Title: Not Enough Time to Say Good-Bye
Summary: Doug is married to Joey. When he is told he is dying, they learn
the true meaning of friendship. And of love.
Rating: PG, probably
Chapter 2
Friday morning found Joey and Doug sitting side by side in an office at Mass General Hospital. The last few days had been some of the hardest of her life. As they waited to meet the specialist - Dr. Julie Steinbeck - for the first time, Joey's mind wandered to the arguments she and Doug had had since the appointment with Dr. Ryan.
The first had been upon walking in the door after the silent ride home. She'd wanted to call Pacey and tell him what was happening, but Doug had vehemently refused.
"No, Joey. We don't know what's going to happen yet. I don't want to alarm him or anyone else needlessly. He's got enough to worry about," Doug protested.
"Doug, he's your brother. You two have gotten so close over the last few years. Why would you hide this from him?" Joey asked.
"I'm not hiding anything. I'd just rather wait to talk to him about it until I actually know something, all right?"
"No. You are hiding. But not from Pacey. You just don't want to tell him because telling him means you have to think about everything the doctor just said, and you don't want to."
"Can you blame me?" he exploded. "Excuse me, Joey, but the doctor just told me I'm going to die. Pardon me for having a hard time with this."
"Doug, I don't blame you for having a hard time dealing with this. But you're dealing with it the same way you've always dealt with everything. You aren't. You're just pretending it's going to go away. And it isn't!"
"I know that, Joey. Trust me, I know." He stormed out of the house and a moment later she heard the squeal of tires as he pulled out of the driveway.
Then there was the fight they'd had when she'd mentioned the therapist that the doctor had told her about.
"Doug, maybe it would help you to talk to someone. She's trained to help people deal with these kinds of things."
"Joey, no psychiatrist is going to make this any easier on me unless they're going to tell me I'm going to live through this after all."
"Don't talk like that. Dr. Ryan said that this specialist would go over options with us. There might be something-"
He cut her off. "Don't go down that road, Joey. A 20% chance of survival is pretty low."
"But it's still a chance, Doug."
"Joey, don't delude yourself. You know better than this. Don't try to convince yourself it's going to be okay when it's not. And don't try to convince me."
That argument had ended the same way, with Doug storming out of the house and driving off for hours at a time. And then they'd fought on Wednesday afternoon about whether he was going to work on Thursday.
"I know you feel like you're shirking your responsibility. But Doug, you're so distracted. It can't be safe. With our luck the one time that something actually happens in this town would be when you're too distracted to be able to do anything."
"Jo, I need this. I need to get out and try to get my mind off of this."
"Think about this, Doug. If something happens and you're too out of it and someone dies - say one of those kids that have just joined the department - you'll never be able to forgive yourself."
He stared at her, knowing she was right, and sank down onto the couch. "I- I don't know, Jo. I just need to feel like something is normal in my life. And nothing is right now."
"But getting yourself into trouble on the job isn't going to help." She sat down next to him and put her arms around him. "I know it's hard. Trust me. I spent the entire time my mother was sick just wanting to feel normal again. Eventually, my friends - Dawson, Pacey - helped me feel like my life was back on track." She brushed his hair out of his eyes. "I know you did the same for Bessie, and she will always be grateful to you."
She'd won that argument, in a manner of speaking. He'd stayed in the house and, though he didn't talk to her about how he was feeling, he didn't have to. They'd sat there on the couch as he gave up the fight to hold back his tears. She'd felt like it was a step in the right direction.
"Mr. and Mrs. Witter?"
"Yes," Doug said as they both stood. "It's Doug. This is my wife, Joey."
"Pleased to meet you." She shook hands with them both and then sat down behind her desk. "Now, how much do you know about what you're facing?"
"We've done some research on it," Joey said. "We pretty much know the basics."
"Good. That makes my job easier." She smiled. "I understand that Dr. Ryan gave you some statistics on what your chances are for beating this?"
"He said my chances were low."
"Unfortunately, yes. How long have you been having the headaches that made you go to him?"
"Months, really. Um, since about a month after my dad died, so, about 10?" He glanced at Joey, who nodded, then looked back at the doctor. "I thought it was just stress. I'd take aspirin and Jo would massage my shoulders and neck, and they'd usually go away, so I didn't think anything of it, really."
