Tag Archives: neurosurgery

Stunted: A Memoir of Delayed Manhood

Forthcoming is such a lovely word.

And I’m happy to share the cover image for my coming-of-age memoir, Stunted: A Memoir of Delayed Manhood, which is slated to be published later this year. It was a long, hard road to get here, but I am honored that the story has found a home with Toplight Books, an imprint of McFarland & Company.

Cover image for my memoir.

The book is also listed on Amazon, Bookshop, and Goodreads.

I began researching this project in June 2013 after marrying my wife, Pam, who has been a steadfast supporter, cheering me on along the way. I obtained medical records dating back to 1984 and incorporated journal entries from the early 1990s. So in many ways, I’ve been writing this memoir my whole life. The impetus to write the book sprang from a long blog post I wrote in December 2014 to mark the 30th anniversary of my initial brain surgery at SUNY Upstate Medical University Hospital in Syracuse, New York.

At Walt Disney World in 1985, a few months after my initial brain surgery.

When I started working on the memoir, I realized I needed to study the genre, so I read the classics like Angela’s Ashes by Frank McCourt, The Liars’ Club by Mary Karr, This Boy’s Life by Tobias Wolff, Running with Scissors by Augusten Burroughs, Wild by Cheryl Strayed, Stop-Time by Frank Conroy, Eat, Pray, Love by Elizabeth Gilbert, I Know Why the Caged Bird Sings by Maya Angelou, and many, many others.

Between that initial blog post and the completion of the book, life intruded.

I had two brain surgeries, was diagnosed with rheumatoid arthritis, mourned the loss of my stepfather, Bill Ruane, my Uncle Fiore DeCosty (nicknamed Fee), and two cousins, Derek and Damon DeCosty. I published numerous poetry collections, wrote a play that was produced by a small theater in Las Vegas, produced a few documentary films, and earned two Emmy awards. I bought a house (reluctantly), and most importantly, became a father to my son, Colin, who will be ten years old next month and was diagnosed with autism in 2018.

The whole time I was living my life in the present while my head remained partly stuck in the time period from 1984 to 1995, covering the terrain of my high school experience in Rome, New York, my undergraduate years at St. John Fisher College (now named St. John Fisher University), in Rochester, New York, graduate school at American University in Washington, DC, and the start of my professional career back in my hometown of Rome and in Venice, Florida.

Here’s me in either my junior or senior year of high school or my freshman year at St. John Fisher College in Rochester, New York.

And as time elapsed and I wondered if I would ever finish the book, I drafted scenes, wrote a crappy first draft, completed multiple revisions on my own, and then hired developmental and line editors through Fiverr, wrote a book proposal, and sent out countless queries to agents and publishers who accept direct submissions from authors.

While I am ecstatic that the book will be published, I detest the necessity of the promotional phase. But it’s a reality I can’t escape. My intention is for readers to find some universal truth or connection to my personal story.

Here is the book description from the McFarland site.

Set between 1984 and the mid–1990s, this coming-of-age memoir follows Francis DiClemente’s experience of adolescence and early adulthood in a body that struggled to develop. Diagnosed with a rare brain tumor that led to hypopituitarism, DiClemente remained physically underdeveloped while his peers matured into young adulthood. As he navigated relationships and sexuality in college, it became evident that his prolonged experience with physical nonconformity fueled isolation, self-doubt, and shame.

This book explores the impacts of his condition on schooling, intimacy, and emerging adulthood, examining how physical differences shape identity formation. It reframes masculinity not as a function of physical development, but as an ethical and emotional practice grounded in empathy, resilience, and responsibility. Contributing to conversations on embodiment and self-acceptance, the work offers insight into the experience of living at odds with normative timelines of growth and belonging.

And I was very fortunate to have some gifted and generous writers provide blurbs for marketing.

“Francis DiClemente’s searingly honest memoir offers a vital perspective for anyone grappling with their own place in the world.”

