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We rushed to her car and she drove as fast

as she could from Sherman Oaks to Toluca


Making an aneurysm an aneur-isn’t…
Lake. We were joking and talking about Los

COLLATERAL
Angeles traffic the entire way. None of it felt
real to me—like I was inside a bad dream.
How could this be? My son didn’t suffer sei-

BLOOD FLOW zures. The entire thing just had to be some


sort of mistake or misunderstanding. I
The Story of Leonardo Palisano Vs. The Evil Brain Aneurysm
thought that possibly someone saw his tick,
By John Palisano where he puts his arms up and shakes when
WHY IS YASMINE CALLING ME? Five he gets really excited, and thought that was a
times in five minutes on my iPhone? I’m in seizure-- had to be.
the middle of my morning meeting at work.
On the way up Cahuenga to Toluca Lake
She knows I can’t pick up, I thought. Some- elementary school, we saw a red fire truck
thing has to be wrong. The second the meet- ambulance pass us. I wondered if Leo was
ing ended she called again. I answered as eve- riding inside the ambulance. By the time we
ryone was breaking up and getting ready to made it to the school, I spoke to the nurse at
go out on the floor. his school who told me they’d just left in the

“What’s up?” I asked. ambulance. They were driving Leo to a hospi-

“Leo’s had a seizure,” she said, her voice tal. I asked Jessica if she would mind bringing
trembling unlike anything I’ve ever heard me. “Of course,” she said. I was relieved.
from her. Something was very wrong.
We headed toward Saint Joseph in Bur-

I asked, “What? Where is he?” bank, but Yasmine called and told us they

“He’s at school. The ambulance is going were actually taking him to Children’s Hospi-
there now to pick him up,” she said. “You tal Los Angeles, which is at Sunset Boulevard
have to get in a cab or something and get and Vermont. This was encouraging news.
there now. I’m going there, too.” My old friend Melissa Millard used to work

“Okay, okay,” I said. there, and I remember when she was applying

We hung up and I looked up. There were that she told how highly esteemed it was all
still people filing out. In a rare moment of over the world. This comforted me.
bravery I called out at the top of my lungs,
Jessica found the port where the ambu-
“Can someone give me a ride to Toluca Lake? lance had brought him. I hopped out and
My son’s had a seizure.” thanked her, and rushed up toward the two

Time froze. EMTs. “I’m Leonardo’s daddy,” I said.

Jessica ran right up to me and said, “I
“He’s fine,” they said. “He’s in the ER
can.” I vaguely remember her speaking to right now. Everything’s stable. He was asking
Matt, our manager, about covering sessions or us a lot of questions.” It looked like the same
something to that effect. red firetruck ambulance we’d seen earlier.

“Just go,” Matt said. “Get out of here!”
“Really?” I asked.

“Yeah,” they said.

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Just then Yasmine pulled up in our big a child who’d had a seizure. Then they found
Toyota mini-van, nicknamed Big Red. The something strange on his CT scan—a calci-
security guard immediately pounced on Yas- fied area on one of the arteries running
mine and told her she couldn’t park there, ig- through his brain. “We’re not sure if it’s
noring her tears and panic. I took the mini- something serious at this point, or it might be
van to the parking lot and hurried out. nothing. We’re going to do an MRI to get a

In the ER, I found Leo’s teacher, the one better look.”
who witnessed his seizure. “We were doing
the walk to the bus where we all hold onto the
rope. His eyes rolled back inside his head and
he passed out. I rushed over to him and
grabbed him before he fell. He didn’t wake up
and didn’t respond to us talking to him. We
ran him to the nurse and called 911. My father
has seizures so I recognized what was hap-
pening.”

