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CHAPTER TWELVE
BEN had seen Emma Stanley’s MRI scans two weeks ago but there had been considerable change in her condition since then. The young sixteen-year-old track and field star had a tumour on her lumbar spine, which thankfully was benign, but that didn’t mean she was out of the woods by any means. The tumour was pressing against the cauda equina, causing numbness in her buttocks and weakness in her legs.
Surgery was the only option but there were huge risks involved, especially as imaging had shown the tumour was extensive and its removal had the potential to cause damage to multiple nerve roots. She had fallen several times over the last few days and her parents had panicked and contacted him directly rather than wait until Monday to see him in his public clinic, as he had advised them to do.
Ben sat Emma and her parents down in his office. Taking his own chair, he began to run through the risks. ‘I know we’ve talked through all this before but as Emma’s symptoms have worsened it won’t hurt to go over them again,’ he said. ‘The tumour is growing rapidly—far more rapidly than I expected. So it’s important we get in there and remove it to minimise the risk of permanent damage to the spinal nerves.’
Glenda and James Stanley each gripped one of their wide-eyed daughter’s hands. ‘We understand, Mr Blackwood,’ the father said. ‘We just want her to get well and be able to run again.’
Here comes the difficult part, Ben thought as he mentally prepared himself. ‘Surgery of any sort has risks,’
he began, ‘even routine operations. We have to go into surgery understanding what these are.’
‘We don’t want to frighten Emma, Mr Blackwood. Is it absolutely necessary to go through these in front of her now?’ Emma’s father spoke with emotion.
‘It’s hard, I know,’ Ben said, before shifting to speak primarily to Emma. ‘Emma, you have to have a basic understanding of the potential problems we face, and you have to ask me any questions about specific concerns you as an individual might have, things that might not be such a concern to, say, non-sportspeople.’
‘I understand, Mr Blackwood, and I want to know everything,’ the young girl insisted. ‘It’s all right, Dad, Mum,’ she addressed her parents. ‘I need to know what’s ahead of me.’
‘So, the risks …’ Ben began once the parents had both nodded their agreement. ‘We divide them into two groups. First are risks that could occur with any operation—such as infection, bleeding, clots in the legs. For someone of your age and fitness, Emma, these risks are going to be very small.’
‘That’s good, Mr Blackwood,’ Emma said. ‘See, Mum? He said the risks are small.’ She turned back to Ben. ‘So I should be OK, right?’
‘We all hope so, Emma. But there’s a second category of risks—risks specific to a particular operation. This is where I really want everyone to understand what the possibilities are here,’ Ben explained. ‘Emma, your tumour is fairly big, and many of the spinal nerves coming off the last few centimetres of the spinal cord look as though they are trapped in the tumour. In order to get rid of every bit of the tumour so it won’t come back, I am going to have to peel each nerve root off the tumour. It is possible that some of the nerve roots might be damaged, possibly permanently.’
‘What would that mean, Mr Blackwood?’ Emma asked, with a worried glance at her parents.
‘It would depend which nerve root was damaged,’ Ben said. ‘The least might be a patch of numbness or weakness. The worst could be those, plus loss of control of bowels and bladder.’
It was Emma’s mother who spoke this time. ‘Do what you have to do, Mr Blackwood,’ she urged. ‘She’s suffered enough. We just want her to be without pain.’
But what about without mobility? Ben thought as he looked into that concerned maternal gaze that so reminded him of his mother’s when Hannah’s life had hung in the balance all those years ago. The same haunted shadows were in Glenda Stanley’s eyes and those of her husband’s. How could he possibly prepare them adequately for what was ahead?
He pulled himself into line with an effort and continued, addressing just Emma this time. ‘Emma, we have a huge task in front of us but I’m thinking that with your experience at track and field training you’re no slouch when it comes to hard work. Am I right?’
Emma smiled a tentative smile. ‘Yep,’ she said. ‘I like a challenge.’
‘Good, because that’s what this is going to be,’ he said, ‘and quite possibly the biggest challenge of your life so far. I can’t promise you miracles, you’re old enough to understand that, but I can promise you I will do my best to remove that tumour and relieve the pressure on your spinal nerves, but you need to be aware of the risks.’
‘Go on,’ Emma said, when he paused momentarily.
Ben glanced at the parents, who were now leaning forward slightly in their chairs. His heart contracted in pain for them.
No parent wanted to watch their child’s dreams be snatched away from them but he had a responsibility to inform them of the possible outcomes of such invasive surgery. He took a deep breath and sat forward in his own chair, his forearms leaning on the desk. ‘I cannot promise you a hundred per cent return to full function,’ he said. ‘Emma’s nerves may already be permanently damaged.’
‘You mean …?’ It was Glenda who spoke but Ben could see that both Emma and her father knew exactly what she was referring to.
‘Yes,’ he said heavily. ‘There’s a chance Emma will never walk again.’
The silence was so heavy he could have reached out and touched it. He waited for the fallout. It always happened. It usually took about five to ten seconds.
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