—Shivaji Das, author of The Visible Invisibles

“Francis DiClemente and I met as teenagers on a baseball diamond in the summer of 1983, and while I have since gone on to work in a different sport populated by alpha males gifted with superhuman size, strength, and athleticism, I know of no better or stronger example of what manhood truly means than my friend. This moving story of self-discovery, which Francis courageously tells with raw honesty and vulnerability, reminds us that the journey toward fulfillment in life is inward, and should inspire us to be less judgmental—not only of others but ourselves.”

—Bob Socci, broadcaster, New England Patriots

“DiClemente’s journey becomes a lifelong battle, man against regrowing tumor. In these pages, he provides the most intimate details of how he learned to be a man while trapped in the body of a boy. Hopefully, his words, and his honesty, can reassure other boys and men grappling with masculine identity.”

—Angel Ackerman, author of the Fashion and Fiends horror series and founder of Parisian Phoenix Publishing

“This is a deeply moving testament to the quiet courage it takes to claim your identity in a world that insists on defining it for you. For anyone who has ever felt unseen or out of place, DiClemente offers a reimagined vision of identity rooted not in the body, but in the soul.”

—Brittany Terwilliger, author of The Insatiables

“Francis DiClemente has written a book on men and masculinity that should be not only savored but consulted by those men who, at some point in their lives, have questioned what their manhood means and what place it holds in society. And by those men I mean all men. This work might have been born of DiClemente’s many masculine hardships, but it becomes a celebration of what is best in us.”

—William Giraldi, author of The Hero’s Body

“DiClemente delivers an unflinching account of the brain tumor that disrupted normal growth and his participation in one of the first human growth hormone trials. …a touching and compelling memoir.”

—Carmen Amato, author of the Galliano Club historical fiction series

“Francis DiClemente tells it like it is—with no BS. This work is honest, human, and full of hope. I respect the courage it took to write it.”

—William Soldato, author of Under Too Long

“Francis DiClemente’s book is a courageous and beautifully crafted memoir that speaks to the quiet battles so many face in silence. With poetic clarity, brutal honesty, and emotional depth, he explores identity, masculinity, and the long road to self-acceptance. A powerful book.”

—Apple An, award-winning author of Las Crosses, Mother of Red Mountains, and Daughter of Blue City

I’m now working on a second book, which is a continuation of the story. There’s no timetable for completion.

One note about the cover.

My Uncle Fiore took my photo in 1985 at the New Jersey shore. We had traveled to New Jersey from Rome one early fall weekend to visit my cousin, Fiore, who was stationed at an Army prep school in Monmouth County, where he would spend a year before matriculating to the U.S. Military Academy at West Point. I remember listening to Bruce Springsteen’s Born in the U.S.A. album on my yellow Sony Walkman in the backseat on the way down from Rome to Jersey. I connected the song “I’m Goin’ Down” with our southbound travel, and I loved side two of the album, especially the songs “No Surrender,” “Bobby Jean,” and “My Hometown.”

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Eight Weeks Later

Today marks two months since my transsphenoidal brain surgery to remove tumor regrowth. I’m happy to report I’m getting stronger every day. I’d say I’m about 80 percent back to normal. I have returned to work and jumped back into the maelstrom of marketing projects, deadlines, and responsibilities.

Eight weeks post-surgery.

My nose still throbs, and I needed a round of antibiotics for a recent infection of the cartilage. I had a follow-up appointment with the ENT surgeon; he mentioned it will take about three to six months for me to be fully healed—not surprising considering they rolled part of my septum and used it as a nasoseptal flap to patch where the cerebral spinal fluid leaked during surgery. But the good news—the seal at the back near the opening of the sphenoid sinus is holding.

My nemesis: the twice-daily nasal rinse bottle.

I still need to do twice-daily saline rinses and take Tylenol for the pain. I lifted “weights” yesterday for the first time in eight weeks—don’t laugh at my little five-pound dumbbells. I hope to resume heaving fifteen-pounders in a couple of weeks.

Hitting the “weights.”

Two songs have been repeating in my head during my recovery.

Elton John’s “I’m Still Standing.”

And Steve Winwood’s “Back in the High Life Again.”

And here’s a photo from a Walgreens: the gift of a beautiful sight revealed to me on a mundane Friday night.

Sublime sunset from a parking lot. Photo by Francis DiClemente.

