Transcript: Part 1: A Life Unravels
When Demetri Kofinas was diagnosed with a benign pituitary tumor, he faced bizarre symptoms and difficult choices. With the help of his father and Dr. Jeffrey Greenfield, Demetri took on the challenges and came to a decision.
Dr. Stieg: I'd like to welcome my two most fascinating guests today, Demitri Kofinas, and Dr. Jeffrey Greenfield. Dimitri is creator and producer of Hidden Faces, a podcast exploring the underlying forces driving global change. And Dr. Jeffrey Greenfield is a Professor of Neurological Surgery specializing in minimally invasive approaches and the complex treatment of brain tumors. I wanted to first clarify for us what the difference is between talking about a benign tumor versus a malignant tumor and then we'll get into where they cross over into the gray area. But Jeff, would you mind talking a little bit about what the difference is there?
Dr. Greenfield: I think that's a really great place to start because that really is one of the more confusing features of being diagnosed with a brain tumor and families will often jump right to the question as to whether or not the tumor is malignant or benign. The really interesting part about craniopharyngioma is that it is a benign tumor, but it carries with it so many complicated features that are often associated with more complex and even sometimes malignant brain tumors with respect to how it affects the brain. It's a little simplistic to call it a benign tumor because while the pathology, what we see under a microscope may be benign. The consequences to the brain and the person experiencing both the effects of the tumor itself and the repercussions of surgery are anything but benign.
Dr. Stieg: And Demitri, I think you can give the personal aspect here. You I'm sure were told though, this is a benign tumor — it's about a decade ago now when you were diagnosed. It had profound impact on you, your life, and who you really were at that time.
Dr. Greenfield: I had gone to a surgeon at another hospital and I had a very negative experience with what he told me. If I remember correctly, was two, I spoke to one over the phone, which was out of New York, and they said, you got get to the surgery now. This is going to grow a hundred, you know, they didn't say a hundred percent I forget what they said, but it was like, it's going to grow. You better do it now rather than later. And another one from New York told me, whatever this tumor is going to do to you, it's not going to be as bad as what I'm going to do to you. And he had a tool on his desk, and they only do craniotomies there from what I understand. And he had a tool on his desk, it was a big tool and he said, you see this like, you know, go in your head, and — I'm kind of paraphrasing here, but that that really kind of was the experience.
Dr. Stieg: So they frightened you.
Demitri Kofinas: It was super scary. My father was with me then and he was my advocate and he was walking me through this process and he was devastated by the situation.
Dr. Stieg: He was with you at the doctor appointments?
Demitri Kofinas: He was.
Dr. Stieg: Was he devastated by the way the doctors were relating to you or by the information you were getting?
Demitri Kofinas: He was devastated by in that first instance, my dad, I think, on some level my dad was relieved because he wanted to believe that he could, we could. That it would be okay that it wouldn't grow because the doctor basically said, it's probably not going to grow. It's been there since you were born. I would leave it. But then he said to me, uh, this is, I'll never forget this. He said, "But don't come back to me in a wheelchair with blinders on and blame me, or something like that." It's totally nuts.
Dr. Stieg: The amazing part about this is early on in your process, you're normal. Now. You find out that you've got this quote benign tumor and it's two physicians you've met with have scared you to death. You and your dad are now having to cope with this.
Demitri Kofinas: I became very depressed. I mean it was interesting. My first reaction was there was almost a kind of you, not euphoria, but you know when you suffer, you go through a lot of suffering. There are periods where you just feel, it's almost like there's a transcendent feeling to it. I just remembered losing my inhibitions. Maybe that's the best way to put it. I lost all inhibitions in a radical sort of way. And that ended up actually then coming back in a much more, uh, in a much more constructive manner later, which was, I would say, the biggest contributor to my life changing around in a positive way. It was devastating. I became depressed. I had a great job working in strategic product development for Cablevision, just me and a handful of people picked by the lead engineer for the company. And I quit. After a few months, I was so depressed. I didn't like what I was doing, why I wanted my life to mean something. I was afraid that I was going to die. I didn't know how long I was going to have and I, I felt like I wasn't living my life, but I didn't know what I wanted to do and I was depressed and I just wanted to, I just wanted it to be over somehow. I didn't want it. It was just terrifying. It was hard. It was. And then, um, eventually I was able to turn my life around, you know. I fell in love. All these things happened for me and I had let it go. I'd forgotten about the tumor. And then, uh, at some point the symptoms appeared.
