Published on December 9th, 2015 | by twwwine
New Yorker “Annals of Medicine” features East Sacramento Neurosurgeon
FROM THE NEW YORKER
As the chairman of the neurosurgery department at the University of California at Davis, Paul Muizelaar saw patients on Wednesdays, at a clinic housed in a former cannery in East Sacramento. Among the people waiting to see him on the afternoon of November 10, 2010, was Terri Bradley, a fifty-six-year-old woman on whom he had operated the previous May, to remove a malignant brain tumor the size of a lime. Sitting in his office, Muizelaar reviewed Bradley’s file. He read a letter from her oncologist, asserting that Bradley was doing well: a brain scan had found no evidence of the tumor. “I think, This sounds great,” Muizelaar, a sixty-eight-year-old Dutchman, recalled. “So I go to her exam room with a big smile on my face, and there she is with her daughter, crying, not able to speak.”
Muizelaar hadn’t seen Bradley’s latest test results. Her condition had suddenly deteriorated, and new scans revealed that her tumor—a deadly type known as glioblastoma multiforme, or GBM—had returned. It had spread from the right side of her brain to the left frontal lobe, acquiring an ominous winged shape that doctors refer to as a butterfly glioma. A second tumor had sprouted in the region of her brain associated with speech. Bradley, partially paralyzed and dependent on a wheelchair, had already undergone chemotherapy and radiation; her doctors believed that more drugs were pointless. “The radiologist said, ‘I’ve never seen anything grow so fast,’ ” Bradley’s daughter Janet recalled. “He said, ‘Call hospice.’ That scared the hell out of me.”
Bradley, a fiercely self-reliant woman who had raised four daughters on her own, refused hospice care. Finally, Janet took her to Muizelaar, who said that he was unable to help. “It’s a blessing to most patients not to linger,” Muizelaar, who practiced medicine in California under a license reserved for eminent foreign-trained physicians, told me. “Within four weeks, this woman had regrown a massive tumor, plus a second tumor. There was clearly nothing I could do about it.”
Yet the conversation did not end there.
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