Wow. How could any of this be real? My
three-and-a-half year old son didn’t suffer
Oh, man. I was exhausted. I was really
seizures. Jesus Christ. I was in denial. hoping that his fainting incident at school was

Finally I saw Yasmine near the front of just some anomaly. He’d not been sleeping an
the waiting room cradling Leo in her arms. awful lot that week, and he hadn’t eaten as
He looked mad and scared, but otherwise much as usual, either. Maybe he was just
okay. From there we were moved into an ER tired?
room with several other patients, including
One of the doctors came in an explained
one little baby suffering from H1N1 Flu vi- to us that what Leo had was an aneurysm.
rus. We were in that little bed for seven hours. That spot was the calcification they’d spotted.
We suffered Leo getting an IV because he They explained to us some of the treatments
would not keep still enough to do a CT scan available. They could use a coiling method,
or an MRI scan. The screams of such a young which threads a tube up through a catheter in
child are the worst sounds I’ve ever heard. the artery in the groin/leg area. From there,

Right before his CT scan Leo fell asleep. they are able to travel up to the blood vessel
All went well until we lifted him out. He in the brain, and then inside the aneurysm.
punched me right in the nose with a closed Once there surgeons can insert small titanium
fist. I literally saw stars. I haven’t taken a hit coils inside the aneurysm, effectively filling it
that strong since my days at Emerson College and cutting off blood flow. Doing so takes
in Boston. I figure he’ll do all right on the away the risk that the aneurysm might rup-
playground in a few years. ture, which can cause serious problems.

The doctors and nurses ran a series of
The other method, and the one that scared
tests. Leo showed no signs of any further sei- me silly, was an open surgery. In this tech-
zures, nor was he showing the correct signs of nique, a craniotomy takes place, performed

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by the neurosurgeons. I had visions of 1950s have never left the hospital without making
horror movies with the entire top of the skull sure all of that was securely on schedule.
removed like a Halloween pumpkin. Nope.
For the next week we struggled with the
Things have progressed tremendously since insurance company. Because we’d been re-
those science fiction stories. leased Leonardo was not considered an emer-
gency; therefore, insurance didn’t want to re-
admit him. We met with neurosurgeon Dr.
Teitlebaum, who examined the films of Leon-
ardo’s aneurysm. He assessed that if it rup-
tured at its size the results would be, at best, a
large neurological deficit, and at worst…

I heard a clock ticking. I wanted to diffuse
this thing right then and there. Dr. Teitlebaum
explained to us how the coiling procedure
would work in detail. We were scared as
heck, of course. Who wants someone poking
around inside your kid’s brain, after all? Even
Leo with Rosie...a visit courtesy of the amazing a neurosurgeon’s hands suddenly didn’t seem
www.LOVEON4PAWS.org precise enough—it was just too frightening.
There’s just something so squeamish about

Our friends Mike Lai, Juan Monsalves, the whole thing.
and Mike Zimmerman arrived and gave us
This was a week before Thanksgiving,
some much needed support. and we really wanted to get Leo in and out

Later that night we moved to another before the Holiday. The beaurocratic mess of
room in the BMT, or Bone Marrow Trans- paperwork and insurance hedging put us
plant Unit. This was the only place where back. I’d developed what I can best describe
there was an available bed for Leonardo. That as a nervous cough. I wasn’t sick; I didn’t
fourth floor was an amazing place. We had to have any other symptoms. I think it was my
wear baggies on our shoes and feet. I spent body’s way of displaying the fear and concern
that first night on a thin play mat on the floor, I worked so hard to hide from little Leo.
wearing my jeans and T-shirt. I bunched up a
I was a wreck until the coiling operation. I
towel for a pillow. couldn’t enjoy anything at all. I just kept star-

Observed over several days, the doctors ing at Leo, hoping that peanut-shaped thing
presented us with two surgical options. We wouldn’t burst. The neurosurgeons told me it
were in that unit for a total of five days, I be- wasn’t likely to rupture, but I couldn’t help
lieve. They took CT scans and monitored but picture the worse with Leo’s every leap
Leo’s vitals. Soon, though, he began to go a from the couch to table.
little stir crazy. I felt so bad for him. One day
Finally the stars aligned and we had our
we found ourselves released without any sur- date for the coiling procedure. We arrived
gical dates in place. Big mistake. We should early at the hospital, Leo’s godmother Laura

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Gardner in tow. I signed the consent forms. had several fantastic instruments he wished to
One of them had ‘DEATH’ in big black letters use. There is a machine that would tell them
under risks. That is something I never want to if an area of the brain would go ‘dark’ while
see again! Never. they were clipping. I found this phenomenal.

