Brain Cancer Hits Close to Home for A Future Neurosurgeon

Op-(m)ed ran the “Match Day” contest in March 2018. We are excited to announce this piece as an honorable mention.

Two months before his diagnosis (left). The monster lurking beneath (right).

On Monday, March 12, 2018, I found out that I matched into a neurosurgical residency. I cannot adequately describe my emotions when I received that ultra-brief, yet oh so sweet, “You have matched!” email, except to say that I was simply THRILLED for what was to come. (And super anxious to find out where I would train for the next seven years!)

Eight years ago, I committed myself to a career as a neurosurgeon-scientist and began the long trek through a dual MD/PhD program. The initial allure of neurosurgery was the acuity of injuries and complexity of patients that neurosurgeons frequently treat, and I have been inspired by my longstanding clinical and scientific mentor, Dr. J. Marc Simard. He has taught me to always strive for excellence and has shown me that curiosity can lead to paradigm shifting discoveries. He has prepared me well for the rigors of residency and a career in neurosurgery.

Six months ago my father was diagnosed with glioblastoma multiforme (GBM), a horribly aggressive cancer of the brain. He died five weeks later.

“Wow, that came out of nowhere,” you say?

Yeah, it shocked me too.

His Story

When this all began, my parents were living in Florida (my mom is an artist), and I was in our hometown of Baltimore, MD finishing medical school, living with my fiancee, Nicole. When we first heard something was abruptly and alarmingly amiss with my father’s behavior, I asked my mom to take him straight to the hospital in Miami. Nicole and I flew to meet my parents the following morning.

What we came to find was absolutely heartbreaking. My dad, who had been in a seemingly normal state of health, was now intermittently confused, agitated, and unsteady on his feet.

Before I knew it, I learned that the neurosurgical team was waiting for me to discuss what they had found. My mother expected gut-wrenching news and couldn’t bear to hear anything but from her son, “the doctor.” It was suddenly up to me to speak with the neurosurgeon, digest the imaging, and explain to my mother that her husband has been dealt a death sentence.

Oh yes, and this is still my father I am discussing. I should not forget this, but I want to. I desperately want to. This brain scan excites me; the tumor is enormous. This brain scan scares me; the tumor is ENORMOUS. What the hell do I know, I am just a student.

I am just this man’s child.

And Nicole and I are getting married in three weeks.

Truly, you couldn’t script this to be any more dramatic.

A Home for Care at a Time for Love

My mother and I decided that the best option would be for my father to receive his care at the University of Maryland Medical Center, in closer proximity to family. The scariest part of this was flying with my dad from Miami to Baltimore — just the two of us — while Nicole helped my mom pack up my parents’ condo in Florida. Our ride felt like an eternity; I had to constantly remind him that we were on a plane, and on our way to Baltimore because he has a brain tumor. “Who has a tumor, me?” Yes, you! And if you have a seizure while we are on this plane, I am going to kill you.

The experience my family and I went through was utterly unfathomable, and inexplicably ironic.

At the time of his diagnosis, I was fresh off of a one-month visiting rotation in the Department of Neurosurgery at the famed Massachusetts General Hospital in Boston, with more high-profile rotations planned. One year prior, I had earned a freaking PhD studying brain injury. I was about to submit my application to residency programs in order to become a neurosurgeon. Oh! and our families were flying high because of our upcoming wedding (the picture above is from Nicole’s bridal shower).

Over the next three short weeks, I witnessed my father’s rapid deterioration from complete independence to requiring 24/7 supervision. He was normally an even-tempered and cautious man, but had become increasingly ornery and impulsive. His remarkable wit and memory had been replaced by a near constant state of confusion. On the painfully bright side of things, however, his sense of humor was still entirely intact — although perhaps a smidge uninhibited by the frontal lobe involvement of the tumor — there was certainly no shortage of dirty jokes!

I found myself automatically doing all of the things that children fear they will not have the capacity to do when their parents become frail. I spent everyday in the hospital with him, showing up at 5:30 a.m. so I could catch the team rounding and update my mom when she arrived at regular-person hours.

We waited until the final moment, but sadly, my father’s health precluded him from attending our wedding. Saying goodbye to him, and wondering what kind of state he’d be in when we returned, was so incredibly difficult that I can’t even write about it.

My beautiful bride. No bias here.

In the days preceding our wedding, we received an outpouring of support from family and friends. With their help, we were able to celebrate in the midst of a gut-wrenching tragedy.

By some unimaginable force of collective will, we were propelled through an absolutely spectacular wedding weekend. It was an experience to be remembered, incredibly, least of all because of who was missing.

The spiritual and emotional tone of our wedding was a resounding jubilee of love and life.

Exactly as my father would have wanted it to be.

Two weeks later, my father would pass away in the presence of our closest family. As a matter of fact, he passed away in a bed in the NeuroICU where I have spent many hours working as a medical student.

I have walked by the room numerous times since, and it has never struck me as odd. I suppose I just feel lucky to have known his care providers so well — very few patients (and their families) have this privilege, and it was a significant source of solace for my family and me.

Ten of my best friends traveled from near and far to Boston and stood by my side as groomsmen at my wedding. And they all traveled just weeks later to help me bury my father. I remember taking a step back at the funeral, watching them sweat through their suits while piling on the dirt, and remarking to myself, “Man. This is love right here.”

A Dedication

One month later, I began interviewing for neurosurgery residency at programs across the country.

I interviewed at seventeen programs, meeting with approximately two dozen faculty per program. In all, I told this story, or some Cliff’s Notes version, to about 400 perfect strangers. Or as I like to jest, I had about 400 rapid-fire, free therapy sessions.

I will add: I think my dad would find some humor in the fact that he is now relatively well-known.

By some tragic twist of fate, I told them all, I have experienced the nature of what it feels like to be a patient or a loved one of someone suffering a neurological disease. And as a neurosurgeon, I will never forget that compassion and respect come first. To my surprise, nearly everyone had a story of their own to share. I realized that while my story is uniquely mine, tragedy and suffering are universal experiences — try as we might, we will not escape them.

I recognize now that the underlying reason I chose this path was for the privilege of offering hope to patients during dire times. I have seen patients unexpectedly recover, and I have seen patients, like my father, unexpectedly decline. The unpredictability of it all has enhanced my passion to improve upon our ability to provide life-preserving care by probing the depths of the nature of disease.

Match Day arrived. This past Friday, on March 16th, 2018 I found out that I will have the privilege to train as a neurosurgeon at NYU Langone Medical Center. While I experienced the day with a certain air of melancholy, not being able to share the joy with my father, I will never forget the lessons I have learned over the past six months.

My entire career is dedicated to the lasting memory of my father. I will see him in every single patient I encounter.

And I will try to have some fun during my training, because that’s the way he’d want it.

David Kurland, MD, PhD was born and raised in Baltimore, MD, and attended college at Washington University in St. Louis, before returning to Baltimore and the University of Maryland School of Medicine for his MD/PhD training. He is thrilled to continue on in his training as a resident in the NYU Department of Neurosurgery.

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