Bobby and his friends discuss a problem from chemistry class. Marissa Parlock sits next to Bobby, and next to her is Mary Dzwonchyk. Both play in the band with him. Justin Donlan is on the left.
He took comfort in his family’s love and soothed himself by petting the family’s cats, Smokey and Misty, as he sat in a living-room chair. He tried to keep in mind what one of his teachers had told him: God won’t give you more than you can handle.
Gradually, the fluctuations grew less distinct and the gray spot in his central vision reemerged as a kind of fuzzy static. His vision declined to the lowest point it had ever been, and Bobby’s world became a twilight of shapes and shadows. He began walking into walls—and kicking them in frustration. One question now haunted him: Am I going blind?
In early June, Jallo didn’t like what he saw on an MRI. He knew it would take more time for the radiation therapy to show results, but he hoped it might have begun to make a dent by now. The MRI scan said otherwise. The cyst was as large as ever. Jallo knew Bobby needed another surgery.
Bobby’s parents asked Jallo if they could take a brief trip to Canada before the surgery, and he told them to go. Bobby, Matt, and their parents and grandparents traveled to the Canadian side of Niagara Falls, where Bobby rode the rapids in a speedboat and took a trip on Maid of the Mist, the boat that takes tourists close enough to the falls to feel the spray. Bobby loved it; so did everyone in his family. After three days, they returned home to face the reality of another operation.
Bobby was rolled into the operating room at Johns Hopkins on June 29. Rather than taking the transsphenoidal approach, Jallo this time made a small hole in Bobby’s skull. He then used the CT scanner and endoscope to guide him as he threaded a thin catheter through the top of Bobby’s skull downward to the cyst. He visualized part of the cyst on the microscope and worked the catheter toward it. He wanted to penetrate the cyst’s outer shell with the catheter to drain and deflate it. He made a two-inch cut in Bobby’s scalp and inserted a small reservoir to collect the cyst’s fluid over time. Then the radiation could do its work and destroy the cells that produced it, Jallo thought.
In early July, Bobby experienced a headache so intense that he threw up and couldn’t lift his head. Jallo told Judy if Bobby threw up again to bring him to the Hopkins emergency room. Bobby did, and his mother drove him to the ER, where Bob joined them. The MRI showed that the cyst was as big as ever. It wasn’t emptying because the catheter Jallo had inserted hadn’t penetrated the cyst.
Jallo felt as deflated as Bobby’s family. He said their only option was to keep trying—meaning yet another surgery.
On July 20, Bobby underwent his fourth brain procedure in seven months. Jallo took the same approach as the time before, going through the skull.
Once again, an MRI revealed that the catheter hadn’t penetrated the cyst. Another failure. Bobby’s family was beyond exasperation. Bobby was weary of feeling so sick for so long and of the seemingly countless needle sticks. But the far deeper fear was that this would never be resolved, that his vision would never get better and the cyst would never go away.
Bobby’s grandmother Maggie had traveled to Hopkins for all the surgeries. She knew they were pushing the odds—that every operation increased the risk of a potentially catastrophic infection. She began considering other options. She researched major hospitals in New York and Philadelphia and mentioned to Judy and Bob the possibility of taking Bobby to one of them.
Judy and Bob said no. They had developed trust in Jallo despite the failures. Judy had read the disappointment in Jallo’s face when the last two procedures had failed, and she knew Bobby had become more than a case to him. The surgeon had developed an affection for him that melted his professional distance. She knew he cared about Bobby, and she wanted to stick with him.