After examining scans and ruling out other possibilities, cancer was the most likely explanation for the unusual symptoms that Rachel Palma experienced beginning in January 2018.
“I was having involuntary movements with my right hand, so I was dropping things,” the Middletown, New York, resident said. “The worst symptoms obviously were hallucinations. And I wasn’t always oriented to time and place.” Once, Palma locked herself out of her own house and another time, her bank account.
“I was no longer able to process the fact that a key opens the door. The computer screen looked completely different — it was almost foreign,” said the now-42 year old. “What I was perceiving was different and so how I was responding was different — if someone was asking for a pen, I would give them, for example, a key.”
Sometimes she had blissful, symptom-free days. With no warning, the dropping things, the hallucinations, the disorientation would return. After January, her symptoms “progressed pretty quickly,” she said, guesstimating she visited the emergency room at least 10 times. “But as soon as they ruled out a brain bleed, I was discharged.
Although I was a danger to myself and probably to others, they still discharged me,” she said. Fascinating, mysterious, and medically amazing case files. This series is the most interesting education into the world of medicine and disease and the human body. She understands why, since no one could identify what was happening with her.
“They said, ‘If you’re not actually having a brain bleed, then it’s not actually an emergency,’ ” she said. A seizure disorder was also investigated and quickly dismissed. On a brain scan, Palma’s primary care physician detected a small lesion in the left frontal lobe of her brain and immediately sent her to Dr. Jonathan Rasouli, chief resident of neurosurgery at Mount Sinai Hospital in New York City, and his colleagues.
“We decided it would probably be in her best interest to do a biopsy of this lesion,” said Rasouli based on the fact that she was healthy and young and was having symptoms that he could directly correlate to the location of the lesion.
Besides, she had no risk factors for anything else that might explain the presence of a brain lesion. Rasouli carefully explained the possibilities to his patient. “I was told that it was most likely a malignant tumor which would require radiation and chemo even after the surgery,” said Palma. The surgery would be risky because the location of her “tumor” was very close to the brain region that controls speech.
Rasouli told CNN, “Her fiancé had just proposed to her and they were looking to move in together and then all of a sudden she had this diagnosis of a brain tumor. Can you imagine?” Palma, though, believed the risk was worth it, “given that it was supposed to be a malignant tumor. I still think the risk was worth it.”