A Portrait of Pain

Metastasis

Word Count: 1,621 words.

Metastasis — an ability of primary cancer cells to travel through blood or lymph and spread malignant tumors to other sites of the body.

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I completed my specialization in Oncology from Harvard Medical School twelve years ago. That was three years after I gained my practitioner's license. Over the course of my career I have seen and studied in forensic detail many peculiar medical cases. I feel the need to illustrate peculiar with real instances here.

When I was working at Cambridge we had a 74-year-old woman named Joline Campbell come up to us with the entirety of her skin covered in an angry red rash. Joline said the rash had started out small, a dotted irritation on her wrist, but overnight she'd turned into "Freddy bloody Krueger". We diagnosed her with carcinoma. The elderly woman told us she had no family and insufficient funds. She drove away from the hospital feeling probably as dejected as she looked. At least she isn't in much pain, we consoled ourselves. She looks like Satan's cousin but somehow she isn't in much pain. We wanted to help her, but cancer treatment is no piece of cake. The manual and machinic effort that goes into it aside, the expenditure alone bears considerable expense. Chances were, without treatment, Joline would be dead within the week.

Only, two months later, she returned to the hospital. I wasn't there when she did, but I heard it was a big event. Because Mrs. Campbell returned without the rash. She returned to us glowing like a girl on her honeymoon. My fellow doctors ran tests on her; she was inexplicably free of cancer. She was in fact healthier than ever, especially for her age. Every clinical mind wanted to get to the root of this miracle — because we have been deepwired by education to not believe in them.

It was a puzzle we couldn't wait to solve. Articles were published about her, summits were held. Examining Joline could lead to the cure of cancer, one of humanity's worst banes. Oncologists like myself were no doubt incapable of sojourn at night thinking about what a world where our jobs were rendered non-vestigial would look like.

Two days later Joline Campbell vanished off the face of the Earth. Resources were expended trying to find her, resources the government wouldn't want an ordinary citizen knowing about. To no avail, however, and Mrs. Campbell was never found. Neither was the cure to cancer.

Another time, and this is around the apotheosis of my career, I had a patient whose MRI test showed neoplasm crawling between the right and left cerebral hemispheres of his brain. It was an actively moving tumor according to the imaging scan, invaginating the corpus callosum (commissural white matter tracts which bridge the two hemispheres). But the patient, an alopeciac young man, was in no excruciating pain, far opposed to what a reasonable thought process would suggest. He'd approached his doctor because he had "the occasional migraine every now and then". 

To our bewilderment, when we opened his head up (that sounds broad: we performed craniotomy — think of it as removing a bone flap to expose the brain, just the way you open an attic door), we saw no such malignant tumor infesting his thinking organ. Funnily enough, when we sealed his head back up, that was when our friend started having manic episodes. The MRI was not faulty. We checked. The next day, a senior surgeon by the name of Dr. Julian Sanders who had been in the OT with me when we performed the craniotomy — she slipped down some stairs and cracked her crown wide open. As though whatever had infested the young man had jumped from his brain when we exposed it into one of ours . . . insane, I know. Leading Harvard doctor being superstitious. But the thought kept gnawing at me. I envisaged a coagulated shadow hopping from brain to brain, an unstoppable killing parasite.