Monday, June 02, 2008

Slayer of Atwater and Kennedy

Death from Glioblastoma Multiforme is certainly not sudden, but it is inexorable. It shuts down the central nervous system as it grows, so one enters a progressively sleepy state punctuated by seizures. Along this downward course, other brain functions start to shut down: paralyzed limbs, a loss of speech. Eventually one enters the deep sleep of coma, and then death.

I'm sure Allan Friedman MD, Guy L. Odom Professor of Neurological Surgery, in the School of Medicine, Chief, Division of Neurosurgery in the Department of Surgery, Co-Director, Neuro-Oncology Program at Duke University ... I'm sure he's a capable guy, but I'm just as sure he knows he made only a gesture today. Nobody has the delusion that they can divert the juggernaut deathgrip Glioblastoma; not even, it is notable, any neurosurgeon. He must have been aware that he was participating in Kennedy myth-building. The patriarch must be seen as fighting to the last. All of the reports I'm seeing on Cablenews about "successful" surgery just indicate the patient survived surgery perhaps without new neurological deficits.

Unlike more well-behaved tumors, Glioblastoma has no definable plane between itself and normal brain tissue. Even with image-guidance, even with large margins taken around any obviously necrotic mass, macro- or microscopic tumor infiltrates and evades. After surgery, after radiation and chemotherapy, these little islands of viable tumor show up bad as ever as malignant little deathblossoms that are sadly never going to go away.


Anonymous Anonymous said...

Got a source?
Even just one?
'Cause -your- expert opinion isn't one that a casual observer should accept, not on brain surgery.

7/26/2008 12:17:00 PM  
Blogger K. Pablo said...

A source for what? Only specific questions can be answered specifically.

This post is a meditation on a disease entity that has fascinated me, although my participation in such cases has been limited. It is not intended as a review of the literature.

Any posts, BTW, that contain predictive information can always be checked against subsequent events. I don't think Ted Kennedy will see much of 2009, if any.

7/26/2008 12:36:00 PM  
Anonymous Anonymous said...

So you admit you spout bullshit.

8/16/2008 11:15:00 AM  
Anonymous Anonymous said...

musing as medical fact

8/16/2008 11:15:00 AM  
Blogger K. Pablo said...

My middle paragraph is the only one with any significant quotient of opinion. The first and last are factual and descriptive. Your posts are bullshit. Why do I need sources for my personal observations, dipshit?

8/16/2008 11:26:00 AM  

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