Planting The “Seeds” To A Cure

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To me, hospitals have become synonymous with illness.  For some visitors, hospitals bring out hope, faith and inspiration.  In the past six years, I have not encountered many of these occasions.  Today however, it was a whole different feeling.   Along with my family members who helped to organize and put together a successful give back concert,  we returned with a check in hand.

It’s nerve-wracking seeing my surgeon, no matter when I see him.  But today, he and his staff were all smiles.  Rather than my family and I thanking them for giving me the chance to live and continue my journey, they thanked us.  What stood out to me was hearing him say that at the time he treated me in 2008, he saw my family’s commitment to me and the desire for me to get better, but that what he’s learned over the years is my family’s commitment to this cause.

I’ve said it all along – my battle and struggles fighting my brain tumor have shaped me.  The person that I am today is due in great part because of what I went through and how I almost lost it all.  But finding preventative treatments and the cure for brain tumors is my new passion.  And knowing how my neurosurgeon plans to use this money now and going forward brings a smile to my face.

Today, we donated $10,100 to The Cusano Family Fund, a newly established fund which my surgeon intends to use going forward.  Specifically, the money that we donated will be used to allow my neurosurgeon and the doctors  to use the money as seed funding.  “Seed funding” you ask?  As the best that I can describe it, seed funding helps propel projects to important milestones that will bring the research to levels that allow scientists at the Yale Brain Tumor Center to take their work to clinical trials.  In particular, Yale will be using this money to help develop nanotechnology that will deliver chemotherapy and other medicine to typically unreachable spots in the brain.  It is very special to know that money in my family’s name can have such a major impact!

But what is even better – the fact that the doctors at Yale are excited about the prospect of making this event even bigger and better in the years to come.  We already have a tentative date for 2015 and have expectations to make this concert a yearly event.  Hopefully, I’ll see all of you readers there.

And next year, hopefully we’ll present an even bigger check…DSC02447

It’s A Beautiful Day

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Fall is my absolute favorite season.  Humidity gives way to crisp air, trees transform to an array of stunning colors and then there’s the food… enough said.  Aside from all that, fall serves as a subtle, beautiful reminder of the transient nature of life – all that lives eventually dies.

Lately, Chris and I have heard many stories of people suffering from brain tumors that haven’t fared as well as him.  Hearing these heartbreaking stories leads to such a heavy feeling of survivor’s guilt.  Why did Chris survive and other worthy, amazing people have not?  Was it divine intervention or just pure luck?  I’m not sure what I believe, but I often wonder if we are living our lives as we should considering the enormous gift we’ve been given.  Perhaps we should be experiencing every ounce of life we can – going on African safaris, skydiving, volunteering as much time as we can to those less fortunate.  Can the way we live our everyday, middle class America, 9 to 5 life ever be enough to say thank you for the gift of life?

The fact of the matter is I’ll never know why Chris survived and the alternative will likely forever haunt me.

In terms of survivor’s guilt though, I think I do have an answer.  While driving to work this morning, I opened the sunroof and commented to myself on how it was my favorite type of autumn day …and then it hit me.  We don’t need to win a Nobel Peace Prize or travel to some far away land to really live.  To do justice to those who haven’t survived, we just need to live it well – no matter what we’re doing.  So do me a favor today.  Take all of your everyday experiences and try to make it worth something.  Smile more.  Laugh until your belly hurts.  Really taste that morning coffee.  Do something nice for someone just because.   Life doesn’t have to be “big” to be wonderful and fulfilling.

Take joy in all the simple things for those who can’t.

Submitted by Ashley Cusano

Maneater [Reprise]

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“We rarely get to prepare ourselves in meadows or on graveled walks; we do it on short notice in places without windows, hospital corridors, rooms like this lounge with its cracked plastic sofa and Cinzano ashtrays, where the cafe curtains cover blank concrete. In rooms like this, with so little time, we prepare our gestures, get them by heart so we can do them when we’re frightened in the face of Doom.”  Silence of the Lambs.