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Post-Surgery Update

I just wanted to give a quick update on my recovery. More than two weeks have passed since my brain surgery.

I had a follow-up appointment with my ENT surgeon yesterday. For the endoscopic debridement with suction, they stick a probe up your nose and suck out the junk, but I’ll spare you the gory, bloody details.

The last time I had this in-office procedure after the same transsphenoidal surgery in 2011, the surgeon maneuvered the probe too close to my brain stem and I suffered the worst headache of my life.

It felt like a gorilla had grabbed my head and shook my skull like a coconut—side to side and front to back—until my brain swished around and undulated on the waves of cerebral spinal fluid. I almost couldn’t drive myself home afterward.

Hence, I was anticipating a similar experience yesterday. But after Dr. A. performed the procedure, I had only a mild headache throughout the day and into the night.

He also saw no signs of a CSF leak, so I feel incredibly grateful. Although my right peripheral vision loss hasn’t improved yet, I am getting stronger every day and anticipate returning to work before the end of the month.

Thank you very much for the kind words and continued prayers—they are helping me!

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Recovery Update

I never post pictures of myself, but I want to share this photo taken by my wife in our backyard. Eight days have passed since my brain surgery. I’m still a little wobbly, but I am getting stronger every day and trying not to strain myself.

Backyard photo. Credit: Pamela DiClemente.

I am also grateful for being able to soak up the sunshine—standing and breathing on my own. And I wish speedy recoveries for other people enduring health crises.

Thank you for your prayers and kind thoughts.

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Post-Op Notes

Here’s a follow-up to my last post. It’s been less than a week since my surgery, so please excuse my scattered and fragmented thoughts.

A neurosurgery and ENT team at Upstate University Hospital removed a stubborn craniopharyngioma in a four-hour surgery earlier this week.

Upstate University Hospital (Photo by Francis DiClemente)

All test results and surgeons’ notes are posted to the MyChart patient portal, and I love the description of my surgery in ALL CAPS. It reads like poetry to me:

ENDONASAL ENDOSCOPIC TRANSSPHENOIDAL RESECTION OF TUMOR WITH NASAL SEPTAL FLAP

Before surgery, George, one of the neurosurgery residents, stepped into the pre-op room to get me to sign some consent forms. He scared the shit out of me when he ran through the complications—cerebral spinal fluid leak (CSF), bleeding, the need for a blood transfusion, stroke, and death. I thought, maybe I should just get out of bed, put on my clothes, leave the hospital, and let the tumor keep growing until it really messes up my vision.

But I overcame my fear and signed the consent forms. Then I met the anesthesia team, a nurse stuck me with a couple of IVs, and I was off to Fairyland.

I woke up in recovery feeling like only seconds had passed. The pain came in waves—going from zero to eight and centered around my forehead, above the bridge of my nose. I was given fentanyl and oxycodone, while a Foley catheter took care of my urine output.

The neuro team quizzed me: What’s your name? Do you know where you are? What year is it? At first, I said 2013, but then I added ten years to arrive at the correct year.

A parade of surgeons, residents, and interns entered my room in the hospital’s Neuroscience Intensive Care Unit, and someone told me they had encountered a CSF leak, but they patched it with cartilage from my nose. Dr. H., my primary neurosurgeon, said they scooped up most of the craniopharyngioma, but some calcium fragments adhered to structures and had to be left behind.

Craniopharyngioma example.

Lying in that hospital bed—humiliated from lack of privacy, with wires twisted around me, with my gown barely covering my naked body, tumid from the high dosage of corticosteroids—I felt like a wounded animal. After the surgical trauma, I now saw my body as simply an object—a machine that either functions or fails.

And I was now at the mercy of the fine nurses who treated me. I enjoyed my conversations with them, and most were serving as traveling nurses doing rotations at Upstate. And one side note: many of the nurses wore Hoka sneakers.

Because of my persistent headaches, I could not read, watch TV, or even look at my phone. With the wall clock ticking incessantly, I closed my eyes, prayed, and reflected on my life.

This was my sixth surgery if you count two Gamma Knife treatments. And since they didn’t get everything, I wondered, how soon will I be back? Will it be two, four, or ten years? How many surgeries will I need before death claims me?

