limb. The scar from the surgery has already started healing, though the incision made still looked quite painfully large, and could be somehow covered by hair. However, he seemed to have some change in attitude which I thought it reflected some distrust toward Dr. Souweidane. I still think the surgery was the best solution and decisions Dr. Souweidane could provided based on MRI images to the problems he was having. I guess some patients come with trust and open mind trying their best to have the greatest results, while some other patients come with distrust and doubts towards their physicians and only are disappointed by the results.

During the week I met a patient with neurofibromatosis type 1. Her left eye was covered with a large growing tissue mass, neurofibroma. She had several brownish dime sized freckles on her skin, I could easily notice. The reason why she came to see Dr. Souweidane was her back problems. Apparently, patients with neurofibromatosis type 1 often have abnormal development of spine, termed scoliosis, which can give discomfort while sitting and standing. She did have trouble sitting straight up but was not so severe. Neurofibromatosis is known to be a genetic disorder, having mutation in proteins that control cell production. Neurofibromatosis type 1 is pretty common occurring in 1 in 3000 individual in the United States. I did not know what I would do if I had such problem and what I could say to cheer her up. Sometimes, and every since I came to Weill medical school, I keep realizing that being able to live a normal and healthy life almost seems like a miracle.

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