The Surgical Valour

The stoicism of a 32-year-old woman battling two life-threatening diseases is a lesson in acceptance and courage

I did not know I was going to meet someone like her. She was all of 32 years old and sat in front of me with the poise of someone who had completed finishing school. Her white top enhanced her wheatish complexion. She crossed her legs one over the other with such elegance that even her linen pants did not wrinkle. Her ageing father watched her as she responsibly arranged all her files and papers on the table in front of us – the metaphysical barrier that allows a physician to maintain an emotional distance from their patient.

She had black wavy hair with streaks of silver. Her eyes seemed to have the accrued wisdom of several previous generations. Her face had the serenity of the Buddha and adorned a gentle compassionate smile. But the first words that came out of her mouth were earthshattering to me. “I have breast cancer,” she said with a composure I have never seen. From the corner of my eye, I could see tears rolling down from her fathers’ face. “In both my breasts,” she added stoically. “I’m so sorry to hear that,” I emphasized, “but what brings you to me?” the neurosurgeon in me inquired. “My oncologist got a PET scan done to plan the course of treatment and they found a tumour in the brain as well. That’s why he sent me to you,” she said. “We also got an MRI dedicated to the brain to ascertain what tumour it is,” she continued as she pulled out the films to show me.

“Aren’t you scared of all this?” I asked her, curious to know what was going on beneath that unflappable exterior. “I have loved the stars too fondly to be fearful of the night,” she smiled, impressing me with some Sarah Williams poetry. Literature is a great coping mechanism.

What was delivered to her was so unfair, I thought to myself as I plugged in the films one by one to analyse the scans. She didn’t have the slightest headache or, for that matter, any other symptom of the 6 cm ghoulish brain tumour nestled within her, between the frontal and temporal lobes in a region of the brain called the insula. After careful thought, I announced that this wasn’t a spread from the breast but a separate primary tumour of the brain. “This is a probably a low-grade glioma, a tumour that arises from the glial cells of the brain,” I decreed. “So, can we just leave it alone?” she asked with the curiosity of a child. “Can I proceed with the chemo and then go ahead with my mastectomy as planned by my doctor?” She told me she was eager to get back to flying as a pilot, and that she’d been granted leave only for three months. I didn’t have the heart to tell her that she might have to resort to a ground job in aviation.

Sometimes, there is no right answer. I thought for a while and explained that we would have to get rid of both tumours, and that we’d have to do them in quick succession. “We could do either of them first,” her oncologist told me over a phone call, “but if the brain tumour can wait, we’d rather do the breast,” he concluded.

I asked her what she would like to do. I remember my mentor, when faced with several options to choose from, always chose to tell his patients, “Whatever decision you make will be the right one.” I have religiously followed that practice over a decade. Except, I end up saying it more to my wife than to my patients.

“Let me get done with the breast and then we’ll proceed with the brain,” she decided together with me. I sat there in awe of her fortitude to take life-altering decisions with such surety although I was sure that a deluge of emotions might be erupting within. I find it tumultuous to deal with a flu, and yet, I see myself giving hope and strength to patients with brain and spine tumours on a daily basis. We bid adieu with a plan to operate on her head once she had gone through a mastectomy and breast reconstruction. Chemotherapy was to start in a week. Yes, oftentimes in the treatment of cancer we need to administer chemotherapy to shrink the tumour before we operate on it.

Two months later, her father called frantically saying that she had had a seizure. She was unconscious at home. They took her to the ER of the closest hospital, which managed to salvage the situation. The day of the seizure was the day she had completed her chemo, and she was scheduled to undergo breast surgery a few days later. However, a repeat MRI of the brain showed that the brain tumour had grown marginally. We had a muti-disciplinary tumour board meeting and decided to go ahead with the brain surgery first. A couple of days later, we opened up the head to enter an area that was once known as ‘no man’s land’; such was the danger that surgeons used to avoid going there. It was like the Kashmir of the brain: difficult to access, but once there, it enraptured you. We strode in bravely and could remove the entire tumour as it was, straddling the areas of cognition, motivation, fear, anxiety, and happiness. She woke up smiling broadly – a rarity after brain surgery. We discharged her in a few days fit enough to have her second operation. Weeks later, she called to tell me that recovery from her brain surgery was a walk in the park compared to a double mastectomy with breast reconstruction. “We only dug a hole; they resurrected a whole new structure,” I facetiously justified the hard work of my colleagues.