It was time, once again.  I was wheeled from my pre-op room around the hospital hallways down to the gamma knife room.  What I remember most about the gamma knife room was that it was very cold and bright.  It was a large room but without many objects.  In fact, there wasn’t much at all – just the machine where treatment occurs.  The nurse and oncologist had me lay down on the cold metal slab.  While this was nothing new, the disturbing part was when they screwed my head down to the table so that it could not and would not move during the treatment.  Much to my chagrin, the bolting down occurred and not before long,  my head was affixed to the table –  as in it was bolted to the table.  Crazy thoughts like “what if I sneeze during the procedure?” ran through my mind.

Once I was guided into the machine, I closed my eyes and let the games begin.  Yes, the games.  I envisioned the procedure something similar to a game of Star Wars.  I could not see what was happening behind my head, but I knew beams of radiation were streaming into the tumor and simultaneously destroying its growth.  In actuality, this machine administers radiation in a hemispherical array and hones in on the specific target.  Hence, the mapping that I discussed in part one of this post.  The rest of the brain tissue is left untouched.  The entire procedure lasted about one hour but felt like eternity.

I was guided out of the machine and aided to sit up where the mask was removed from my face.  The oncologist grabbed his trusty drill and began to remove the screws that held the frame in place.  Forget the fact that I could not feel the pins coming out of my skull or feeling the blood that dripped out, the sounds of the drill so close to my ears still haunts me to this day.  The pin sites were all cleaned and my head was wrapped in gauze.  photo(9)Alas, the procedure was over and I was wheeled back to where my family was waiting during the treatment. I could not be happier to be going home – but who am I kidding, I’m pretty sure that anyone who is released from a hospital stay, no matter how long or how short, is happy to be told they’re going home.

It didn’t matter to me that I felt nauseous, hot and then cold,  extremely groggy and tired from the procedure.  After all, this was all “to be expected.”  I do my best recovering at home.  admin-ajax.phpComfy chairs, good food and the best nurses.  Not sure if they would agree though…

Up to today, I have felt great and have no reason to believe that there is any further growth.  Yet, I cannot be certain and will always have my doubts.  I prepare for the worst because then, any sort of good news makes me feel like I’m on top of the world.  Yea, I deserve that.  Hopefully good news comes my way next month when I go back for my MRI.

Maneater

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At the time that I began writing this blog, I had just experienced my latest obstacle in my life as a brain tumor survivor:  Gamma knife surgery.

As a reminder, at my MRI last October, it was discovered that there was a small regrowth of the tumor.  But so quickly?  Yes, this was the unfortunate truth.  I knew what I needed to do: I remained resilient despite the news; I had to continue battling and fighting on.

I was presented with three options –

(1) we could take the “wait and see” approach and re-scan in three months to ensure that there was no further growth;

(2) daily radiation for six weeks to destroy the growth of the tumor cells and radiation to the rest of the brain if other cells were discovered; or

(3)I could undergo gamma knife surgery.

I tried to rationalize and understand the benefit to each.  Each option had its pros and cons in my mind but I just could not reason with myself why I should wait and allow the monster in my head to continue to grow and possibly affect my life as it had five years ago, nor could I envision myself going in for treatment every day for six weeks if it was possible to have it done in one day.   I had already made my mind up, but wanted to hear the thoughts of my medical team.

Each of the options were presented, again all having pros and cons and different possible outcomes that could affect my livelihood, but  at the close of my consultation with the radio-oncologist, he indicated that gamma knife surgery would likely be the most effective course of treatment.  Relieved to hear this, I expressed that this was my preference.  Yet, before a treatment plan could be established, a consultation with the “brain tumor board” was necessary.

A few days later, I got the phone call that gamma knife surgery was the chosen course of treatment and I would be on the schedule before the end of the year.  Time to get my game face on yet again and prepared for battle.

I knew very little about gamma knife surgery; let alone what it even meant.  However, I soon read up on the procedure and educated myself on it.  I’ll do my best to describe the pre-procedure steps below and then in my next post, I’ll tell you about the treatment itself.

Upon arriving for my treatment, I was brought in to put on my bracelet and hospital gown. This entire routine has become all too normal for me. The nurses gave me a finger prick, followed by putting in an IV port to administer medication and contrast for the MRI.  However, this is where this procedure differs from being given anesthesia and waking up hours later.  On gamma knife day, the neurosurgeon and nurses applied a local anesthetic on my forehead where the head frame was to be placed.  Using a drill.

