Sunday, December 10, 2006

やっぱり、多発性硬化症

'An oversize problem is an expanding bubble. As it grows, it presses everything else out. At it fills you, it leaves you empty.'

No, that's not right.

'An oversize problem clings to you like a wet sheet. Like a spiderweb. You brush at it and pluck at it, and it just tangles itself around you all the more.'

No. No no no.

An oversize problem starts at the tips of your little fingers, and spreads up your arms. It runs up your chest and neck, burning the side of your face. It travels down your thighs, lingers around your calves, and numbs your toes. It drops your chopsticks. It shakes like St. Vitus in the heat. It casually eats up money and time and thought.

In the end, an oversize problem is not that big. An oversize problem is just you.

"See this black hole, with the white edge? That stands out. It's older. We'll call that the first incident." Change films. "Now these smudges here and here, on your spine... those you know. They're what's causing your current numbness. So now we have two events, separated in time. This brings us back to my original diagnosis. Coupled with the bloodwork, I'm willing to go ahead and lay my cards on the table and say you have MS. Most likely primary or secondary progressive MS."

"When can we know for sure?" 'You know what your problem is, Katie? You have a low tolerance for ambiguity.' 'Why Jerome, what precisely do you mean by that?'

"There's no exact moment. Everyone's MS is different. Originally we had this other diagnosis of ADEM, and it responded well to the IV steroids. But after 2 months of continual symptoms, breaking through the oral steroids... Do we wait 6 months before we say MS and start your treatment? Have we already done you harm by not putting you on medication from the beginning? It's hard to know."

"What should I expect? With the way my face is going, am I going to have Bell's Palsy? Am I going to go blind? How quickly will this advance?" 'Katie, you ask too many questions. It ruins things. I actually really liked you. You overanalyzed it; you killed it.' 'I know. I'm sorry.'

"Again, it's hard to say. Everyone's MS progresses differently. But the medication will help."

"And if I decide not to take the medication... what will happen?" 'Sara, I really don't want to go through all that again.' 'Katie, you know, right -- you know that's stupid?' 'Yes, but still...'

"Can I point to someone, their body devastated by MS, and say 'Look, that's you in forty years if you don't take this treatment'? No. But can I say, 'It's a possibility, and because I care about you, we should try to do everything we can to prevent that possibility'? Yes. This will be easier once you admit to yourself that you have a condition."

"Right. Right. Let me think about it." 'You know, it could always be worse.' 'Yeah, the trees could come alive and start eating us.' 'Sorry?' 'Oh, just something my sister always says.'