Don't Shoot the Messenger

25 - 2nd opinion

*edited 

Monday

Macello POV

I left a note for Claire and headed out at 5 am, allowing 4 hours for a 3 hour drive. I will not risk being late.

"Your wife could not make it?"    "She is too stressed about this. I had to sedate her for the last MRI. I have Medical Power of Attorney; you can share everything with me."  "Very well. If I may see the documentation?" I hand over excellent forgeries. He is soon satisfied that I have the legal right to make medical decisions for Claire.

"Here is the MRI you provided from October, and this is the one from last night. Even the untrained eye can observe the growth. Here... deformation of the occipital lobe, and the cerebellum... the brain stem is most concerning. Has she had any fainting spells or disturbed sleep patterns? Chest pains?"  "Not that she has admitted to."  "The brain stem controls heart rate and breathing. I'm almost surprised that she hasn't had some sort of episodes." I think carefully... the time she fell in the bathroom, she said she slipped. She could have fainted instead. There were a few times she tripped or claimed to have been pushed a bit in the crowd. Was it the after effects from my nightmare that made me imagine her breath had stopped for a few moments? I explain, and the Dr. takes notes. I recognize his non-expression and the seriousness behind it.

"Unfortunately, she has been untreated too long for me to reassure you as you wish. Her odds of surviving the surgery itself are 40% now, at best." His posture is confident bordering on arrogant; I am more irritated than reassured. "You may be a good neurosurgeon, but not the BEST. I've heard of another neurosurgeon in the United States...a Dr –" He holds up his hand to stop me. "I am sure that you can find someone with a world class reputation. Whether you can get them here in time is another issue. You are free to try. I do not recommend that you fly your wife to the states now. It is a 9 hour flight to NY alone, and longer if you are headed to some of the specialists further inland. She should never be that far from medical care."

"A good surgeon who can operate on her while she is alive is worth more than the best in the world... who arrives after she is dead. I admit that there are a few neurosurgeons who I admire and would be glad to recommend if there was time. There are only 500 neurosurgeons in the world with the training to attempt something like this. Most of them are in the United States, not Europe. I'm one of the better ones, I think, and I have over 30 years of experience. I doubt that you can get anyone else here on zero notice who is at least as good. You are also not counting in jet lag. She needs this surgery as soon as possible."    He is saying that it could be life threatening to be cut off from medical care for less than half a day... I do not have time to fly in a Dr who needs time to recover from the trip. She could die now. "It's ...that bad?"

He nods, his lips tight. "I am sure that you would like to rush her into surgery tonight. It will take a few days to plan every step of the surgery. I must make sure all of my team are fully familiar in detail with the plan and contingencies. Where people stand and who will have their hands in the surgical area at any given time to assist... everything must be organized in advance. No reputable neurosurgeon will attempt surgery without taking the time to plan it out thoroughly. I will make certain it is done very best of my ability. When we are ready, we will re-schedule a less critical surgery and schedule the operating theatre for your wife."