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.