"And what made you make an appointment? The dizzy spells?"
"Yes. I almost passed out at work, and, ah, that wasn't a good thing."
"What do you do?"
"I'm Sheriff in Capeside, Mass."
She nodded. "I can see how collapsing at work would be a bad thing in that job."
"Yeah." He shifted uncomfortably. "What's going to happen?"
"Right to the point. I like that - it's how I am." She glanced down at her notes. "First thing first, we're going to arrange a biopsy. Do you know what that involves?" When they both nodded, she looked surprised. "Usually people don't have a clue."
"My mother died of cancer 13 years ago. I'm familiar with a lot of the procedures," Joey said quietly. "And Doug was practically a part of our family even then."
Dr. Steinbeck nodded. "I understand." Shuffling some pages she said, "I'll just go over it briefly with you anyway - there are some things you need to understand where this is dealing with the brain."
Joey and Doug nodded, and she said, "First of all, it's actually called a stereotactic biopsy. As with a lot of surgical procedures, you can't eat or drink anything from midnight on and no alcohol after six p.m. the day before the operation. When you come in, we'll do another MRI, and then we'll do the actual surgery."
She paused and tilted her head to the side, waiting to see if either Doug or Joey had any questions. When neither spoke, she went on. "For the surgery, we anesthetize you, but you'll remain awake. We shave part of your head, drill a small hole through the skull, insert a needle, and take a tissue sample. Then you're done. You go to the recovery room, and go home the next day." She paused. "It's a relatively simple procedure, but not without risk. You need to know that."
"What's the risk?" Joey asked, feeling Doug tense beside her.
"There's a 3% mortality rate with a stereotactic brain biopsy. Working in that region of the body is always dangerous."
Uncomfortable with that statistic, even though she knew 3% was low, Joey asked, "How necessary is it to do a biopsy?"
"Right now we're about 85% certain of the diagnosis. The biopsy will confirm that so that we know for certain what we need to do to treat it. If you really don't want to do it, we can go ahead with treatment without doing a biopsy, but I don't recommend it."
"And what happens after you confirm the diagnosis?" Doug asked.
"We start the first stage of treatment, resection. That's surgical removal of the tumor. We perform a craniotomy - removing part of the skull to access the brain. We replace the pieces of bone when we're finished. And we try to remove as much of the tumor as we can. It's a very risky procedure - we do lose patients. I won't lie about that. But without it, your chances of survival are approximately zero."
"Jesus Christ," Joey muttered. "Sounds like the treatment's just as bad as the disease."
"Unfortunately, that's all too often the case."
"What are the chances of being able to remove it all?" Doug refused to look at the doctor as he spoke, fearing that he already knew the answer to his question.
"Right now, the chances of that happening look very slim. But surgery isn't your only hope. As I said, that's the first stage of treatment. Chemotherapy follows the resection, and then there's radiation therapy."
Joey closed her eyes. Those were words she'd never thought she'd have to hear again. And definitely not in association with the life of the man she loved.
"If we don't do the treatments - if I decide to just go home and forget about all of this - how long will I live?" Doug fought to keep his voice from cracking, to no avail.
Dr. Steinbeck frowned. "I'd say, given the results of the MRI, about six months."
Joey's heart nearly stopped. Six months? Her husband could be dead in six months? "And if we agreed to the surgery and nothing else?" she asked. She was fairly certain Doug would agree to the surgery. She wasn't sure about chemo or radiation. They both remembered her mother's suffering all too vividly.
"Well, that will depend on the outcome of the surgery - how much we are unable to remove."
"Can you give us some kind of estimate?" Joey persisted.
"Let's see." She glanced at a few of the pages scattered on the desk. "Going on the aforementioned assumption that we won't be able to remove it all, I'd say a year to 18 months."
"And with chemo and radiation?"
"Two to two and a half years."
"So what you're saying is that I'm going to die no matter what?" Doug asked, a hard edge to his voice.
"I'm giving you an estimate based on what little information I currently have. Medicine is far from being an exact science, especially without so much as a confirmed diagnosis."
