P.S. Let’s Not Forget Mack the Knife | May 27 2022

May 26, 2022

Here’s a quick report on today’s MRI of my brain.

I am pleased to report that I no longer comport myself like a loudmouth boor on a pub crawl after taking my benzo, lorazepam.

However, I continue to jump in the tube as the first noise sounds. Then I kind of doze off to random rounds of banging and beeping.

After we got home, I slept until just before we were to go back to visit with Mack the Knife. The MRI report landed in my medical chart before we went. The news was good. The fried spot is shrinking, a sign of death. But also, “Punctate focus of enhancement within the white matter of the left frontoparietal junction which is indeterminate, but concerning for a new metastasis.”

Awww, jeez, he — one of the docs who reads scans– had to go and spoil it. He’s read my scans before. I hate his readings, because he is consistently stingy with words. (We’ll call him Dr. Stingy.) There’s a Russian doctor I prefer, who is, by comparison, positively voluminous in her discussion. Her reports are much better when a doctor prefers to read the report and not the scans themselves.

But Mack the Knife knows his way around an MRI– he’s an oncology radiologist, for goodness sake. So we skip the report and go right to the image. He points to the black spot at the top of the image with an air of satisfaction. As for the other spot? He shrugs. It’s so small there’s no way to know. He moves his finger into the air with a fast pokepoke– “like pinpricks,” he says. It could be as simple as a vein the scanner captured because of a random angle. Here’s a repeat lesson: if it’s bad, it’ll change. This one will have to grow a lot for him to get excited. It just means a repeat scan sooner that I’d like. 

BUT he’ll turn me back over to our hero, Dr. Radiology. “She can read an MRI mumble mumble and if she needs me, she’ll yell, ‘Mack’!” Clearly this guy prefers frying things with his toys instead of hanging out with patients. Fine by me. 

The most important thought I would like to leave you with is below. It’s from a bathroom in the CT department. Don’t let the man’s disarmingly attractive smile detract you from the key message in the lower left corner.

Life is better with clean hands.

Thanks for reading. Now go get some soap.

• Whipsaw by OpenClipart-Vectors
• Whole-brain tractography was created with a method called constrained spherical deconvolution using dMRI data from a high-sensitivity MRI (the Connectome scanner) at the Martinos Center for Brain Imaging, Massachusetts General Hospital, in Charlestown, Boston, Massachusetts.
• Poster by CDC