Its 10:30 pm on a Tuesday night.  We are in the Toronto Western emergency department waiting area.  Anna is sitting beside a woman named Kathy, she has visible mental health problems.  After speaking to one another for a few minutes in their secret language of random words; Kathy declares that the two of them are in a sisterhood.  Anna wrinkled her nose and forehead then looked at me.  It was time to leave Kathy in the waiting room and get the doctors on Anna’s case.

When Anna got her first brain met in January 2015, I was scared, but mostly because she was getting a craniotomy.  Her personality never changed.  She was always herself, just a version that couldn’t read.  This time it is different.  Over the last few days she has floated in and out of lucidity and delirium.  Her ability to read, write and express what she wanted was minimal.  I have always said that Anna was crazy, but I didn’t think it would ever actually come true.  One minute she could be speaking to a nurse or doctor answering appropriately, then the next minute drop into a trance repeating the number three and telling them how clever they are.

Over the last couple of days, she has improved drastically.  The moments of confusion and incoherence have appeared less frequently and decreased in duration.  She is becoming self aware and conscious of the situation, which unfortunately leads to frustration and moments of depression.  Who can blame her.  Brain mets have always been the one location that frightened her the most.  Retaining higher cognitive function and the ability to advocate and manage herself has always been paramount.  The last few days have made us both realize how fragile this journey has become.

Thankfully, friends and family have stepped up and given us the support we need to get through this ordeal.  I am confident Anna will be home early this week and well on her way to being herself.  I have no doubt that she will be blowing up twitter, advocating for young adults with advanced cancer, and blogging in the weeks ahead.

Ian