Thursday, November 18, 2010

A Day When Life Isn't Taken For Granted

It was not an ordinary day. I found myself in the skin cancer day surgery unit at Oregon Health Sciences University (OHSU). I wasn’t there by my choice, but today was the day for my wife to have her melanoma on her leg removed.

When we were getting on the elevator in the parking garage, two guys walked on to the elevator with us. One guy had his arm in a sling, and looked to be the patient. The other guy had one shirt sleeve turned inside out, stuffed back into the arm hole of the shirt, to hide the stump of his missing arm.

We made sure we visited the bathroom one last time before we were ushered into the exam room, or surgery room. I’m sure there is a politically correct term for the room. There was a big padded chair in the middle. Karen called it the Edith Ann chair, the big chair that Lily Tomlin used in her TV show, where Edith Ann, a precocious child, would give an entertaining monologue about the perils of childhood.

She settled in, as best one can when it’s the day the melanoma is cut out of one’s leg. I was assigned the Spouse’s Chair, ominously close to the impending action on Karen’s leg. I’d have opted for placing my chair on the other side of the room. No such luck.

The nurse came in and typed in all of Karen’s answers on the form they had mailed to her. All the usual questions, including the litany of prior surgeries, allergies, and the like.

The surgeon came in, smiling a bit, and even making eye contact with Karen, and with me. He made a point to make sure we were both engaged in what was going on today. He got right down to business, and talked about skin cancer, melanoma.

Melanoma. There’s a nice sounding word. Certainly more friendly, more mellow than skin cancer. During the pre-op exam, the surgeon makes sure we know what melanoma means. Yes, we do. Is this a test of informed consent? Or just making sure we know what is going on and how serious it is. Or just plain mental competency. It was, actually, a good thing to check. I think we passed. We gave the right answer, at least.

The surgeon was happy with what the plan was, and left us in the hands of the Nurse of the Hundred Needles.

Then, the needles came out, gleaming stainless steel at the end of big tubes of clear liquid. The nurse referred to it all as her “ammo”. A slosh of reddish orange liquid was mopped across the skin, followed by the dance of the hundred needle pricks.

Karen grimaced, this being her least favorite and most dreaded part of the whole process. She made hideous O shapes with her mouth; her eyes slammed shut, as the needles found their mark and the “ammo” not yet deadening all the nerves around Mr. Melanoma. I got the bird’s eye view of the whole dance of the hundred needles. I thought I might whip out my iPhone and snap a photo, then sharing the event with my 150 Facebook friends.

Probably not a good idea. Not my surgery. Not my melanoma, and certainly not the usual Facebook fare of kids’ school successes, family events, and commentary on the trivia of daily life, or the latest gridiron victory of the Ducks.

Then, Nurse of the Dance of the Hundred Needles announced she was done, the area was deadened to her satisfaction. And, so was Karen, or at least she was finished with the Dance of the Hundred Needles. I nodded my concurrence, my mind racing to what was next. Was I expected to stay, to watch the exorcism of Mr. Melanoma? The surgeon had warned of blood, and cauterization. The biopsy jar was ready, all labeled and on the little TV tray next to the Edith Ann chair.

At least the scalpels, or hatchets, or whatever they were going to use, weren’t brought out of the dungeon yet. For that kindness, I was grateful.

Just then, the surgeon came in again, now in scrubs and gloved and masked, so we were a little unsure it was the same nice guy we’d chatted with twenty minutes ago. Everyone looked at me, apparently wondering if I was going to run screaming down the hallway, or faint dead away when the first scalpel was drawn. I could go, now, they all said.

Well, good. They were obviously not going to give me any of my own pain killers or anti anxiety pills, and they sure didn’t need my own inadequate medical expertise. Digging skin cancer out of my wife’s leg wasn’t in the job description of Loving Spouse, and certainly wasn’t included in our now ancient premarital agreement.