The head frame was made of a heavy metal and was extremely tight-fitting to my face.   When I was looking at it sitting on the table, I didn’t connect the dots that this slab of metal would soon be placed onto my face and head.  I was unable to appreciate and fully comprehend that that was the frame to be put onto my face.  While the nurse held it in place, my neurosurgeon got his drill and proceeded to drill pins into my forehead and skull to hold it in place.  Not even the localized anesthesia was not enough to prevent the pain.  But alas, the frame had been affixed to my head.  I don’t know what a vice feels like, but this sure as hell felt like what I would imagine.

Next step: picture a colander.  Something very similar looking to that was then placed on my head.  I wish I could have seen what was taking place at the time because it sounded like a great game of battleship was taking place…”B52”…”E13.”   Joking aside, the letters and numbers were the doctors’ method of mapping where to administer the radiation.

Upon completion of the mapping, it was time for the MRI.  I was wheeled around the hospital in a wheelchair with this metal vise on my face – if I could have known what the visitors to the hospital who had seen me were thinking.  I have been in for numerous MRI’s, but never one with a metal frame on my face.  The radiologist had to add another piece to the frame and this made my head feel that much heavier.  Luckily, this MRI was only 35 minutes, compared to the usual 50, but the frame and contrast combined to make it one of the most unpleasant MRI’s I’ve had to date.

With all of the “pre-procedure” work over, it was time for lunch… with the frame still on my face.  I thought to myself “how the hell am I supposed to eat lunch with this thing on?”  I wasn’t given a choice – either I was going to eat my lunch or fast some more until dinner.  So in came my gourmet lunch and drink (luckily, they gave me a straw).   I heard an occasional snicker from Ashley and my parents as I wrestled with the food to get it around the frame and into my mouth but I managed to eat and drink without spilling on myself.  This is a perfect example of a simple task too often taken for granted.

All the while, and what nobody knew at that moment was the angst and restlessness that I was experiencing.  Outside, I was smiling and content.  On the inside, it was a completely different story.  My mind was racing and I began thinking of the worst possible outcome.  But then, like I had done on previous occasions, I took a deep breath, composed myself and prepared to walk down the hall toward the gamma knife room.  A red-haired nurse greeted me.  I wondered if her name was Clarice…

If I Had A $1,000,000

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Let me just get this out there – having a brain tumor is life-changing. No, I don’t mean in terms of how I look at life now.  Rather, I am talking about the unintended consequences that we don’t think about when we are faced with this type of situation unless we are in it.

From what I’ve been told, recovery after brain surgery can vary from: having a quick and seamless recovery, to being in the fight of your life like I faced or you may never recover and remain in a diminished capacity.  And if that’s not enough to think about, the cost and toll of living as a brain tumor survivor can wear you down pretty easily.  Let’s talk about cost…

As kids, we are told that if we do well in school and pursue our dreams, we’ll make lots of money and live a happy life.  But what our teachers did not tell us as innocent students in elementary school is that sometimes, life throws us twists that come out of left field and blind side us – and leave us scrambling for solutions on how to solve them.  Growing up, I at least assumed that nothing could stop me if I did well in school and graduated college, let alone graduating law school.  After all, we work to make money to pay for all of life’s wants and needs.  Until you are admitted to the hospital, that is, and your money can no longer be spent on your wants.

When I returned home from a wonderful vacation in Nantucket two weeks ago, my wallet was thin.  Yet, it was well spent.  However, within the first few hours that I was home, the mailman delivered another bill for my MRI this past March that I currently pay on a payment plan and CVS called because my Keppra is ready to be picked up.  This leads me to my rant – the absurd costs of health care and health insurance.

For an MRI, my insurance company bills the hospital $4,900.  Yes, you read that correctly – approximately $5,000. I for one am extremely grateful that MRI machines exist.  But for the forty-five minutes, sometimes an hour, that I am in there, I find it hard to believe that that machine actually requires $4,900 to run, notwithstanding the plethora of MRI machines on site.  And I understand that the machine produces images but they are all viewable on a computer.

The next item on the bill: the cost billed by the technicians to read that MRI – $450.00.

Then there’s an associated cost for my doctor’s visit.  A measly $245.00.  For me, and I’d imagine others in my position, the doctor’s visit is the most important part of the entire process.  I get to hear progress from my own doctor’s mouth and view the images so that I can see the news for myself.

