THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Sunday, December 3, 1995 TAG: 9512030179
SECTION: FRONT PAGE: A1 EDITION: FINAL
SERIES: BRAIN SURGERY
The Seizures
SOURCE: BY MARIE JOYCE, STAFF WRITER
LENGTH: Long : 190 lines
It started June 15, 1976. President Gerald Ford was speaking to the Southern Baptist Convention at Scope.
Jack H. Pearce Jr., a traffic engineer for the city, was working to help control traffic flow around the blocked-off streets.
He and some co-workers had just finished eating at the Knife & Fork Restaurant on Granby Street. On the way back to the car, Jack tripped, stepping off the curb on City Hall Avenue. He lost his balance and smacked his head on the side of his city car.
Jack picked up his sunglasses and shrugged off the concern of the others. He was fine, just going to have a big knot there.
He climbed behind the wheel, tossed the sunglasses onto the front seat beside him and picked up his radio. He said ``10-8,'' the signal that meant he was back on the air.
Next thing he knew, he was lying flat, looking up at some guy he had never seen before. The guy was a doctor.
``Welcome back,'' said the man. ``Do you remember what color the gates were?''
``What gates?'' asked Jack.
``The pearly gates.''
Nothing was the same after that.
When Jack applied for his job, he told the boss right away about his epilepsy.
``Look, I have this problem,'' he said.
He had suffered a massive cerebral hemorrhage that day in 1976. Blood built up on the brain, and, with nowhere to go in the closed box of the skull, it pressed down on brain tissue, destroying it.
Ever since, renegade electrical impulses sparked in the damaged area and danced across his brain, taking over his body, shaking him like a rag doll for a minute or so and then letting him go.
He worked for the city for 2 1/2 more years. After that, he worked as a private detective, then in collections. In 1988, he applied to Kevin Cook.
Cook didn't really know what having epilepsy meant. He needed somebody to help him track down people with delinquent car loans, and Jack had a good resume.
Cook never regretted hiring him. Jack was twice as productive as other workers, and extremely loyal. He reported every morning at quarter to seven, though he didn't have to show until nine.
A few weeks after Jack started, Cook looked up from his reading to see him pacing down the hall. It was very early - only a few other people were there. Jack was doing what he usually tried to do when he felt a seizure coming on - escape to someplace private, so no one would see him shaking and grunting.
He didn't always make it. This time, he hadn't unplugged his headset telephone, and he was dragging his phone across the room with him. The cord swept across two desks, sending stacks of work and a coffee cup crashing to the floor.
``It kind of shook us up,'' said Cook.
Jack didn't like to talk about it. He was embarrassed.
Cook got some pamphlets on epilepsy. Then he got some books. He had a talk with Jack's dad. He and Jack's co-workers learned what to do when Jack had a seizure.
``We pretty much got used to it.''
They noticed that he tended to have seizures on days he yawned a lot. If he lost his equilibrium and started listing like a ship, he had too much medication in his system, and they'd send him to the doctor.
In fact, they could laugh with him about the funny stories. Like the time Jack tried to hide in the restroom and kept rattling the locked door while a woman inside shouted ``I'm in here trying to pee!''
He took different combinations of anti-seizure medicine, took so much his hands shook and he felt dull and tired. It never worked for long.
Used to be, he could feel them coming on. That changed; the seizures seemed to get worse over time. In recent years, he'd be sitting on the couch, watching television. Next thing he knew, a different scene would be on the television, and he would feel downright beat. Laurie, his wife, would be saying, ``Do you know you've had a seizure?''
Jack was a good softball player. But he quit after he had a seizure on the pitcher's mound, in front of everyone.
He took up skiing, but the second time he stood at the top of a slope, he had an ``aura'' - a feeling of disorientation that sometimes precedes a seizure. That was the end of skiing.
Maybe he could live with all that. He couldn't live without his driver's license.
Anyone who has a seizure is supposed to report it to the Department of Motor Vehicles. Most of the time, the person loses his license until he goes six months without having another seizure.
Jack had lost his license several times over the years, regaining it when it seemed that a new combination of drugs was controlling his problem. Cook worried about Jack's driving, but Jack claimed he never had seizures behind the wheel.
