I gots to know
Callahan: I know what you’re thinking: “Did he fire six shots or only five?” Well, to tell you the truth, in all this excitement, I’ve kinda lost track myself. But being this is a .44 Magnum, the most powerful handgun in the world, and would blow your head clean off, you’ve got to ask yourself one question: ‘Do I feel lucky?’ Well, do you, punk?
[The thief gives up trying to retrieve his shotgun; Callahan picks it up and starts to walk away, lowering the hammer.]
Thief: Hey! [Callahan turns around] I gots to know…
Story so far…
I have a diffuse low-grade glioma. It’s too diffuse for surgery and too big for radiation. The only other possible treatment is chemotherapy but the kind of chemo given depends on the type of glioma. The tumour is slow-growing — I’ve probably had it for at least 5 years, maybe 10 — but most gliomas eventually transform to a higher grade, at which point they grow faster. I might be around for another 10 years with no treatment or my tumour could transform tomorrow. I can’t have treatment without a biopsy but the biopsy might say I can’t have treatment anyway.
Do I feel lucky? Well, do I?
My oncologist thinks I should have the biopsy. She thinks I might be the kind of person who just likes to know stuff. She might be right. She said biopsies are pretty safe and it’s better to know than to not know.
If my tumour has a particular mutation, then there is a pretty good chance that a particular kind of chemo — PCV — would be worth a try, though there is zero data on whether chemo-without-surgery does any good. The oncologist says that PCV should not be too hard to bear for a fit young man like myself (she might have said ‘handsome’ too, but our memories are hazy on that).
One more argument in favour of biopsy: I feel like I’m stuck in a kind of limbo where I am under the care of a surgeon but I am not going to have surgery. The oncologist won’t accept me as a patient until I have had a biopsy so my biopsy is my ticket out of limbo.
We saw the neurosurgeon yesterday so he could talk me through the process of a biopsy. He will drill a hole in my skull and stick a needle in to grab a sample and send the sample away for testing. The risks are fairly minimal and the recovery is usually quick. When the results come back, we’ll see what to do next.
Wait in line
‘Till your time
The neurosurgeon was on good form — plenty of smiling and laughter — and he answered all my questions. He even invited a junior colleague to come join us and enjoy our banter. We shared a joke about how losing your sense of taste is not the worst thing in the world as long as the beer still tastes good.
I think I feel lucky.