"Is. That. What. You're. Saying?" Doug asked slowly, accentuating every word.
"I'm saying that is what you need to be prepared for. I don't believe in giving my patients false hope. Your outlook could be a lot better than that, and I hope that it will be. But there are no guarantees." She spoke slowly and her words, though harsh, were softened by the obvious compassion and understanding in her voice.
Joey's mind was spinning. She'd expected to hear this, had tried to prepare herself, but her attempts had been futile. She was again reminded of something Jen's grandmother had said to her after their friend Jack had told them his boyfriend had tested positive for HIV.
"Trying to prepare yourself for pain in the future is a wasted effort. You can't do it, and it only makes you dwell on the pain you feel in the present. Spend your energy looking for the positive. Yes, Mark will die far, far too young. But enjoy the time you have with him now. It is in those memories that you will find comfort once he's gone."
She could have been talking about now, really. Joey had thought about Grams' words several times over the last few days, and she'd tried to follow the advice, but it was easy to forget sometimes. It was easy to convince herself that the words wouldn't be so hard to hear if she'd prepared herself to hear them. "This is unbelievable," she heard herself say.
"Unbelievable but unfortunately very real," Dr. Steinbeck agreed.
Doug sat silently, eyes closed. His head was pounding, a constant, rhythmic reminder of why he was here, in this office, his life changing with every word spoken. He tried to take a deep breath, but suddenly felt as if his throat was closing up on him. Opening his eyes, he saw the room spinning around him. Squeezing them shut again, he clutched at the arm of the chair and tightened his grip on Joey's hand as his stomach did somersaults and tied itself in knots. He heard someone say his name, but it sounded as if it was coming from somewhere far away and he couldn't recognize the voice.
Joey felt Doug's hand tighten on hers. Glancing at him, she saw his eyes closed and his face twisted in an all too familiar expression of pain. "Doug? Doug, just breathe, okay? Deep breaths. Come on, it's all right. Just breathe." She kept her voice calm and level; she was getting used to this by now, and that was a thought that frightened her beyond measure - when she gave herself leave to think about it.
Dr. Steinbeck watched them with interest. Seeing Doug start to calm down, she decided not to intervene. "You're very good with him."
"This has been happening a lot lately," Joey replied softly. She rubbed Doug's back gently, giving him a grounding touch to help him through the dizzy spell.
Slowly, his breathing evened out, but Joey didn't release him. She held his hand as he leaned his head back against the cool wall.
By the time he could open his eyes and not have everything moving around him only three minutes had passed but, as always, it felt like a lifetime to Joey. "You okay?" she asked him gently.
He nodded, his white face flushed with embarrassment. "I'm sorry about that," he murmured, glancing at Dr. Steinbeck.
"You needn't apologize," she told him. "However, I would like you to tell me what just happened."
He ran a hand through his hair. "It, ah, got kind of hard to breathe, and then the room started to spin."
"Headache or nausea?" she queried.
"Both. Um, my head's been hurting for a while, and I started feeling sick once I got dizzy."
"This is how it's been for the last few weeks?" she asked, making a few notes on the pad in front of her and looking up at them.
"Yes, but it's usually not that bad." Doug glanced at Joey out of the corner of his eye and caught the concerned expression on her face. He knew she hated seeing him like that, and he hated having her see him like that. He hated scaring her, and he knew these episodes always left her frightened.
"Is it getting worse a little at a time? Or was this one a lot worse than it has been?"
"Um, a little worse each time."
"All right." She made a few more notations and pushed the pad aside. Then, pulling out a drawer, she took out a few sheets of paper. "This is information on what a stereotactic brain biopsy is and the procedures we follow here at Mass General." She handed the pages to Joey who, after a quick glance, folded them and slipped them into her bag. Then the doctor picked up a pamphlet from the corner of her desk, which she also gave to Joey. "That is information on treatment options. Now, do you have any questions?"
Joey nodded. "Two things. One, who is the doctor who'll perform the operations? Is it you? And is there anything specific we should be watching for right now?"
"Yes, I'm a certified neurosurgeon, and I will be the one who operates on Doug. As for what to look out for, yes, there are a few things. If the dizzy spells suddenly get substantially worse, cal me immediately. Also, be aware that seizures are common among people with brain tumors."
