As my racing schedule accelerated in a fairly dramatic fashion, with several races scattered over the summer and other planned events such as testing (the racers’ word for practicing), my work schedule became exceptionally pressured. With my now-mature surgical practice, the demand for both busy office hours and surgeries was fairly significant—and thankfully so. However, between work and racing, there was little time for simple relaxation, with the exception of formally planned events such as the trip to Disney World—and even that was tied into a race event. The upshot of all of this was that the majority of my available free time was in fact spoken for long in advance, and I rarely had the luxury of off days. This concept bled over into my birthday, which fell in the middle of the summer, but nonetheless required me to have a normal working surgical schedule on that day. However, the unusual events of this particular summer day would result in a longstanding policy to never again perform surgery on my birthday.
Bernie Mathers became my patient in a consultation after his family practice physician referred him to me for evaluation. Bernie was a seventy-something-year-old who had been suffering from progressively worsening clumsiness of his hands, pain in his neck, and numbness in his arms. Over the past six months his gait had deteriorated to the point where he was no longer able to ambulate even short distances; in fact when he came to me he was essentially wheelchair-bound.
A rather obese aging gentleman, Bernie was absolutely pleasant from the moment we met. He was accompanied by his wife, Helen, and it was clear that they were one of those rare longstanding couples-for-life. In fact, the briefest of interactions with Bernie and Helen led one to believe that they were both gentle God-fearing folk who were destined to be together ‘til death do they part. Of course, at our first meeting I had no inkling that I would play any role in the fulfillment of that last concept.
Once I had examined Bernie and reviewed his imaging studies, I pointed out the findings of great concern. As he and Helen sat in my office examining room, I stood in front of a light box, where his MRI studies were hung.
“If you look up at this picture, right where I have the red marks, you’ll be able to see just what I’m talking about.” I used a wax pencil, circling areas of concern on Bernie’s neck images, especially the parts where the bone and discs in his neck were squeezing and damaging his spinal cord. “Right here is what the normal area looks like, where there is plenty of room for the spinal cord. But if you look down here,”…I pointed the tip of the red pencil a little lower… “There is a significant amount of bone and disc material that is pressing right up against your spinal cord and basically crushing it.” Both Bernie and Helen paid very close attention as I continued my little teaching session.
“If you look at the spinal cord itself,”—that’s this gray stripe down the middle—you’ll see that there is a white area inside it. That’s the kind of thing we see when the spinal cord is already showing significant damage.” Bernie and Helen nodded in unison, as I suspected they had done for the last sixty years or so. “If this problem is left untreated, it will continue to further damage your spinal cord, and things can only get worse. You already lost most of the ability to walk because of this; eventually you’ll lose the use of your hands and arms altogether.”