A stitch in time

    I recently wrote about having some moles excised at the dermatologist and this Friday, two weeks to the day, I went to have the stitches removed from my ear and the back of my head. The rules, having been changed to ensure social distancing guidelines, were that I had to go around the side of the health centre, to the staff car park, where I was under strict instructions not to park (I haven't had a car for five years), then I was to press the buzzer at the staff entrance and announce myself. 

    Dutifully, I did as ordered. Hello, I'm a bit early but it's Richard Douglas, I have an appointment.

    The person at the other end huffed irritably, and replied: Right, I'll let 'em know. 

    The intercom fell silent and I began loitering in the car park. I was the recipient of two, side-eyed, suspicious glances from people who had parked and assumed I'd come to break into their hatchbacks, and almost the victim of a hit and run, except they didn't actually hit me and the only running was done by the flustered healthcare worker who, at 9.40am, I think was running late. 

    I paced the potholed tarmac and checked the time on my phone. I'll let them off, I thought, the appointment wasn't till quarter to. T minus two minutes. I examined what appeared to be pieces of a tiny, plastic palm tree strewn across the ground and, bored, sent a message to Alison to ask her if Lego still made those little green trees. She told me to Google it, I told her I had become too reliant on Google. I paced some more.

    Are yer still there? The voice eventually bellowed through the tinny intercom, like a furious Metal Mickey. Noticing they were now a minute late, but not wanting to say anything, I trotted to the door and confirmed that I was, indeed still there. She'll just be a minute, she's findin' a visor, said the voice.

    A full three minutes later than my assigned appointment time an excellent woman opened the door and beckoned me in with wide eyes and an enthusiastic voice. I immediately forgave her tardiness as she led me down the corridor and asked if I'd eaten because she didn't want me fainting like all the other men that have stitches taken out. I told her about my Weetabix, took a seat in her room and pointed out where the stitches were. 

    Have you been fighting? she asked.

    No, I had some moles removed. Do you get a lot of fighters?

    Yeah, loads. And stabbings.

    Really? I was shocked, this is a nice neighbourhood.

    You'd be surprised. After the pub when they all start scrapping. She paused before adding, And gunshot wounds.

    I couldn't tell if she was joking so I didn't pursue it.

    One of her colleagues came into the room and, so as not to disturb me, pulled a blue curtain half way across the room. I'm not sure how it was going to help as, despite the fact I couldn't see her, I could certainly hear her as she struck up a conversation.

    Where did you get them fancy biscuits? she pried.

    Reception, but I had the last ones. Do you want them? offered my nurse.

    No. Yer alright.

    Are you sure?

    Yeah. Then almost as an afterthought, They're fancy though.

    By now I needed to know just how fancy these biscuits actually were so I piped up: If I'd have told you I hadn't eaten this morning would you have given me your biscuits?

    Yeah, do you want them?

    No, thanks.

    Are you sure? You can have 'em.

    I leaned forward to have a look: Biscoff, extra large, double pack, separately wrapped. I wanted them but I knew I had some baby Biscoffs at home so I declined. The other nurse collected her tools—something about an open wound on a foot—and left. I never did see her face as she ogled the biscuits.

    Right, which ones do you want done first? my nurse asked as she sat down next to me with a tiny blade in her hand.

    A few minutes later, I was done, stitches removed with only one tiny twinge of pain—they were very tight knots I was told—and I was sent on my way with instructions to call if I had any problems with anything, At all, she emphasised. I wanted to ask if I could call her about a few personal issues I wanted to work through but thought better of it. I liked her very much, I think I'd enjoy working with her.

    An hour after I'd left the house I arrived home. There was a letter waiting for me from the NHS with the results of the biopsies. The larger, uglier mole behind my right ear was thankfully harmless but the small dark one, on the rim of my left ear, was described as 'moderately abnormal'. The letter went on to inform that, to cure it, I would need to have further surgery and that I would next hear from their colleagues at Wythenshawe Hospital.

    I'd not expected that. I'd been a bit concerned about the results but everyone, myself included, said it'd be fine, no need to worry, better to be safe than sorry and so on. I'd almost written it off as a formality.

    The letter was short and, while on the face of it, it appeared to the point, the more I thought about it, the more questions I was left with. What does moderately abnormal mean? Is there an abnormal scale and if so, where does moderate sit on that? Should I be worried—I already am—or is it routine? What is further surgery? I'm already missing a small chunk out of my ear, which has left me looking like a bad cat after a fight, but how much more will I lose? A couple of millimetres; half a centimetre; half an ear? Can you get your ear reconstructed on the NHS? I wondered. 

