Frank Turco sits hunched forward. He is worried. But he is also powerless. Turco is in the waiting room on the fourth floor of the Barrow Neurological Institute of St. Joseph's Hospital and Medical Center. Down the hall, behind rows of swinging doors, surgeons are operating on the brain of his wife Nancy, 42. They are burrowing a tunnel into the deep recesses of her mind. Hovering around her is a team of neurosurgeons, anesthesiologists and nurses, headed by Robert Spetzler. Dr. Spetzler's operation will actually take place inside Nancy's brain. It is a risky leap into the hazardous frontier of neurosurgery. He is attempting to prevent lethal intercranial bleeding caused by a malformation of the artery located on the left side of Nancy's brain. To accomplish this delicate, dangerous feat, the team has reserved the operating room for ten hours. "Nancy has been very scared," Turco says. "She knows there's a possibility that . . . " He speaks in the flat tones of a man whose stomach is held in a vise. "But she's strong. She decided it must be done. Nancy said that if she didn't have this operation, she might not wake up some morning." Before making the decision, the Turcos consulted many doctors. Nancy herself is a registered nurse who works at Phoenix Memorial Hospital for the Phoenix Health Plan. Turco is a highly skilled Arizona Republic reporter, currently specializing in business. He and Nancy have a five-year-old daughter and sixteen-year-old twin boys from their present marriage. Nancy understood her odds going in. Some doctors said her chances of coming out of the surgery the way she went in were fifty-fifty. Most said they couldn't do the job. But Dr. Spetzler, a leader in the field who is head of neurosurgery at Barrow, was the only one who assured her that her chances were much higher than that. They wheeled Nancy into surgery at 9:30 a.m. Now it's already noon. Eight years ago, Nancy had suffered an episode of intercranial bleeding. For a time, her eyesight and memory were affected. At that time, doctors told her she didn't have to worry. They said the internal bleeding had sealed itself off. At any rate, there was nothing doctors could do. They didn't have the knowledge or the equipment to get inside her brain and back out again without killing her. Frank and Nancy hoped that it would all go away. "We thought it was over," Turco says. "Then, in February, Nancy had this brain scan on a magnetic resonance imaging machine. They call it an MRI. They're so much more advanced now. The scan showed that the bleeding could start again at any time. "`What would happen?' we asked the doctors. "They all had the same answer. It could cause coma, blindness, speech loss, even death." In the world of surgery, there's a way to measure whether to operate. You weigh what happens if you do it against what happens if you don't. If you can't help, don't do any harm. Let nature take its course. But Nancy had no choice. She had to take a chance or face the inevitable. She and Frank were told of a doctor at the University of Virginia who had invented a special gamma knife that could reach safely to the affected area of her brain. "Nancy called down there and actually reached the doctor by phone," Turco said. "He told her he'd used it fifteen times for that type of procedure and it had never worked. `Warn your doctor about that,' he said." "Finally we were told about Doctor Spetzler, who was right here in Phoenix. He is the doctor who is going to work on the Siamese twins. They told us he was extremely conservative about operating. So we went to see him. "Doctor Spetzler told us he thought he could do it. We decided to go ahead. We had no choice." An hour later, Turco sits at a table in the hospital cafeteria. He chews slowly upon food he can't taste. A friend comes down from the waiting room on the fourth floor. "I heard the doctor came to the waiting room after you went to lunch," the friend says. "I'm not sure. I think they may be finished with the operation already." It was just two o'clock. It was much too soon for the operation to be over. Unless . . . What could this mean? Turco turns suddenly quiet. His eyes show the strain. He heads quickly for the elevator that will take him up to the fourth-floor waiting room. The message was a misunderstanding. The operation isn't over. It's still going on. Dr. Spetzler had merely sent out word that everything was going according to plan. More time goes by. At 4:30, the word comes out. The operation is over. Nancy is on her way to intensive care. But no one will know for a while how Nancy is doing. "We'll have to wait until she comes out of the anesthesia," they say. At 6:30 p.m., word comes that Nancy has regained consciousness.

Frank is led down the hall to the intensive-care unit. His legs feel numb. He is weak with anticipation and fear. Nancy opens her eyes. She looks up and see Frank standing there. "Hi, honey," Frank says. She tries to smile. He fights back the tears. Nancy has come through it all just fine. He speaks in the flat tones of a man whose stomach is held in a vise. To accomplish this delicate, dangerous feat, the team has reserved the operating room for ten hours.


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Tom Fitzpatrick

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