Joey swallowed and felt the knot in her stomach growing larger by the second. "Seizures?"
Dr. Steinbeck nodded. "My secretary will give you some information about what to do if someone near you has a seizure, but I'll tell you the most important things. First, protect him - try to keep him from falling, or to keep him from injuring himself on anything. Secondly, don't try to put anything in his mouth to keep him from biting his tongue or lips. Third, don't try to hold him down or move him in any way. Fourth, pay close attention to what happens - you'll need to be able to tell emergency responders as much as you can. For example, pay attention to how long the seizure lasts, what movements his body made, how he acted before and after it happened." She paused. "And always call for medical assistance as soon as you can. But don't leave him alone."
She stopped speaking and regarded Joey closely. Her face was pale, and she looked stunned at the prospect of this happening to her husband. Can't blame her, she thought to herself. No one should have to even think about this. "But there is one other thing you should know. Not all seizures involve the person moving at all. Some people, when they have a seizure, simply seem to lose touch with reality. They seem to be awake but they don't respond normally to their environment, and once they snap out of it, so to speak, they won't remember that it even happened."
Joey closed her eyes tightly and took several deep breaths as she tried to sort out everything she'd been hearing. This was just one nightmare after another. "This is just going to get worse and worse, isn't it?"
"I'm afraid so. Oh, the other thing to watch for is, have you been getting sick at all? Any times you've been unable to keep food down?"
"No. Not yet anyway."
"Good. If that happens and goes on continuously for more than 24 hours, call me. My business card, which I believe you already have?" she asked questioningly. At Joey's nod she continued, "has my cellular number. If you can't reach me at the office, call that."
"Thank you," Joey said softly.
"No thanks necessary. This is my job; it's what I'm here for. Any other questions?" When they both shook their heads Dr. Steinbeck stood. Coming around the desk she said, "My secretary will make the appointment and get you any additional information that you need." She waited as Joey helped Doug to his feet, then shook their hands. "It was good meeting you, though I wish it had been under other circumstances."
"Me too," Joey said softly, turning to follow Doug out.
Chapter 2
Friday morning found Joey and Doug sitting side by side in an office at Mass General Hospital. The last few days had been some of the hardest of her life. As they waited to meet the specialist - Dr. Julie Steinbeck - for the first time, Joey's mind wandered to the arguments she and Doug had had since the appointment with Dr. Ryan.
The first had been upon walking in the door after the silent ride home. She'd wanted to call Pacey and tell him what was happening, but Doug had vehemently refused.
"No, Joey. We don't know what's going to happen yet. I don't want to alarm him or anyone else needlessly. He's got enough to worry about," Doug protested.
"Doug, he's your brother. You two have gotten so close over the last few years. Why would you hide this from him?" Joey asked.
"I'm not hiding anything. I'd just rather wait to talk to him about it until I actually know something, all right?"
"No. You are hiding. But not from Pacey. You just don't want to tell him because telling him means you have to think about everything the doctor just said, and you don't want to."
"Can you blame me?" he exploded. "Excuse me, Joey, but the doctor just told me I'm going to die. Pardon me for having a hard time with this."
"Doug, I don't blame you for having a hard time dealing with this. But you're dealing with it the same way you've always dealt with everything. You aren't. You're just pretending it's going to go away. And it isn't!"
"I know that, Joey. Trust me, I know." He stormed out of the house and a moment later she heard the squeal of tires as he pulled out of the driveway.
Then there was the fight they'd had when she'd mentioned the therapist that the doctor had told her about.
"Doug, maybe it would help you to talk to someone. She's trained to help people deal with these kinds of things."
"Joey, no psychiatrist is going to make this any easier on me unless they're going to tell me I'm going to live through this after all."
"Don't talk like that. Dr. Ryan said that this specialist would go over options with us. There might be something-"
He cut her off. "Don't go down that road, Joey. A 20% chance of survival is pretty low."
"But it's still a chance, Doug."
"Joey, don't delude yourself. You know better than this. Don't try to convince yourself it's going to be okay when it's not. And don't try to convince me."