As for surgery, well I hope you’re sitting down because I don’t want to be the cause of any unintended fainting spells.  You’ll recall that I had gamma knife surgery last December.  The total amount billed from that one-day procedure alone was $92,000.  That’s for one day.  For my extended stay in July 2008 when I had the tumor removed and the surgery for the subdural hematoma, the hospital billed the insurance company $297,000.00.

Okay, so once the tumor was removed and my head was mended back together, I needed to rehab and did so at Gaylord Hospital.  For each day that I was there, our insurance was billed $2,600.00.  This was for my therapists, pens and paper, flash cards, alphabet charts, balancing beams and workout equipment.

The scary bottom line is this: If I didn’t have health insurance at the time, I would not be here because the procedure would not have been performed.  I am grateful for health insurance, however it continues to remain a problem for so many Americans today.

Fortunately, I am offered health insurance through my employer but for someone like me, even the insurance plan is costly.  For my co-pay to kick in this past year, I had to put up the first $4,000 of medical expenses.   When I called to make my payment on my account last week, I was informed that my “other” balance was going to be sent to collections soon if I did not pay the entire sum or apply to pay the balance on a payment plan.  After all said and done, this “other” balance was my procedure in 2012.  At the time my procedure was performed, I had not yet hit my deductible, so my portion of coverage was in excess of $2,000.  Add that to my 2013 balance and my total responsibility is $2,530.67.  Well, I guess my payment plan was just extended.

Some people go to work to provide for a family, pay their mortgage and have nice things.  What you cannot plan for is your health – you can only hope that you stay healthy each year.  If you don’t, not only will your personal world spin around, but your financial health will too.  Who is not going to try their best to afford to pay for their life?  And while I know hospitals are running businesses too, quite frankly, the extent of the costs seem somewhat criminal.

Playing for the Cure, Brainstormin’ – A Success!

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I am pleased to announce that, last night at Playing for the Cure, Brainstormin’, we surpassed $10,000 in proceeds to be donated to the Yale Brain Tumor Center for research and treatments for brain tumors and brain cancer!! Thank you to everyone who came out last night and to everyone who gave donations, and to our corporate sponsors. Thank you Broca’s Area Daphne Lee Martin for providing a night filled with great music. However, the highlight of the night came from my surgeon, Dr. Piepmeier. Humbled and honored, and looking forward to our new partnership with Yale-New Haven Hospital:

 

 

Playing for the Cure: Brainstormin’

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Playing for the Cure_Brainstormin'-2There’s one week to go until Playing for the Cure: Brainstormin’, a benefit concert for The Yale Brain Tumor Center next Friday, August 15th at The Ballroom at the Outer Space in Hamden, Connecticut.  All proceeds raised will be donated to the Nora Brignolo Fund, c/o Dr. Joseph Piepmeier at the Yale Brain Tumor Center to raise awareness and research for the cure to brain tumors and brain cancer.

The concert is featuring the talents of Broca’s Area and Daphne Lee Martin.  Seeing that I never blogged about it until now, I’ve included a link to one of the articles here.

My family and I completely overwhelmed by the show of support and generosity from the community already.  A huge thank you to media outlets such as the Hartford Courant, CTNOW, The New Haven Register, The North Haven Courier and The North Haven Post; our corporate sponsors The Hartford Courant, Stop and Shop, Edge Technologies, Doug Anderson, ShelfSpace Marketing, LLC, Carla’s Pasta and Severance Foods; and to all who have donated the awesome prizes for our raffle.  Your generosity and support of our effort is extremely appreciated.

For me, the work and time that are expended on putting an event like this together are a no-brainer (no pun intended) and I know my family would agree.  It is simple acts such as receiving a handwritten letter along with a check in the mail from a fellow brain tumor survivor, to receiving an email from a brain cancer warrior right here in Connecticut who had been looking so forward to our event letting me know that due to her medications and rigors of treatment that are currently wearing her down, it’s likely that she’ll be unable to attend but is sending a check regardless that make me realize my purpose in life and give me a sense of pride.

Please help me in this final week  to spread the word and help me in saying “thank you” to the doctors and caregivers who saved my life.  I look forward to seeing you all at The Ballroom at The Outer Space next Friday night!

