Cancer in, cancer out: surgery day
/September 29, in the blighted year of our lord, 2020. Surgery day.
After a month of appointments and preparations, I awoke at 3:00 AM to make a 5:00 AM launch at Stanford. After dousing myself in antibacterial soap for the second time in seven hours, I took the small sip of water I was allowed to choke down my morning medications and, with otherwise empty stomach, set off for the hospital. In hindsight, I was surprisingly calm as I was more concerned about removing the cancer than how it was done.
I haven’t written much about managing in-person appointments when Covid is in the air, particularly when oral examinations can’t be conducted with the patient be-masked. In summary, before entering a clinic your temperature is taken and you’re asked an assortment of questions about symptoms and people you might have come in contact with. For particularly intimate examinations or a surgery, you’re required to get a Covid test. (With four such tests under my belt, I’m now something of an expert in having a swab jammed into the back of the skull—jab, count to 10, twist, count to 5, extract.) Physicians, nurses, and staff are masked at all times.
Checking in for surgery isn’t much different. Unless you absolutely need assistance, you go in alone. You’re given a clean mask, asked the Covid questions, and confirm with medical personnel, for the umpteenth time, your name and date of birth. After taking a seat in a properly social distanced chair, you’re called back to prepare.
If you’ve had surgery, you know the drill. Put on the gown, have your vital signs taken, chat with the nurse about this and that, insert an IV, have cold electrodes attached to your body, suddenly realize that you have to use the bathroom, ask the nurse to rewind the last few things she did, do your business, get back on the bed, re-tether, and finally listen to your neighbors’ complaints, hoping that some of them are more dire than yours.
Because Stanford is a teaching hospital, I was visited by more people in gowns than I might have been elsewhere—nurses, surgeons, anesthesiologists, and I-have-no-idea-who-these-people-are. I was told things were running behind, but don’t worry, they hadn’t forgotten me.
Because we were running late, I missed the full journey to the operating room. In past surgical procedures I’ve had a chance to cheerily wave at people I pass in the hall and, once wheeled into the OR, suggested, in the kindest way possible, that the assembled do their best to make sure I emerge alive. But not this time. Instead, my surgeon appeared with an anesthesiologist, we chatted a bit, and then I was given “a little something to help you relax.” This, I believe, was the injectable form of a pole-axe.
The next seven or so hours passed with me blissfully unaware of the indignities being conducted upon my person. I’ve since learned that events went something like this:
Unspeakable things are inserted into places not designed for such ingress.
The dental surgeon and her team arrive to cut out the tori that had taken up residence behind my bottom teeth. (Tori are jutting bits of bone that extend into the mouth and are generally caused by years of teeth clenching—see earlier comments related to anxiety.) The reasons for getting these things removed are more involved than I need to get into. Suffice it to say that it was in anticipation of dental issues associated to my having radiation treatment at a later date.
The head and neck surgeon or someone like him moves in and prepares my mouth for tumor removal. This requires a car jack to prop open your gob, a grabbing-and-pulling device that retracts your tongue to Tom & Jerry extremes, and positioning the head for easiest access to the throat.
Bring on the robot and engage lights, scalpels, melon ballers, tweezers, pliers, and cauterizers (no lasers, though I hear my surgeon would dearly love one).
Do surgery stuff.
Give the tongue a rest for half an hour cuz man, it’s been through the mill. Grab a bit of lunch during this intermission—them, not me.
Do more surgery stuff and tumor begone!
Dab the brow, make a four-inch incision in the side of the neck, remove the malignant lymph node, and take samples from surrounding nodes and tissue to ensure they don’t contain cootie traces that didn’t appear in the MRI and PET scan.
Close up after a job well done and wheel the patient into recovery.
I’ve been in recovery a few more times than typical for a man of my age so I know of what I speak. If you’ve missed out on that pleasure, it’s basically you coming to in a no-time-has-passed haze, then the doctor arrives to tell you how great everything went and, perhaps, provide a few details (all of which you forget because you’re high as a kite).
You’re in no pain and babble in response to the extent that you’re able. In the case of this surgery, babbling is good as it indicates that you can talk. Also unique for this surgery is that a lot of people want to find out if you can swallow.
If you’ve ever had your muscle car come out of the shop after a severe and predictable smash-up, you’re aware that your greatest desire is to find out if your baby’s still got it going on. Your medical team is just as enthusiastic about swallowing and wants to take you for a test drive as well.
Half the root of your tongue has been shipped off to Pathology, your mouth has more stitches than the dusty Bless This Mess embroidery hanging in your grandmother’s kitchen, and the area between your collar bone and chin is gazing around dazedly wondering, “What the actual fuck happened here?!” And they want you to swallow? Yes. Because if you can’t, a feeding tube may be in order.
And so a nurse, or doctor, or magic badger, or whatever creature you conjure in your drug-addled state holds out a cup and straw and asks you to take a sip. Do it without choking and you graduate to apple sauce. Move that through your gullet and you’re the good good boy who’s survived surgery and taken the first big step toward recovery.