The Financial Times recently published an article on the unexplained rise of cancer among millennials. It mentioned that the past 30 years have seen an upsurge in cases of so-called “early onset” cancers in the under 50s. So marked is the increase that leading epidemiologists have suggested it should be called an epidemic. Scientists are not sure why, but changes to nutrition and ways of living hold at least part of the key to the puzzle. The consumption of food high in saturated fat and sugar is believed to alter the composition of the protective gut microbiome in ways that can harm an individual’s health. Excess usage of antibiotics and other medication may also be responsible for altering the gut. Whether it will happen to one of us, only time will tell; now, it is also possible for us to do a whole genome sequence analysis to check if we could be at risk. “Our graces don’t stand to reason any more than our sins do,” I read on someone’s Twitter handle.

She returned three months after having valorously completed both her surgeries. Her long hair had transformed into a small frizzy bun, gracefully sprouting again after being jettisoned by the chemo. There was no tumour in the brain and the breasts were brand new. She beamed with confidence, hugging me tightly.

“When can I start flying?” she asked like a little child eager to return to her playground. Knowing that this was a permission I couldn’t grant as yet, I replied, “You’re already soaring way above everyone else.”



35 Comments on “The Surgical Valour
  • Amit Gupta says:

    Excellent. That’s the beauty of being a neurosurgeon, ability to change lives.

  • Arun Pushkarna says:

    What a gem that was!
    Captivating from the very first sentence.
    The closing line though….. gosh! you write so well!
    Wonderful article Mazda!!

  • Supriya Correa says:

    A Heroine indeed. Respect.
    Beautifully touching piece, Maz. Though this time the protagonist’s valour upstages even your neurosurgery. I believe your literary talent simply allows her to.

  • Dr Indu Bansal says:

    “I have loved the stars too fondly to be fearful of the night “. What a beautiful line ! As an Oncologist so many times i wonder , do i derive strength and motivation from my patients or they get it from me? Some patients handle the cancer diagnosis with so much grace and ease that u are just awestruck and desperately want them to be back to health soon. Such a beautiful piece yet again .

  • Rohin says:

    @maz – love the compassion with which this is writen. May be you could take some time to educate children on the ills of saturated fats (read French fries) and sugar.

  • Tasneem says:

    So hearteningly beautiful. Love her love for life. Her Stoicism amazes me. May she be blessed with a healthy life. Thank you Dr for sharing

  • Amit Ray says:

    Loved the comparison of the insula to Kashmir! That analogy would never have struck! Beautifully written

  • Clera Menezes says:

    Sir …
    It seems like you have such a magical pen at your home, huh?
    The way you explain a complex topic in an easy-to-understand way is really impressive.
    Every day i see you and your team dedication and compantion for your patients .Feel proud to be Working with you ..
    You pen what ever you are doing and feeling for your patients .
    God bless you….
    keep up the good work .

  • Dr anil parakh says:

    So heart touching fact which we come across in our lives many times but you have written so beautifully that when I was reading- I felt she is sitting in front me me and I am witnessing every moment
    Thanks mazda

  • Dr anil parakh says:

    So heart touching fact which we come across in our lives many times but you have written so beautifully that when I was reading- I felt she is sitting in front me me and I am witnessing every moment
    Thanks mazda

  • Dr Ajit Randhawa Neurosurgeon says:

    Beautifully written. Congratulations

  • sathya saran says:

    Phew! Thank goodness she came through. And smiling.
    Thank you for sharing.

  • Phillie Karkaria says:

    Impressive, lucid style. You explain a complex subject with simplicity and lots of empathy for your patients. The reader is fully engaged throughout your piece. Thanks for sharing your experience and please continue to do so.

  • Anuradha says:

    Superb article. Here you have beautifully projected the braveheart spirit of a young woman, courageous to the core and determined to accept her fate and fight back. Hats off to this young intelligent beauty.
    About you what can we say. One of the best we can have in this field.
    In a crisis situation, the unfathomable bond between a patient and his/her doctor takes both sailing to victorious shores.
    Proud of you doctor and your amazing writing skills


    I would say this God bless her, she is a brave person. Also bless all you medical guys to make our life easy.

  • Vipul shah says:

    Dearest Dr Mazda Sir ……

    What a Lovely described piece on Double Trouble handling so nicely & tactfully…..

