Aug 31, 2015 05:38PM
Celia Finestone, seventy-nine years old, a highly respected nurse for sixty-two years, the longtime chief nurse to neurologist Dr. Daniel Britton, has seen thousands of patients, and looked at hundreds of X-Rays and MRIs to help doctors diagnose their patients’ ills in hospitals from Corning to Wellsboro.
When she was a girl she saw what others couldn’t see. She couldn’t explain it, though southern preachers thought she may have been of the devil and shamed her for staring at the women knitting in her Kentucky church. They clicked their needles together, a beehive of Madame Defarges, and Celia saw the colors radiating from them. All different colors, or auras, that spoke to the mood they were in and also who they were at their core. She saw it in men, too—especially when she was in high school—but most of the men were overseas fighting in World War II.
Celia also saw visions of a majestic, female eagle who looked like a cross against the sky. The eagle was, in some ways, her silent guardian and watchful protector. But when she was eight or nine, she repressed the auras and the eagle in respect for the local culture. In fact, she never thought these sights were special or different from anyone else’s. It wasn’t until she was in nurses’ training that the colors blossomed again, but this time, no matter what the world thought, she was going to let them stay.
In 2005, at age seventy, Celia began to have headaches just behind her right eye. It wasn’t chronic, but the pain “felt like the floor came up to meet me,” she says. She got an MRI and it showed a small growth, a meningioma underneath the dura.
She didn’t panic. In fact, she was moderately relieved. To that point, fifty some years of nursing taught her a thing or two about what merits worry and what can be dismissed as merely a pimple on the brain.
Celia knew it wasn’t malignant, but it wasn’t harmless either, and in those years since 2005 the tumor gathered strength, securing peace, preparing for war.
Dr. Daniel Britton shook out his elbow. He was an avid golfer and he complained about the pain in his left elbow. Celia had heard enough of his complaining. They had been working together for over twenty years and she could say just about anything to him, so she said, “Quit your bitching and get an appointment.”
What could he do? So he set up an appointment to have his elbow looked at on the condition that Celia would get another MRI to see just what was happening in the theater of her brain. It had been several years since she had her meningioma imaged.
In November, Dr. Britton triumphantly told Celia that he had set up his appointment to fix his elbow, so she picked up the phone right away to set up a long-awaited MRI.
The prognosis wasn’t good. This benign, harmless meningioma had multiplied in size.
The tumor sat there indenting Celia’s brain. There was extra swelling and it had shifted slightly to the left. It couldn’t be left alone.
How had this happened? Was it the harp lessons she started at age sixty- five? Was it only sleeping three hours a night? Was it still working as a full-time nurse at the age of seventy-nine? Celia thought that maybe all this activity prescribed to help train her brain away from the Alzheimers that killed her mother stirred the pot and intensified the problem. Celia called Dr. Britton, who was recovering from his elbow surgery, and gave him the report.
“You have to do something,” he told her.
It appeared that Celia had a choice. To keep fighting, to live another day. She wasn’t going to just give in and give up.
They thought of Rochester, Hershey, and Cleveland. What they failed to consider was the divine magician just fifty miles south at the Williamsport Hospital—Dr. Hani Tuffaha. He was right there under their noses. So they called him right away.
Celia called Dr. Tuffaha’s office and said she had to refer a patient and she had the report and the report was hers. Dr. Tuffaha, who Celia immediately felt was this “smart, wonderful man,” said he’d call her back after lunch.
Celia went home to her retired husband Steve. He, a man of modest stature, slightly stooped in the manner most eighty-one-year-old men are stooped, looked straight down past his tightly cropped mustache to a pan of soup he was preparing, then set the table. “Tell me about the MRI,” he said.
She told him the news and, as Celia recalls, “After I peeled him from the ceiling, he was going to jump in all these directions. I said, ‘No, Steve, we’ll take care of it in order. I’m expecting a call from Dr. Tuffaha’s office this afternoon sometime.’”