Once Jack showed up for work at First Merchants Acceptance Corp. all bruised. He said someone had cut him off and caused an accident.
Sure, Cook thought. At 5:30 in the morning, with no one on the road.
One morning this spring, Jack climbed into his car to visit his doctor. He popped a tape in the tape deck.
Next thing he knew, he was lying flat, looking up at his father.
``Son,'' said his dad. When Jack Sr. started a sentence that way, Jack knew he was in trouble. ``You totaled your car.''
Something changed in Jack after that accident. His license was gone. So was his independence.
``He was a totally different man, the day they took his driver's license away,'' said Sonja Webb, a close friend and colleague. ``Jack is a jokester, the life of every party. You could see he was disappointed in it, and the disappointment he carried on his shoulders.''
His doctor had told him about a type of radical brain surgery that might help.
It was time to do something drastic.
The surface of Jack's brain, seen on an monitor at Sentara Norfolk General Hospital, looks gray and remote as the moon.
If Jack passes this test, he may be able to have an operation. A surgeon would cut out a piece of his damaged brain tissue, the part where doctors think the seizures start. Jack would be only the second person to have the surgery at a Hampton Roads hospital.
But first, they must make sure the price of a cure wouldn't be too high. What would he lose if they removed some of the right side? Could he still talk, read, remember?
A fine tube, snaked up a carotid artery, delivers a fast-acting barbiturate that effectively shuts down the right half of Jack's brain, the damaged side, for a few minutes.
``Tell me what this is,'' says Dr. Ella Pecsok, a psychologist, holding something up.
``That's a comb.''
He thinks, ``Boy, I am really high as a kite.'' He struggles against sleep.
Pecsok holds up a card with a drawing on it.
``It's a bed,'' says Jack. ``Where I'd like to be right now.'' More objects, pictures and flashcards with written words. He recites ``Mary Had a Little Lamb.''
When the medicine wears off, they see what he remembered. He answers almost every question right. A good sign - it means the undamaged side of his brain is controlling speech and memory.
A dose into the other artery, to shut down the good side of the brain. Now the damaged side is in control.
He can't count to three. He can't talk. He tosses his head impatiently and grunts.
``Jack,'' asks Pecsok after minute or so, ``What happened to you?'' She wants to see if he can remember the last few minutes.
``I got hurt June 15, 1976. . . . I stepped off a curb on June 15, 1976. I had a cerebral hemorrhage. . . ''
' On an evening in late June, a week after the test, Jack sits in the living room of his Virginia Beach home and thumbs through a pack of Polaroids showing the wreck that used to be his car.
``I could have killed somebody,'' he says.
In two weeks, his doctor would meet with the surgeon and staff at Sentara's Comprehensive Epilepsy Program. They would analyze the results of some tests and decide if he would be a good candidate for the surgery.
Just thinking about it scares Laurie.
But ``I want what he wants,'' she says. ``He's the one that's got to make the decision.'' MEMO: TOMORROW: Jack Pearce pondered the risks of having surgery to remove the
part of his brain causing his seizures. Suppose he lost some of his
memories? Was that too much to ask? ILLUSTRATION: Color photos
MARTIN SMITH-RODDEN/The Virginian-Pilot
When Jack Pearce learned he was a candidate for the rare brain
surgery at Sentara Norfolk General Hospital, he agreed to let The
Virginian-Pilot chronicle his experience.
HIS LIFE: ``I could have killed somebody,'' Jack Pearce said,
thumbing through a stack of Polaroids of his car, totaled when he
ran off the road during a seizure. His wife, Laurie, was willing to
be his driver, but Jack cherished his independence.
Photos
MARTIN SMITH-RODDEN/The Virginian-Pilot
As one test begins, neurologist Joseph Hogan asks Jack to hold up
both arms as a barbiturate is injected to anesthetize half of Jack's
brain. As that half goes to sleep, the corresponding arm drops,
indicated that the drug has taken effect and testing can begin.
As testing begins, a hush falls over the medical staff monitoring
Jack's progress.
Dr. Ella Pecsok holds up cards for Jack to identify and memorize.
This test determines his brain's dominant hemisphere. It turned out
to be his right.
KEYWORDS: EPILEPSY SEIZURES BRAIN SURGERY by CNB