Changes In Latitudes

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At the time that my shunt was inserted, the doctors cautioned me that I should prepare myself for the day that it would need to be replaced.  Little did I know that that day would come just four years later.  While nothing in life is certain, nor should anything be taken for granted, the actual expectation was that the shunt would only need to be replaced every 10 years or so.

I’ll admit, I do not profess to understand all of the complexities and technicalities of the brain, though I wish I did.  Ever since my diagnosis, I have become fascinated with the brain, how it works and controls every part of the body.  I soak in everything I can possibly learn about it.  My doctors informed me of the signs and warnings that I should be on the lookout for that would signal a need to replace my shunt: redness or swelling along the path of the shunt, headaches, confusion, memory problems or any other symptom I experienced prior to having the shunt inserted would indicate there could be an infection or malfunction.

Knowing everything I had learned about my shunt made the results from my six-month follow up MRI in September of 2012 surprising.  I was feeling great and functioning normally – none of the signs my doctors warned me about were ever present.  Low and behold though, diagnostic imaging showed a buildup of cerebro-spinal fluid in the ventricles and a malfunction with the shunt.  But why wasn’t I manifesting the symptoms I had previously, such as trouble with my speech, confusion and aphasia?  Had I been so entangled with the bar exam that I lost sight of how I was feeling and lost my ability to assess myself?  Despite my optimism that all was well, my surgeon decided that it was already time for a shunt revision.

Emotionally, this was a major blow to my recovery process.  I had come such a long way in the span of 4 years and now I had to face the prospect of starting all over.  I feared that the shunt might not be as effective as the first one or that complications which I did not experience the first time around might arise.  I had finally found my groove and was comfortable with my new robotic mind – and now this.  Why couldn’t something, just anything, go right for me for a change?  But hey, nothing good comes out of complaining.  Glad I can find a sense of humor in these things now530e9c97ed7a3e96831b5a77bd3ca664.

On October 1, 2012, I headed back to Yale.  As I was wheeled into the OR and instructed to lie down on the cold metal slab for the surgery, I was again faced with the question of “what if?”  But in my head, I knew everything would be okay and I’d be as good as new in no time.  Before Ashley and my parents had the chance to enjoy the spread of food that the hospital serves them while I’m having my head drilled open, the surgery was done and I was back in my room sleeping off the anesthesia.  Sorry to them all that they were unable to finish their chocolate chip muffins…

This hospital stay was different from my previous stay, however.  Rather than being a complete invalid, I was conscious and alert of my surroundings and life around me.  Then again though, how could I not be?  I was woken up every hour by the nurse and resident neurosurgeon to take my temperature, make sure that I was sleeping, asking me questions such as “do you know what day it is” or “can you tell me where you are?”  My favorite one of that night though was “Chris, have you been walking around?”  I thought to myself, “seriously, at 4:30 in the morning?”  My response: “no doctor, I’m just trying to sleep.”  I had returned to my quick and sarcastic self in no time.

I wrote a text message to my parents at 4:30 that morning to share with them the latest updates.  I felt like my life had become a daytime soap opera.  img_ynhh_tab1Rather than General Hospital, I’d call it “Yale-New Haven – Against All Odds”.

How did my life come to this, I wondered.  But it did and I have learned to accept it because after all, life is full of adversity and I had learned to readjust the sails to go with the direction of the wind.

I Get Knocked Down, But I Get Up Again

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April 11, 2012 – it was my mom’s birthday!  But that date also holds another meaning for me.

I just finished eating dinner and was in the kitchen, when suddenly, out of nowhere, visual auras commenced.  I last experienced these in 2009 when I had my first seizure.  Here we go again.  Bring on the flashing lights and spinning room.  I panicked – I looked for someone, anyone, to catch my fall.  Within a matter of seconds, I was down on the floor – unconscious on the cold tile.  When I came to, I got myself over to the couch, put my head in my hands and said to myself “no, not again”.  I got on the phone with the closest people at the time – my parents, and they urged me to call Yale immediately.  The sound of concern in their voice resonates with me to this day.

Frightened and still disoriented, I called the hospital and left a message.   Within a matter of minutes, I heard my surgeon’s calming voice: “Chris – talk to me.  What happened?  How are you feeling? Is anyone there with you?  Did you take your medicine today?”  My responses were soft and slow, but at least I was able to answer.  At his direction, I took an additional Dilantin pill and assured him that I would be in contact as soon as someone arrived.

