Death Be Not Proud Read Online Free PDF

foreign growth is present, the skull itself must be opened or death will be caused by pressure. The only other accepted means of therapy for brain tumors are X-ray and, rarely, radium. Now, to open the skull and extract all or part of a brain tumor is a refinement of surgery of the most elaborate kind. The operation, in fact, did not exist as a practical possibility until the advent of the late Dr. Harvey Cushing. Almost all the great contemporary neurosurgeons—like Putnam himself and Wilder Penfield— are Cushing men, Cushing trained.
    The technique (of course I am oversimplifying vastly) is to locate the tumor with exactness, open the skull and remove as much of the tumor as possible by suction and other devices, meantime preventing hemorrhage by various means and so keeping the patient alive. In blunt fact the operation itself, though prolonged, may not be violently dangerous, and though the technical preparation may be difficult, the actual surgery is of the most primitive type—simple extrication of an alien mass. Everything depends on the type of tumor the surgeon may discover, and there are half a hundred different kinds, some comparatively benignant, some malignant in varying degree. The location of the tumor is also of prime importance. Obviously a tumor close to the surface, in the so-called silent areas of the brain, will be easier to extract than one deep down. At first it was thought that Johnny’s tumor was of the fourth ventricle. When, up in Deerfield, I asked Dr. Johnson what kind of operation this entailed, he simply shook his head and replied, “There have been very few successful operations in that area.” Actually Johnny’s tumor turned out to be near the surface and in the right occipital parietal lobe, which made the procedure some-what less formidable, though, God knows, formidable enough. Another difference among tumors is that some have a greater velocity of growth than others and a tendency to recur. It was a bad sign that Johnny’s had apparently developed with such speed. Another difference is that some are encapsulated, and so can be lifted out in a piece, like a marble stuck in jelly. These are comparatively easy to remove. But others are of an infiltering spidery type that creep and burrow along the minute crevasses of the brain, slowly but inevitably destroying function, and almost impossible to remove. If the surgeon goes too deep, the patient dies of loss of blood or, worse, so much healthy brain tissue has to be destroyed that he will be better dead.
    Traeger gave up his practice for a day, no small sacrifice for a busy doctor, when Putnam asked him to attend the operation. We hoped desperately for good news to the last. Putnam had explained that he would know little until he actually went in. For all anybody really knew, Johnny might not have a tumor at all. What caused the pressure might be a blood clot. It might be a mere cyst. It might, even if a tumor, be the most innocent kind. At about 4:30 that afternoon, while Putnam was still washing, Traeger (who had stood up hour after hour during the entire operation) came down and found us in the solarium near Johnny’s room. I took one look at his face, and knew the worst. Traeger had aged five years in those five hours. He was as gray and seared as if drawn by Blake. He could hardly control his features. Nor was I controlling mine. I took him aside and asked him just one question. “Was it encapsulated?” He answered, “No. ”
    Putnam came down a few minutes later, briskly but looking like officers I have seen after a battle. I heard him call, “Where are the parents?” He walked me down the hall after a word of encouragement to Frances. “It was about the size of an orange. I got half of it.”
    What, in all sanity and conscience, is a brain? How in the name of heaven or all that is reasonable could an evil thing the size of an orange have existed in Johnny’s head without making him sicker? The answer is, I daresay,