Sunday, August 30, 2009

Perception vs. Reality

On Friday, August 28, we returned to Charlottesville for yet another (seventh) Gamma Knife treatment session. This time, nine brain lesions were targeted with ionizing radiation (that makes 52 lesions to date) -- all but one of these was pre-existing and had progressed in size since the last treatment session. Unfortunately, at least one of these lesions encroached upon the optic tract in the right side of the brain, causing an intermittent distortion of a small area in the left upper field of vision (similar to but more psychedelic than the image depicted above). Closing one eye neither improves nor worsens the temporarily warped image.

Although this particular session resulted in more severe side effects than ever before (headache, nausea, vomiting, dizziness, fatigue), I am happy to report that all those symptoms have nearly completely resolved in 36 hours. The intermittent distortion of an area in the left upper visual field, however, has so far persisted. Time will tell...

Meanwhile, whenever this painless "scintillating scotoma" occurs, I am forced to mentally compensate for the distorted image in order to reconstruct reality. Having had many years of experience regarding the true nature of the world around me (and the people in it), I have had little difficulty staying oriented and readily recognize familiar faces in spite of the transient distortion. (If I briefly look at you askance, please forgive me.)

Out of all the potential ill effects of this devastating cancer, I have found this single (relatively minor) dysfunction to be more troublesome than all the weakness, pain, breathlessness, or malaise I experienced when metastatic melanoma was rampant throughout my body. When I ask myself why this is so, I conclude that it is because (perceptually at least) this complication threatens my ability to recognize the world as it truly is. During these episodes of distorted vision, I am forced to call upon well-learned patterns of proportion, symmetry, and pre-recorded images to reconstruct the reality that is before me. I am so grateful that I have that well-established frame of reference.

Not everyone is so fortunate... A young child with a "lazy eye", if not corrected early, will become blind in that eye, due to the inability to reconcile the widely divergent images streaming from each orbit. And some dear people I know who have suffered devastating losses early in life's journey have had their vision of God diminished or distorted. I am thinking of a number of former patients of mine... one whose husband died leaving her with seven young children to raise alone, another who lost his sixteen year old son... both of whom continue to struggle to see God as holy, loving, and just. There are countless others who, because of a devastating event or a slow-growing despondency of spirit, have a distorted image of the God who promised "life, and life abundantly".

I have no easy answer for these my friends. I only know that when I was given clear sight, I was introduced to a God that did not spare His own Son from all the suffering and pain that we experience, in order that by trusting in Him, we might know Him as He truly is and enjoy life with Him forever. In spite of the temporary distortions of my current vision, I cling to that reality.

May you too see Him clearly,
Dr Dan

PS -- Future treatment for the residual systemic melanoma is uncertain. Dr Grosh would like to assess the effectiveness of this most recent Gamma Knife procedure before committing to another round of high-dose Interleukin-2. Many thanks for all your prayers.


  1. Dan

    Thanks for sharing and the update.

    We can only hope in God's grace in times like these. I know that I personally experienced it yesterday with a leaking gas line on the side of the road after managing to exit the Midtown tunnel. I think many of us take for granted all too many times how God works in our lives - both small and huge. I know that ya'lls "vision" allows seeing everything that God is doing.

    I know that Linda and you are reaching out to God as hard as you can for answers as the road seems to becoming narrower and narrower. We are on that road with both of you.


  2. It was good to see you and Linda at church yesterday. Prayers continue as you fight the battle.

  3. Lifting you in prayer...heal well..heal quickly...Nothing like an IL-2 cocktail to kick mel to the curb!

    It's all about FAITH...

    Debbie Stage 4 MM NED

  4. Dan and Linda,
    I dont get to talk to you or see much of you anymore, but may you know that not a day goes by that I"m not thinking and praying for you both and it's quite obvious to all who read your blogs, that your eyes are focused heavenward, in order that you continue in the peace that JESUS promises through tough times.(Is.26:3)Whether vision is impaired externally,you see and know because you know all that GOD is doing and allowing for HIS glory in this journey. (For the joy set before HIM, HE endured) YOu too are enduring and the joy that you are giving others, even now in your pain by sharing what you are learning to help others is really so remarkable. Even though the focus seems narrower for you now, praise GOD that eternity is wide and there are NO FENCES, NO BOUNDARIES, NO BARRIERS in HIS Kingdom. How sweet that is.

    As I laid on my couch the past 3 weeks on bedrest and crutches with a lower leg wound and hematoma that has not yet resolved, I have had time with the LORD that I might not have had any other way. OH, to share all that GOD teaches us in these times!!!!! IT's priceless. But after reading your blog about the gift and the giver....I was convicted. Laying here, I thanked GOD that I was able to still do things and that it could be much worse. But then I thought of how many people that are down, cant get around, are stuck and alone and helpless and it moved me with so much compassion to the point that I might never be the same when I see a need and think I"m too busy to help or meet it for someone else. BUT it's GOD and that sweet intimacy and relationship we have with HIM that we should be mindful of, not so much the gifts of this or that like you said. So...thank you for that's so true. You are both remarkable in your walk and I've been so inspired and moved by your blogs...thanks very very much and may you continue to heal quickly as you step over one more stone in this journey.
    Love you both, Audrey Lewis