Demitri Kofinas: I was beginning to play Tetris incessantly in the summer of 2012, which was super weird because I could tell you we've all probably played Tetris. But it wasn't until this experience that I realized what a dumb game it is. It doesn't require much of any intelligence at all.
Dr. Stieg: Glad I've never played it.
Demitri Kofinas: It doesn't, I wouldn't have known to tell you that if I hadn't had gone through this experience, but it was this, it was a, a sort of, I don't know what people do when they have tumors. I'm sure Dr. Greenfield's seen all sorts of crazy things. But I — then I was also smoking incessantly, by the way, in which I was embarrassed about, when I met with Dr. Greenfield and I had to get a chest scan. And afterwards he, I think he even told me explicitly that he better not catch me smoking. And I, I remember feeling super anxious or guilty that I might, you know, be confronted by Dr. Greenfield in a random place. But anyway, to, to bring it back. I was playing Tetris incessantly during production meetings. I was, the host of my show was asking me questions. I was playing Tetris. So that was weird. And I began to smoke incessantly. That was weird too. But, it wasn't until my drive up, we got the U-Haul with my ex-girlfriend from Washington DC, and drove up to New York. And I found out that my grandfather had died. And I did not remember that fact until about a month or two after my surgery. Most of my memories came back, what felt, what felt like days after my surgery. But they were these sort of things that came back later. And that just came back one night and I emailed my sister and I said, I just remembered that our grandfather died and I expressed a bunch of feelings about it.
Dr. Stieg: Perhaps Jeff, you could give us a little bit of groundwork here about why, where this tumor is Demitri would have had these problems with memory, emotional changes, concentration changes and things like that.
Dr. Greenfield: Well, I don't think Demitri and I talked too much about whether or not that was going to get better or not. I think that when I usually talk to patients and their families, like I was talking with you and your dad. We're really so much more focused on the things that we're familiar with that are tangible things like the pituitary gland and the hormones that it creates and the impact that the tumor might have on your vision and the repercussions of surgery. And I think we often forget about some of these cognitive impacts that tumors might have. The neuropsychological aspects of craniopharyngioma are hard to understand. And what scientists have looked at and explored for this is it's pretty minute. And so we're really on the tip of the iceberg in terms of understanding why this all happened to you.
Dr. Stieg: The decision process that you were making was when you were normal except for this questionable testosterone level. Over time, you started having symptoms both memory wise but also emotional. But the other large part, it seemed to me about your decision process was you were terrified about losing pituitary function and the thought of being on all those replacement hormones. And maybe you can talk about your emotional part and Dr. Greenfield can talk to us a little bit about what that means for a patient.
Demitri Kofinas: This whole experience was devastating for me. Dr Greenfield mentioned the possibility of blindness that was a risk, a major risk of surgery. The only options that had been presented to me were full craniotomy.
Dr. Stieg: Craniotomy meaning making a big hole in the skull.
Demitri Kofinas: Making a hole in my head, yeah. And using that tool, that medieval device that the other physician was waving at me — or the endonasal surgery or transsphenoidal. But these were just medieval. This is just what, you know, what is this thing? And in all of those cases, that was a risk as I understood it, of blindness. So I was stuck with those images in my head. And I think also to be honest, it wasn't just that I had a hard time remembering what Dr. Greenfield had told me because I remembered it in a way, but I biased the other ones. I was so despondent and I was so afraid of opening my heart to the possibility that something good could come of this situation that I, I was unable to really hear what he was saying, which was we can do the surgery with no side effects.