“Sometime!?” Steve cried. “You have to call him now.”
“They’ll get in touch with me.”
Back at the office, Celia found a message waiting for her from Dr. Tuffaha’s office. He didn’t like what he had seen in her report.
Enough waiting. It was time to go on the attack.
Dr. Tuffaha took a look at the MRI and the tumor and said, “That doesn’t look pretty, does it?”
“I came to give you a piece of my mind,” Celia said.
“You’ve got that wrong. I’ve come to take a piece of your mind.”
“Can you just save me half a brain to think with?”
They set a date of December 22 for the surgery.
Celia heard that Dr. Tuffaha had described her as vibrant, which she undoubtedly is, and she wondered just how vibrant she would be on December 23.
Celia felt uneasy, not so much nervous as unsettled by this growth inside her head. She had never been sick and she hadn’t felt any loss of motor control, yet there was this parasite on her brain ticking away like a bomb.
She took her precious harp over to Garrison’s on Main Street and played for two hours. She felt her fingers pick at the strings as she played Celtic melodies and Civil War tunes. She feared she might never have this feeling again, this delicate control over her fingers that created such wonderful music. She knew the tumor wasn’t malignant and that gave her some confidence, but if this drew on any longer it could prove debilitating. If it pirated her ability to live, to make music, to move, it will have won.
Celia visited a friend who helped guide her through some meditations. She saw colors encased in a glass sphere, healing colors. The glass orb encircled her, making her feel utterly protected. Celia saw the eagle again, the same eagle she saw as a girl. The eagle was nervous for her this time. “Fear not, for my spirit is with you,” it told her. “I am with you always. Trust. Don’t be afraid. Have no fear. It is not malignant. Swelling? Don’t worry about that. Pictures are not always as they seem.” It also told her to pay attention.
Celia conversed more and more with her eagle, asking it if she should bring her harp to the hospital. The eagle, always a calming presence in her life, calmed her again. The harp would tell her all she would need to know: if the surgery was a success, if she could play again, if she was even alive to play again.
So Celia left the meditative session and stepped out onto Main Street. She lost her footing and fell, face first, onto the sidewalk, hitting her right eye—the offensive line blocking her tumor. The injury required several stitches and swelled her eye completely shut.
Just ten days before the surgery, and now this?
Celia performed healing touch, a gift she’s had since her teenage years, channeling energy from a higher power, to her eye. It’s a practice she performs for anyone willing to accept it. She hovers her hands over the area, radiating warmth, funneling energy to the trauma that needs it. As for her eye, she was already up against the clock, and it was unclear, at this time, just how this injury would set her back.
And, more importantly, had she ignited the fuse to the bomb inside her skull? And if she did, when would it blow? Today? Tomorrow?
The operative report said Celia had a moderately large, progressive right subfrontal meningioma with severe vasogenic edema. Essentially, lots of swelling. Waiting any longer would be tempting the fates.
Dr. Tuffaha showed concern over the injury to her eye, but, after examining it, he found there to be no residual interference. The surgery would go on as scheduled.
She had the utmost confidence in Dr. Tuffaha and knew she could trust him because, “He’s quiet. He’s certain in what he says. He’s very friendly, very warm. It was his manner: you knew you were in good hands. He was not going to jump if something bad happened.”
She made a pact with Dr. Tuffaha in
his office that, if the surgery took a turn he couldn’t steer out of, Celia was to be let go. “I could not take living as a vegetable. Just pull the plug and let me go. I’ve had a beautiful life.”
Dr. Tuffaha nodded.
It was time. It was time to defuse this bomb.
At 4:30 on the morning of December 22, 2014, Celia played her harp. It may have been the final time, and she wanted to savor it once more. Maybe she could further imprint the memory of the movements so when, and if, she regained consciousness, she could still play.
Celia kissed her daughter, Karen Kmetz, also a nurse, and said, “I’m going to be fine. I’ll see you later.”
