I have been a consultant vascular and general surgeon for ten years and am always busy. I have been tired but I have never been so exhausted as now, finishing a long theatre list on a dark October night.
I walk back to the car and feel unbalanced, especially in my trade mark high heels. Maybe I have just got to the age when I need to wear flats. My trainee comments that I am walking like I am drunk. Alarm bells start to ring.
I pop into the neurology clinic the next morning and explain my worst fears: ‘I think I have a brain tumour’. It is probably just vestibulitis after an awful cold, but it is not getting better. Instead, my symptoms are worse. I have headaches and I report that my right eye feels dry.
The neurologist reassures me but arranges a scan. She phones MRI and they can fit me in straight away. I have my scan and realise, because they need a second scan with contrast, that they have found something in my head. I am a professional but in those few minutes become a worried patient. I think the worst: what type of brain tumour, how large and where is it?
I find the neurologist waiting for me to explain the scan findings. They have found something. I have a 3cm mass in my cerebellum which is compressing my brain, causing the dizziness. It is not malignant but couldn’t have been sited in a worse place. I cry. The neurologist explains that I will need to see a neurosurgeon and their team. I have an acoustic neuroma.
Within two days, I am referred locally and told I need surgery; there is no other choice. I will need three months away from work. Then it gets worse. I will lose my hearing, there is a 20% risk of damage to the nerve supplying the movement of my face, a risk of damage to the sensation of my face, and to my ability to balance. I will feel sick after the surgery and, of course, there is the pain.
I listen and make my decision: I am not having surgery, there must be other ways. Perhaps radiotherapy or just wait for it to settle. I become an expert on acoustic neuromas overnight. I read all the literature. The patient leaflet explains that if I do have surgery ‘it will attempt to preserve my quality of life’. Great.
I seek a second opinion and am reassured by the surgeon. I finally understand what I teach. To have compassion and to gain your patient’s absolute trust. In his explanations of the surgery, his words are comforting as he has pre-planned management of any complications that might be expected. I explain my own fears; I would struggle with a facial nerve palsy. He listens patiently and discusses all options with me. I take all the advice and it slowly dawns on me, I really do have no choice but surgery.
I start thinking about the cost of care and how fortunate I am in the NHS. I start calculating the cost in America and it mounts up to hundreds of thousands of pounds. I cannot imagine having to make sure that I can pay before taking advice, or letting the cost of care drive my decision making. I have my efficient and thorough pre-assessment and get a date for surgery in February.
In my rapid journey from being a professional to a patient, I have had so many worries. I have however been lucky about one thing. I am in the NHS