My brother, who fortunately lived nearby at the time, called and said he was on his way over to stay with me until my parents arrived.  While I pride myself on being an independent person, I have to admit that I was relieved to hear him say that he was minutes away.  As I was walking away from the door after unlocking it, out of nowhere once again, the auras returned, I twitched, spun around and was down.

I was woken up to the voices of my parents and brother, all of them nervously hovering over me.  My parents pressed me for answers to the questions, but knew that I was incapable of answering.  We all sat together for a few minutes on the couch and no one really said much.  I think we were all in shock and scared – or at least that is how I felt.  When the small talk reconvened, I told them that I talked with my surgeon and took another pill at his direction.  Rightfully so, they were concerned about the second seizure at the moment.  The three of us sat on the couch for a few more minutes, nobody saying anything and fearing the worst.  We rushed down to the emergency room at Yale-New Haven Hospital where more blood tests and an MRI were ordered and I was pumped up with medicines.  I was finally released around 3:00 in the morning.

Home to sleep for a few hours then back to Yale we went for an appointment with my surgeon.  Because I was alone for both seizures, there were not many answers to the questions as to why this happened twice in succession.   The results of my MRI were clear – there was nothing present on the scans that was cause for concern.  However, the results of blood levels provided further insight.

After my first seizure in 2009, I was prescribed Phenytoin (or more commonly known as Dilantin) and instructed to take 300/mg twice per day.  Phenytoin is used to control and prevent seizures and works by decreasing abnormal electrical activity in the brain.  The one caveat – the drug is dependent upon your body’s ability to absorb the drug in the bloodstream.

Thanks to breakthroughs in science, blood tests are used to determine whether the drug concentrations are in the therapeutic range.  For a patient my age and weight, the magical range is between 10-20mg.  When I arrived at the ER, my phenytoin level was down to six.  Yikes!  I was given a loading dose – 10 to 15mg by slow IV drip, at a rate not to exceed 50mg per minute.  After the IV had completed and the drug was in my system for some time, the blood test was re-administered.  Shockingly, the level had only gone up to an eight.

My surgeon referred me to a neurologist – someone who specializes in and is better equipped to handle seizure disorders.  During my visit with the neurologist, he explained that Dilantin’s requirement to stay concentrated in the bloodstream does not work for some people for reasons unknown.  Fortunately, there are other medications that can be taken that do not depend on blood concentration.  I take this moment to introduce levetiracetam, also known as Keppra.

I am prescribed to take the maximum daily dosage of 1,500/mg twice per day.  With Keppra, the drug instead works by communicating with nerve signals in the brain.  I just picked up my prescription at CVS and have the paperwork here which reads: “Leveiteracetam has been shown to decrease the number of seizures in adults and children.  It is not known how it works to prevent seizures.”  Awesome right?  But for whatever its worth, and knock on wood, I have been seizure free now since April 11, 2012.  I’m not sure if that was my mom’s birthday wish that year, but I like to think so.

Life continues to throw curveballs at me.  Though I never hit one of them as a kid, probably because I never had good eyesight (I like to think that it was due to the tumor growing, but that’s highly unlikely), I knock everyone out of the park now.  Watch out Ty Cobb, I’m coming for you.

I Fought The Law But The Law Won

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So today is July 2, 2014.  “Why is that significant?”, you ask?  Well, today marks six years since my first craniotomy to remove the tumor.  Not a day goes by where I don’t think about that day, or the endless possibilities that leave me asking “what if?”  The night before that operation, I prayed that that night would not be my final night on this earth.  But here I am – tougher than ever.  At first, the one-year, two-year marks were somber reminders of what I had gone through – the travesty and fright that my family and I were faced with.  But now, they are cause for a celebration, or a “Brainaversary” as I like to call it.  Last year, for my fifth-year Brainaversary, Ashley baked me a brain cake.  imageHopefully, I’ll have another one waiting for me at home today!  Regardless, I wish to thank my family, friends, medical team and support group from therapy and school for their tireless support in my battle.  Without you, I would never be here today.  To think how far I’ve come in six short years (but what has also felt like an eternity at moments) is astounding.