Dr. Stieg: Loss of vision is pretty understandable, but this tumor also involves the pituitary gland. Jeff, perhaps you could explain if you lose that gland, what does that mean for a patient?
Dr. Greenfield: Pituitary gland, people often have, as kind of a rudimentary idea, that it controls hormones in a global sense. And it is true. The pituitary gland is actually made up of an elegant mix of lots of different cells. Each one which secretes a specific molecule, which then interacts with the brain in a complex feedback pathway to allow the body to do a number of things. It helps the body make steroids. It helps the body make the hormones that regulate the sex hormones, how we make our eggs and our sperm. It affects the levels of thyroid molecules in our body. So there are a complex harmony of molecules that the pituitary gland regulates. And the key for patients with craniopharyngioma like you had, is that it's not actually the pituitary gland that was dysfunctional in your circumstance. We weren't worried about making it dysfunctional. We were worried about the connection between the pituitary gland and the brain. There's a very thin little fiber bundle called the stalk that actually connects the pituitary gland to the brain. And that's where craniopharyngioma comes from. And so it's almost impossible to remove a craniopharyngioma without a significant risk of damaging that stock, thereby disrupting this kind of beautiful highway between the pituitary gland and the brain. And that's the situation that you've found yourself in trying to balance.
Dr. Stieg: And what that means for the patient, when Dr. Greenfield talks about all of these various hormones is really what the patient describes is change in sex drive, change in energy levels, change in sleep, change in the ability to concentrate, change in their ability to deal with stress or not deal with stress. The impact that you are worried that, oh my God, if I have this surgery I'm going to be left with, with the symptoms that actually eventually developed for you.
Demitri Kofinas: Hearing Dr. Greenfield, talk about the pituitary stalk. I just had visions again of how complicated the surgery appeared to me both before and afterwards. I sent Dr. Greenfield email an email the day after I got released where I, I expressed my just, awe at what he and his team had done and it just, just hearing it again, just thinking about that he was in my brain and there was just such a narrow margin for error. No margin for error.
Dr. Stieg: Another interesting component of all this is the relationship you had with your girlfriend at the time and the relationship that you had with your father. You said he's a physician. Sounds to me like he was a real guiding force and light for you in this process. How did those things change as your disease progressed?
Dr. Greenfield: Well, I didn't see my dad much when I was getting my, my symptoms. I was living in the city, I was living with my ex girlfriend and she was, you know, working a lot and I was, I was home, you know, uncharacteristically despondent, not just despondent. I would say what was uncharacteristic about my condition was that I was stumped and that's not something that is usual for me and it was so, it was so, it was so difficult for me and what was I doing? I was going out in the balcony and smoking incessantly, smoking cigarettes and throwing them on the balcony. Not tying my shoelaces. I mean I was doing all these things and I spending a lot of time alone. I lost the capacity to imagine and that impacted not just sex. I realized so much of what was missing only when it came back.
Dr. Stieg: What was it about the doctor patient relationship that you obviously had some frightening things happen early on. Then you met dr Greenfield and a light went on that this was the way to go.
Dr. Greenfield: Well, look, I grew up around doctors, so I know doctors in and out. I think it's a tall order to ask most physicians to fulfill the emotional duties that we wish they would fulfill. Uh, and that I think in some ways they should be able to fulfill. Unfortunately, they don't often, I'd like to say your physician, your doctor should express a certain, I don't know what the, what, how you would describe it as, uh, a warmth of basic sort of empathy. But I think that's a tall order to ask for honestly. You know, I don't know if there's an incompatibilities with most physicians, the type of learning and expertise that it requires to be a physician and the emotional intelligence that is also necessary. You know, the type of patch Adams, but dr Greenfield did have that. If it were not for my father, I wouldn't have found dr Greenfield, you know, none of this would have happened.