That argument had ended the same way, with Doug storming out of the house and driving off for hours at a time. And then they'd fought on Wednesday afternoon about whether he was going to work on Thursday.
"I know you feel like you're shirking your responsibility. But Doug, you're so distracted. It can't be safe. With our luck the one time that something actually happens in this town would be when you're too distracted to be able to do anything."
"Jo, I need this. I need to get out and try to get my mind off of this."
"Think about this, Doug. If something happens and you're too out of it and someone dies - say one of those kids that have just joined the department - you'll never be able to forgive yourself."
He stared at her, knowing she was right, and sank down onto the couch. "I- I don't know, Jo. I just need to feel like something is normal in my life. And nothing is right now."
"But getting yourself into trouble on the job isn't going to help." She sat down next to him and put her arms around him. "I know it's hard. Trust me. I spent the entire time my mother was sick just wanting to feel normal again. Eventually, my friends - Dawson, Pacey - helped me feel like my life was back on track." She brushed his hair out of his eyes. "I know you did the same for Bessie, and she will always be grateful to you."
She'd won that argument, in a manner of speaking. He'd stayed in the house and, though he didn't talk to her about how he was feeling, he didn't have to. They'd sat there on the couch as he gave up the fight to hold back his tears. She'd felt like it was a step in the right direction.
"Mr. and Mrs. Witter?"
"Yes," Doug said as they both stood. "It's Doug. This is my wife, Joey."
"Pleased to meet you." She shook hands with them both and then sat down behind her desk. "Now, how much do you know about what you're facing?"
"We've done some research on it," Joey said. "We pretty much know the basics."
"Good. That makes my job easier." She smiled. "I understand that Dr. Ryan gave you some statistics on what your chances are for beating this?"
"He said my chances were low."
"Unfortunately, yes. How long have you been having the headaches that made you go to him?"
"Months, really. Um, since about a month after my dad died, so, about 10?" He glanced at Joey, who nodded, then looked back at the doctor. "I thought it was just stress. I'd take aspirin and Jo would massage my shoulders and neck, and they'd usually go away, so I didn't think anything of it, really."
"And what made you make an appointment? The dizzy spells?"
"Yes. I almost passed out at work, and, ah, that wasn't a good thing."
"What do you do?"
"I'm Sheriff in Capeside, Mass."
She nodded. "I can see how collapsing at work would be a bad thing in that job."
"Yeah." He shifted uncomfortably. "What's going to happen?"
"Right to the point. I like that - it's how I am." She glanced down at her notes. "First thing first, we're going to arrange a biopsy. Do you know what that involves?" When they both nodded, she looked surprised. "Usually people don't have a clue."
"My mother died of cancer 13 years ago. I'm familiar with a lot of the procedures," Joey said quietly. "And Doug was practically a part of our family even then."
Dr. Steinbeck nodded. "I understand." Shuffling some pages she said, "I'll just go over it briefly with you anyway - there are some things you need to understand where this is dealing with the brain."
Joey and Doug nodded, and she said, "First of all, it's actually called a stereotactic biopsy. As with a lot of surgical procedures, you can't eat or drink anything from midnight on and no alcohol after six p.m. the day before the operation. When you come in, we'll do another MRI, and then we'll do the actual surgery."
She paused and tilted her head to the side, waiting to see if either Doug or Joey had any questions. When neither spoke, she went on. "For the surgery, we anesthetize you, but you'll remain awake. We shave part of your head, drill a small hole through the skull, insert a needle, and take a tissue sample. Then you're done. You go to the recovery room, and go home the next day." She paused. "It's a relatively simple procedure, but not without risk. You need to know that."
"What's the risk?" Joey asked, feeling Doug tense beside her.
"There's a 3% mortality rate with a stereotactic brain biopsy. Working in that region of the body is always dangerous."
Uncomfortable with that statistic, even though she knew 3% was low, Joey asked, "How necessary is it to do a biopsy?"
"Right now we're about 85% certain of the diagnosis. The biopsy will confirm that so that we know for certain what we need to do to treat it. If you really don't want to do it, we can go ahead with treatment without doing a biopsy, but I don't recommend it."
