A novel by Lance Fogan, M.D.—IN PREPARATION.
Conner’s family, teachers, psychologists, and pediatrician attribute the boy’s school difficulties to anxiety and stress because of his dad’s military service in Iraq. When he has a fever-related convulsion Conner is referred to a neurologist. The specialist ultimately makes the correct diagnosis of complex partial seizures. It’s epilepsy. For this family, just as it is for the general public, the condition is surrounded by ignorance, misconceptions, and fear. The emotional journey to reach their son’s diagnosis is written sensitively and with the realism that only a seasoned clinical neurologist could provide.
Summary and excerpt from CHAPTER 1.
The novel opens with eight-year-old Conner experiencing confusion during his third-grade spelling test. The nature of the child’s problem is unrecognized by his teacher, and he is too young and inarticulate to complain about these ding spells, as he thinks of them. We learn that he has been having non-convulsive complex partial seizures—blank outs and confusion—every few weeks for almost one year.
Conner didn’t know what he was feeling. At least, his eight-and-one-half-year-old vocabulary couldn’t express it in words his mom, dad or anyone else could understand. These little dings, as he thought of them, happened every few weeks. Sometimes they happened every few days. They began when he had visited Grandma Betsy and Grandpa Larry almost a year ago; but he hadn’t known what they were, what to call them or how to tell anyone about them. They seemed to only last a minute or so. First, he’d get this funny feeling in his belly. Next, he’d get scared for a few seconds—he didn’t know why—because there wasn’t anything to be scared about. Then, he’d smell something bad, but he didn’t know what it was. Finally, he’d feel a little dizzy, but not enough to fall down or anything.
It was just too strange for him to explain. A few times the dings happened while he was at school, but no one said that they could see a change in his apricot-complexioned face. No one told him that they could see any movement of his body. No one said that his head of light-brown hair—Mom kept telling him that it was too long—moved. Did his brown eyes, with those tiny flecks of green sheen in the colored part—the iris, Mom called it—move? Did they close? He thought that they must close, because he couldn’t see during the ding. But no one seemed to notice anything different about him when it happened.
He was tall for his age, lithe and he always seemed to be moving. Once, his mom had even complained to his pediatrician that Conner was always fidgeting and jumping around. The doctor told her, “Conner just has a lot of nervous energy, that’s all. He’s doing fine.”
Yesterday, during a spelling test, his third-grade teacher was calling out the test words, and then—ding! He felt that funny thing in his belly rise, and there was that strange smell again, and then…and then…the test was over. Mrs. Dorsey, his teacher, looked fuzzy to him. It was as if she was moving around the room in slow motion. The sound of the other children’s voices was funny, too. They were talking, but he couldn’t understand anything his classmates said. Their words seemed to be echoes coming from far away.
As she collected the test papers, the teacher was thinking that the single most important factor for a child to be successful is the classroom teacher. It was a privilege to teach; teachers are difference-makers. Janet Dorsey was in her mid-thirties, tall, with long dark hair and green eyes. She was curvy in the way that Conner and the other third-grade boys liked, and she always smelled so good. She relished having such influence in shaping these little people into those whom they would eventually become. She liked to imagine what they would be like as adults, with jobs and families of their own. She would be a part of their lives just as her teachers were a part of hers. What would they remember of her in twenty or thirty years?
Arriving at Conner’s seat, Mrs. Dorsey’s stomach dropped. Once again, he’d filled in only half of the words. “Do you need more time to spell these words, Conner?” She knelt down close to his ear, speaking softly. “Do you need more time, Conner?”
Confused, Conner avoided her gaze. He looked down at his incomplete test paper. What? What is she saying? Why?
“I did spell the words!” Conner blurted, his face flushed. “I don’t know why I didn’t finish, Mrs. Dorsey. I—I just couldn’t!” His vision blurred with tears.
“Conner, there’s no need to cry. I’ll help you.”
“I did spell them! I did! I did!” He began to sob.
Mrs. Dorsey turned away from him, confused and frustrated. She walked back to her desk, her mind racing as she stared into the classroom. The third-graders were busy doing their free-reading assignment, but the teacher was no longer aware of them. It’s October, well into the school year. Is he just lazy? I know that his dad’s on his second tour in Iraq. That has to be hurting. Why am I not getting through to him?
Summary and excerpt from CHAPTER 12.
Conner has a fever-related convulsion at home. He is brought to the local emergency room where he undergoes a spinal tap and a brain CT scan. The results are normal and the E. R. doctor orders a referral to a neurologist. As no one is aware of his frequent dings, the multiple seizures of epilepsy are not suspected.
…Then, he took up the spinal needle. It was less than four inches long, but it could look a foot long to a patient. The doctor inserted its point through the Lidocaine-numbed skin, stopped to confirm that his aim was correct, and then, pushed it deeper and smoothly into Conner back.
Dr. Choy took a deep breath and waited a second or two. No movement, no cries, no moans. At least I haven’t hit any bone —yet, he thought.The doctor pushed the needle deeper until he felt the welcoming “pop” as the tip penetrated the thick, fibrous ligamentum flavum membrane that encloses the spinal canal with its spinal fluid. This fluid nourishes and protects the brain and the spinal cord. He pulled out the stylet that fills the hollow-cored spinal needle, and colorless, clear cerebrospinal fluid dripped quickly out the end of the needle. The tightness in his shoulders dissolved. The first drops fell onto a towel on the floor.