We brought him into the operating room, Getting the machine transferred would put us
where there were large machines all around. back another week, but I agreed that having
There was a small table on which he would such equipment at the ready would insure
lie down. We kissed him and hugged him and Leo’s safety and lower the risks substantially.
gave him his favorite stuffed animal, Blue
Children’s Hospital discharged us for the
Bear. Then he was asleep and we went down week with a solid surgery date in place and
to the cafeteria to wait it out. with the insurance approving everything top

Again,we talked about all sorts of things, to bottom. The week would be a good one
and I did my best not to talk about surgery or where we all got some rest and Leo was able
brains. I thought it might make things go to heal from the first surgery. We also had our
faster. Then, after two hours or so, our buzzer friend Denny Grimmett come over and shave
vibrated. We hurried upstairs and met Dr. the sides of his head before the surgery. We
Teitlebaum in the hall. hoped he would be able to keep his long hair

They had not proceeded with the coiling. after the surgery, it being his trademark look!
The aneurysm had a second branch coming
Returning to Children’s Hospital on De-
from it that fed into the motor skills portion cember 16th, 2009 we found everything ready
of the brain. Uh-oh. Now what? and in place. Waking up at 4:30am is not

We faced an open surgical procedure—the easy, although Leo remained asleep as we
craniotomy and the clipping of the aneurysm. dressed him, carried him to the car, and even
Dr. Teitlebaum consulted with Dr. Giannotta, into the admitting area of the hospital. He
Dr. Krieger, and Dr. Winer about just such a stayed that way until his lab work. Getting
procedure. This time we did not want to leave blood drawn has probably been one of the
the hospital without getting a surgical date most difficult things. He hates it, of course,
and making sure all our ducks were in a row. and is fully awake and, damn it all, it hurts!

Leo still had a few days of recovery, any-
Very soon after we shuffled from one
way, while the staff lined everything up. He waiting room, into a prep room, and finally
was in a brace that kept him still from the inside the operating room itself. That place
waist down. This was to insure the puncture sparkled. It appeared clean and well taken
at the crux of his leg/groin area healed well care of. Oddly, it felt warm and safe. The an-
enough for him to be mobile. esthesia team spoke to us about putting him

Dr. Winer and Dr. Krieger’s office worked under, and we signed more of those consent
to make sure we could schedule a surgery. forms. That 5% risk area cycled in my head. I
Initially, they tried to book him for the up- imagined the worst case scenario for weeks.
coming Wednesday. For that to happen, Dr. Here I was, facing it down.
Giannotta had to be available, as did several
Doctor Winer visited us and asked if we
other specialized equipment. Dr. Giannotta had any last minute questions. Yasmine was

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very concerned about his getting his hair just fine. It’d still be a few more hours, they
shaved. I was very concerned with his brain said. Yasmine chose to volunteer wrapping
being okay. Both of us reacted differently out Christmas presents in the lobby of the Hospi-
of defensiveness but we were very much to- tal while she waited. I chose to keep on read-
gether as a family unit. ing and hanging out inside the waiting room.

