The patient’s letter was short and angry. I had not helped her; she did not plan to return to see me. And, she didn’t; she might as well have moved to Australia, such was her silence.
Six months earlier, she had undergone a temporal lobectomy for epilepsy, present since her teens, usually manifested by episodes of being disconnected from her surroundings, and only partially controlled by medication. I had been her epileptologist for a dozen years, guided her through two successful pregnancies and assuaged her nervousness about her condition several times a year. Her brain scans showed a stable cystic lesion. We had often discussed surgery, but she was not ready until she had a major motor seizure at age 35, almost 20 years since one other similar event had heralded the onset of her condition.