I was lying on a hard bed of some sort, a moving bed that is…I saw houses and trees fly by through a window, which is never a good thing and a siren going off. Why a siren? Then a young male face came into my view. Pleasant enough, the man was in an EMT uniform. Now, that was serious. I just had dinner at a Chinese restaurant called “Cooking Papa”. Great food: beef stew and drunken chicken, and a fruity desert with my colleague and close friend Jacob Cohen.
Another EMT was driving up front.
So I asked the first EMT, who was seated next to me: “What is going on?”
His calm reply was completely irrational: ”You just had a seizure“.
?Me and a seizure? Impossible” I said... “What is that nonsense? You are totally mistaken. “I never have seizures.” “No you had a seizure,” he said calmly.
”What kind of lie is that?” I demanded. He replied: “no, you had a Grand Mal seizure”. “Stop lying to me”, I thundered, and hit his arm twice or thrice for emphasis. He stayed cool, and asked me the usual questions, like my name – Minoru Freund -, what day of the week it was  - Tuesday -, what date it was – October 5th, 2010 -,
“Where had you been right before?”  came the question.
“At the Cooking Papa restaurant of course”, I replied, while he was checking my vitals…
“What were you doing there?” he asked. “Eating with my friend Jacob” I replied.
Jacob and I had one of those occasional dinners that were keeping me sane grounded, and energized.
My mother was home by herself, and my father was in Los Angeles for some meeting.
“What are the last things you remembered?” He asked.
“A fruity desert. Did you have some? If not you should – it is really good.” I replied.
Then I remembered that my left hand - my weak hand - had suddenly cramped into a tight fist, and I had tried with my right hand to loosen the fingers of my weak hand and to pry open the fist.
Those memories and the sounds of the dinning room came flooding back and mixed with the noise from the ambulance I was in.
“Where are we going?” I demanded. “El Camino hospital” was the reply.
That was good: “My primary care physician Dr.  Shane Dormandy, is at El Camino. He would sort things out for me” I thought.
At that moment, as the ambulance slowed at the emergency entrance of the El Camino hospital, the following memory hit me: “I was seeing both my arms reach up and then I was bending backwards in my dining chair touching the floor with my hands and almost with my head.” Then utter darkness…
“OK I guess you are right”, I admitted, “I did have a seizure.” “I am sincerely and terribly sorry for hitting you earlier”, I offered.
“It’s OK.” He said. “No really, I apologize wholeheartedly”.
“It’s OK.” He repeated.
The ambulance door opened in the back, I was moved out of the ambulance and my moving bed, became a rolling one. This was cool.

Then the usual paperwork, so out from my pocket came my insurance card and ID, The minutes crawled by like molasses. I must not forget to retrieve those items later.
I was transferred to a gurney, vitals checked again, by a friendly nurse this time.
The two EMTs still there. I apologized again. I asked him to please forgive me. Everything was starting to wobble. More questions, like if I had pain, and on a scale of 1-10, how bad is my pain. “Just in my lower back, pretty severe around a 10 ” was my answer. An IV is inserted in my right arm. “What are you doing?” I asked the nurse: “we will giving you intravenous anti- seizure medication”. “Oh no you are not going to start me on that path again.” I thought out loud.



Then finally a doctor (in a pale green dress). I love green - makes me calm. I looked at him.
“Patient has had a grand mal seizure, and says he has pain in the lower back”, said the nurse.
“ Sorry what is your name?” “Dr Dan Fox, head of ER”. “I am Minoru Freund, a Director of Research at NASA Ames. I had two glioblastoma tumors in the past 12 months. The first was resected at Columbia Univ.” and I continued to rattle off my clinical history for a few minutes. I wonder why they cannot find my medical record. I have a doctor here. His name is Shane Dormandy.” “Shane? He is a good fried of mine.”
“We will be giving you a CT-scan of your head and then some some antiseizure medications via IV. and later an x-ray of your lower back. “
“ Are you allergic to CT contrast material?” asked a nurse, while hooking me up to about a dozen EKG leads.  I was still finding contacts they left on my skin two days later.
“Look I had about 16 or so CT scans in the last 12 months, so no I get that contrast material every day for breakfast.”
“Great then will first give you the CT scan right now”.
Then I saw my mother of all people, just as they started to move my gurney out of the ER room.  She tenderly took my hand, and with lots of concern for me asked how I was.
“I need to vomit,” I said. Finally, after what seemed like 10 minutes a tiny tray, enough to spit in, but not to vomit in materialized in my mother’s hands in front of me. “Too small!!” was all I could think, but it was too late, as I vomited all my dinner into the tray, onto my mothers hair, her beautiful red wool sweater, and all over the floor. It just kept coming out. It felt great, as if a heavy burden was lifted. “ Wonderful Mino-chan Get it all out”, my dear mother encouraged me. “Don’t worry about the rest.”  The movement of the gurney was the trigger. As I was rolled away for CT scanning, a janitor started to clean up the mess on the floor.
CT scanners are awfully cool places. I always think of them as a cross between jet engines that sound like helicopter taking off in the movie “Apocalypse Now” and guillotines. Finally a few precious minutes of solitude. Then back to my ER room.

