It began as a routine address, the kind Dr. Bobby Mukkamala had delivered many times to fellow members of the American Medical Association (AMA). As the president-elect of the AMA, he was providing standard updates from the Board of Trustees. But during his recent speech to the AMA Minority Affairs Section at the 2024 AMA Interim Meeting in Lake Buena Vista, Florida, something unexpected occurred.
“In the middle of my speech, for a couple of minutes, I wasn’t making any sense,” recalled Dr. Mukkamala, a board-certified otolaryngologist and head-and-neck surgeon. “It was English, but none of it made any sense.”
The brief episode of expressive aphasia alarmed many of the physicians present, who feared it might indicate a transient ischemic attack. Dr. Mukkamala, 53, promptly sought care at an urgent-care clinic in Florida. There, his blood pressure appeared normal, and an electrocardiogram revealed no evidence of atrial fibrillation. Since he experienced no further speaking issues that day or during the rest of the meeting, he opted to wait until he returned to his hometown of Flint, Michigan, for more thorough testing.
It was there that an MRI exposed the truth: an 8-centimeter tumor on the left temporal lobe of his brain. The tumor had likely been growing slowly for years. In hindsight, Dr. Mukkamala said he had noticed occasional lapses in sharpness, moments he casually referred to as “brain farts.” The tumor is suspected to be a grade 2 glioma, a type with a five-year survival rate ranging from 40 to 80 percent depending on final pathology.
“There’s just no way to know until it’s under a microscope, getting more testing,” he explained. Brain surgery is scheduled for December to remove the tumor.
Dr. Mukkamala will remain awake during the procedure so the neurosurgical team can test his language functions in real time by asking him questions like “How do you say goodbye in French?” This approach aims to prevent damage to crucial language-processing areas in the brain’s left hemisphere.
Following surgery, he is likely to undergo both chemotherapy and radiation. These treatments are expected to take him away from his clinical practice and AMA responsibilities for two to three months. In preparation, he has already begun taking levetiracetam, known commercially as Keppra, to prevent seizures, along with steroids to manage swelling near the tumor.
This unexpected health crisis has offered Dr. Mukkamala a profound new perspective on the American health care system. “My eyes are wide open from the patient perspective,” he said.
In response to his diagnosis, he began compiling what he calls a “tumor wisdom” file—notes and reflections inspired by the ordeal. He’s long had a habit of writing weekly reflections for his twin sons, now 24 years old, and this new development has deepened the meaning behind those messages.
One clear insight, he said, is the deep and persistent inequity in health care across the United States. “Within 48 hours of this MRI scan, I had half a dozen opinions from leading neurosurgeons around the country,” Dr. Mukkamala stated, expressing his gratitude. “If I lived two miles that way [in Flint], there’s no way that I would even have a picture of my tumor, let alone access to that many opinions that quickly. I’d still be waiting—maybe for prior authorization.”
These delays are compounded, he said, by the nationwide shortage of neurosurgeons and specialists. These gaps are especially severe in underserved communities, where access to health care is already limited.
“We’re short on brain surgeons, so the better we can do to address that shortage, the more likely it is that the guy two miles from here can get in, get an appointment and get a plan in reasonably close to the same amount of time that it took me,” he explained.
His diagnosis has also reinforced for him the significance of protections under the Affordable Care Act (ACA), especially those that prohibit discrimination based on preexisting conditions. In early November, just before the Interim Meeting, Dr. Mukkamala renewed his family’s ACA insurance through HealthCare.gov.
“And there were no questions about preexisting conditions or anything like that because the Affordable Care Act gives us the ability to get whatever insurance we can,” he said.
But those protections may not always be guaranteed. “That concerns me as a physician, and it concerns me as a patient, just because it shouldn’t have to be something that’s on my mind when I’ve already got an 8 cm mass on my mind—literally in my mind,” he said.
Dr. Mukkamala’s “tumor wisdom” file also contains deeply personal thoughts. The hardest part of the journey so far, he admitted, has been telling his loved ones and witnessing the sorrow in their eyes. The outpouring of prayers and messages of support from people across faiths and backgrounds has touched him profoundly.
His reflections have brought him to a powerful conclusion: this diagnosis presents “a unique opportunity to share thoughts that usually go unsaid, thinking that there will always be time to share later.”
But, he urged, the time to express love and gratitude is now. At the top of his list of insights is this reminder: “Don’t wait to show affection to people until a moment like this.”
So tonight, he encourages everyone to embrace someone they love and tell them how much they mean. If they ask why, the answer is simple—because it was doctor’s orders.