The Weight of Two Brains

Learning to let my two minds walk hand in hand.

Free link here

We were having a casual chat at tea. Table was decorated with biscuits, kebabs, cake and pizza. My husband had informed me just a few hours before that he had invited his consultant over tea. It was a bit unusual for me. I was busy packing to go back to Pakistan after a year in Ireland. I knew his visit was long overdue. So, I went with the flow. "I got to know you underwent an MRI," he started after the tea. "Your husband and I actually went to the radiology department especially today to get it reported ourselves. It's report was not showing in the system even after two days." "Ahann," I said, sipping my tea. My focus was entirely on the tea cake in front of me. I had been having severe sugar cravings for a few weeks. I assumed he was just letting me know that he had made an extra effort for the reporting. Then he said it: "They found a small cyst in the pituitary." "That's a Rathke's cleft cyst" my Dr brain uttered casually. I didn't even look up at his face right away. But then my husband flashed his mobile screen in front of me. I caught the last line of the conclusion: The other Differential is Rathke's cyst.

I tried to squint to read the second-to-last line, but he put the phone back in his pocket. And only then some more neurons fired inside my brain and I became entirely attentive to what was being said to me. "Your prolactin levels were quite high," the consultant continued smoothly.

"So it's most probably a 1.5 cm sized adenoma." There was silence that only I could listen. 1.5 centimeters.. these two words started echoing. In that fraction of a second, my radiologist brain whispered a bitter translation to myself:

A macroadenoma, Javaria! A tumor, though benign!

I am a radiologist, married to a pediatrician and I was sitting in a room with another consultant pediatrician so things quickly turned into a purely clinical discussion. My doctor brain knew all the facts, management options, complications, and the delicacy of the anatomy involved. I asked my husband to let me see the report again. This time, I read the details. They weren't all bad, but they weren't good either. I read the lines detailing the mass effect: it was significantly compressing the normal gland. My analytical side quickly noted that it was still confined to the gland itself. But I couldn't wrap my head around the fact that it had been there all along without raising any suspicion.

The rest of the meeting slowly became a talk where three doctors reassured each other that this is a very well behaved kind of lesion that responds to simple medication fast. I figured out that I just needed recent blood work, a referral from a gynecologist to an endocrinologist, and then a decision about starting medications. My brain was slowly fetching the data I had stored in it during my training period. It turned over a lot of pages quietly, while at the same time keeping the rest of my body engaged in the conversation as a polite host.

I was swallowing another piece of my favourite split cake, smiling and nodding while pretending I am all ok. And then, a massive "AHA" moment took over me.

My brain started recalling all the physical symptoms I had been completely unable to decipher over the past weeks, which were now underlined on the pages which are open and lit in my memory. The depression I had been secretly battling for a month… The frequent headaches…The loss of "Satiety" causing binge eating.. The irregular cycles... Everything suddenly made perfect sense.

A wave of pure relief hit me. I wasn't crazy at all. I wasn't a thankless person for feeling such low moods.

My emotional lash outs and withdrawals at home with my son were not just a failure of emotional regulation. All of this..every bit of the scary thoughts I had been carrying..had a real medical explanation. The moment the consultant left the room, my logical brain sighed..felt overworked and took a back seat.

What it left was only a mother and a wife. I looked at my husband, tearyeyed, forcing a fake laugh to break through the heavy air.

"Our kid is still too young for this" He kissed me on the forehead emotionally. My chest got heavy. I felt tears stuck up in my throat.. pressure in my ears.

I couldn't listen to his comforting talk. I just couldn't shake my logical brain to wake up from its nap. I felt betrayed. I tried hard for a while, and then I just let my emotional brain take the lead. After all, my body needed to release the shock it had received. After a week, I am still unable to fully process how I could never once suspect that something was growing in such a delicate space for so long. I am still trying. I want to cherish the remaining life with my kid, but I am struggling to do so, as active symptoms of depression and frequent headaches are constantly holding me back.

The weight of knowing it all doesn't prove good all the time. The bright side is that the crushing guilt I was harboring for a month while wrestling with my mood swings has shifted now. I know now that I am fighting a hormonal imbalance; I am not being just emotionally weak or thankless. My love as a mother and a wife is whole and complete. This is an immense relief. But I still find my two brains fighting with each other most of the day. My doctor-brain keeps bringing up facts to reassure me, trying to map out my future plans regarding consultations and management options. But somewhere in the process, the biochemical glitch produced by the tumor itself blurs the whole detail and leaves me alone and stranded. I never imagined I could be entangled in such a tough inner battle—where I would own the ground, know the rules, and own the fight, only to be defeated by my own self in the end. And this has given me a huge lesson.

I don't have to put the two of them in front of each other for a win-lose fight. I just have to let them walk hand in hand for the rest of my life.

In fact, both my brains helped me decide on my final strategy, a choice I am incredibly proud of. I have scheduled my urgent appointment with the gynecologist. And after that, I am flying back to my homeland. I am looking forward to meeting my parents, my only sister, and a lot of extended family. I have decided to leave the diagnosis behind in Ireland. I will step into that plane as a sister, as a daughter and as a friend—not as a patient. I don't just want to see my family; I want to stare at them hard, feel them long, and smell them enough. I want to spend every single moment absorbing my loved ones with all of my senses. By giving this much-desired food to my emotional brain, I know I will keep it safe from jumping blindly into the dark. For the first time in a month, my two brains are finally at peace, ready to carry me home.