By 7:30 the nurses rolled her into the operating room. Karen kept her dad company. Steve was rightfully nervous. He would be watching the screens in the waiting rooms as the hours ticked by.
Celia made a joke about being in good hands, better than Allstate car insurance. The team of nurses and doctors, led by the honorable Dr. Hani Tuffaha, laughed.
Celia went to sleep with the sound of laughter in her ears.
The intubation was successfully administered and Celia received Kefzol, Tobramycin, Decadron, and Keppra IV prior to the procedure.
They placed her on her back with her head facing slightly left, secured to the horseshoe headrest, exposing the right side of her head. The right front of her scalp was freshly shaved, where there was once flowing white hair. The area was sterilized using Betadine scrub and Betadine solution, and a Vi-Drape was applied to the area.
Dr. Tuffaha started his incision in front of the right ear pinna then extended upward and backward behind the hairline. He maneuvered the scalpel creating an incision in the shape of an arch. He secured Raney clips on the margins for hemostasis, to stop the bleeding.
He dissected the scalp flap from the pericranium, the surface of the skull. He made a series of cuts to the thin sheets of muscle exposing the temporal bone just below the temple.
He made five burr holes and a keyhole at the junction of the temporal and frontal bone above the pterion, just behind the eye. Dr. Tuffaha then took the craniotome of the Midas Rex drill and he removed a bone flap and rested it in a solution of Kefzol saline solution. Now he was looking at a hyper-vascularized section of the brain.
It was what he had expected.
Celia may have been unconscious, but she woke.
Her body lay sleeping, but she heard Dr. Tuffaha call for mannitol and she felt the pressure on her brain. Mannitol, she knew, was supposed to reduce swelling. She was hyperaware and knew not to open her eyes. If they saw her awake-awake they’d put her into a deeper sleep where her blood pressure could drop, the bleeding couldn’t be stopped, there could be clots in the brain or chest. All these thoughts ran through her mind.
Celia could see the colors in the room, like the knitting women of her youth. She felt the angst. She felt fear. Above all she felt doubt. She felt lifted up by the shoulders, a familiar presence.
She’d later say, “That’s where my truth begins.”
Celia felt no pain, just pressure.
She felt sharpness on her shoulders—talons? They belonged to her eagle. It lifted her away from her body.
She felt the sticky earth and smelled something putrid in the air. It was dank and the wind fluttered her patient gown like curtains in the breeze. She thought of the 23rd Psalm: “Yea, though I walk through the valley of the shadow of death.” The landscape was purplish and gray. The ground was slippery and tacky, like clay. It discomforted her, but she wasn’t scared.
She saw a river, flowing, turbulent water. Celia could still sense the tension in the operating room. Things weren’t going smoothly. She looked beyond the banks of the river and knew crossing it would mean she could no longer return. She knew she had a choice.
Celia peered to her right and saw the deep, dark orb of her eagle’s eye. It hoisted her up onto its left shoulder. It took flight, carrying Celia above the Valley of the Shadow of Death and its putrid fumes and river rapids.
They flew down the middle of the stream. It looked like Pine Creek, but it wasn’t Pine Creek. Celia knew if the eagle flew her to the other side of the bank that there would be no returning.
Dr. Tuffaha would have to fulfill the pact and let her go. But she didn’t want to go there. There was too much to do, still life to live. So her soul clamored, ever longer, just to stay in the sun.
Dr. Tuffaha controlled all the bleeding points on Celia’s brain. The dose of eighty grams of mannitol reduced the swelling of the brain. That, and the induced hyperventilation also eased the pressure.
The use of the mannitol—an osmotic drug—helped coax the blood into the tumor, de-irrigating the surface of the brain, like draining a swamp.
Dr. Tuffaha called for the fine malleable brain retractor. Gently, delicately, he retracted the right frontal lobe of Celia’s brain. There, before him, rested the meningioma, exposed, defenseless, ready for the knife.
He had reached the bomb.
It was no longer an image on an MRI, but a growth looking to choke the life out of Celia. He began dissecting the tumor, the part attached to the brain’s surface, and also cutting parts from the tumor’s dome.
