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It declared itself abruptly with bright flashing lights in the left visual hemifield. Our 71-year-old left-handed dad (figure 1), a general practitioner and master handyman, had been painting the ceiling, his neck in forced extension. Thinking that the rapid flashing (approximately twice his pulse rate) may relate to his neck position, he lay down hoping it would pass. Fortunately, he answered his mobile when mum rang, but could say just a few words: “So”, “OK”, “I think”; repeating them over and over. He appeared vague and was aphasic, but could walk downstairs. The seizure then generalised when in the ambulance.
His scan showed a solitary right parieto-occipital, primary high-grade tumour (figure 2A–D). Our world collapsed. Surgery was scheduled for 7 days later, giving dad time to sort out his affairs. He promptly retired from general practice, having done several home visits on the day before admission. He was courageously practical: “I'm grateful it's a tumour rather than a stroke. At least this way I have a period of grace”.
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