procedure

I used to feel sorry for the people who came out of the skin cancer clinic, next to my local supermarket, a white gauze swab stuck to their face. They were getting on, I thought. They hadn’t worn a hat. And even if they weren’t getting on, and had worn a hat, the sun here in Tassie takes a lot of prisoners.

For months I circled the clinic, telling myself I should walk straight in and book an appointment to check a spot on my temple. But I didn’t. Eventually, it was advice from James Clear’s newsletter that did it. When you’re trying to make a decision you’re dithering about, he wrote, it’s best to balance the benefit of making it against the risk of not making it. Yes, I thought, the benefit of being free of the worry of having a skin cancer on my hairline was greater than the fear that I had a melanoma which my kids would kill me for not having had treated.

When I sat on the consulting room bed, with the doctor’s huge magnifying light up to the pimple on my temple, the doctor changed his mind about what it might be. What he initially told me was a ‘not to worry about spot’ became, in his next breath, ‘Well, actually, I’m almost certain it’s a BCC (basal cell carcinoma)’, requiring a biopsy a week later.

The week between the biopsy and its results was hard. Waiting for medical results is famously hard. If the results came back with news of a melanoma, I realised, as the week passed, that emotionally I needed a week to pass before I could wrap my head around the possibility of it.

Thankfully, it wasn’t a melanoma. It was a slow-growing carcinoma that still needed to be cut out. It was two weeks before Christmas, I had a trip booked for January, and the next available surgery was early February.

The procedure took half an hour under local anaesthetic. A blue plastic sheet was placed over my head as I lay on my side, with a porthole square cut out for the surgery. Above the blue plastic sheet, the doctor and nurse chatted about their kids’ sports practice. I felt numb but very much awake. Then the chatter stopped and the surgery began. Never has my yoga breathing come in so useful. Surgery is physical and skin is stuff that can be pulled and, as in my case, flap surgery, stretched over what would have been without it a ten-cent-sized hole on my temple. Instead, after a lot of deep breathing, I was left with a jagged wound which seemed, in the mirror I was handed, fifty times bigger than the growth that was gone.

That night at dinner, the anaesthesia wearing off, I felt like I’d been in a pub brawl. My daughter, who was enjoying not being a patient for a change, helpfully switched her first reaction to my wound from car accident, to shark bite. Still, it was done, the surgery was over. Now all I had to do was wait for the stitches to do their job and avoid putting my head below my heart for the next ten days in case of bleeding.

Before the stitches came out, I had two more trips to the clinic for the doctor to check the wound, the second time at his asking. It was the day before a long weekend and, as he rewrapped a white gauze bandage around my head, after checking the wound was ‘healing nicely’, he said that he’d got me in for a check because he’d ‘had a nightmare’ about my head the night before. ‘Really?’ I thought, suddenly realising that the doctor was a person with a mental life of his own.

I felt ridiculously self-conscious with my bandaged head, seeking out forest trails with my dog that I hadn’t been on for years. On the third morning, walking the dog in the bush, I listened to such an engaging podcast about consciousness, between Michael Pollan and Ezra Klein, that it blew the lid off my self-consciousness. I went back home for breakfast, invited four friends for dinner that night, and took my dog to the beach. Why hide away for another week, I thought, ashamed of my bandaged head, when what I needed, to heal well, was fresh air and the shore line?

After a few more walks with my dog, out in the open, I came to the conclusion that there were three kinds of people in the world. There were little kids who sniggered when they noticed my wrapped forehead, which seemed fair enough to me. There were people, often men, who, out of unspoken courtesy, walked straight past without catching my eye. And there were people who, seeing me coming, gave a warm and sympathetic smile as we passed.

Apart from having a month off teaching yoga, which has been blissful, the other unexpected benefit of having surgery on my face is that I haven’t been able to wear a hat. After years of wearing a hat religiously, it feels so nice not having something on my head outside. It feels freer, like my head is part of the world. Besides which, this experience has left me wondering how effective wearing a hat is, given that I got a carcinoma anyway.

When the nurse saw me today to remove the stitches, before she did, she asked if I’d been given my second lot of results. When I said I hadn’t, she went to fetch the doctor. It was only a couple of minutes that I waited for the doctor to appear, but it was long enough to feel quiet panic and to make a silent prayer. ‘What’, I worried, ‘surely no more surgery? Please no.’ Then the doctor appeared and told me the results were clear, the growth was gone. Before he left the room, he turned on his heel with his hand on the doorknob, and said that he’d see me soon for a full body scan.

‘Yes, of course’, I said, obediently, thinking to myself that at least I liked and trusted him, and now knew that I could bear whatever.

I pushed myself up off the bed, checked at the desk that I’d paid the procedure in full ($750 with $550 paid back by the government), and booked myself in for a body scan before leaving the building. It was only later that day, after I texted family and friends with the news, and was on the beach with my dog, still without a hat, that I realised I’d gotten through the whole procedure without Googling anything about it, which meant that I still wasn’t certain what a carcinoma was, apart from not being a melanoma. And I liked not knowing.

The next time I see someone coming out of the skin cancer clinic, with a white gauze square stuck to their face, as I leave the supermarket with a bag of yoghurt, frozen peas and bananas, I plan to give them a very friendly smile.