The tumor had an intricate system of blood vessels. It colonized this territory and kept itself nourished, but once Dr. Tuffaha dissected the pedicle—like a taproot—of the tumor, the vascularity decreased immediately. It began to lose its parasitic grip on Celia.
Dr. Tuffaha encountered, and was able to preserve, Celia’s right olfactory nerve, her sense of smell, and, in time, he removed the tumor from her brain and cast it aside for Pathology to handle.
The eagle rested and placed Celia in the feathers of her chest. They were infinitely soft and the smells were impossibly fragrant: wild roses, hyacinths, honeysuckle, jasmine, gardenia.
Celia heard the most ethereal music playing and when she looked up she was encased in a glass sphere with vibrant, electric colors. She began to hear chanting, like the Gregorian monks, “Help Dr. Tuffaha. Help Dr. Tuffaha.”
Did he need the help? Was Celia in trouble? Was it almost over?
No, he didn’t need any help. He was the calm, steady beacon in that OR. The worst of it was over. Celia made her choice to stay on this side of the river and Dr. Tuffaha kept her anchored, grounded to this life.
Dr. Tuffaha could sense the end.
There was no residual tumor remaining. The tumor was out and he aggressively burned the meningeal attachment of the tumor.
The frontal lobe of Celia’s brain fell back into its natural position entirely intact. The heavy bleeding had stopped and, with warm saline solution, Dr. Tuffaha re-irrigated the field.
He used 4-0 Vicryl sutures and he placed, in the usual fashion, DuraGen atop the dura. He affixed the bone in position with three twelve-millimeter “Rapid Flap” discs. He sutured the fine musculature with 2-0 and 3-0 Vicryl sutures and used regular staples for the skin, thirty-eight in all.
He placed Bacitracin ointment on the scar, followed by a strip of Xeroform mesh. And, most importantly, Dr. Tuffaha fashioned a headdress so that whoever saw her first wouldn’t be startled by the scars. If it didn’t look pretty on the outside, how confident will they be that he had performed a pretty surgery on the surface of her brain?
Celia woke in the ICU and loved her headdress, because she is, indeed, into pretty. But, above all, she needed to test her motor control to see just how successful the five-hour surgery had been. She asked Karen to fetch her harp.
Karen brought it and Celia put her hands on each side and began plucking. It all came to her with the easy fluidity it always had. It being three days before Christmas, she played carols. She played “Hark the Herald Angels Sing.” She looked out into the hall where a tall, male nurse pirouetted back and forth, moves taught to him by his three daughters. Everyone laughed.
The next day, post-op Day One, Celia was discharged and she took her music with her.
Many of Celia’s friends thought her story was just beautiful. So much so that it brought chills to their skin just thinking about it. Celia has relayed the story many times to give people hope, to let people know there’s nothing to hide and even less to fear.
Still, there are others who find the story too fantastic. Oh, you were just dreaming. Maybe, but then again, there are few people who can see auras and perform healing touch. It could be that Celia’s brain has access to other areas of consciousness others will never fully understand or believe.
Celia, just a few months shy of her eightieth birthday, is finally retiring from nursing. It’ll free up more time for music and volunteering and, were it not for the resilience on both sides of consciousness, there would never be an eighty-first year of life. It’s her truth and you may believe it or not. She doesn’t care. She was some place other than here and lived to talk about it, thanks to Dr. Hani Tuffaha.
Dr. Tuffaha wrote in his report, “She tolerated the procedure extremely well and her assessment in the recovery room showed her to be fully alert, coherent, and with no focal neurological deficits.”
If Dr. Tuffaha could amend the report, he would have added, “I was quite amazed and happy to learn that Celia played her harp in the hours after surgery.”
The first chance Celia got she told him, with love, admiration, and gratitude, “What a great surgeon you are.”
“The great surgeon,” and he pointed to the sky, “is the One who uses my hands.”