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Six Weeks?
6 years ago2,211 words
I saw the neurosurgeon again on Wednesday, and I decided to have surgery at the start of September, in about six weeks. Here's what I want to try to achieve in that limited time...

I started writing this on Wednesday when I got back, but I think I might have caught something at the hospital, and I've been feeling physically terrible because of that. So that's great!

Also, the title has a question mark because though I distinctly remember agreeing on September during the consultation, I got a letter today telling me that I'll need to ring to confirm my stay in the hospital, which has been arranged for the start of August. Hmm. So I'll have to ring on Monday and sort that out (ugh).

Since I got back, I've been cringing constantly about every little detail of the conversation I had with the neurosurgeon, even though there's absolutely no good reason to. The Self part of my mind doesn't think I did or said anything particularly stupid, but my demons have been using their dark tendrils to probe every nook and cranny of the interaction, every word spoken and every little facial expression given or received, to find reasons to generate self-disgust and shame to feed on. So I've been caught up in this excessive cringing self-torture which makes me want to die just so then I don't have to endure it anymore.

It's as willful as the compulsions of OCD or PTSD; thoughts invade my mind rather than being deliberately generated, and I wish they'd just go away. This is why I avoid things that involve social contact, though; the aftereffects linger longer than the interactions they come from, sometimes for years. I still cringe over little things I did as a young child.

I think it's more likely to happen the greater the distance between me and the other person, which is the sum of both horizontal distance (how personally close we are) and vertical distance (how much I perceive them to be 'superior' or 'inferior' to me in terms of value to society). As I have a deep-rooted feeling of inferiority due to my unimpressive life situation (lack of a clear career, for example), most people who are horizontally distant would also be vertically distant, and I assume they'd look down on me. Talking to someone who's an actual brain surgeon - who'd be respected by pretty much anyone - presents vast vertical distance. So even though I feel that he and I aren't worlds apart in terms of personality and I can talk with him quite freely during the interaction, once it becomes a memory and the demons can play around with it, the long shadow his high respectability casts over mine provides plenty of darkness for them to torture me with.

So ugh. That's something I've been having to deal with, even though I know I 'shouldn't' be having such thoughts, that 'he probably doesn't look down on me/remember/care anyway', etc, etc. It's not a choice, and I just have to wait for it to fade down over time, as always happens.

Maybe the daemons in the story I described in the previous post feed on pain in the mind of their 'owner'. Hmm. Inspiration.

Anyway, while that relates to my brain, it has nothing to do with what we actually talked about. I actually had a choice about whether to have surgery or not, and I really wasn't sure what to do. I'm still not, and I have six weeks (hopefully) to change my mind. My tumour hasn't changed in size dramatically in the two years since the first scan, but it has changed a bit, and will likely continue to do so. Probably. This kind of tumour is so rare and was only so recently described that nobody knows what'll happen in the long term. Surgery will definitely cause harm, though, and I'll be debilitated for about a year - perhaps for life - not just from the surgery but from follow-up radiotherapy that I'll have to have for quite a long time. It's a tough decision.

I've essentially planned everything around having the surgery, though, it's too late to go and do a Master's this year now, and I don't particularly want to get some mediocre job out in the real world (I wouldn't even know how, or what I'd do). So I've decided to have the surgery... but maybe I'll change my mind. I don't know. Either way, it seems like something I'll have hanging over me probably for the rest of my life, since even if the surgery is a success (and that isn't guaranteed), these types of tumour seem to often recur, and they're so rare that it'd be necessary to monitor the progression just because it'll be so unknown. And if it does recur, then a second surgery would include far more risk than the first because of something involving scar tissue and such that I don't fully understand...

One of my biggest concerns (and this is going to get quite technical, so I don't know if anyone's interested but I'll ramble on about it anyway) was that he wanted to get at this pineal tumour using what's called an interhemispheric transcallosal resection, which would involve going in through the top of the head and cutting a hole in the corpus callosum, the bundle of fibres that connects the two hemispheres of the brain. Even minor damage to this connective bridge can cause severe side effects. One would be deficits to short-term memory that render people with such damage unable to enjoy stories of any kind because they can't remember the beginning once they get to the end. Another would be the disabling of the person's ability to dream, or at least to remember dreams, as dreaming mostly happens in the right hemisphere, but it's the left that contains the sense of Self and the language used to communicate externally, so even if the right hemisphere was happily dreaming away every night, the left would never hear or be able to talk about it because its lost part of its connection to the right. Neither of those would be desirable for what I want to do with my immediate future!

