Journal entry by Michael Bischoff

We met today with my surgeon, and reviewed the functional MRI that I had this past Friday.

He recommends a less invasive laser surgery, LITT (Laser Interstitial Thermal Therapy). My understanding is that they drill a small hole in my skull, insert something like a straw, and usera laser to burn part of the tumor. After that, they’d do traditional radiation for the new tumor, and some of the area between the new and old tumor, since there is probably cancer in that section too.

I’m attaching an image from the functional MRI, which shows a key area for speech, in red, right up against the new tumor, in light grey. There is risk of impairing my speech from the laser therapy, but not as much as a regular surgery, and the impairment might be short term.

I don’t know yet if my insurance will cover LITT. A team will have to come from Chicago to do it, but they’d do it at my hospital. Scheduling is more complicated, but they hope to do it within the next week or so.

The surgeon thoughtfully reviewed other options too (traditional surgery, radiation, no treatment for now). My wonderful doctor partner, Peter, was in the appointment, and he supported the LITT option, partly because it would be less invasive and disruptive for me.

Because I wanted to make sure I documented some things while I knew I could speak, I made videos this past weekend for my kids, and some others. I feel pretty prepared with financial and practical things, if I can’t speak. It feels a little like clearing off my desk and responsibilities before going on a vacation. For me, having that clean plate can sometimes be as much fun as the actual vacation. I don’t want to wait until death for that kind of freedom.

As we biked to the surgeon’s office, I imagined that when I was there, he might say, “You’re healed, son! Pick up your mat and walk.” While I didn’t hear him say that, I still felt some of that invisible invitation. I also appreciate the possibility of a less invasive medical treatment, to give more space for intensive love and nature therapy as the primary treatment.

I’ve posted this song, Everybody’s Chains Came Off, here before, but it felt appropriate to play it loudly again today, when my family was out of the house. All the chains fell off, even for the shy one in the corner. Freedom is calling. The loss of my language and thinking won’t be the end of me. Death won’t be a failure, and freedom doesn’t have to wait until death.

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