“How many seizures has Mino had until now?” Dr. Fox asked my mother.
“None. Mino never has experienced any seizures. Exactly one year ago today on Oct 5th 2009, Dr. Jeff Bruce from Columbia Univ. performed his first brain surgery. Ever since Mino was taking anti-seizure medications, first Keppra then Depakene.”
“Well then…” Dr. Fox seemed perplexed.
“Mino’s neuro-oncologist at UCSF stopped to give him any anti-seizure medication in July. She said Mino doesn’t need the antiseizure drugs anymore. At the same time she prescribed him Ritalin,” replied my mother.
“Ritalin?!?” Dr. Fox rolled his eyes. “Ritalin is known to cause seizures. Stop anti-seizure medication and give Ritalin? Crazy! It’s like inviting seizures to happen. Crazy…”

However, I was carted off again to the x-ray room. – just two quick photos of my lower back. Then back to my room.

I see Dan Fox in the ER in an animated conversation on a cell phone, so I ask my mother whom he is talking to. “Rose Lai” comes the answer. My dear neuro-oncologist Dr Rose Lai from Columbia is talking to Dan Fox, and instructing him on what to give me and what to do and what not to do with me at about 2am her time. My mother had called her. So as Dr Fox is standing upright in full attention like a soldier, rocking up and down from his toes to his heels, I can hear Rose’s forceful voice, instructing him, and all I see is a green clad soldier being commanded by my dear Rose. I ask my mother, how she came here.


The CT scan showed no anomaly, no new lesions in my brain. The x-ray scan was also clean, but my back pain was palatable. What the hell was going on, I thought since the x-rays did not show anything.
They gave me some IV drugs, Keppra as it turned out, and I felt finally some calm, knowing that Rose Lai had cleared everything. What about the pain I inquired.
That was next. “Do you have allergies for any pain medications?” they asked me: “yes I am allergic to Percocet.” “What happens?” came the question.
I had to do a full stop - and was reminded of an episode on about Oct3rd 2009, just before my first brain surgery at Columbia University. It was at 3am in the morning. I had been under intense pain, and just been given some Percocet. At that time, I was on an EKG monitor, as well as a device to measure my blood oxygen saturation level. All of a sudden I felt like a steel band was placed around my neck, and I felt like I was suffocating. My mother was fortunately at my bedside. I needed oxygen, and a lot of it. She called the night nurse, and one of the scariest episodes unfolded with me as the experimental subject. She called the night nurse again. No response… things were getting black and white. She ran out to the nurse station. Nobody there. “Help, help” she shouted. Finally a rather unfriendly burly African American nurse shows up – her name is Joyce -, and demands what the problem is.
“He needs oxygen.”
“I need to get doctor’s orders.” was the reply. “What do you mean doctor’s orders?” “I’ll have to call the doctor, and that will take about one hour and also we don’t have oxygen in this hospital” she declared. Now I can believe you have no guns in the acute care at Columbia, but no oxygen?
There is a bright yellow-labeled oxygen outlet right behind me. “Can’t give it to you”. By now, she screams at my mother over my head. While I see more black, I catch the blood-oxygen saturation drop from my usual 98% down to below 80%... on and on it goes between my frantic mother, who storms out of the room to find a more reasonable supervisor. Finally, after more than 20 minutes I receive my O2, my blood oxygen saturation value having plunged to below 55%. I could have just died. That nurse at Columbia that night was what is called a street nurse, not a Columbia employee, and she was fired that morning.
Different states have different requirements on nurse staffing levels, and New York has one of the worst at something like one night nurse for every 8 patients, while states like Ohio have much tighter requirements. Street nurses are hired off the street often quite literally, and are employed by staffing agencies in the same way as say tech support personnel, but often do not know how the specific procedures and practices at say Columbia Univ. hospital.
So back to the ER in El Camino hospital at ~11pm. So, they give me 20mg of Morphine. I love Morphine. It works like gangbusters with me.  I always get immediate relief and no side effects.
Finally, I see Jacob, and we talk about the last minutes before my seizure. He caught me just as I was stretching backwards, and just was about to fall off my chair. Fortunately, two MD’s were at the table next to us, did first aid, and held me until the EMT's arrived.
My room was full with people: my mother, Jacob, Dan Fox, a couple of nurses.
Then another surprise: my good friend Deb Feng showed up. The time just kept creeping by and it was already 2am. Where did the hours go, I cannot recall.
Suddenly, another familiar face: my primary care physician Shane Dormandy. He is a very caring doctor, and I feel loved all around. Just wished my father was there.
Dan asks Shane who the hell Rose Lai is. “Oh she is Mino’s neuro-oncologist from Columbia University.” Moreover, he adds, “She is relentless in fighting for her patients. You better do what she tells you to do, because otherwise she will be all over you.” What an absolutely perfect phrase:“ she will be all over you.”
“UCSF took Mino off the Depakene and gave him Ritalin? That is just monstrous!” Shane exclaims, having been told my story. “  It’s common sense to keep taking anti-seizure medication in cases like Mino’s – and Ritalin? Everybody knows it has a high risk of causing seizures.”
The time just disappears, but finally I am discharged, somehow magically my mother and I make it into Deb’s car. We finally arrive after 4am, exhausted but quite alive.

Postscript: This January my parents and I visit Dr. Dan Fox, and he is pleasantly surprised as we hand him a New-Years card. He looks at me, then at my parents and says words that stay with me forever: “ When I saw you the last time, I gave you at best 50 – 50 chance of making it through the night.”