    Your style of explanation is so good & so descriptive that we are working with you through out 🌹

  • Hutoxi Doodhwala says:

    Speechless ! Heart breaking and then heartwarming.
    God bless the young pilot and God bless all the doctors who healed and gave her a brand new life.

  • Sushma Sowraj says:

    Always inspiring! the way you pen down your words and emotions it’s magical, and your ability to intertwine the medical intricacies with the emotional turmoil experienced by the patient truly made for a thought-provoking read.
    What always hit me, the way you focus on the patient’s emotional well-being. It is often overlooked how profound the impact of such diagnoses and surgeries can be on a person’s mental and emotional state. By shedding light on the patient’s emotional journey and highlighting their fears, hopes, and resilience, and medical narrative you make a quiet intresting article.
    Keep doing what you do best!

  • Sunita Masani says:

    Keep sharing your inspiring experiences doctor.. thank you 💕

  • Dr. Vijay R. Sheth says:

    Great patient, her attitude & courage, Great Surgeons, doing superb work, in saving life of patient.

  • AT says:

    You are not only a good doctor but also a good writer.

  • Navzer Irani says:

    What a courageous lady. I truly believe the will of God passes through your hand. Mankind is blessed to have Doctors like you. God bless.

  • Dr.akil contractor says:

    Excellent write up…so touching…made me feel I was with the patient.
    But I salute her bravery and confidence understanding her condition and courage to fight back .
    It was very touching to read the episode and happy ending was the climax.

  • Natwar Panchal says:

    Excellent Dr

  • Dr. Arvind Vartak says:

    Dr. Mazda,
    That’s great
    You have penned it extremely well.

    I can understand how difficult it must be to make a decision; for both, yourself and the patient too.
    Hats off to you.

    At our time, when we were students such result could be only be in the dream ( you can confirm this from your father )

    Best Wishes to you Dr Mazda for even more successful stories be penned from you 🌷

    Best Wishes for you and your family too.

    Dr. Arvind Vartak

  • Anjali Patki says:

    A story of resilience, well narrated, expressed eloquently and sincerely. Great job as usual dr Mazda. Keep up the fab work.

  • Dr. Surekha Meecheri says:

    Superb narrative! felt like watching a movie ” The Surgical Valour”. Appreciate your great surgical skills and your empathy towards your patients. waiting to read next interesting story…

  • Perviz Dara Bhote says:

    Doctor Mazda Turel. Hats off to you Sir. You use your pen with as much skill, accuracy, efficiency, and effectiveness as you wield the scalpel.
    To observe the minutest details of a patient’s demeanour – her physical appearance and her composure while narrating the details of what could be her shattering medical history, noticing the pain in her father’s tears, while at the same time concentrating on the professional aspects of her visit to you, is nothing short of micro sensing.
    The analogy used to describe the surgery was mindblowingly ingenious.
    I read with a sense of great excitement an earlier piece of creative genius you had penned on the Pope with a denouement that was such a surprise. But the present piece ended on a note of resilience of the human spirit, and told the tale of how doctors too are human and loaded with emotions although they appear like detached demigods.
    Dr Mazda, please do set aside time within the framework of your busy schedule as a neurosurgeon for such literary creative efforts to give us the pleasure to note another aspect of your genius.

  • Gloria Msampha says:

    She is certainly flying high. Not easy to be optimistic after all she has gone through. It’s tragic to be told you have cancer, but double tragic to also have a tumor. Wishing her the very best as she continues to fly. Her enthusiasm is contagious.

  • Sivaraman says:

    You have deftly handled a very serious health problem faced by a brave working woman. The result is a happy moment for both the Surgeon and the strong willed patient. Thanks for your achivement.

  • Rita singh says:

    Dear doctor, what a fascinating wonderful true story. One expects such happenings only in the emagination of a writer but u happen to have first hand experience of it all.I am so impressed by it all.

  • Setu Ram says:

    Ill but brave

  • Marzian Mowji says:

    Once again you have written about the beauty of the brain in a language that we lay people can understand.
    Thank you. We learn a lot from you.

  • Viju Daniel says:

    Nice write up Mazda
    Time for a book

  • Leah G. says:

    Wow, you are one of a kind Dr Mazda! Thank you for how you serve humanity! Be thou blessed “always and in all ways”; to borrow from my older son’s favourite saying.


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