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Imagine that you are the director of the Human Brain Collection Core at the National Institute of Mental Health. You are at the forefront of research into finding a possible neurological substrate of schizophrenia. Imagine also that you are a stellar athlete who has completed several Olympic-distance triathlons. You are in training to participate in an Ironman competition. Now imagine that you are sitting at your desk at work. You reach out to switch on your computer—and your right hand disappears! You move your hand back to the left and it returns. When you move your hand back into the lower right quadrant of your field of vision it disappears again. As a neuroscientist, you realize to your horror that you have a brain tumor!
Barbara Lipska did not imagine it! It happened to her for real! Imaging studies detected a tumor the size of a raisin lodged in a sulcus between two gyri in the left occipital lobe of her brain. It was a metastatic residuum of a melanoma from which her doctors believed she had been cured three years earlier. A melanoma had killed her first husband! She was absolutely terrified! But she was not the kind of person who would simply give up without a fight. Two months later, after surgical removal of the tumor and a number of radiotherapy sessions, she was back running and back on her bicycle—training for an athletic competition.
Her ordeal was far from over, however. She was to experience firsthand what lesions in the brain and their vigorous treatment can do to a person. Follow-up imaging detected several other tumors in her brain. She managed to get into a clinical trial in which the infusion of two monoclonal antibody drugs, ipilimumab and nivolumab, which are checkpoint inhibitors, were expected to “teach dysfunctional T cells, which are fooled by cancer into ignoring the disease, how to recognize, attack, and (we hope) kill off the melanoma cells invading the body” (p. 53). Combining the two drugs, however, can produce serious side effects, as