'Fortunately', an alternate path to the tumour is via the back, the infratentorial supracerebellar approach, and I made it clear that I'd prefer him to go in that way, as it doesn't involve actually cutting through any brain matter (instead, the surgeon goes through a gap between the occipital lobe and the cerebellum). He said that it was certainly possible, and that he'd discuss it with his colleagues. But even then, that can lead to side effects. There are a lot of veins around this area, some of which definitely have to be sacrificed to even reach the tumour, and if the wrong vein is cut or a major one is damaged accidentally, then it's game over, and I'd become a vegetable. The cerebellum is also used for balance etc, and disruption to it could cause persistent feelings of nausea or movement issues. The occipital lobe itself is where visual information is processed, and damage to that can produce visual deficits, even blindness. This path would also likely result in some disruption to the tectum, which controls eye movements, so I could end up unable to move my eyes properly.

So there's no good outcome. Either way, some serious and lasting harm is likely to come to me. Either I just leave the tumour, risk it, and find out that it's got too big one day and caused damage in its own way (it's encroaching upon my thalamus (or one of them, anyway) and pressing against the brain stem, both of which are used in fairly basic and necessary life functions). Or I lose my ability to dream and tell or enjoy stories from corpus callosum damage (even if it's minor and subtle, it'd be like a pianist losing a finger), or I suffer potential vision and balance problems and feel constantly nauseous. The surgery may also cause memory disturbances and deficits, regardless of the path the surgeon takes.

So sigh. Some people are lucky enough to have stable, fulfilling careers, loving partners, and a home of their own by my age. I am far less lucky. The thought of suicide to just escape all this - the tumour, the demons - is constantly tempting, but I'm aware that's irreversible. So I've been trying to think what I can do with the next few weeks.



Primarily, I want to continue planning and then working on the story I described in the previous post, about 'daemons' and such, told via 3D conversations. There are technical issues I'm wrestling with, however.

Currently what I have is made in Unity, but exporting from Unity is a pain because it takes several minutes every time I want to export (which sounds minor but it's really off-putting), the resulting file is large and cumbersome, and while it works in browsers to some degree, it has some limitations and doesn't work on mobiles.

I've been playing around with some 3D/WebGL JavaScript libraries (three.js, babylon.js) that allow me to handle the 3D stuff in a way such that it's intertwined with the website code rather than some monolithic thing made externally and inserted onto the page, which is nice because it becomes much easier to change one little bit (like, say, a line of dialogue, or a character's model) without having to re-compile, -export, and -upload the whole Unity project, and it's supported by mobile browsers and is likely to be more consistent across browsers as well. Plus I think that Gamma/Linear lighting thing I talked about in a previous post will no longer be an issue.

There are issues that I've been frustrated by, though. I managed to make ∞ this ∞ in just a few minutes, which shows just a basic rotating 3D model which should work on both desktop and mobile browsers. Hopefully. But these libraries seem to prefer a model format called gltf (which I'd never heard of before), and the Blender gltf exporter I downloaded produces ∞ this result ∞. Though I've yet to figure out how to get it to animate using my own code, I was able to view the model using an external gltf viewer (which has the same distortions, so it's not just my code), and the animations exist, but they're horrifying. (If you want to see it for yourself, download ∞ this ∞ and drag it onto ∞ this viewer ∞, then open the Animation panel in the upper right, play around with the tick boxes, and proceed to have nightmares.)

(I actually downloaded two different gltf Blender exporters, and one exports fine but doesn't support multiple actions (animations), whereas the other one produced this monstrosity (but does support multiple actions!!). I think it's something to do with the model specifically because it didn't happen with a new rigged model I made to test it. Whatever the issue is, it isn't obvious; it might be related to IK or weighting or bone names or something, but I need to spend more time looking into it and/or contact the developers of the exporter to see if it's an issue on their end. Either way, ugh.)

So that's my fun, fun project at the moment. Once I get the basics figured out, porting from Unity to that won't be too difficult, though, because it's not like it's a huge, complex game engine or anything.


In addition to that, I've also been working on a community website that I've yet to talk about. I'll probably post about that in more detail soon. It's about trying to figure out the nature of the universe... sort of. Hard to succinctly explain. Different to what I've done before, anyway.


I'd also like to get back to music composition; I've been meaning to write a post about that. Maybe I'll do that sooner rather than later.


And on a more personal note, I've been trying to learn how to have lucid dreams more reliably, or even at will. I've had a few through the years and they're amazing, but I've lacked the discipline to learn and practise specific techniques, so when they occur is entirely random. Such techniques do seem to exist though, so I've been looking into them... though progress is slow because I'm depressed so much of the time. Annoying. Some people report having out of body experiences during surgery, where they see the surgeons working from a vantage point above them, and I wonder whether it'd be possible to deliberately trigger such an experience using lucid dreaming techniques. It's unlikely because they're very different experiences, but I'd like to at least have the skill in my arsenal before going through with the surgery because it's not like it's an opportunity that comes up often.



So yes. Brain surgery and plans. I'll abruptly end this now because I'll never finish and post it otherwise!

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