Dr. W. tapped the scab on my nose with a gloved finger and frowned over the top of his glasses at me.
“How long have you had this?”
“Ten or twelve years, I think. I had it frozen off the first time, and I’ve returned to the clinic every two or three years since, so they could freeze it again.”
“And nobody ever did a biopsy?”
“No, the freezing seemed to work fine, until this year. They treated it a couple of months ago, and it came right back. That’s why they sent me to see you.”
He shook his head. “I don’t know why people wait so long. Well, let’s do it now.”
* * *
The next Monday, Dr. W’s receptionist phoned me. “The biopsy came back positive,” she said. “The doctor thinks it’s a basal cell cancer and he wants to schedule you for outpatient surgery in a couple of weeks.”
It didn’t worry me. A lot of people I know have had this procedure, and none of them had any issues with it.
* * *
At my pre-op visit the following week, Dr. W., who is also the surgeon, told me what to expect.
“We are going to lightly anesthetize you, so you’ll be awake, but relaxed, during the procedure. You will need a driver,” he said. “Arrive by seven thirty a.m. and don’t eat or drink anything after midnight.”
No big deal, I thought, expecting to return home with a small band aid on one side of my snout. Well, you know what “they” say about expectations.
* * *
At the hospital, a young, brown-haired staffer wearing a name tag that read, “Susan” escorted me to a small room containing a bed on wheels, a chair, and a closet. She handed me one of those infamous floral hospital gowns, open in the back.
“Strip down to your underpants and socks, put this on, and hang your clothes in the closet.”
“Huh??? Aren’t they just going to work on my nose?”
“You’ll be in a sterile room, so no street clothes. They also have to attach electrodes to your bare skin.” She turned toward the door, calling over her shoulder, “Don’t fasten the ties on the gown; just lie on that bed. I’ll be back for you soon.”
A parade of visitors entered the room and sized me up. First, a nurse, who took my temperature and blood pressure, poked a hole in my hand, and hooked me up to an IV. She patted my shoulder. “It’s just a saline solution. Are you nervous?”
I shook my head. Ignorance is bliss.
The surgeon stopped in next. “Here’s what’s going to happen after we sedate you. You’ll likely have your eyes closed because of the surgery lights, but you’ll be able to hear everything that happens. I’ll make an incision here,” he tapped the side of my nose, “and here.” He tapped my cheek, just below the right eye, “After the growth is removed, we’ll graft skin from here to the wound to keep the stitches from pulling your nostril upwards.”
Dr. W. folded his arms. “I will slice off the tumor and send it down the hall to the pathology lab, where they will check the margins to make sure I got it all. I won’t close the incision until they bring me the results. Sometimes I have to go back in once or twice to clean up the rest of it. Once it’s done, I’ll stitch you up and you’ll be good to go.”
As the doctor left, the anesthesiology nurse came into the room. “I’m Matt,” he said. “I’ll be sitting by you during the entire procedure, so all you have to do is tell me if you are feeling any pain.”
Somehow, that didn’t reassure me.
“The aides will take you to the operating room,” he continued. “I will hook up the sedative to your IV. You’ll receive the most potent dose while they numb you up, then I’ll back it off, so you will remain conscious during the procedure.”
Two women wheeled me down the hall to the operating room, which seemed to be full of people. They pushed my bed up against a narrow operating table. “Scooch over onto this,” one of them said, “and position yourself in the center.”
I moved into place as someone whisked the mobile bed away. Before I could think, the people in the crowded room burst into action. I had the sensation of being an automobile in a busy detailing shop, with people coming at me from all directions.
Someone raised the table and put up its side rails. Women on both sides of me grabbed my arms and secured them to the rails with sturdy straps. One of them ran a third strap across my chest to hold me in place. I started to worry. Do they think I’m going to escape?? Apparently so, I thought, as she secured another strap across my forehead.
A third attendant placed a pillow under my knees, while yet another aide adjusted two overhead lights, but did not turn them on. From behind my head, somebody I couldn’t see stuck electrodes on each of my shoulders.
