handtototalparalysisovernight.Thequestiontherefore
waswhentogoin,andhebelievedthatshouldbewhen
thesituationbecameintolerableenoughformyfatherto
wanttoattempttreatment.Thesurgeonwasnotasblithe
aboutits risksastheotherneurosurgeon.Hethoughtit
carriedaoneinfourchanceofitselfcausingquadriplegia
ordeath.Myfather,hesaid,would“needtodrawaline
inthesand.”Werehissymptomsalreadybadenoughthat
hewantedsurgerynow?Wouldhewanttowaituntilhe
startedtofeelhandsymptomsthatthreatenedhisability
todosurgery?Wouldhewanttowaituntilhecouldn’t
walk?
Theinformationwasdifficulttotakein.Howmanytimes
had my father given patients bad news like this—that
theyhadprostatecancer,forinstance,requiringsimilarly
awfulchoicestobemade.HowmanytimeshadIdone
thesame?Thenews,nonetheless,camelikeabodyblow.
Neithersurgeon cameout and saidthat thetumorwas
fatal,butneithersaidthetumorcouldberemoved,either.
It could only be “decompressed.”
Intheory,apersonshouldmakedecisionsaboutlifeand
deathmattersanalytically,onthebasisofthefacts.But
thefactswereshotthroughwithholesanduncertainties.
Thetumorwasrare.Noclearpredictionscouldbemade.
Makingchoicesrequiredsomehowfilling thegaps,and
whatmyfatherfilledthemwithwasfear.Hefearedthe
tumorandwhatitwoulddotohim,andhealsofearedthe
solutionbeingproposed.Hecouldnotfathomopeningup
thespinalcord.Andhefounditdifficulttoputhistrustin
anyoperationthathedidnotunderstand—thathedidnot
feel capable of doing himself. He asked thesurgeons