A Disquisition on Macrocephaly

another comedic tragedy, or tragic comedy

When Klaus was born, his mother looked at him lovingly and exclaimed, What a big head you have. It was undeniably true, everyone else in the hospital and the family said so, none of them so lovingly as his mother of course, but in any case it was no cause for alarm, everyone knows that babies' heads are disproportionately large for their tiny bodies, and that this discrepancy is remedied by the inexorable passage of time.

By age four, however, the problem, if it can be called such, was still very much visible, to use a euphemism, for as soon as one laid eyes on the boy, it was impossible not to see. The fact was that it was now becoming alarming. The body grew, yes, as expected, but so did the head, just as quickly, when normally it ought to have at least grown at a slower pace. This was certainly not the case, if anything it was outpacing the growth of the body, and the child's big head was becoming too conspicuous for anyone to ignore. Klaus was a precocious child, intelligent and pondered beyond his years, always curious and eager to learn everything, the whys and hows and also the wherefores, and soon the parents ran out of answers for his unending questions, and this too he was curious about, Why do adults cease to ask questions, or seek answers, and of course, for this, the adults had no satisfying answer. For his part, he decided, he would never cease to ask and to seek, and in this unceasing pursuit to enlarge his mental horizons, he also succeeded in enlarging his head, which admittedly is not a common occurrence, thankfully.

The parents never considered his intelligence and curiosity to have any bearing on the disproportionate size of his head, however, and thus, believing it to be an illness, or at least a sign of illness, they took him to a doctor, and then another, and then another, but one after the other, they failed to find anything wrong with the boy. The doctors ruled out Sotos syndrome, Weaver syndrome, Simpson–Golabi–Behmel syndrome, Noonan syndrome, Costello syndrome, Gorlin syndrome, cardiofaciocutaneous syndrome, Fragile X syndrome and many other syndromes. They also ruled out Cowden disease, Alexander disease, Canavan disease, Niemann-Pick disease and many other diseases. And they also concluded he did not suffer from megalencephalic leukoencephalopathy with subcortical cysts, glutaric aciduria, MGAT2-congenital disorder of glycosylation, parietal foramina, neurofibromatosis, tuberous sclerosis, achondroplasia, autosomal recessive osteopetrosis, as well as many other anomalies, dysplasias and deficiencies. He was healthy by every measure that medicine could conceive, and luckily for him, medical doctors could not conceive many more, so that after a few months he was spared the cruel and humiliating procedures of medicine. The big head was merely a curious but surely temporary affair, and the doctors finally dismissed the mother's concerns with similar words, He will grow out of it eventually.

The eventuality, however, was taking some time to manifest. He went to school before he turned six, his head too large to go unnoticed by the peculiarly cruel attention of schoolchildren, who teased him endlessly, made up unpleasant nicknames, and even beat him on several occasions, and not just the boys but the girls too. Being a quiet child, Klaus never fought back or even spoke in his own defense, though he felt shame about his disproportional head. Yet not all was tragedy, at least from a certain point of view. Learning to read and write had opened the boy's horizons even more, and coupled with the ostracism from his colleagues, he retreated into the imaginary world of books and the comfort of knowledge, while his head grew larger still, now clearly outpacing the growth of his body, every collar of every shirt now had to be stretched in order to fit, and once stretched out, they would not go back to their regular size, adding not only to the parents’ expenses with the child, but also to the unusual appearance of the boy, who now always wore shirts with stretched out collars.

By fourth grade, and seeing as the problem was not only getting worse but accelerating, the parents took him again to several doctors, and while they now agreed that there was definitely something wrong, they could not, with all their instruments, find what it was. All the tests came back negative, all exams inconclusive. He was physically healthy and the only firm consequence, born out of all those medical visits, was the hefty sums the parents paid for them. Out of options, they turned to another type of medical profession. If the problem was in the head, and it clearly was, maybe those doctors who specialize in heads would have the answer. Not neurologists. They had seen those with no luck, but rather psychologists and psychiatrists. After being submitted to yet another series of tests, though of a much different nature, the doctors, much like the other ones, could find nothing wrong. He had no particular traumas, no repressed feelings, no chemical imbalances. His only peculiarity was having a prodigious imagination, an insatiable desire for learning, and his big head.

The problem grew larger as he entered middle school, and so did the abuse from his mates. Conventional medicine having proven to be so useless, the parents now turned to religion and consulted a priest. After speaking with the boy for a few hours, the priest did not find any sign of diabolical oppression, but did leave the parents with a couple of suggestions. First, prayer. It doesn't always help, but it never hurts. And second, more specifically, the priest observed that the boy lived very much inside his own head and all his energy was spent either on learning or on his own imagination, and both of these were precipitated and expanded by one culprit alone, books. Priests know all about the strange and mysterious connections between mind and body, soul and flesh, and so he recommend that the parents, somewhat harshly, cut off his access to books, as maybe all those things he was reading were both figuratively and somehow also literally filling his head and making it bigger.

The parents, out of options and losing hope, followed the advice, encouraging him to get involved in sports, hoping his head would begin to deflate. He entered high school determined to make it happen, but his big head did not allow for great feats of athleticism, except, of course, in scoring headers in association football. But that was not enough to make a difference. In every other athletic pursuit, his big head was a hindrance, if not a prohibition. Just as he was losing hope, however, and being deprived of books, he found that his head was not the only large thing in school and became fascinated by other, curiously round shapes, and how they seemed to become bigger every week, his female colleagues’ breasts. For a time he was as obsessed with them as he had been with learning, and this indeed made his head deflate a little, giving the parents undue hope. But seeing as no girl was interested in him, the pastime and interest was abandoned as untenable and soon he found something else to occupy his attention.

Being still deprived of books to read, he began to write his own and this proved disastrous. The little deflation he achieved while enthralled by female breasts was quickly undone as he wrote pages upon pages, and very soon his head was once again getting larger at a rapid, and accelerating, speed. Soon he had to be placed at the back of the classroom, otherwise his colleagues could not see the blackboard, or the teachers. Despite his challenges, he still got good grades and was accepted into an elite university, which was at least a consolation, and it made him happy, happier than he ever had been. Perhaps now, in university, his big head would not be so out of place.

In order to prepare for the new phase in his life, when he would finally find a suitable place in the world, he spend the summer studying, and when he was not studying he was writing stories, ideas, poems, diary entries, expanding his mental horizon in all directions, his head growing larger and larger, but it was not a problem, he was going somewhere safe for his big head. But on the first day of university the tragedy became apparent. He could not get in the doors to the classrooms, they weren't big enough to fit his head. The same was true of his room and every other room. He was hopeless, and like many hopeless people, he sought the comfort of religion. But it was too late. He couldn't fit in there either. His big head could not get through the church door. And so without any other ideas he chose exile and went to live in the wilderness, the only place, if it could be called a place, large enough to fit his big head, retreating more and more into his ever expanding inner world, living finally in peace, entirely inside his own head, while the birds perched on his ears and hair, sometimes.

But that was not the end, for the wonders of nature only seemed to furnish his inner world with more and more riches, even more so than books ever did. And so his head grew and grew and grew until it was the same size as the whole earth. The most powerful governments, believing it to be a threat, for whatever reason, proceeded to launch missiles and even drop nuclear bombs on his head, and while they did not succeed in destroying it, they hurled his big head and his tiny body with it into outer space, where soon rivers and seas and mountains and plains and trees and beasts and birds and gods populated it, and eventually a man and a woman sprang from the dark ground of his imagination, and a new world began. Though it was not all roses, for sooner or later a desert appeared. He was going bald.