Without more, I can’t leave you hanging so I’m going to get back to the story.  After all, my intent in writing this blog is not to gain sympathy votes but rather to inspire and connect with other warriors out there.

Back on March 11th, I wrote about waiting.  Reverting back to 2011, I was in a waiting period for the bar exam results to be revealed.  I’m not sure what was worse – taking the bar or waiting for results.

The exam lived up to all of the hype.  “Grueling” is the word I would use to exemplify the entire process.

Nothing could have prepared me for the moment I walked into the room and was handed the exam booklet.  Prior to that though, I was taken into the room where I would spend the next 4.5 hours.  After booting up my laptop and waiting at the prompt screen to type in the word “Start” to bring me to the first blank sheet of paper for my response, I waited some more while further instructions were read. At least some states, including Connecticut, now allow examinees to complete the essay portion using exam software that you must download and pay a license for.  Ahh yes, more money.

The overwhelming feeling of sitting with the Bar Examiner who gave the instructions to applicants with disabilities made it all become real.  All examinees must sign an oath and are then escorted into their hotel room where you are instructed to start your laptop and log in to the software.  Finally, I was handed the first six essays.  I took a deep breath, collected myself and then focused my attention on the task at hand.  While applicants can begin with any number they want, I started with number one and away I went.  The first six questions were pretty much what I expected and though I could have written for days, I did not have the stamina or time to do so.  Before I knew it, time was up and I had completed the morning session of day one – 1/4 of the bar exam was complete.  Given that the break was only an hour, and at the advice of past applicants, I brought my lunch.  I was able to find a private, quiet seat outside where I ate – all while being completely exhausted and wondering how the hell I was going to go back in there and write for 4.5 more hours.  But I had to, and I did.  The six questions administered after lunch were even harder, but maybe that’s because I was drained from the energy expended on the first six and the work-up that I put into this day.  Nonetheless, the questions all called for responses that I knew, except for one but it’s okay, I made some stuff up and explained my reasons for what I was saying.  Before I knew it, time was called and day one was over.

Day two of the bar exam is known as the Multistate Bar Exam (the “MBE”).  You know…those really long multiple choice questions that I described in part one of this post.  After the morning session and 100 questions, I was mentally and physically exhausted.  I had no energy left.  On my lunch break, I wanted to just put my head down and take a nap. I was so close now though – I would fight hard until the end, just as I had done in getting to this point and putting myself in a position to be sitting at the desk taking the exam.  Yet, questions 101-200 were more of the same: oddly worded questions, many filled with old, ancient law that required you to have a brain like a sponge.  Thanks BarBri for the charts telling me that these types of questions were only tested a very small percentage of the time.

However, the clock continued to wind down and the 6:00 hour approached.  Finally, with a few seconds to spare, I had bubbled in my final marking on the scantron sheet.  Jubilation!  I had just completed the bar exam.  Where were all of the people who said that I would never return to law school, let alone graduate or sit for the bar?  What about the medical report that stated I should forget about going back to law school and was likely to remain at the capacity of a second-grader?  When I got home, I had a celebratory dinner with my family who was there for me every step of the way.  I had nothing else to do but to sit and wait for results.

In the months that followed, I replayed questions over in my head again and again.  Fortunately, I returned to work at law firm in Connecticut where I was keeping busy in the asbestos defense practice.

October 7, 2011 was a bright and sunny morning.  This was the day the Connecticut bar exam results were to be released.  In Connecticut, the committee simply posts on its website the names of those examinees who passed the exam and are recommended for admission to the bar.  So everyone and anyone can get onto a computer and look – not the fairest or best way for nervous examinees.  Nonetheless, I was confident this morning.  More than two months removed from taking it, I truly felt that I had passed and was about to burst into tears of joy.

After refreshing the page time and time again, the list of names appeared.  The names were presented in alphabetical order by the applicant’s last name.  Slowly, I scrolled though until I came to the C’s – there were lots of them.  I looked away from the screen, collected myself and then refocused my eyes on the screen.  I went one by one and low and behold, my name was not on the list.  I tried again and again, thinking perhaps I overlooked it in anticipation of the excitement.  But reality set in and my name was not on the list.

