When Eric Markowitz suddenly began feeling a bit nauseous in January 2023, he thought it was just a bug. But within a day, his symptoms became severe. The scariest part was the , he recalls.
“The room was kind of spinning. That’s just what it felt like constantly. No matter what I did, no matter what position I was in, I just felt like I was in the state of spinning,” Markowitz, who lives in Portland, Oregon, tells TODAY.
com. “It’s a really out-of-control, really scary feeling paired with an intense nausea and throwing up.” He was a healthy 35-year-old man, so the extreme vertigo out of the blue seemed bizarre and concerning.
Markowitz’s wife took him to the emergency room, where doctors at first suspected a stroke. But an MRI of his brain seemed clear, and no other problems showed up. He was told it was likely , an inner ear problem that would go away with some head repositioning exercises.
But when he left the hospital, the symptoms only got worse. It would be another month before Markowitz got the true diagnosis and underwent a brain surgery that saved his life. The ordeal started when Markowitz was visiting his in-laws in Santa Barbara, California.
By the time he flew back home to Portland in early February 2023, the vertigo was so extreme he could barely walk and had to use a wheelchair to get on the flight. He saw specialists in Portland who suggested — exercises to manage his symptoms -- but nothing worked. Markowitz lost about 35 pounds in a month because he was constantly vomiting.
“I was so hungry because I wasn’t able to eat anything, I remember getting really obsessed with cooking shows,” he recalls. “I was just thinking about food all the time. In retrospect, I think I was starving because I couldn’t keep anything down.
” Markowitz was spending 24 hours a day in bed. He describes the experience as “hellish,” turning to meditation and hope to get through it. But he knew something was really wrong.
In mid-February 2023, Markowitz underwent a second brain MRI at the insistence of his wife and primary care doctor. It revealed a grape-size lesion in his brain that was somehow missed in the first scan. He needed immediate surgery.
But doctors wouldn’t know if it was cancer or something else until they opened his skull. Brain cancer looks a lot like a brain infection on an MRI, says Dr. Zachary Medress, a neurosurgeon at The Oregon Clinic who performed Markowitz’s surgery on Feb.
17, 2023. The two possibilities were , a lethal brain cancer; or a brain abscess, a pocket of pus that can be life-threatening if it ruptures. Before the procedure, Markowitz wrote a goodbye letter to his then-18-month-old daughter, Beatrice, he recalled in an .
“It felt at that moment that I was likely going to die,” he tells TODAY.com. Besides the overwhelming sadness of leaving his young family, he was shaken by the irony of his job.
As a director of research for an investment firm, Markowitz gives advice about long-term investing. Now, his own time seemed to run out at 35. “It was like this crushing reality that the future might not exist.
The idea of long-term might not apply to me,” he says. The lesion was in Markowitz’s cerebellum, the part of the brain in the back of the head near the brain stem. For the surgery, he was positioned face down so Medress could remove a piece of his skull and make a small incision in his brain.
When the neurosurgeon got to the lesion, he immediately saw a capsule filled with pus. He was then 99% sure it was a brain abscess. “We were actually happy to find an abscess and not brain cancer in terms of his long-term prognosis.
,” Medress recalls. He removed the entire pocket of pus, careful not to not release the infection into the patient’s spinal fluid or other parts of his brain tissue, which would spread the bacteria and have “very disastrous consequences,” the doctor notes. A neuropathologist who examined the tissue under a microscope confirmed it was a brain abscess, not cancer.
It’s an infection in the brain, usually caused by bacteria that get into the bloodstream — perhaps from a dental abscess or an infection somewhere else in the body — then travel to the brain and take up residence there, Medress says. People getting their teeth cleaned, for example, always get a bit of bacteria into their bloodstream, but it’s not an issue unless someone is immunocompromised. Even in that population, a is uncommon.
“For someone like Eric, who is otherwise healthy and has no other risk factors, it’s exceedingly rare,” Medress says. The bacteria can also come from the sinuses, which are right next to the brain, but that didn’t happen in Markowitz’s case because his abscess was on the other side of the brain, the neurosurgeon explains. Tests of his teeth, sinuses, heart valves and other areas where bacteria can lurk showed no signs of infection, so it’s a mystery how Markowitz’s brain abscess began, Medress says.
He experienced extreme vertigo because the infection and swelling were in a part of the brain involved in coordination, equilibrium and eye movements, the doctor notes. It was also very close to the nausea and vomiting center of the brain. If Markowitz didn’t have the emergency brain surgery, the abscess would have continued to grow and could have been fatal if it pressed on the brainstem or released into the spinal fluid, Medress says.
Finding out he didn’t have brain cancer was like getting a second chance at life, Markowitz recalls. He in the hope it might help other people. But the recovery was hard.
He received “really hard-core antibiotics” for two months after his surgery. The side effects included nausea and dizziness, so there was no immediate relief for his symptoms. A year-and-a-half later, Markowitz is feeling much better.
His cognition, memory and speech weren’t affected by the surgery. He goes for walks and recently played pickleball with his brain surgeon. Markowitz and his wife are expecting their second child this month.
After his ordeal, he says he’s much more present, tries to spend less time on his phone and has made peace with uncertainty in life. He also calls himself lucky. “What you realize is the fact that for our bodies to work every day, so many millions of things need to happen correctly.
And when one of those things breaks, the whole system breaks down,” Markowitz says. “I’m just grateful that things are working. There’s a lot of beauty to that.
” A. Pawlowski is a TODAY health reporter focusing on health news and features. Previously, she was a writer, producer and editor at CNN.
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