A crisis and an answer
On the evening of Sept. 27, while working late at a university lab, he felt particularly awful. His headache and dizziness resembled a terrible hangover, he had great difficulty walking and he noticed black spots on his hand that did not wash off. Alarmed, he called his twin brother, a medical student in Oklahoma.
Harms said his brother thought the spots might signify internal bleeding and told him to go straight to an emergency room. He called a friend, who drove him to the hospital, which he later called “the most important decision of my life.” While waiting to see a doctor, Harms said, he sheepishly realized that the symptom that had freaked him out — the black spots — were stains left by silver nitrate, a chemical commonly used in the lab. “I felt so foolish,” he said. “I considered leaving the hospital then; I couldn’t believe I hadn’t known what they were.”
But a doctor who wanted to further investigate the headache and balance problems ordered a CT scan of his head “just to be safe.” The results were startling: Doctors told Harms that they had found a benign cyst deep in his brain and that he should follow up with his doctor. Harms said the advice was matter-of- fact.
Because he was concerned about Harms’s headache, a doctor ordered a spinal tap to rule out meningitis. After the test showed no sign of infection in his spinal fluid, Harms said, he was handed discharge instructions for headache and vertigo and told he would be going home.
“I remember feeling baffled, like how can they discharge me with a benign brain tumor?” Harms recalled. He said he felt intensely nauseated and somewhat disoriented after the spinal tap. As he prepared to leave the ER, a neurosurgeon made a beeline for his bedside.
Because it was abnormal, Harms’s CT scan had been flagged for the specialist to read — after the spinal tap had been performed. The neurosurgeon determined that the growth was a colloid cyst that had grown so large it was blocking the ventricles, fluid-filled spaces in the brain. The blockage had caused hydrocephalus, a dangerous accumulation of cerebrospinal fluid that was increasing the pressure on Harms’s brain, causing his headache, vertigo and other problems.
To complicate matters, Harms had undergone a spinal tap, a procedure that should never be performed in colloid cyst patients. The procedure increases the risk of brain herniation, an often fatal event that occurs when tissue or fluid in the brain is shifted from its usual position.
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