Leo took a small dose of a drug to relax
The next couple of hours felt like forever.
him while he was in the waiting room. It The worst thoughts circled my head. Things
didn’t take long until he was zoned out, which are going bad. I was convinced of it! Why
was a relief. Then the crew wheeled Leo to- else would it be taking so long? Of course I
ward the operating room. I watched his little remembered Dr. Winer telling me the opera-
legs kicking up a bit. Please don’t let this be tion might take anywhere from three to five
the last moment we’ve got, I thought. Grim, hours. After an hour I was already panicked.
but I was terrified of losing him. The risks
After two-and-a-half hours the reception
were small but so was the probability of a desk called me over. The man had a big smile.
child his age having an aneurysm, and one its I didn’t take it as a good sign. I’ve heard
size, to boot. I couldn’t help my fear although many stories of medical staff delivering the
I did my best to shove it down where no one worst news with a smile. My fears were un-
could see-- hopefully. founded. “They just called down and let us

Me, Yasmine, and Laura returned to the know that the operation is progressing nicely
surgical waiting room, where there were tele- and Leo’s doing well,” said the warm-voiced
visions, as well as a large LCD display. Leo young Latino man. I was relieved…for a few
surgery had its own number. On screen, next seconds. I imagined clipping was to come.
to the number, waiters could see the status of
the patients. I read an entire issue of Cemetery
CHLA’S LITERALLY HEALING program pro-
Dance magazine, and most of Anne Rice’s vided Leo with great books from their Book Moo-
book, Angel Time. Laura, bless her heart, was bile. He was thrilled with this wonderful program.
marching through, Midnight Walk.

We went to the cafeteria when it opened
Returning to my seat, the smell of lime-
and shared a long breakfast. I watched the scented spicy chips filled the air. Laura had
clock from the corner of my eye. After two found a goodie in one of the vending ma-
hours, we ran into family friend Barbara chines. I didn’t have any, but it was comfort-
Foley-Smith. She toured us through some dif- ing because it reminded me of our apartment
ferent parts of the hospital, which was awe- complex. “Soon we’ll be back there in the
some. We got some great views, and found a middle of the weekly mini-siestas and super
second cafeteria. In the midst of catching up loud Les Tigres CDs,” I thought. “Leo will be
with Barbara the plastic octagonal pager vi- safe again.”
brated and lit up.
I finished my Cemetery Dance magazine

When we returned to the surgical waiting and turned my attention to a great National
area the receptionist let us know Leo’s opera- Geographic special on the TV, Who Killed
tion was progressing nicely and that Leo was Jesus? I love those historical shows.

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Then, just as I was wondering if the fel-
“Wow,” I said. “Seems like we had the
low portraying Pontius Pilate was wearing a best outcome.” Or maybe that was one of the
wig or not, Dr. Krieger and Dr. Giannotta neurosurgeons who said it. I was probably
showed up. I was shocked. It’d been 301 trying to talk, with my mouth moving and
minutes, and the board never read that he was nothing coming out.
Out Of Surgery.
My beautiful son was okay.

I hopped up and shook both their hands.
There’d been no big complications.
Dr. Giannotta had somehow changed into a
“He’s just coming out of anesthesia and
spectacular suit before coming down. “Is your you’ll be able to see him in about an hour or
wife here?” Dr. Krieger asked. so,” said Dr. Krieger.

“She’s wrapping presents in the lobby to
I think I said, “Wow,” and “Thank you,”
kill time,” I said. “Let me give her a call.” about sixteen times in the next minute. They
Laura went back inside the lobby to wait for slipped out of the room and I squeezed Yas-
Yasmine, so she’d know where to head. mine’s hands.

We went inside a small patient consulta-
“He’s okay,” I said and hugged her with
tion room. I was scared to death. These guys all my might. “We’re so lucky.”
were very hard to read. Was Leo all right?
Was there a complication? Did he suffer a
stroke? Were they able to fully take care of
the aneurysm?

I think Dr. Krieger saw my fear and said,
“He’s okay,” to me. Inside I sighed the sigh of
a hundred sleepless nights.

Yasmine showed up, as scared as I was.
She shook their hands, too, I believe. Then we
went inside the Patient Consultation Room.