Demitri Kofinas: He worked very, very hard to make it happen. He didn't just apply his expertise and his intelligence and his vetting capacity, but his persistence and he had reached out. It started by reaching out to someone at Harvard who had directed him to someone who was at a conference in Germany who took my call with my father and said, you need to speak to this woman. And she said, you know, this is too big for radiation, at least right now, but you should speak to Greenfield. And, and my dad, that's the one thing stuck out to my dad that he said to me, and he said it repeatedly, was that she said, "He, he can, he might be able to come in from above." Which is so weird to hear given everything that we had been told. And then we met with Dr. Greenfield together. And that was basically what he said. And it was, to me it was just like, what are you talking about? Like, you know, I don't know what you're saying. Like I have a brain up there and what do you mean you're going to come in from up there and you're not going to cut anything. But my dad got it and I was in such a fragile intellectual condition that I was unable to process what he said, but I was able to Intuit from my father's emotional relief.
Dr. Stieg: Jeff, maybe you can in lay terms, describe what simplistically was different about what you were offering versus what Demitri had heard before.
Dr. Greenfield: Yeah, I was thinking that maybe we needed a pause there to explain a little bit about what he's referring to because there are a number of ways to get to the center of an egg. And essentially when you're talking about a large craniopharyngioma, this is a basically a big mass that's right in the center of the skull. And so, the ability to get at it from different orientations through the nose or through the skull, through a big hole like we mentioned before, are certainly things that are, have been passed down through generations. And it's the way that most surgeons address these. In a funny way Demitri, the fact that you waited so long and were so, um, insistent upon continuing to find other alternatives probably is the single factor that allowed us to approach it via this technique because it had gotten so large that the big kind of cystic portion, which is a fluid balloon, like a sac that comes off the tumor, had actually extended so far up into the middle of your brain that it went into an area called the ventricle. And we don't often see tumors that large in adults. And so when you look at a picture of your tumor from the side — I remember going over this with you. The actually the shortest distance to get to the tumor was actually right through your brain. It obviously involves going through your brain a very short distance, but that accessibility allowed us to access it through a very, very small hole with a very, very small instrument called an endoscope and actually drain out all the fluid and reduce the size of this big cystic mass down to a small fraction of what it was originally.
Dr. Stieg: We've gone through the lead up to surgery and we'll come back in another episode to discuss what life is like after surgery.
Part 2: Rebirth After a Brain Tumor
Memories return – along with a surge of confusing emotions – after Demetri's surgery to remove a craniopharyngioma. Dr. Jeffrey Greenfield joins his patient and Dr. Stieg to talk about revelations after brain tumor surgery: Demetri learns the value of surrender while his neurosurgeon develops a better understanding of his role in his patients' lives.
Dr. Stieg: I'd like to welcome back Demetri Kofinas and Dr. Jeffrey Greenfield. We've been talking about craniopharyngioma and Demitri has gone through the history of his life up to the point that he had surgery and the intellectual and emotional changes that he'd had on his life and his relationships and his work, and he then had surgery with Dr.Greenfield. Now I'd like to concentrate more on what happened after. This was obviously an anguishing episode in your life that went on for what, about five years prior to having the surgery and then you had the surgery in what, 2013? What happened?
Demetri Kofinas: Well, by the time I went in and had surgery, I was, I had full blown anterograde amnesia as I think we either stated or, or it was implied by what I was saying in terms of the symptoms. I couldn't remember much. I couldn't remember who I had just seen. I couldn't tell you what a giraffe was. I could tell you it was an animal. I could tell you had a long neck, but I didn't know what an animal was. If my symptoms had persisted after the surgery, I wouldn't have probably known where I was. So the first indication that I had had some relief as a result of what happened was that I even knew where I was. And I knew immediately where I was. And I remember seeing my father and my mother and, uh, my, uh, my girlfriend and I had told my dad before the surgery and I remembered this, "I'm going to look to you and I want you to tell me what happened." And I looked at him and he said, you know, it was great. And, I remember my dad saying that he saw the hyp— that Dr. Greenfield saw the hypothalamus pulsating after the, the pressure from the cyst had been removed. And I said, "Wow, he saw, he saw the hypothalamus pulsating." I understood immediately what that meant. And so immediately understood that I, I was getting better and my father had, that was an emotional experience for him because he hadn't seen that. I mean—
Dr. Stieg: You saw that the lights were on.