"And what happens after you confirm the diagnosis?" Doug asked.
"We start the first stage of treatment, resection. That's surgical removal of the tumor. We perform a craniotomy - removing part of the skull to access the brain. We replace the pieces of bone when we're finished. And we try to remove as much of the tumor as we can. It's a very risky procedure - we do lose patients. I won't lie about that. But without it, your chances of survival are approximately zero."
"Jesus Christ," Joey muttered. "Sounds like the treatment's just as bad as the disease."
"Unfortunately, that's all too often the case."
"What are the chances of being able to remove it all?" Doug refused to look at the doctor as he spoke, fearing that he already knew the answer to his question.
"Right now, the chances of that happening look very slim. But surgery isn't your only hope. As I said, that's the first stage of treatment. Chemotherapy follows the resection, and then there's radiation therapy."
Joey closed her eyes. Those were words she'd never thought she'd have to hear again. And definitely not in association with the life of the man she loved.
"If we don't do the treatments - if I decide to just go home and forget about all of this - how long will I live?" Doug fought to keep his voice from cracking, to no avail.
Dr. Steinbeck frowned. "I'd say, given the results of the MRI, about six months."
Joey's heart nearly stopped. Six months? Her husband could be dead in six months? "And if we agreed to the surgery and nothing else?" she asked. She was fairly certain Doug would agree to the surgery. She wasn't sure about chemo or radiation. They both remembered her mother's suffering all too vividly.
"Well, that will depend on the outcome of the surgery - how much we are unable to remove."
"Can you give us some kind of estimate?" Joey persisted.
"Let's see." She glanced at a few of the pages scattered on the desk. "Going on the aforementioned assumption that we won't be able to remove it all, I'd say a year to 18 months."
"And with chemo and radiation?"
"Two to two and a half years."
"So what you're saying is that I'm going to die no matter what?" Doug asked, a hard edge to his voice.
"I'm giving you an estimate based on what little information I currently have. Medicine is far from being an exact science, especially without so much as a confirmed diagnosis."
"Is. That. What. You're. Saying?" Doug asked slowly, accentuating every word.
"I'm saying that is what you need to be prepared for. I don't believe in giving my patients false hope. Your outlook could be a lot better than that, and I hope that it will be. But there are no guarantees." She spoke slowly and her words, though harsh, were softened by the obvious compassion and understanding in her voice.
Joey's mind was spinning. She'd expected to hear this, had tried to prepare herself, but her attempts had been futile. She was again reminded of something Jen's grandmother had said to her after their friend Jack had told them his boyfriend had tested positive for HIV.
"Trying to prepare yourself for pain in the future is a wasted effort. You can't do it, and it only makes you dwell on the pain you feel in the present. Spend your energy looking for the positive. Yes, Mark will die far, far too young. But enjoy the time you have with him now. It is in those memories that you will find comfort once he's gone."
She could have been talking about now, really. Joey had thought about Grams' words several times over the last few days, and she'd tried to follow the advice, but it was easy to forget sometimes. It was easy to convince herself that the words wouldn't be so hard to hear if she'd prepared herself to hear them. "This is unbelievable," she heard herself say.
"Unbelievable but unfortunately very real," Dr. Steinbeck agreed.
Doug sat silently, eyes closed. His head was pounding, a constant, rhythmic reminder of why he was here, in this office, his life changing with every word spoken. He tried to take a deep breath, but suddenly felt as if his throat was closing up on him. Opening his eyes, he saw the room spinning around him. Squeezing them shut again, he clutched at the arm of the chair and tightened his grip on Joey's hand as his stomach did somersaults and tied itself in knots. He heard someone say his name, but it sounded as if it was coming from somewhere far away and he couldn't recognize the voice.
Joey felt Doug's hand tighten on hers. Glancing at him, she saw his eyes closed and his face twisted in an all too familiar expression of pain. "Doug? Doug, just breathe, okay? Deep breaths. Come on, it's all right. Just breathe." She kept her voice calm and level; she was getting used to this by now, and that was a thought that frightened her beyond measure - when she gave herself leave to think about it.
Dr. Steinbeck watched them with interest. Seeing Doug start to calm down, she decided not to intervene. "You're very good with him."
