Pratima’s son brought her to me for the first time around three months ago. He was a big burly fellow with the gentleness of candy floss. “She had a very transient speech disturbance a few days ago,” he described his 77-year-old mother’s symptoms with a certain softness that has escaped today’s world. “The slurring lasted about five minutes and then she was absolutely fine,” he went on to explain. I confirmed that she didn’t have frothing from her mouth, upward rolling of her eyes, or any jerky movements or weakness in the arms or legs — the additional features of a possible seizure or even a stroke. She sat beside him, a quarter of his size but holding her own. “There is nothing wrong with me,” she insisted. “I can cook, eat, bathe, and go out on my own,” she asserted her independence. 

“Then why are you here?” I asked with a smile. “The MRI shows something,” she justified, as her son pulled out the films for me to see. There was a tiny bright dot surrounded by a celestial blush, a distant galaxy in the lower part of her left frontal lobe, which was her speech area. “You look great, but this doesn’t,” I explained, gently nudging her to get it removed. “Can we not wait it out a little, given her age and the fact that she’s doing well?” the son asked respectfully. “You can,” I wavered a little, not entirely sure if this was as sinister as my first impression was, “but it’s taking a chance,” I added. We concluded that we would repeat an MRI after three months, or earlier if her speech decided to throw a bigger party. 

Eight weeks later, when her son called me on the phone, I instantly recognised his voice because no one in this chaotic world had spoken to me that respectfully since I’d last met him. “Mom’s speech has gotten worse over the last few days,” he described. “She’s mixing up words, she repeats the same thing over and over again like a broken record, and some sentences are incomprehensible,” he said, his tone dampening to an inaudible thud. “Repeat an MRI and come and see me,” I urged. When they returned the day after, I was a little taken aback to see that the dot on the MRI had exploded. The frontal lobe looked like it had been hit by an asteroid. There was a galactic collision. The tumour had exponentially grown tenfold. “We have no choice but to remove this,” I declared, and they agreed without any hesitation this time, without even a polite request to procrastinate.