Demetri Kofinas: Exactly.
Dr. Stieg: And, you appreciated that the lights were on. Internally and emotionally, how did that affect you?
Demetri Kofinas: Oh my God. I didn't have my cell phone on me and I wanted all these numbers cause there were certain people in my life who had stood by me or who I had a close relationship with during this time as I wanted to call them and tell them how, how well I was. And they were so overwhelmed, they could still tell you the story of what it was like to hear it from me. It was a, I heard from other people's voices and from their facial expressions when they saw me, it was an affirmation that I was getting better. I was okay. It was a miracle.
Dr. Stieg: So for you, it was an awakening.
Demetri Kofinas: It was, um, first of all, the reacquisition of memories that I had never remembered making, but that all of a sudden were, there was one of the scariest things that I've ever, because it was evidence of how messed up I was and there was no guarantee that that was not going to reverse.
Demetri Kofinas: So it was scary. At the same time. It was exciting. I mean, when I left the hospital and I came home, I wasn't able, for example, to use Skype for months and I thought it was because Skype was broken or my computer was broken, but I just didn't remember the password. I go home and just enter my password, my computer. I go into my parents' house put in the code for the garage. Everything just started. It was like, you know that sound on your Mac when you hear the unclick—.
Dr. Stieg: You got your life back.
Demetri Kofinas: Yeah. But literally everything unclicked.
Dr. Stieg: Jeff, what did you see? The same kind of changes?
Dr. Greenfield: Well, I mean I'm getting a little emotional because, no, I mean I think to touch back on what Demitri had said before about how do you, how do you find the right balance as a physician with the physician-patient relationship so that you emote that empathy and you create that connection and warmth but at the same time protect yourself against what we do, which is a very scary field sometimes. And I think we all as physicians find that own particular balance and that own line where we get as close as we can and feel that it's comfortable. But we don't operate on our loved ones. We don't operate on our friends. And there's a reason for that. And so I think I might not have appreciated the intensity with which you were experiencing that rebirth and that renewal. And again, I read that article afterwards and it blew me away that maybe I was blind to some of the things that you were experiencing before and actually the rebirth that you had after surgery. Clearly I knew it was successful and in a technical sense and looking at the MRI scans, I felt validated with those kind of metrics that we're familiar with. But you know, it's actually really powerful for me to hear you describe it like this.
Demetri Kofinas: It was, it was kind of like the movie Awakenings, that particular moment in my mind, the way I remember it because everything was kind of this rebirth. Everything was, and uh, and I remember it was like five in the morning, six in the morning. It was like before you did anything else. It must have been when you came to my bedside was the day that I got released and you were just sitting right across from me. And I just remember waking up and just seeing you there. It was the weirdest thing. I was like, what is this? *laughs*
Dr. Stieg: How long has he been watching? "Hope I didn't do anything embarrassing!"
Demetri Kofinas: So great. Right? Cause like for me, Dr. Greenfield was in this, in this story. I mean, I was the protagonist. Clearly, I was the one with a brain tumor. But, you know, chief, chief character, right? And so it's an unusual feeling to have to give your life to someone that you hardly know and for them to, to service you in a way that is not just, you're not just grateful for, can't even, it's not even reasonable to expect that type of outcome. And so you have an unusual feeling of gratitude that is just not normal for any other place in your life. You don't normally feel that way about someone that you don't know. And so that was, you know, those were intense feelings that I had.
Dr. Stieg: You seem to be a person that's very comfortable with expressing your thoughts and emotions. And I wanted to touch upon one of the aspects that we as neurosurgeons, unfortunately I have to deal with on a daily basis is not only your disease process, but the process effect on both you, your emotional sense of self, your relationship to your surrounding world, and also your relationship with the loved ones in your, in your life and their relationship with you. And our role as physicians trying to help you balance that. Do you have any advice for people about how to deal with all of that stuff going on? The emotional, the physical.
