A Textbook Case

“Dr. Cusimano will forever be in our hearts,” says Paula Koss, “and St. Michael’s has been an angel to our family.”

Paula speaks from experience as several family members have been treated at the hospital within the same year. This family knows St. Michael’s very well in many different ways, and the care was great across the board. “Everyone was just amazing,” says Paula.

But the most dramatic St. Michael’s experience for the family is what happened to Paula’s daughter Cassy. It was in the fall of 2013 when Cassy, an active grade 11 student, started to experience extreme headaches and tingling, mainly localized around her right eye. A CT scan revealed a mass in her head and her doctor referred her to St. Michael’s neurosurgeon Dr. Michael Cusimano. At an appointment in July 2014, a reaction test on Cassy’s foot made him decide the tumour could not wait any longer. Although benign, the meningioma (a growth of the membranes surrounding the brain and spinal cord) was starting to affect her mobility. Surgery was required. Although Dr. Cusimano could see what the problem was, he wouldn’t know the extent of the problem until the procedure.

Says Cassy, “Dr. Cusimano talked to me – rather than through my parents – about what he needed to do and the risks. Because he was so caring and calming and answered all my questions, I wasn’t scared at all.”

The operation lasted nine hours. Paula tried to stay positive, but admits that when a nurse told her that everything was going to be all right: “I lost it.” Dr. Cusimano came out, calm as usual, and hugged her; then he took Paula and Robert, Cassy’s dad, into the ICU. With the bandage “turban” on her head and some swelling, Cassy looked to her family “like a football player.”

Dr. Cusimano talked to me – rather than through my parents – about what he needed to do and the risks.— Cassy

Cassy remembers Dr. Cusimano asking her to wiggle her toes after the procedure – and she could. She was so happy that she high-fived him. It was the first night in the ICU when Cassy felt the anxiety that she had been keeping at bay. Dr. Cusimano was reassuring, saying, “Of course, you’re upset; you’ve just had surgery and you’re in hospital,” and told Paula that she could stay with Cassy overnight.

Cassy’s case and Dr. Cusimano’s treatment now has educational impact as well. With her permission, Cassy’s procedure and photographs appear in a new book, soon to become a standard text, about skull base surgery.

During her recovery, Cassy juggled classes, but she graduated on time and finished grade 12 with very good marks. “Dr. Cusimano treated me like I was his own daughter,” says Cassy, “and he was very concerned about school, how it was very important and how I was doing.” She keeps in touch with her “hospital Dad” with prom and grad photos. Cassy’s now finishing first year at McMaster University in social sciences but considering a career in health and, earlier this year, she got her driver’s license.

She and Paula come back to St. Michael’s for regular check-ups for her right eye, which was affected by the tumour, with neuro-ophthalmologist Dr. Irene Vanek, who has also taken an interest in Cassy’s progress. Cassy says that when she comes for her appointments “Mama” Vanek’s first question is “How are your grades?” And she’s given Cassy many private pep talks.

When she was in the ICU, Cassy once asked Dr. Cusimano if his work was fun. He said “It’s fun when you like what you do, and you should only do what you like.” Advice Cassy plans to follow.