As a result of working for a law firm and all the attorneys having gone through the process, they knew that the results were also posted.  Before I even had the time to process what had happened, I received email after email offering condolences.  I needed to talk to my family; to Ashley – I could not handle the moment.  Within minutes, I received an email from the office administrator offering me the rest of the day off if I wished to leave and be with my support group at home.

The feeling of defeat stung for a little while.  But I had overcome so much that I knew I would be back to try again.  When I received my actual results from the Bar Examining Committee, I saw the score that I earned and the score needed to pass.  Without revealing the number, I knew I had to go for it again; I’d be a fool not to.

In the ensuing months, I geared up for the February 2012 exam and worked with a tutor to master the methods to take the exam.  One of the things that I learned from my score is that it was not a lack of knowing the information, but rather, there exists a defect in my ability to communicate my mastery of the subjects in my brain into the multiple choice answers that were provided after each question.  I’ll tell you this much – my essay scores were well above-average.  Given ample time and opportunity to explain my reasoning and analysis in reaching a conclusion, I have no trouble.  But when I am presented with a long and complex problem with four possible answers, all of which could arguably be correct, I have trouble.  I worked tirelessly to master the technique of reading and analyzing within the strict time constraints presented on the bar exam.

Now, for those unfamiliar with the process, only your scores on the multistate bar examination can be used on subsequent examinations but your essay scores cannot.  So my strong essay scores would go to waste.  I had no choice but to study and prepare for the entire exam again.  I took a leave of absence from work and locked myself in a room and library for the winter months.  The tutor provided me with some suggestions on how to approach the questions and additional tips to narrow the possible answer choices down to two.  From there though, it was a matter of processing the right answers from the wrong answers.  The bar exam does not test how smart you are.  Rather, it is a test of endurance to see if you can arrive at the “best” legal conclusion to a problem in a short period of time.  After two days and six hours, you will have handled two-hundred-and-twelve legal matters and counseled that many clients.

When time was called for the final time, I felt once again that I had done it.  Fast-forwarding to May 11th – results day.  Like a nervous wreck, I checked and checked the website until the list had been published.  I looked for my name, but again, my name did not appear. Upon seeing my results, I was astounded to find that my multiple-choice score had improved but my essay scores had dipped.  Go figure.  As a result, I was right where I was the first time.  There was no fluctuation in my score.

Well, the old saying is that the third time is the charm so I decided to try again.  I took some time off in between administrations of the exam to give myself a mental break and gear up for the studying and preparation.  I also had to find a way to pay for my life so I waited until July 2013 to retake the exam.  In addition to the financial situation, I figured that some time would be the best thing for me.  I still had all of my books to prepare and after much research and reviews, I opted to purchase flash cards to help me ingrain the material in my brain to allow me to quickly recall and spit out the material when I was presented with a problem on the exam.  After another leave of absence from work and countless hours of my life devoted to studying, the two days arrived.  I was again escorted into my private room where I would spend the next two days killing the rest of my good brain cells to pass the test.  But in what felt like a snap of the fingers, it was over and I was on my way home.

At the time that I registered to take the exam, I did not think to look when the bar exam results were going to be posted.  Yes, they actually tell you the dates the results will be released for the next three years that the bar exam is administered.  So I tell you this because on October 4, 2013, bar exam results were released – and I was on my honeymoon in Italy.  I dreaded the moment, but had to look – after all, I told Ashley that if I passed, I’d buy her a Louis Vuitton.  Plus, I just had a feeling that my luck was about to turn.  I had been through hell the past five years but had just married the girl that I loved and was with her eating everything in sight and drinking the best wine on earth.  So despite the data plan that I was paying for, I did it all through my phone.  And when I checked, I felt the same semblance of defeat I had grown accustomed to.  My name was not on the list.

For some who have been down this road, all hope might be lost.  But for me, I have so much to live for and strive for.  At the current time, I have decided to hold off on retaking the exam as my scores have not improved and at the recent advice of my surgeon who looked me in the eyes and said: “Chris – you will never be measured by your performance on an exam, but rather your testament in overcoming the odds to live and the only advice I can give you is to follow your heart.  You will succeed in whatever it is you want to do.”

That was all that I needed to hear.  I knew in my heart that right now, passing the exam was not meant to be, for reasons outside of my control.

The law may have won this time.  But at the end of the day, I’m alive and well.  I have my whole life to live and an exam cannot and will not define me.

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