And now, Mark Greene stars in Prognosis: Negative. A man I'm going to assume is a neurosurgeon says, "The ring enhancing legion and central necrosis on MRI was suspicious. The biopsy confirms it." Mark chokes, "Another pathologist should take a look. Could be an astrocytoma." Dr. Death says, "Two neuro specialists have reviewed the slides independently; they concur. It's a GBM." That stands for glioblastoma multiforme, which is most common in patients fifty years of age and older. It's a kind of tumour that most frequently occurs in the cerebral hemispheres and grows as an irregular mass in the white matter of the brain. The prognosis is very poor; the mean survival length, post-diagnosis, is less than a year, with less than 10\% survival after two years. (Thanks, Brigham Hospital at Harvard University!) Mark looks stricken, of course, and asks the survival rate in his case; Dr. Death says that, untreated, the rate is eight weeks, but that he can gain six to nine months with radiation treatment. Well, at least he doesn't have to worry about losing his hair! Mark asks, "What about surgery?" and Dr. Death breaks it to him with no preamble at all: "I'm afraid the tumour is inoperable." Mark asks why, and Dr. Death explains (speaking really fast in order to make it as difficult as possible to transcribe), "It looks like it invaded Broca's area. The speech arrest that you were experiencing was probably the result of a focal seizure. Even if we removed the entire tumour, you'd most likely be left with the inability to speak and understand language." "Communication," Mark surmises, steepling his fingers in front of his mouth. Dr. Death clarifies, "More than communication: you'd lose all ability to comprehend, interact with the world around you -- essentially what makes you human. Even if you consented, I wouldn't even consider operating. We'll keep you on Dilantin, three hundred milligrams daily. Do you have disability insurance?" Mark doesn't answer right away, and Dr. Death prompts him, "Dr. Greene?" "Yeah," says Mark. Okay, first, this is my PSA: it's exactly because of stuff like this that it's even more important that you get hooked up with disability insurance than it is that you have life insurance. The likelihood that you'll hurt yourself and linger on, unable to work, is much greater than that you'll be accidentally killed and leave your heirs destitute. You should have both, of course, but -- disability insurance! I'm not on commission! Get some! Second, I'm experiencing intense option paralysis, here. I can't decide which is more appealing: a Mark who can't talk and is barely human, or a Mark that's dead like a doornail. Oh, and, happy holidays!