The Tribune

By DR KENNETH D KEMP

There are moments when I can’t help but think that the human brain is as mysterious, wonderous and awe-inspiring as the entire solar system. In that regard, I know that I’m not alone. I’d venture to guess that the same level of wonderment and veneration that astronauts experience when they see the vastness of space for the first time is like that which a neurosurgery resident experiences operating on a brain for the first time. It is rarified air to be in either position and unquestionably a blessing to behold.

Humans have made vast advancements in exploring and trying to understand our brain and the planet we inhabit with notable success over the past century. And yet the more we learn, the more we realise how little we really know. But while we may never know all their secrets, research on the most studied of the two tells us that the brain is the most complicated and important organ within our body housing 100,000 miles of blood vessels that can encircle the earth four times. That level of complexity in its simplest form illustrates why so many diseases connected to the brain can be so challenging to predict, diagnose, understand and treat.

No one understands this better that the patient herein referred to as Mariah featured in today’s report. Several pathologies secondary to a familial brain disorder have manifested within Mariah’s family. Over the years she’s watched helplessly as conditions, and the episodes they generated, wreaked havoc on her and the lives of so many people she loves.

Mariah was born in Nassau in 1975, just a few days before the Mariner 10 satellite returned the first clear surface photographs of the planet Mercury. Thousands of miles away and far removed from such colossal aspirations, looking back Mariah only remembers how simple and easy life seemed. As the youngest of ten siblings, she always had someone to play with so playing is what she did. Before, during and after school, sometimes well into the evening. And with playing there was laughter. As time passed, however, the laughter and games faded and by the time she was 16 years old, the laughter stopped abruptly.

Mariah began experiencing sleepiness and moments of mild and transient visual blurring. Then, one day while riding home on the school bus with her best friend at the time, without warning she lost consciousness. The bus quickly transformed into a frenzied beehive. A swarm of panicked children at full pandemonium surrounded her limp body. Her friend tried to revive her, all without success. Finally, the bus driver was able to arouse Mariah following a series of forceful convulsions. He took her directly to the hospital where multiple tests were performed. Doctors quickly acknowledged that Mariah had a seizure and she endured several more seizures and tests before they adequately diagnosed her with a Stage 2 brain tumor (fibrillary astrocytoma).

If the diagnosis was not enough to cause her mother to panic, the news that emergency surgery at Miami Children’s Hospital would run $30,000 nearly drove her into despair. Mariah’s mother was a housekeeper in a gated community in western New Providence. They didn’t have insurance. She barely had one percent of that and that $300 was designated to pay another bill.

Given how dire the situation was, the hospital agreed to admit and operate on Mariah without any upfront payment. Mariah doesn’t remember anything from the day of her surgery except for a nurse holding her hand and whispering to her to be brave. She was pre-warned that her hair would have to be shaved off and that when she awoke, she’d have a noticeable bruise around her eye. The black eye was shockingly large and it took ten days to resolve, which was shortly after she was discharged from the hospital.

Following her surgery, Mariah suffered from intense, recurrent headaches that only subsided with strong narcotics. Fortunately, the headaches slowly dissipated and she hasn’t faced any medical complications since then. Although Mariah missed a lot of classes, she was able to graduate with her friends the following year and attend prom. To this day she remembers how good it felt to be with them, on the night her laughter returned.

In 2003, Mariah’s strength was once again tested when her older brother died from an undiagnosed brain tumor. Because he lived on a Family Island, the family never knew if he’d been experiencing prior symptoms or, if he had, why he apparently never sought medical treatment. All they knew was that one day he was alive and the next day he was dead; the result of a ruptured brain tumor. He was only in his early 30s.

His death took a terrible toll on their mother who was already suffering with high blood pressure. Mariah’s aunt died from a stroke and her uncle died from cancer so it was a dark time for their family. Not long after, they began to notice a decline in their mother’s mental acuity. She began to misplace things and became easily confused with dates and names. She was diagnosed with Alzheimer’s disease and over the next five years, right up to the time she died, she couldn’t remember anyone except for Mariah who was living with her at the time.

In a moment of self-reflection, Mariah began to notice that everyone in her family was dealing with medical conditions related to the brain. From brain tumors to stroke to Alzheimer’s disease, they had vastly different pathologies but their conditions were just different planets in the same solar system. The analogy came to her while taking care of her mom during one of her ‘sundowning’ episodes where she became notably more confused in the late afternoon and evening. As her mother’s mind atrophied and was becoming as blank as space and all her memories were slowly lost, Mariah says she reminded her of a star that was slowly burning out.

Two years later in 2010, her theory was tested when one of her sisters died when she fell and hit her head during a schizophrenic episode. Researchers have suggested that schizophrenia may develop because of an inflammatory response within the brain that damages the cells responsible for thinking and perception. Understanding this has made Mariah more appreciative of what her sister may have gone through and truth be told, it saddens her that she didn’t see these correlations before now.

Famed scientist Isaac Newton once proposed in the law of universal gravitation that all objects throughout the universe pull on each other through gravity. Expanding on this, some philosophers have proposed that through the cosmos of space and time, all humans are connected. They believe that there are unseen bonds between every life and existence that ever was and those that are to come and energy throughout the cosmos is required to sustain these bonds. The atoms of our body they feel are intricately linked to the stars. Those who believe in this interconnected universe theory say that our consciousness guides us and meditation is what allows our consciousness to develop.

Mariah was laid off from her job in sales shortly after the COVID-19 pandemic. She chose sales because she has an innate ability to sense the connection between each human being. And yet, while she loves customer service and interacting with people, today she’s looking for a slower-paced job, like a librarian, to match her desire to live every day in slow motion. Mariah testifies in her church often that her life is miraculous and she wakes up grateful to be alive every day. When asked what she has in store for the future, she smiled and said that she lives day by day. Tonight, she’ll gaze at the stars while thinking about her mother and praying that God might see fit to continue holding her in his hands. Tomorrow, she says, will be totally up to Him.

This is The KDK Report.

• Nicknamed ‘The Prince of Podiatry’, Dr Kenneth D Kemp is the founder and medical director of Bahamas Foot and Ankle located in Caves Village, Western New Providence. He served as the deputy chairman for the Health Council for five years and he currently sits on the board of directors for the Princess Margaret Hospital Foundation in his role as co-vice-chairman.