Demetri Kofinas: Well, it's a big question. Do I have any advice? Um, people have reached out to me over the years. Many people have reached out to me from having read my article or, or for other reasons and I have never shied away from helping people on an individual basis. Some people reach out to me and it's like, you know, you want to say to them, "Why are you reaching out to me? You should reach out to a physician. This is, this is crazy."
Dr. Stieg: That was the point I wanted to get to is, like you said, everybody is different. But do you think that recognition of whatever the situation — is probably the key component? I recognize that you feel badly about not remembering and now all of a sudden you remember. I recognize that you ignored me and just, you know, giving the person permission and talking about it.
Demetri Kofinas: Yeah. The worst feeling in the world is when you're going through hell and everyone around you is not experiencing what you're experiencing. And they have the luxury of playing it down. Yeah. And that's the worst experience for anyone to say, "Oh that's good. It's going to be okay." No, it's, you don't know it's going to be okay. You don't know that it's going to be okay at all. Don't tell me it's going to be okay. Acknowledge what I'm telling you. Acknowledge what I'm feeling. And that was an experience that I had before my surgery. And it was an experience I had after my surgery. The first time I cried was when I came home after my surgery and there was a friend and God bless her, it's not, it wasn't her. You know, she did the best she could, but she happened to be there and she, uh, she said, "It's over now. It's, it's behind you. You've got to move on." And I just remember being so angry cause I just thought, you know, I had just been through all of this. You haven't been through any of that. And, and, and in this, just, this one moment makes you feel uncomfortable. You're not doing it to hurt me. I just remember one of the experiences I had was this, the resentment and anger that this had happened to me. It's such a young age and my inability to relate with the people of my age group. I didn't know anyone else that had had a brain tumor.
Dr. Stieg: Did you get help with that?
Demetri Kofinas: Well, I was seeing a therapist after my diagnosis who I still see. He was a wonderful support during the process, but again, I would just say like, it's just one of things where you can't — also for loved ones, like I just feel like the best way to handle the situations for the people around a patient is just to be as transparent, honest, and unfiltered as possible.
Dr. Stieg: Give you the space.
Demetri Kofinas: Yeah, and I feel like, you know, people want to feel seen and they want to — I think that you feel alone because you are alone. Look at the end of life. We're all alone. You know, we have to face death on our own. And whether someone's with you, they're not going with you. You know, Christopher Hitchens, the writer and intellectual, when he was facing death, he wrote a book on mortality. He was writing out his thoughts and one of the things he said was that the worst feeling is not just that you're at this great party and someone taps you on the shoulder and says, "Got to go." But it's that the party is going to go on without you. It's the sense that you're leaving everyone. And that was what I felt when I went into surgery. I had that experience, this just an animalistic level of fear. And it was in that moment, it was a fear of loss of not just my mother, not just my father, but of the whole world and not knowing what was outside that door. And that was so scary.
Dr. Stieg: So you've had the luxury of thinking that you were leaving the party and now you're back in the party. How is, how is life different?
Demetri Kofinas: How's life different? I mean, one benefit of the experience was seeing old things anew, but in fundamentally more profound ways. There were movies that I wanted to watch. Again, I'm a very big a visual learner and so I, I've, I never realized really until after my surgery that I had a natural gift for that almost photographic memory, you know, and I can recite, you know, lines upon lines for movies and scenes, which I actually did for fun to my ex-girlfriend. I did the whole, like the first 20 minutes of When Harry Met Sally. It's so crazy—
Dr. Stieg: Hopefully not that scene in the diner?
Dr. Greenfield: Well we all know that scene, but I literally put on the movie and I was reading the lines before right before they would come and it was just crazy. But I didn't realize that until afterwards, but there were movies that stuck out to me cause I learned that way and they all made sense to me. The whole thing made sense and myths and stories. They made sense. I understood where it was all coming from. And the culmination of that was during my radiation. That was, you know, I describe it as a religious experience and I'm not religious. I'm an agnostic. I'm an instrumentalist when it comes to science. I don't have any answers, but uh, I'm a mystic in some sense. But uh, but it was, I was walking, I lived. I had a beautiful apartment at the time. I would walk from Columbus Circle all the way down to Memorial Sloan Kettering at 7 in the morning for my radiations. I was so scared the night before, you know, my mom said, "Don't worry, you know, it's going to be over in six weeks."