"This has been happening a lot lately," Joey replied softly. She rubbed Doug's back gently, giving him a grounding touch to help him through the dizzy spell.
Slowly, his breathing evened out, but Joey didn't release him. She held his hand as he leaned his head back against the cool wall.
By the time he could open his eyes and not have everything moving around him only three minutes had passed but, as always, it felt like a lifetime to Joey. "You okay?" she asked him gently.
He nodded, his white face flushed with embarrassment. "I'm sorry about that," he murmured, glancing at Dr. Steinbeck.
"You needn't apologize," she told him. "However, I would like you to tell me what just happened."
He ran a hand through his hair. "It, ah, got kind of hard to breathe, and then the room started to spin."
"Headache or nausea?" she queried.
"Both. Um, my head's been hurting for a while, and I started feeling sick once I got dizzy."
"This is how it's been for the last few weeks?" she asked, making a few notes on the pad in front of her and looking up at them.
"Yes, but it's usually not that bad." Doug glanced at Joey out of the corner of his eye and caught the concerned expression on her face. He knew she hated seeing him like that, and he hated having her see him like that. He hated scaring her, and he knew these episodes always left her frightened.
"Is it getting worse a little at a time? Or was this one a lot worse than it has been?"
"Um, a little worse each time."
"All right." She made a few more notations and pushed the pad aside. Then, pulling out a drawer, she took out a few sheets of paper. "This is information on what a stereotactic brain biopsy is and the procedures we follow here at Mass General." She handed the pages to Joey who, after a quick glance, folded them and slipped them into her bag. Then the doctor picked up a pamphlet from the corner of her desk, which she also gave to Joey. "That is information on treatment options. Now, do you have any questions?"
Joey nodded. "Two things. One, who is the doctor who'll perform the operations? Is it you? And is there anything specific we should be watching for right now?"
"Yes, I'm a certified neurosurgeon, and I will be the one who operates on Doug. As for what to look out for, yes, there are a few things. If the dizzy spells suddenly get substantially worse, cal me immediately. Also, be aware that seizures are common among people with brain tumors."
Joey swallowed and felt the knot in her stomach growing larger by the second. "Seizures?"
Dr. Steinbeck nodded. "My secretary will give you some information about what to do if someone near you has a seizure, but I'll tell you the most important things. First, protect him - try to keep him from falling, or to keep him from injuring himself on anything. Secondly, don't try to put anything in his mouth to keep him from biting his tongue or lips. Third, don't try to hold him down or move him in any way. Fourth, pay close attention to what happens - you'll need to be able to tell emergency responders as much as you can. For example, pay attention to how long the seizure lasts, what movements his body made, how he acted before and after it happened." She paused. "And always call for medical assistance as soon as you can. But don't leave him alone."
She stopped speaking and regarded Joey closely. Her face was pale, and she looked stunned at the prospect of this happening to her husband. Can't blame her, she thought to herself. No one should have to even think about this. "But there is one other thing you should know. Not all seizures involve the person moving at all. Some people, when they have a seizure, simply seem to lose touch with reality. They seem to be awake but they don't respond normally to their environment, and once they snap out of it, so to speak, they won't remember that it even happened."
Joey closed her eyes tightly and took several deep breaths as she tried to sort out everything she'd been hearing. This was just one nightmare after another. "This is just going to get worse and worse, isn't it?"
"I'm afraid so. Oh, the other thing to watch for is, have you been getting sick at all? Any times you've been unable to keep food down?"
"No. Not yet anyway."
"Good. If that happens and goes on continuously for more than 24 hours, call me. My business card, which I believe you already have?" she asked questioningly. At Joey's nod she continued, "has my cellular number. If you can't reach me at the office, call that."
"Thank you," Joey said softly.
"No thanks necessary. This is my job; it's what I'm here for. Any other questions?" When they both shook their heads Dr. Steinbeck stood. Coming around the desk she said, "My secretary will make the appointment and get you any additional information that you need." She waited as Joey helped Doug to his feet, then shook their hands. "It was good meeting you, though I wish it had been under other circumstances."
"Me too," Joey said softly, turning to follow Doug out.