‘We would drill a small hole in your skull and go in with a computer-guided needle to take a sample of the tissue that we can then analyse.’

‘Can I stay awake during the procedure?’ asked Lucy. ‘I’m terrified of not waking up, so I would rather not go under.’

‘Yes, you could,’ said Mr McEwan. ‘We frequently perform awake surgeries, but this is not a risk-free procedure and you should think very carefully before going ahead. The risk of death is less than one per cent, but there is also a chance of bleeding on the brain and having a stroke. That could leave you paralysed on the right side of your body. It’s not very common but it does happen.’

‘Jesus,’ said Lucy.

‘Also, these are not very detailed images,’ McEwan went on. ‘All we can see is that you have a lesion in the left frontoparietal area in the paracentral lobule. We need to do a functional MRI to understand what neural tissues surround or are inside the tumour. Hopefully, we won’t have to go through any key functional areas in order to get a sample, but there is a risk of damaging healthy tissue, which would leave you with certain impairments, depending on our approach.’

‘I see,’ said Lucy, closing her eyes.

‘Is there a case for just monitoring the tumour?’ asked Olivia.

‘That’s possible,’ said McEwan, ‘but I must emphasise that if this is a high-grade tumour, you will want to know as soon as possible so you can begin treatment to extend Lucy’s life expectancy.’

‘My life expectancy,’ said Lucy faintly.

‘After the fMRI, I am going to present your case to my colleagues. There’s a weekly meeting where sixty of our most senior doctors and researchers at Queen Square get together and discuss all new cases. I suspect they will all recommend the biopsy route since, without it, there is really no further treatment we can offer you.’

‘Well, I guess I don’t have much of a choice then.’

‘You should feel no pressure. This is entirely your decision.’

‘Assuming I want to proceed, what are the next steps?’

‘My assistant would book you in for an fMRI next week. And I might also send you for a cognitive evaluation with one of my colleagues in the Neurology Department. So, we are looking at a surgery date within the next two weeks or so.’

‘Okay, let’s do it,’ said Lucy, standing up. ‘Thank you for squeezing us in,’ she added, shaking Mr McEwan’s hand.

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