Friday arrives with no change whatsoever in the size of the purported cyst. Surgery is set for four o’clock. I am to be his last patient for the week. The room is the usual non-descript eggshell white trimmed with a particularly noxious shade of pale green I have never seen anywhere outside of a medical setting. The operating table is covered with some kind of tufted vinyl overlaid with paper. I am asked to don the ubiquitous green gown tied at the back, though I am allowed to keep my trousers on. The surgeon takes considerable time positioning me so that he will have easy access to the lump, which is awkwardly located. I am placed on my right side, then tilted at a forty-five degree angle so that I need bolsters to support my torso if I am to hold the position. He then gives me two large shots of what I assume is Novocain, or its equivalent, and leaves the room to let the anesthetic take affect.
Ten minutes later the surgeon returns, looking as if he is already anxious for his weekend to begin and is determined to be done with what promises to be a routine procedure as quickly as possible. The sullen nurse who follows him in is short, of mixed blood–African and Asian as well as Caucasian–and wearing a white uniform much too snug for her ample figure. She is obviously at some crossroad in her short life, faced with a crucial choice: to diet or to acknowledge she needs to upgrade her uniform size. She does not speak a single word throughout the entire operation. Nor does she ever seriously look at me. I might just as well be a lump of matter lying on the office examining table for all the attention she pays to me.
Shortly after the scalpel’s first incision, the atmosphere in the room changes dramatically. Without a word being spoken, I can feel a tension that was not present a minute before. In an instant the surgeon’s impending weekend is forgotten. He has ceased indulging an old man’s vanity, and is now heartily intent upon rooting out the seeds of that same old man’s impending death, which, he must be all too conscious at the moment, would have been considerably accelerated had I accepted his original, and emphatic, claim that my lump was only a harmless cyst and decided to be more civic-minded and not added an unnecessary burden to the City’s over-taxed health system. It must be this knowledge that feeds his increasingly aggressive behavior, which seems to totter on the edge of anger, as he cuts deeper and deeper, and then responds to my sudden shiver of pain, by pausing.
“Well, it’s not a cys. As you must already have guessed,” he says. Then after a heavy, resigned sigh: “I think it best we close you up and schedule a proper operating room to finish the job next week.”
“Oh, no you don’t,” I threaten with all the menace my voice can muster. “I’m not leaving this table until it’s out. Now. Not next week.”
And I mean every word. I am not leaving, short of a police eviction order, until whatever is there is removed.
“It’s much deeper than expected,” he cautions me, obviously anxious to terminate the present ordeal by frightening me. “The anesthetic is only going to give limited relief. Possibly none at all for the last few minutes.”
“I don’t care how much pain it causes. I want it out!”
His anger seems now directed at me as he sends the nurse out for another syringe and more Novocain. Then after two new deeper shots administered into the open wound, they both leave the room, she never to return, and I am left to brood alone. When he finally returns, scowling, he sets to with silent, brooding intensity to cut away. There is virtually no evidence of any blood, which surprises me. It is a long, and as he promised, uncomfortable procedure, very uncomfortable, but pain is a relative word, and compared to a full blown migraine or a dentist’s drill hitting a live nerve, I’m not sure that what I am feeling is worthy to be called pain. It is the idea behind the discomfort that is harder to accept than the discomfort itself–that I am feeling my own flesh being cut and clipped away–and for one mad, uneasy instant the surgeon becomes Julia Child trussing her chicken for the waiting oven.
When he is finally done he tells me in the most ungracious tones possible to get dressed and meet him in the reception room. Everyone else has left the office, including his nurse and the receptionist. We are the only two remaining. When he joins me dressed now in his street clothes he is carrying a small plastic container, not unlike those I get my olives in at the delicatessen counter.
“Well, I hope you got it all out,” I say.
“It’s not that kind of cancer,” he snaps, and I am for the instant shocked that he has used that word, the second most dreaded word in the language (a former colleague of mine, who could never bring himself to voice the word itself, always referred to it as The Big C), rather than the more benign “tumor”–though the tumor itself is apparently anything but benign. That much I have already surmised. He is angry, even belligerent, and there is no one else to direct his anger at, though I know it is himself he is most angry with. I have merely been the unwitting witness, catching the fallible doctor out in his moment of extreme weakness–a false diagnosis that could have led to an unnecessary fatality. And the even more dreaded law suit.
“Are you a smoker?” he asks. “Most of those we find on the neck like that come from heavy smokers.”
“I haven’t had a cigarette in thirty years,” I answer with undue pride, though failing to acknowledge the twenty previous years of addiction.
“Would you care to see it before I take it to the lab?” he asks in a far more conciliatory tone. He is obviously regretting his previous rudeness, but doesn’t quite know how to apologize.
I admit I do, oddly, want to see the source of all this anxiety. It is as large as the first two joints of my middle finger, an obscene mix of pink, red, gray, blue and purple, like something cut out of an eviscerated fowl, part of a chicken neck with soft bones, perhaps. The chilling word Lymphoma is mentioned. “I’ll let the lab decide precisely what kind,” he adds, all business now, “and have the biopsy report sent to your primary physician. I’m sure he’ll call you sometime on Monday.”
Since my house is only five and a half blocks away, I walk home, all the vigor I have been recently so conscious of sucked out of me. It is a lovely early evening in late February. On the walk up Clay Street, past the Alta Plaza, which is looking rather scruffy, the lawns more like meadows of wild grass than the neat, disciplined fields they are designed to be, I keep seeing the cover of Time Magazine with Jacqueline Kennedy on it. I first saw it from across the central square in Greve, the capital of the Chianti area of Tuscany. I couldn’t imagine why she should suddenly be a news item at this late date, and then, as I got closer, I saw the telltale double set of dates. I don’t ordinarily buy American news magazines when I travel, but I bought that issue.
She is much on my mind throughout that dismal weekend. Somebody still so young, so beautiful, and so rich, with all the best medical advice and care hers to command, dead, and almost before anyone even knew she was sick. It is a humbling moment.
As the Novocain wears off, I become ever more conscious of something else I am going to have to live with: an electrical storm of major proportions is playing itself out on my face. The nerves along the edge and lobe of my left ear and on my lower left cheek and jaw are bristling with a multiplicity of electric currents mingling and clashing. The tumor had no sensation whatsoever, but its absence, I soon become aware, is going to be constantly her
alded by all the nerve ends severed or otherwise crippled in the process of its extraction and now loudly protest the damage done to them. For the first few days I think I might go crazy, but the brain is a marvelous adapter, and over the months I become ever less conscious of these damaged nerves; and now I only notice them when I have to adjust my pillow to accommodate them at night since I sleep on my left side and have never been able to break myself of the habit.
On Monday afternoon my primary physician starts speaking the moment he enters the room, preempting any accusatory words waiting to leap off the tip of my tongue.
“Well, weren’t we lucky we decided to have it out!”
I take note of the “we” but refuse to comment on it and merely smile in answer. I have no wish to humiliate anyone.
“It’s non-Hodgkin’s Lymphoma, if you don’t already know. I’ll let the oncologist explain the different varieties and how they concern you. I’ve found you one I think you’ll like. He’s young but comes highly recommended. You’re to see him on Thursday. On the second floor of this building. I couldn’t get anything earlier. He’s very popular and had to make a concession to fit you in at all.”