    And this is where I started catastrophising. What if I end up without an ear? What if the radiotherapy (that nobody has suggested I'll need) gives me a brain tumour? Is it too late to get life insurance so Chris isn't lumbered with the rest of the mortgage? Should I leave my grandparents' antiques to my brothers or Chris? An upward spiral of ridiculousness; ad nauseam.

    There's been an (un)fair amount of cancer in my family, we've waved farewell to a lot of people before their time, and this is obviously where this neurosis comes from. 

    My granny buried four of her children—twins in cot deaths, my mum's half brother Peter at the age of seventeen from cancer, after having his legs amputated at the knees, and my mum's sister Anna (the only one I knew) at the age of 45, who died after a particularly bad seizure at the Chalfont St Peter Epilepsy Centre where she was a patient; and my dad and his three siblings all lost their spouses in their fifties—all but one to cancer. These things have led me to spending a lot of my adult life both worrying about dying young and trying to fit as much as possible into my time because you never know when it's up.

    I like to think I'm rational but I've also spent the last nineteen years counting down the years till I die. In my head it's inevitable that I'll pop off at the same age as my mum did, 56, giving me slightly more than a decade left to squeeze everything in. Somehow I manage to dismiss the knowledge that her dad lived till he was 94 years old and on the Douglas side of my family—various ailments, conditions and situations notwithstanding—all seem to be plodding on into or at least towards their seventies.

    The rational side of my brain tells me I should wait for information from the hospital, or indeed contact them myself and ask for it; it says this might not be cancer (but that's what they check moles for isn't it?); half a centimetre of my ear is not such a big deal in the grand scheme of things; medicine has moved on since 2002; this is why I got it checked in the first place; better now than in five years time; and whatever you do, don't Google it. I haven't Googled it, but I'm sorely tempted.

    The side of me that I show to friends, family and colleagues makes light of the situation, because that's what I do. I've joked that I've always wanted to wear a monocle (I don't even wear glasses so the joke's on them) and I talk about looking like that bad cat I mentioned earlier. 

    I make light of it because I don't know what the letter implies, because I don't want folk to be awkward with me and make it weird, and because it's only a tiny little mole. But mostly I do it because I'm a bit scared that I might have skin cancer.

    Time will tell, that's all I know, and so I imagine a day, when I'm ancient and wizened, that I find myself sitting in the corner of one of those down at heel modernist pubs from the sixties, pint in hand, with my one and a half ears and my monocle. I'm telling stories about the olden days during the great pandemic, when surgery meant being stitched up with a needle and thread, the nurses were all called Jackie, and if you pretended you were going to faint you could get your hands on a packet of posh biscuits.

Roseanne Barr

    In seven days time it will be twelve months since I started writing this blog again after a hiatus of nine years. I started writing it again to keep a record, ostensibly for my own purposes, because I've got a terrible memory and I suspected 2020 was going to turn out to be a notable one. 

    In that post I wrote: "Yesterday the Prime Minister urged the British public to avoid all non-essential contact with others. While at present it feels a little over the top I'm confident that in the near future we'll see this as sage advice and suspect this is just the beginning of a long haul." 

    So here we are, almost a year later, and what a long haul it's been, with 140,000 people having died in the UK with Covid-19 registered as one of the causes on their death certificate. Even with the question of excess deaths that I was wondering about in my last post, it's a pretty sobering situation.

    The positive news—for there is always something positive to be found—is that nearly 24 million people have had their first dose of a vaccine, another 1.8 million have had their second, and the rates of infection and deaths are dropping. Here in Greater Manchester the rate has fallen below 100 positive tests in 100,000 people for the first time in months, with only three of the ten boroughs counting more.

    There are reports of folk choosing not to have the vaccine—fine I say, it's up to them—and the odd case of evangelical anti-vaxxers who rather than just saying, it's not for me, are intent on using the powers of social media to convince the rest of us that we're sleep walking into some kind of dystopian future where we'll all be killed by our own governments.

    As far as I know my dad, who is just over a week short of 71 years old, has yet to be vaccinated and last time I asked he didn't seem especially concerned or in any hurry. Like I said, fine, it's up to him.

    In other news, I've had a couple of moles removed, one from my left ear and one from behind my right ear, which was loads of fun. I contacted my doctor about something else entirely and during the phone consultation (because during a pandemic everything is done remotely) I happened to mention that I'd like him to look at some sun damage on my skin. He asked me to upload some images via a hyperlink then called me back to say the one on my cheek was a common or garden liver spot—I thought they were something old folk got—the one on my nose needs some attention, but wasn't anything to worry about, and the one on my ear needs an urgent consultation with a dermatologist. 