But when I walked the floor on my second day after surgery, I passed other rooms with patients unresponsive and intubated, and deeper thoughts gave me solace. The words that kept coming to me were nothingness, fragility, and gratitude. I saw myself as a minuscule being with absolutely no control over my body or power to alter my existence. Death could come at any point. This is my fate and everyone’s fate. But I remained alive. I was still here.

And late in the afternoon, two days after surgery, I was discharged. While waiting to get a couple of prescriptions filled at the hospital pharmacy, I was wheeled to the Discharge Hospitality Center. Let me tell you, if you need to be in the hospital, that’s the place to go.

A nurse with blond hair, brown plastic-framed glasses, and wearing orange scrubs, greeted my wife Pam and me, asking us if we wanted a cup of coffee. “Sure,” we said. We enjoyed a cup of coffee and some Lorna Doone cookies while we waited, and I told the nurse that her room was a sanctuary.

Then, while waiting at the circular drive for Pam to pick me up, she asked me about my medical history. When I told her this was my sixth surgery, she expressed concern and said she was sorry I had such problems.

I said, “Yeah, but the thing is, you can’t change it, so you just deal with it. And every time I leave Upstate, I feel lucky that I can just walk and breathe.”

“Right, that’s true,” she said. “That’s a good way to look at it.”

At home, Pam told our autistic son Colin that “Daddy is sick and needs rest.” She put a note on our bedroom door—which has a lock—to remind him not to go inside. With his strong physical presence and his habit of jumping into our bed at night, we need to keep him away so he doesn’t whack me accidentally.

The post-op precautions include no nose blowing and drinking from straws. No straining or lifting more than five pounds. Sneeze with your mouth open and keep your head elevated at least thirty degrees. Pretty simple rules to follow.

I’ll keep you posted as my recovery progresses—slow healing, day by day.

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Tumor Talk

I am undergoing another brain surgery on Monday morning. This marks the fourth time since my craniopharyngioma (benign brain tumor on the pituitary gland) first appeared when I was fifteen years old.

Image by the National Cancer Institute.

My last blast of Gamma Knife radiation in 2020 kept the tumor away, but subsequent regrowth began affecting my vision in the past two years. Another round of radiation could not be performed because the tumor sits only a millimeter away from the optic nerve. My radiation oncologist gave me the grim news that radiation presented a twenty-five percent risk of blindness.

So a neurosurgeon and an ears, nose, and throat surgeon at Upstate will team up for a transsphenoidal approach—meaning they would go through the nose to access the tumor. I had the same surgery in 2011, followed by a rough recovery where I stayed locked in my room for about a month, suffering from excruciating headaches. I have added concerns now because in 2011 I was on my own; now I have my wife and son to think about.

Image by the National Cancer Institute.

Anyway, I want to present a piece of experimental writing inspired by my tumor. I think this falls under the essay category, but it could also be considered fiction.

Tumor Talk: A Conversation with My Craniopharyngioma

“I’m back, baby!”

I heard those words in my head after my radiation oncologist discussed the results of my latest MRI. Dr. L. said my craniopharyngioma—a benign, slow-growth tumor at the base of the brain near the pituitary gland—had grown over the last two years, causing my recent double vision.

Dr. L. said the proximity of the neoplasm to the optic nerve and blood vessels meant radiation was no longer an option. I would need surgery.

“You must be pretty proud of yourself, Fred,” I said to my tumor friend resting inside my head.

“Oh, come on, man, don’t be like that,” Fred said. “You know this was inevitable. Us craniopharyngiomas are like the cockroaches of the tumor world. You know no matter what you do, we always come back. You think that weak-ass radiation was gonna work on me?”

Yes, my tumor has a name. Since he’s been residing inside me for so long, I figured we should at least be on a first-name basis.

And Fred was right. There’s no denying his Terminator instincts for coming back. He’s like Buster Keaton in The General. He keeps barreling down the tracks no matter what you do to him.

Fred first appeared in 1984 as a large tumor engulfing my pituitary gland. His removal led to hypopituitarism and diabetes insipidus (a disease affecting water and sodium balance).

