Continuing In the Neurologist’s office—making the diagnosis—the
little boy admits to his spells under sophisticated questioning.
“Sandra.” Sam reached
for my hand. I snatched it away.
I pressed my lips
together and shook my head. “I don’t believe this!”
“Conner, when did
these dings start?” The doctor asked. His voice was gentle and even. I looked
at my lap and tried to organize my thoughts. Dr. O’Rourke continued, “Do you
remember when you had the first ding, your first one?”
“I—I don’t know.”
“Well, did they start
a month ago? A few months ago? Before Christmas? Did they start last year, when
you were still in second grade? Or, even before that? When do you think?” He
smiled at our son. “Take your time. You’re doing very well, Conner.”
“Last year…um…I
think, when I was in second grade. Yeah…ahh…second grade. I think...”
“And what do you mean
by what you call ‘dings,’ Conner?”
“They’re dings
because…uh, uh…I guess, because they feel like, uh…like little dings. You know…I
don’t know.”
The doctor nodded and
regarded him for several seconds. “What does a ding feel like?”
“Um…I get this funny
thing…I think it’s down here.” Conner looked down and touched his shirt right
over his bellybutton. “Then I get scared…but I don’t know why because there’s
nothing around to make me scared. You know. Then I smell that bad thing. And
then…I don’t know! I don’t know!” He sniffed and wiped his nose with his
sleeve.
Dr. O’Rourke directed
a quick gaze at us and then back at Conner. “How long do the dings last,
Conner?”
“I don’t know!” He
started to sob again. I flashed a weak smile at the doctor as I wiped my son’s cheeks
and put the tissue into his hand.
“Have you ever fallen
down when a ding happens? Do they ever happen when you’re standing up?”
He sniffed. “No…um…but,
yeah, sometimes I fall when I’m running or playing a game.”
Dr. O’Rourke smiled
at him. “Do you think you fall because you’re having a ding?”
“No.” He snorted and
wiped his nose with the tissue. “I’m just playing and…uh…I trip on something or
somebody tackles me. But, sometimes I drop things…you know…when I have a…um…a ding.”
“Oh, Conner. Why
didn’t you ever tell me you were having these things?” I tried to smother the
panicked tone in my voice as I brushed a lock of hair out of his eyes. “Honey,
have you had these dings at home? Have I ever been with you when they happen?”
I turned back to the neurologist, “I can’t recall seeing anything like what he’s describing, Doctor.”
“I don’t know when
they happen, Mommy.” He sniffed again and rubbed his nose with his sleeve. “I
don’t.”
The office was quiet
now except for his sobs. It shimmered with the vibrations of our fear and
pain—a pain that pierced and gripped me completely—an agony that I would carry
and remember for the rest of my life. Whatever happened to my son would
change—no, it had already irrevocably changed—our lives. Just weeks ago we were
having the happiest of days: Sam came home from Iraq; we pulled into our
driveway with him; neighbors welcomed him home; he put on his old clothes; the
gifts he gave us; that wonderful first dinner with candles…
“Has Conner had any
problems with bed-wetting?” Dr. O’Rourke asked me.
“Hm? Oh,
ah…bed-wetting?” I looked at Conner. This was not the time to shelter him—not
here in this office. “There’ve been a few times, and he’s had a few accidents
in his pants during the day. On laundry days—a few times I’ve found yellow
stains on his underpants. They smelled like he had wet them.”
Conner moaned,
“Mo-om!” and looked up at me, his eyes pleading.
I placed my palm on
the top of his head. “Honey, I’m so sorry. I don’t mean to embarrass you, but
this is important. The doctor has to know.”
“Conner, do you lose
your urine—your pee—during these spells?” The doctor asked softly.
“We-ell...” Conner
looked at me.
I nodded. “You can
answer the doctor, Conner.”
He said, “Um…yeah.”
“Do you know that
you’re going in your pants and you can’t stop it? Or is it that all of a sudden
you’re wet and you didn’t know that you were going?”
“I-I d-don’t know
that I-I’ve done it until I-I’ve d-done it,” Conner stammered through his sobs.
“Have you ever pooped
in your pants?” Dr. O’Rourke’s voice was so low that I could barely make out
what he said.
Conner gulped down a
sob.
The neurologist cast
a quick glance from Conner to us. “Has he had any bowel movements in his
pants?”
“No, thank God.” I
shook my head.
“Has Conner ever
bitten his tongue or lip when he’s sleeping? Have you ever found blood on his
pillow, Mrs. Golden?”
“Only on the night of
his seizure, Doctor. I’ve never seen blood any other time.”