    Shortly after I received a text message from the health centre confirming the referral process and of course they used the word cancer which was somewhat disconcerting. I next received a letter to give me my appointment date and thirteen days after my initial call I went to get them checked out. 

In the interim Chris pointed out another mole on my head, behind my right ear, which of course I had no idea about because I couldn't see it. I discussed the moles I'd mentioned to my GP with the dermatologist and also asked them to look at the newly revealed one as well. The long and short of it is that the thing on my nose was some kind of vessel damage and they zapped it there and then with liquid nitrogen to burn it off; the one on my ear they weren't hugely concerned about but because it was dark they said it was best to whip it off; and the secret, surprise mole was of some concern because it was of an irregular shape and looked suspicious.

The remains of the frozen nose thing.

    A few days after the consultation I received another letter inviting me to have the two suspect moles surgically removed.

    Two days later, in her consulting room, I chatted with the dermatologist about that favourite lockdown pastime: going for a walk, and she regaled me with a story about stumbling on a secret garden village in the heart of Burnage. We then passed the time of day discussing books: I'm reading The Little Friend by Donna Tartt and she's just finished Hangover Square by Patrick Hamilton, which she recommended and I've since bought. We talked about the imminent excision, almost in an abstract way, as if she was teaching me how to do it, then I signed some documents and, lulled into a false sense of security, followed her to the next room.

    The anaesthetic was pretty straightforward, though a needle going into the edge of my ear stung more than I expected, then I lay there while it did its magic. The two women assisting the consultant tried to distract me and keep me entertained. Will you be going on holiday this year? What's your job? That sort of thing. They were pleasant enough but I think they could learn a thing or two about their patter from a hairdresser. Chit chat about city breaks only goes so far when international travel is all but banned.

    All numbed up, the consultant slipped around my side, weapons of choice secreted upon her person so I couldn't see what she was about to cut me with, and said, Can you feel that?   

    No, I replied. 

    And that? she asked as she jabbed me in the side of the head. 

    No. I could not feel anything, happy days, the anaesthetic had done its job. 

    I'm going to start on this side, she said, indicating the big one behind my ear. You'll just feel a bit of tugging.

    To begin with I sensed the work being done and the mopping of blood, a strange sensation, accompanied by the dulcet tones of the three women trying to get me involved in a discussion about their favourite comedians, a distraction technique if ever I've heard one.   

    With the benefit of hindsight I'd say it was about a third of the way through the procedure when I realised the anaesthetic hadn't flooded all the way across the flesh that was being cut out. 

    That was sharp, I thought.

I didn't say anything obviously. 

    Ouch! Shit, that hurt.

    Everything okay? asked one of the butchers as I unclenched my fists and wiped the sweat on my jeans.

    Roseanne Barr, I replied, she's hilarious.

    Roseanne! I'd forgotten about her, said the consultant, and carried on slicing me up.

    Had I known the pain was going to continue for as long as it did I'd have said something but I thought, just get it over with, it won't be long, it's not that bad. So I gritted my teeth and tried to focus on something else: the drawers with paperwork in them, the pile of swabs on the counter, the crinkle of the protective paper I was lying on, the OH MY GOD SHE'S SEWING MY HEAD UP!

    And she was. The offending mole had been removed, they'd talked over the works of Miranda Hart, and the wound was being sewn up. I couldn't tell whether what I was feeling was the needle going in or coming out but I knew I could feel a hot puncture in my skin followed by tugging and instructions in secret medical talk to do something to each of the stitches. One, two, three, four in turn. 

    All done! she eventualy said, chirpily, Just the little one on the other side to do now.

    Thankfully while the bloodbath behind my right ear was occurring it had given my left ear sufficient time to numb properly and all I felt was the tugging previously promised. The consultant was done in no time. She assured me that the flesh would be lab tested for cancer and I'd receive the results in two to three weeks. She then scuttled off back to her office leaving me in the capable hands of the other two women who briefed me on stitches etiquette. 

    Don't get them wet for three days; book yourself in at your health centre to have them removed in two weeks; and don't lie on them when you go to sleep. Followed by a moment of realisation as she appreciated there were stitches either side of my head and that might make sleeping tricky. Maybe you could... Er... I'm not sure how you're... Well you could try...

    I tried to help her out by saying, If only I had one of those hard little pillows Geishas sleep on so as not to mess their hair up. She looked at me like I was mad. I'll find a way, I assured her and left, light-headed and with a handful of leaflets.   

Stitches behind my right ear.

Stitch in my left ear.