Matt appeared on my left, holding the electrode for my side. “Sorry about this,” he said. “I know my hands are freezing.” He grinned as he stuck the sensor to my skin. Then, he messed with the IV, and shortly I began feeling drowsy.
A gray-haired man appeared upside down, standing behind me and leaning his head over my face. “I’m Todd. I’ll hold your hand and help keep things steady.
“Are we ready?” I couldn’t see the surgeon, but I recognized his voice. My eyes instinctively closed when someone switched on the bright overhead lights. I drifted to the edge of consciousness, sensing the numbing needles piercing my skin, but feeling no pain.
I heard, rather than felt, the scalpel slice into my skin. Nobody spoke as Dr. W. worked. I thought he must be handling me roughly because I could feel pressure when he rested his wrist on my forehead, and then on the side of my face. I could sort of feel the muscles in my nose being pushed to one side, and then the other, but I felt no physical discomfort. Occasionally he’d thump an instrument down on my chest and ask someone to hand him a different tool.
Finally, the weight of the surgeon’s hands lifted, and I heard him step back. I imagined him handing the tumor slice to someone to take to the lab. The overhead light switched off, and I tried to peek through my eyelids, but I could barely move them. Time seemed to stand still.
Dr. W.’s voice roused me. “It looks like we’ll have to go back in and slice again.”
I felt more activity on my face, but time lost all meaning to me. It seemed like a series of disconnected events that I had trouble following.
Somebody said, “Look at that white surface!”
“That’s cartilage,” the surgeon replied. “This sucker is deep.”
The surgery lights turned off, and I managed to open my eyes a little more than before. I felt Todd squeeze my hand. “They’re taking another specimen to pathology,” he said. “Just rest.”
As if I can do anything else.
The lights came on again, and I lapsed into half-consciousness, feeling the now-familiar weight of hands and instruments. When the doctor handed the next sample off, I opened my eyes. My peripheral vision picked up Matt, playing on his phone. He looked up.
“How do you feel?”
“Okay, I guess. I really can’t feel anything. This is an interesting experience. I think I’ll write about it.”
“You’re a writer?” Todd’s face popped into view.
I attempted to tell him about my books, but I’m not certain my words made any sense. I finally said, “I’ll bet you guys meet some interesting people.”
“That’s an understatement,” said Matt.
As the dazzling lights turned on and off, my mind wandered. How long have I been on this operating table?
“Damn,” I heard Dr. W.’s voice. “I didn’t expect to work on one patient this long. There are others waiting.”
More scraping followed, and someone said, “I wonder if this will require radiation?”
Then silence. I drowsed.
Finally, I heard the doctor mutter, “It’s about time.”
The brilliant lights came on and I heard a grating sound as the surgeon used a needle to pull sutures through my skin to close the wound. Why doesn’t this hurt?
The crowd of workers descended on me, releasing straps, lowering the rails, pulling the pillow from under my knees, and moving me back to the rolling bed. I don’t remember being wheeled back to the room where my clothing waited.
Dr. W. pushed open the door. “That was quite a run,” he said.
I asked, “How many stitches?
“I didn’t count, but you set a record for the number of trips to pathology. Seven times, until we knew we got it all. That was a deep, deep tumor. I want to see you at my office tomorrow for a follow-up.”
Someone fetched my husband from the waiting room, and Susan showed him how to change the dressing. Before she covered the wound, she held a mirror up to my face so I could inspect the damage.
“That little band aid I expected for my nose definitely won’t cut it,” I said.
* * *
The pain hit when the numbness wore off. I’ll spare you those details. But I counted over forty stitches. I’ve learned my lesson. If ever again I have a sore that doesn’t heal, I will immediately demand a biopsy.
I can’t wear my glasses until my incision heals, so my ability to type is limited. This took most of the day to write. I’ll be back when my nose can support my spectacles.
#procrastination #dontwait #basalcellcarcinoma
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