Demetri Kofinas: It was daily, six weeks. She's like, "Don't worry, you won't even remember it. It'll fly by." I was like, don't you get it? I was like, I don't want time to fly by. Like time had become so slow and it becomes something that I wanted. I wanted every moment. I wanted to soak everything out of life and to think that I had to find a way to get through six weeks of this, what seemed like just horrible going back to the hospital. But it turned out to be the most beautiful experience of my life. And that's not a joke.
Dr. Stieg: Well, it's clear that you've got much to share and much to teach. Jeff, what did you learn from all of this as a physician?
Dr. Greenfield: I feel like I've learned a lot throughout the entire process. I mean, I think part of reflecting on a complicated case and developing a relationship with a patient is, is fairly unique and I think we all have experiences as physicians, particularly with the neurosurgery where we can affect such a dramatic change in someone's life that the relationship changes forever. And that is both a blessing and can be a curse as well for neurosurgeons. And so for me, both reading your article and then reconnecting with you and hearing your experiences makes me very introspective about how I talk to my patients, how I will think about patients going forward with respect to the things that are not on the MRI scan. How will you reflect on the relationships that people have with their family? I feel like I do this inherently to some degree, but I think in a more conscious sense, and maybe part of my role as an educator will be to impart this to future generations, is that this is really part of who we are as healers and as doctors. It goes beyond neurosurgery or fancy technical achievements. It really comes down to why we get into the field and why we love being physicians. So I think you've probably taught me a whole lot more than the other way around.
Dr. Stieg: I really want to thank both of you for your sincerity and your honesty and what I hope this has highlighted, for certainly has for me and everybody else participating in this podcast, is an enlightenment about the complexity of the brain. Not only structurally. no, you had a tumor sitting and pushing on a certain part, but also the functional component and really — your reachievement of brain health, how you've gotten back to a healthy, normal life, and it's a, it's a physiologic, a biologic process, but it's also an emotional and a conscious development that has gone on in your life. I think that it's marvelous that you are willing to and extremely capable of sharing that set of concepts and emotions with our listeners.
Demetri Kofinas: I'm extremely lucky. I not only my lucky that I was able to find Dr. Greenfield, but I was lucky that my, as he said, my tumor had grown so much that it was protruding through the third ventricle and that the surgery was possible. I feel, I just feel grateful. I feel lucky being here.
Dr. Stieg: Do you feel like you're just lucky or do you feel like there's a sense of grace that's been granted to your life?
Demetri Kofinas: The best way I could describe what I experienced to answer your question was it felt like revelation. It felt like my life had meaning. It had, it mattered. That I mattered. That it wasn't something that I just had to convince myself of. It just was, and it helped make something that could have been so difficult. So not just easy, but as I said before, one of the most beautiful experiences of my life.
Dr. Stieg: It's interesting how people that go through near-death experiences actually have the same experience as a death experience in terms of the Kübler-Ross concept. And that's what you've been describing. Your original response to the information was anger, then you started to negotiate and eventually you came to terms with what has happened. And now because of what has happened, you've actually gotten a new lease. And it's interesting to watch how that's affected you.
Demetri Kofinas: I knew that every day mattered. And I was present in a way that I had never been before. And I was just so aware of people's emotional states and, and I was in such a place of just acceptance. And, and you know, one of the things that I learned through this process, you know, I was a fighter since I was a kid, literally and metaphorically, I never accepted an outcome that I was not happy with. I found a way, even if I couldn't get what I wanted, I fought in the, in the face of it.
Dr. Stieg: You were one of the 300 Spartans.
Demetri Kofinas: I kind of, I actually had the opposite experience after my surgery. I realized there is a time for surrender and surrender is not the same thing as quitting or giving up, and I learned the value of surrender and that has served me well in my life.