My role was better served holding down the waiting room, where I could properly guard my wife’s purse and her book, and find my true function of clock watching and preparing to be the nurse’s aide and chief chauffeur during our hurried drive back home across the mountains, Karen’s leg swathed in bandages and an ice bag.

I kissed my wife good bye, knowing that her leg was properly numb and she was in the good hands of the masked surgeon and the Nurse of the Hundred Needles, who, by the way, amused us by her sense of humor and willingness to let us laugh nervously at the whole pre op ritual. For what she gets to do in her day, she was great.

The waiting room was no place for the timid, however. It was, after all, the portal to the skin cancer day surgery area. Real serious work went on here. And, our doctor had said that even though Karen’s melanoma was detected early on, it was the most vicious kind of skin cancers and even if things went well, there was that nagging two percent chance this experience would be fatal.

Now, two percent seems pretty small, and its good odds if you are in Las Vegas, or even playing a nice parlor game with your neighbors. But, when it’s really life and death, two percent really gets bigger.

When I had my heart attack last winter, and the cardiologist was explaining the need to open up my femoral artery, run some wires up into my heart, and put in some wire mesh “stents”, the risk of death was only one percent. Given how invasive that procedure was, what with cutting into a major artery and running wires up into my seriously damaged heart, the odds sounded real good.

So, this two percent thing with what had started out with a mole that was growing, well, it was more than disconcerting.

I found little solace in my fellow travelers in the waiting room. Karen’s melanoma seemed like small potatoes. One man had one eye bandaged over, and he was obviously in pain. His family was pretty upset about the experience. And, when he came out, the wad of bandages was bigger, and he told his wife that “more meat” was removed today. They were certainly not going to be done with Skin Cancer Ward anytime soon.

The guy next to me on the couch had most of his ear missing, and a third of his face was inflamed and swollen.

One lady’s legs were enormously swollen, and she could barely walk. I guessed she was the patient, as her husband sat quietly, reading a magazine. Yet, when the nurse called them, he was the patient. And, then, I saw the big bandage on his leg. This was obviously his day in the hospital, giving her a rest for a bit from her own medical experiences.

Another couple sat quietly, the man’s face obviously the subject of numerous skin grafts. They talked to the lady with the swollen legs, talking about how the Veterans Administration didn’t offer them much care, and the cancer was spreading. He could only get some immediate attention at OHSU. They were running out of money, because he couldn’t work anymore. After they were done with today’s surgery, they were going to need to look for a cheaper place to live.

She came out after a while, mentioning to everyone in the room that he was going to “get cut on again” today, and they weren’t sure how it would turn out. She wiped away a tear and picked up her magazine again, leaving the rest of us to contemplate what that news meant in their lives.

I thought of the two percent statistic again, wondering where these folks were with those numbers. Probably not really thrilled about this game in this time in their lives.

Finally, Karen came out from behind the giant door to the surgery area, now all smiles and the tension in her shoulders gone. She was done, paroled, set free. She was even joking with the Nurse of the Dance of the Hundred Needles.

We fled down the hall, stopping once again to relieve our bladders, and found the barista on the ground floor, who offered us lattes and mochas for the road, made with our favorite coffee roast. We were a bit giddy, like kids let out of school early for a snow day, and found the elevator to the parking garage, hot drinks, sans caffeine, in hand. We’d had enough stimuli in our lives this afternoon.

Our fellow travelers, the two guys, one with the missing arm, again shared the elevator. They, too, seemed relieved, and were laughing and joking about leaving the hospital. I wondered what they had experienced, what with the other guy having a bigger bandage than when we went in.

In a few minutes, we were back on the freeway, back with the rest of the world starting their commute home, from their ordinary days outside of the Skin Cancer Ward. Tomorrow, the bandages would come off, and we could watch the incision heal up pretty quick. But life wouldn't be taken as much for granted. Not after the day in the cancer ward.

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