The exact words the neurosurgeons used,
well, it’s a blur. It all went something like
this:

“He did quite well. It was a little bit more
difficult than we thought, but not much, and
as soon as we clipped the aneurysm, he had

the collateral blood flow up and around it. Soon we made our way up to the Pediatric
That’s what we were hoping for. We didn’t Intensive Care Unit on the second floor. There
have to do any kind of bypass or reconstruc- was our little baby looking as beautiful as
tion. He should be just fine.” ever, his right side covered with a large ban-

I’m not sure who said what. dage, tubes and wires protruding from his left

I looked to Yasmine, who appeared to be clavicle, the crook of his left leg, his big toe,
very much in shock. Who was to blame her? and matching IVs in each arm. Didn’t matter.

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Leo made it through. I knew in my heart that Slowly he was introduced back to juice and
he was going to be all right. food. He wasn’t so interested in food, but he
drank well.

As is natural in this surgery, his face
swelled. He looked like a different boy. His
eyes swelled, too. It reminded me a lot of
Rocky after one of his fights. Surprisingly, a
few days later the swelling went down.
Within a week, he was barely swollen at all.

We found Leo’s recovery pretty spectacu-
lar. After the first two days many of his tubes
were removed. First went the catheter, then
many of the lines. The last to go were the IV
lines in his arms, which were the very last
things to go—and that was right before we
were discharged.

The army of nurses helping Leo during
this critical time were amazing. A.J. Came
from a lineage of family, all in medicine, and


was truly an amazing individual. His ability
OVER THE NEXT DAY Leo only woke for
to keep us at ease during such a time was a
moments at a time, usually saying one or two
gift. So many other nurses brought their own
words, or moaning. I crawled in bed with
caring to us, as well. Sydney. David. Danielle;
him. After a short period, he felt his legs
they were all beyond wonderful. How do they
move and felt the fingers on both of his hands
do it? I’m very envious and grateful.
twitch. He seemed neurologically intact.

On the fourth night Leo was moved out of

We were told we had a period of a few
Pediatric Intensive Care Unit and back up to
days where he’d need to be watched for signs
the sixth floor. The sixth floor was our home
of stroke or other symptoms. He was given
away from home the last time we’d been in
steroids to help with the swelling, and other
the hospital, so we were quite familiar with
medicine to keep his blood pressure up. He
the layout.
had an oxygen mask, although it wasn’t

The morning of December 19th, we were
strapped to his face. Nurse Danielle put it a
informed Leo would soon be able to go home.
few inches from his nose and mouth to help
Yasmine was worried about caring for a child
him out. He was breathing almost normally.
who’d just had brain surgery, but we were

They kept him pretty dosed up the first
told he should be fine so long as we didn’t
two days or so. I was grateful. He’d be so
submerge his bandage. He’d just have to be
restless otherwise. Best to let him heal.
looked after. I was happy to bring him

Dr. Winer, Dr. Krieger, and Dr. Laduceur
home—he was starting to become extremely
each stopped by often to check with him.

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restless. His returning energy meant Leo’s
recovery was progressing nicely.

Driving home with him in his chair next
to me felt unreal. I knew the day was coming.
Everything we passed seemed better some-
how. The streets, the fast-food places, the
newsstands…this was our world and we had
our son back.

We’d lived on the rim of fear for so long,
with so much anxiety and uncertainty. Getting
used to our lives being okay again was going
to take some time. I don’t think Yasmine
Here is a post operative Leonardo going on the
smiled for two days! It was as though we Christmas Train at Griffith Park’s Travel Town.
were living within some sort of reciprocal
shock. I couldn’t stop marveling that Leo was
both home and doing better and better.

Today, December 22, 2009, we feel we
www.johnpalisano.com
are among the luckiest people on the earth. I
am so eternally grateful for the tremendous
amount of support and kindness we were


given from people all over the world through


the message boards at the Brain Aneurysm
Foundation. There are countless good people.

In addition, I am simply astounded at how
far medicine has progressed. When I was in
the hospital as a youth, things were much
more medieval. The neurosurgery he under-
went is simply astounding. We are truly lucky
that his body responded so well, and that we
had such an amazing team of people looking
after him at Children’s Hospital Los Angeles.

The End.




For more information on brain aneurysms:

BRAIN ANEURYSM FOUNDATION


www.bafouond.org

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