Six or eight weeks ago I noticed a scaly patch of skin above my left temple. Over time it became a raised bump, dark pink, sort of waxy feeling, a minor protuberance not much bigger than a BB. I called the clinic. Who needs a minor protuberance?
Doctor says, “I could refer you to the dermatology clinic.” I’m thinking, “Well, duh…”
Doctor says, “Probably a basal cell carcinoma.” I’m thinking “Is that like in Switzerland?”
Doctor says, “Dermatology is usually booked for months in advance.” I’m thinking, “This is the maintenance part of HMO, just maintain, just maintain…”
Doctor says, “I’ll have Amy see when they can get you in.” And the Doctor leaves. Half an hour later Amy comes in and says, “I can’t reach Dermatology. I’ll have them call you to set up an appointment.” I’m thinking lots of things, like “Can I bill back that last half hour then?” and, “That’s why they call us patients,” and “If I won the lottery I would drop this whole group health thing.”
Surprisingly the next day someone from the Dermatology clinic called and gave me an appointment for the following Monday. So today, I took the minor protuberance in to visit with the nice man in the red suit. Really. Red. The Doctor’s uniform was disconcertingly different from the pastel blue scrubs or the starchy white coat most of them have so long affected. The scarlet scrubs, the new sanguinary chic are designed — I believe — to alienate us further from using the medical benefit.
The assistant has me fill out a questionnaire. It’s like a mimeographed thing, a form designed for a duplication technology of an earlier generation, poorly formatted and barely legible, but output no doubt on the laser printer near the reception desk. I fill out the front and nod off for twenty or thirty minutes. She comes in and points out that I failed to turn the form over and fill out the back. I’m thinking, “Some forms have little leading indicators like turn over for page two, or don’t stop now dummy.” The second page has the part about what medications have been known to almost kill you in the past, and does your family have a history of mortality? I endeavor to be as truthful and complete as possible. Another fifteen minutes pass and the skin doctor shows up. In the red scrubs.
“Sit on the table,” he says. I do. He looks at the minor protuberance and asks a few questions that I’ve already answered, both on the front page of the awful form and during the cursory visit in primary care last week. “What we’ll do,” he says, “What we’ll do is remove it and send it out for biopsy. Rather than have you come back if it’s positive, we’ll just treat you right now as if it is. Then you won’t have to come back for a follow-up visit.”
I eat this stuff up. Really, I just think this makes great sense. No follow-up visit needed! Why, what a paragon of productivity, red scrubs or no.
The Derm Doc leaves and the nurse says she’d like to give me a little shot to numb the area, and I figure that sounds like a pretty good idea if they’re going to be cutting later, so I say go ahead and she does and it hurts like bloody fire! The feeling in my scalp above the temple where the needle goes in is like someone has introduced a trickle of hugely corrosive acid in my veins. This hideous interval passes in five or ten seconds, and the nurse finishes her work, turns on what I presume to be the cauterizing unit and departs.
More time passes, then the Doctor and his nurse (now looking suspiciously like a Diener named Igor) return. The Doctor does something near the offending growth… “Just testing the numbness,” he says. I don’t even want to know how he tested, but he’s satisfied and now I’m worried that my blue Ike Behar shirt is going to look like his crusty red scrubs in just a minute. He goes to work with the scalpel explaining, “We have to take surrounding tissue so no possibly cancerous cells remain.” The son-of-a-bitch gets out his nine iron and leaves a divot the size of Manhattan. “Now we have to scrape,” he says and the next thing I hear is a scritch-scritch-scritch and I’m wondering if it’s his intention to remove the entire skullular periosteum and drill for gray matter.
Now you might feel a little heat he says, and Igor rubs her hands together and says “henh-henh.” The cauterizing unit is hot enough to weld steel and he lays that thing in the raw wound he has created and he rolls it around and I feel heat alright, I feel like he’s holding a hot iron against my skull and I can smell the hair and raw flesh burning and then he says “Okay.”
Things are not “Okay.” My head hurts like crazy and I’m still anesthetized. Igor gives me some instructions about bathing and vaseline and bandaging that I understand only vaguely, and she slaps a huge band-aid over the wound before I even get a chance to see what they’ve done to me. “How big is it?” I ask, and am informed that my BB sized minor protuberance has left a hole the diameter of a dime.
And all I can think, whenever my thoughts turn to this experience throughout the rest of the day, all I can think is, “Am I supposed to hope the biopsy comes back positive and it was really cancer?” Because if it comes back negative, I want to talk to Mr. Chip Shot and his caddy about replacing the divot.
