In Jallo’s office, Judy was on the verge of breaking down but held herself together for Bobby’s sake. She and Bob asked the question foremost on their minds: “Is it cancer?”
Jallo said he couldn’t be certain, but these types of tumors were usually benign.
They asked how he planned to treat it.
“Surgery is our only option,” he said.
He wanted to perform the surgery as soon as possible to save what he could of Bobby’s vision, but he warned that the surgery carried a risk of leaving Bobby blind in one eye or both.
“I’m going to do my best to save your sight,” he told Bobby.
Jallo rearranged his schedule to operate the next week.
On the drive home, Bobby and his parents and grandparents all agreed they’d been very impressed by Dr. Jallo. Bobby had visited his grandparents during the summers from the time he was a little boy. He loved and trusted his grandmother and, because of her medical training, looked to her for reassurance.
“Things are going to turn out all right, Bobby,” she said. “You’re at one of the best hospitals in the country, and you’re being treated by one of the very best doctors.”
Maggie had assisted on countless surgeries and knew what an ordeal this would be. She knew he was upbeat and resilient, and she also knew him as the little boy who wouldn’t kill bugs and who became inconsolable after he saw someone step on a caterpillar.
The extended family had often taken trips to Gettysburg, Hersheypark, and Ocean City. When Bobby was well again, they agreed, they’d take a family trip. Bobby said he’d like to visit Niagara Falls.
Since learning about Bobby’s tumor, Judy had reproached herself for not detecting Bobby’s vision problems earlier. She thought of the hours she and Bob had spent with their sons at family dinners, attending church, driving them back and forth to school, looking over their homework, watching TV.
How could I have missed this? she asked herself again and again.
Bob kept thinking back to the time Bobby told him he didn’t think he’d be a good driver. Both parents were consumed with guilt.
In bed that night, Bobby sensed his world unraveling. The word “tumor” scared him, and so did the impending brain surgery, but nothing frightened him as much as the thought of living his life in darkness.
“I’d like to have the anointing-of-the-sick sacrament,” Bobby told his parents the next day.
Bobby’s parents felt uneasy about the request—it’s a Catholic rite usually administered to the dying—but they took Bobby to St. Mary of the Mills Church, where he had been confirmed three years earlier. There, a priest administered the sacrament to give him strength, forgive him his sins, and prepare him to enter the next world in a state of grace.
The evening before Bobby’s surgery, Judy went upstairs to her bedroom, safely out of Bobby’s earshot. With Bob at her side, she wept until she had no tears left.
On the morning of the surgery, Judy and Bob went with Bobby into the operating room, walking on either side of his gurney and holding his hands. The announcements that morning at Pallotti high school included a prayer for Bobby.
Of the surgical options available, Jallo chose the least invasive, a transsphenoidal approach. Jallo would enter through Bobby’s nose and sinuses and drill into the sphenoidal bone to gain access to the base of his brain and the tumor. This approach meant Jallo could thread only small instruments up into the region of the tumor.
With an operating microscope to guide him and an endoscope lighting the way, Jallo snaked instruments into a cavelike space in Bobby’s lower brain. There he saw a gelatinous brown tumor through the operating microscope, which enlarged his field 10 to 20 times. He moved his scoop-shaped curette into position and began to scrape and peel away small pieces of the tumor from the optic nerve and pituitary gland. The tumor had hard white flecks on it from calcification that proved hard to remove.
As minutes turned to hours, Jallo continued to strip tumor tissue away piece by piece while keeping a safe distance from the left carotid artery, one of the two major arteries that supply blood to the brain.
The vision in Bobby’s right eye was already down to 20/200, the definition of legal blindness. Jallo knew Bobby’s optic nerve already had been so damaged by the tumor that it couldn’t absorb much more punishment. He didn’t want to risk removing more of the tumor than he safely could. When he finished peeling off all the tumor possible, he could see the optic nerve decompress as the pressure on it eased.
After nearly five hours in the OR, Jallo ended the operation. A postsurgery MRI revealed that he had removed nearly all of the tumor.
At about 5 pm, Jallo walked to the waiting area to talk with Bobby’s family.
“It went well,” he said. “I got almost all of the tumor out. By the look and feel of it, I’m certain it is benign.”
Judy and her mother hugged him.
Bobby woke up in the pediatric ICU sometime after midnight unable to breathe through his packed nose. The intravenous lines into both arms caused pain, and he became frightened. At his bedside, Judy and Bob became alarmed when the monitor showed his heartbeat increasing rapidly. They and the nurses gave him water to drink and consoled him, and Bobby calmed down. His parents stayed through the night and into the next morning, when Bobby became alert.
His friend Ryan Brophy had visited him after the surgery and pasted blue Pallotti football stickers around the room. From his bed, Bobby realized he could see them clearly enough to read the print. The TV came on, and he read the station-identification logos at the bottom of the screen, something he’d not been able to do. On a football sports clip, he could see the numbers on the players’ jerseys, and now he could see faces clearly—it no longer seemed as if he were looking through a screen door. Bobby looked to his left and right and discovered that the black curtains of his peripheral vision had opened wider.