NARRATIVE ESSAYS

The Butterfly of Death

Justin C. Cordova, MD

Fam Med. 2024;56(2):135-135.

DOI: 10.22454/FamMed.2023.830544

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“… and this is my wife.
We got married in September.”

 

September (my heart fell and failed at his words)
was just five months ago.
Five short months of marital bliss,
of blissful ignorance,

 

of living happily ever after
without an inkling that he was dying of cancer;
five months of planning, of dreaming,
before his first seizure quickly gave way to his second,

 

before magnetic resonance and computed tomography
identified for us the beginning of his end.
Through the grays and the blacks, we found a butterfly glioma,
which sounds so peaceful, so sylvan.

 

It was as if one of Carle’s hungry caterpillars
had nestled itself inside his white matter,
growing and cocooning,
metamorphosing and molting,

 

eventually emerging as a full-fledged astrocytoma,
what I have come to think of as the butterfly of death.
Once discovered, once it had made itself known,
its taxonomic classification

 

(the genus glioblastoma, the species multiforme)
was appallingly superfluous.
What difference did its nomenclature make,
either to us as clinicians or to him as a patient,

 

when compared with the devastation it would bring?
We wondered then if he would make it to forty-five.
We wonder still.
Yet, despite all of this,

 

the seizures and the Keppra,
the brain biopsy and tumor board,
his outlook is too full of life to leave room for death;
too full of living to speak of his dying,

 

so proud to show off his new wife
and new life, ignoring his silent butterfly

 

until the day its death can wait no longer.

 

Lead Author

Justin C. Cordova, MD

Affiliations: Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, MD

Corresponding Author

Justin C. Cordova, MD

Correspondence: Department of Anesthesiology, Walter Reed National Military Medical Center, Bethesda, MD

Email: jcordova91@me.com

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