“So, it seems that he
hasn’t had any other convulsions in his sleep that you and Mr. Golden had not
witnessed.”
I shook my head and
looked at Sam.
Dr. O’Rourke smiled
at his patient and asked, “Conner, have you ever noticed any weakness in your
arms or legs when you have a ding? It can be before the ding or after it, or at
any other time.”
“No.” Conner
shuddered.
“Good. What about
tingling feelings? Have you ever had any tingling—you know, like the
pins-and-needles you get if you hit your funny bone in your elbow—anyplace in
your body when you have a ding?”
“Uh…no. I don’t think
so.”
I wanted to know more,
as I listened to their exchange. Yet, I feared more bad news.
“Conner, have you had
any headaches or double-vision? You know, like seeing two things instead of one
thing. And, do you ever have any trouble seeing out of one eye? Or numbness,
like funny feelings that stay there on your face?”
“My face itches,
sometimes.” Conner scratched his cheek.
“Well, yes. That’s
normal. What about any funny or tingly feelings on your face when you get your
dings?”
“No.”
“What about swallowing
or hearing problems? Do you ever hear strange noises or voices when there’s no
one talking and no one else around during your dings?”
“No.” Conner shook
his head.
“Which hand do you
write with, Conner?”
“Um, my right hand.”
The boy held up his left hand, looked at it and quickly replaced it with his
right. He turned toward me and gave me a tentative smile. He asked abashedly,
“Is this my right hand, Mom?”
“That’s good,” Dr.
O’Rourke said with a wide grin. He looked at me. “He is right-handed, correct?”
“Yes. He seems to
write and draw with his right hand, Doctor.”
I looked at Sam. So,
he finally spoke up.
“Since he writes with
his right hand, the middle section of the left side of Conner’s brain is where
his language center resides. In other words, it’s his dominant side. That
suggests that there’s no serious structural problem in that part of Conner’s
brain, especially since he had a normal CT scan. You see, the left side of the
brain is dominant for most people. If you or your son reported that he had
speaking or comprehension problems—that is, difficulties understanding
speech—it could be a clue that his seizures came from that left-sided language
area. However, he will need an MRI—a Magnetic Resonance Imaging scan, with—”
“What’s that? No! Will
there be needles?” Conner leapt to his feet. Sam and I immediately reached up
and touched his shoulders.
“Sit down, son.” Sam
tilted his head in the direction of the boy’s seat.
Conner dropped hard
onto his chair. He elevated his shoulders, opened his mouth and squinted at the
neurologist. His voice quivered, “Will there be needles? Will there?”
“The MRI scan is just
like the CT scan you had at the hospital. But, this time you’ll be in a
tunnel.” The neurologist moved his gaze from Conner to Sam and then to me.
“Conner wasn’t awake
when he had the CT scan, Doctor O’Rourke. He was still asleep after the
seizure.”
“Oh. Okay. I see.” He
nodded and turned back to his patient. “Well, Conner, there shouldn’t be any
needles, but I can’t promise. That will be up to the radiologist. That’s the
doctor who does the MRI. The radiologist will be evaluating the images as the
scan is being done. If the doctor believes that more information is required,
then an intravenous line may be started to inject a special dye, but—”
Conner pouted and
crossed his arms over his chest. His swollen, red eyes welled up again.
“No. Wait, Conner!
That won’t be done unless it’s absolutely necessary.” Dr. O’Rourke reached
across the desk and touched our child’s hand. “The MRI shows the brain structures
a little differently from the CT scan. It can give us additional, more detailed
information. We—the doctors—need to be certain to rule out any problems.
“Look, Conner. We are
going to become a team. From now on, we are going to be working—like playing—together,
for a long time. I am going to be your coach. You are the star player. I will
give you your rules and your plays. Your mom and dad will be like our team
trainers. I’ll tell you what the team will do.”
I liked that
metaphor. It should capture Conner’s cooperation. Brilliant. I smiled at my son
and touched his back.
Dr. O’Rourke watched us momentarily, then continued, “I know this can all be confusing, but usually we don’t find any cause of epilepsy.”
Lance Fogan, M.D. is Clinical Professor of Neurology at the David Geffen School of Medicine at UCLA. His hard-hitting emotional family medical drama, “DINGS, is told from a mother’s point of view. “DINGS” is his first novel. Aside from acclamation on internet bookstore sites, U.S. Report of Books, and the Hollywood Book Review, DINGS has been advertised in a recent Publishers Weekly, New York Times Book Review and the Los Angeles Times Calendar section. DINGS teaches epilepsy and is now available in eBook, audiobook, and soft and hard cover editions.