As he watched the fluid drip out, Sam Choy felt a kind of pride. He mused at the similarities of spinal fluid and the sea: it shared the same chemistry as sea water, as oceans. He thought, the sea, gentle and undulating, yet devouring. The human body: so grand, so amazing—we come from organisms in the sea. He thought of his Grandma Liu and her stories about growing up in China. She had trained her pet cormorant to dive for fish to sell and for the family to eat. Her bird had a tight ring around its throat, however, so that it couldn’t make the fish its own meal.
Summary and excerpt from CHAPTER 18.
The neurologist’s skillful questioning reveals that the boy has been experiencing the classic symptoms of complex partial seizures for at least one year. Conner has epilepsy. It’s not just a single grand mal convulsion related to fever. His parents are devastated, but Conner is relieved to learn what his dings are. The boy now understands what has been happening to him, and he knows that the neurologist will help him.
…Hal said to his patient, “So, Conner, did you see the pictures of your brain on the CT scan? They’re really interesting. Let me show them to you.” The doctor turned the computer monitor on his desk toward the Goldens so they could all see the images. “Have you studied the body and the brain in school yet?”
“No. Not yet.” Conner stood up and leaned on the desk to get closer to the monitor. “Gee!” Conner was warming up to this Zeus Giant. That’s how he was starting to see this brain doctor. That’s what the doctor was becoming to him. The boy propped his elbows on the desk and cupped his chin in both palms. Then, he saw it: a brain. His brain! Just like on TV shows, only this was cooler.
The neurologist explained what they were looking at. He point to the smelling nerve, the eyes, and the ears. Then he showed the family where Conner’s balancing center was and which part makes the eyeballs move. Hal told the family that the cortex of the brain was for thinking, speaking, comprehending, remembering, moving, touching, and seeing. Then, he indicated the cerebrospinal fluid that surrounded the brain and which filled the chambered ventricles. “Dr. Choy had obtained some of this fluid from your lower back, Conner. It was a very important part of your examination, and it was normal.”
His father bent over the desk. “Amazing! Fantastic!”
The boy reached his hand around and touched his lower back. His eyes widened in comprehension: “That’s why I had that Band-Aid on my back when I came home from the hospital!”
Hal felt a wave of shared confidence crest and surge between him and the family. He sat back with his elbows propped on the armrests of his chair and he steepled his fingers under his chin. “It’s Mother Nature.” He smiled and they all laughed with him. “Everything in the brain looks normal; now, we can screen to find out how it’s all working inside your head.”
…“Conner, have you ever had any blanking out of your thinking?”
“Well, uh, what do you mean?”
Hal cleared his throat. “I mean, if you’re thinking of something—or watching a movie or a TV program, or if someone is talking to you—does it ever suddenly seem as though you missed what was happening? I don’t mean daydreaming; everyone does that. In daydreaming your mind is still thinking of something. What I mean is, let’s say something is important to you, and you’re really paying attention. And then, all of a sudden, the scene in the movie or on the TV screen has changed, and boom”—Hal clapped his hands once—“you don’t know what happened, even though you were really following closely. Has that ever happened to you?”
Conner slid forward in his chair and gripped the front edge of Hal’s desk. His parents looked at him intently. “Well, umm, sometimes I get these, uhh, these dings. You know, I get this funny feeling, and I get real scared. And then, I don’t know, I—I—and then something else has happened, and I don’t know what. Is that what you mean?”
Hal looked intently at Sandra and Sam. Both parents’ jaws dropped.
Sandra asked, almost whining, “What do you mean, Conner? When does this happen?”
“A lot. It happens at school sometimes, and Mrs. Dorsey gets mad at me.”
“Mrs. Dorsey gets mad at you? What do you mean? What happens?” Sandra blurted. She took hold of Conner’s arm as she spoke to him.
Hal’s placid expression masked his sudden concern over the unexpected implications in this exchange.
…The doctor looked back at Conner. “You’re doing just fine, son. You really are. This is very good.” Dr. O’Rourke smiled warmly. “Now, do you ever imagine that you smell something that’s not really there, that nobody else can smell?”
The parents locked eyes.
“Well, yeah.”
“Does it smell like something bad, like burning rubber, something like that?”
“Yeah! It does! It smells real bad!” Conner brightened, “That’s just what it smells like. I couldn’t really tell before, but that’s what it is. Like the things that burn sometimes at Daddy’s construction yard!”
“And then what happens, Conner?” Hal’s chest was surging. It was as though he was that hunter, now, and now he had his prey.
“I don’t know.” He rubbed his nose back and forth excitedly with the back of his hand and shrugged. “I don’t know.”
Hal looked at Sandra and Sam. “Have you ever witnessed one of these ding spells? Have you talked with his teacher about them?”
“I don’t even know what he’s talking about. I’ve never seen anything.” Sandra looked at her husband. “Have you, Sam?”