Despite surgeries in 1984, 1988, and 2011, plus two blasts of Gamma Knife radiation, Fred continued to aggregate the tumor vestiges, scooping up the fragments and wrangling them into a well-formed regiment. I gotta give him credit for its spunk and resiliency.

But after leaving the medical office and waiting at the bus stop, I wanted to set some ground rules with Fred, to see if I could talk him down or at least minimize his impact.

“Why are you doing this to me again? Life has been pretty stable with my family. Why do you have to make trouble for us now?”

“Come on, man, get real. Don’t give me those bullshit questions. Why anything? Why do you breathe or drink water? Why does a horse gallop, a deer prance, a cat meow, or a goat bleat? Do I need to go on? I’m a fucking brain tumor.”

“So what if you’re a tumor? Can’t you control yourself? Can’t you stop growing?”

“Now you just sound naïve. I can’t be something other than what I am. And I have a clear objective. As a tumor, my job is to expand and invade. That’s it. That’s why I’m here on this planet.”

What could I say? I couldn’t offer any retort.

“Look, don’t be so glum. You’re in good hands with your doctors, and our history shows we both come out alive.”

“Yeah, but I wish you’d agree to leave.”

“Well if it’s any consolation, I do like where I live. You’re a good host. Don’t get me wrong, I’d prefer to be inside the head of some brilliant mathematician or a swimsuit model reclining on a beach. No offense. Look, you’re not a bad guy. But let’s not get carried away. You’re no fucking Einstein or Dave Chappelle. And frankly, I get a little bored with your prosaic thoughts.”

“Tell me how you really feel.”

“Oh come on, man. I’m just busting your balls a little bit, trying to cheer you up. Which reminds me—I thought of a theme song for our relationship. Come on, sing it with me:

“In your head, in your head,
Zombie, zombie, zombie-ie-ie-ie …”

“Very funny.”

“Come on, man, don’t be like that. We need to learn to live together. Look, I haven’t caused irreparable damage. Your brain functions, memory, and language processing are all intact.”

“I suppose I should thank you for that. But with any luck, the neurosurgeon will go up through the nose and pluck you out.”

“Oh, why so adversarial? We’re just talking here.”

“You have your objective. And I have mine. You’re a squatter. A nuisance tenant who needs to be evicted.”

“Yeah, good luck. I adhere to things. You can’t just kick me out. I stick around. Been doing it for more than thirty-five years.

“Yes, you’re one tough foe.”

“But why do you have to think of me like that?”

“What do you mean?”

“Maybe I’m more friend than foe?”

“I don’t buy it.”

“Just hear me out. You wouldn’t be the man you are today if it weren’t for me.”

“How do you figure?”

“You’re pretty driven, ambitious, and disciplined, right?”

“Yeah, I suppose.”

“Well, if it weren’t for me, you wouldn’t have had to overcome those endocrine challenges—being the shortest guy in your class. I may have stunted your growth, but I gave you determination—a fire in the belly.”

“You know, I have to admit, I think you have a point. From the moment you came along, I felt like you were a ticking time bomb inside my head, and I had to strive to achieve something before you exploded and shattered my skull.”

“But, lucky for you, I’m not a bomb. And I’m not vicious, pernicious fucking glioblastoma. I’m just an aggravating nuisance, a little hangnail or a sliver under the skin. Think of me as a dented fender or a toilet that keeps running.”

“Well, I guess I should say, ‘thank you’ for that.”

“Don’t mention it.”

“Can we at least come to some agreement? Can you just stop growing and stay put for a while, until I have this surgery?”

“I don’t have that kind of control, kid. You give me too much credit. I don’t know where I’m going. I just keep moving.”

“Well listen, after Dr. H. does his transsphenoidal resection work, I’ll let you come back slowly, over the next ten years.”

“I hate to break it to you, but I don’t need your permission to inhabit some space inside your head. And let’s face it—we’re gonna be together for a long, long time. We’ll be two old, shriveled geezers playing shuffleboard in Clearwater. So let’s stay friends.”

I laughed. “I guess you’re right. I don’t know what else to say. See you later, Fred.”

“See you in the operating room, kid.”

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