Saturday, December 31, 2016
Maps at Halfway
I have twelve stitches running up the middle of my back. They've been knitting themselves together for eight days now, pulling together pieces of skin on my back that have never been neighbors all these 45 years until now.
I have a mole on my upper lip that once concerned a periodontist when I was in my middle thirties. At that time I was still feeling pretty immortal, I'd picked up smoking again while I was training for a marathon and was drinking heavily in fits and starts, trying to parent two people and failing miserably at parenting myself. I had no time to worry about concerning moles, I could barely keep my daily shit together. It was monumental that I was having my gunky gums deep cleaned, that was as healthy as I got that year. For some reason this fall I got around to the idea that I should see a dermatologist.
Something happened to me when I turned 40. One day the big thought occurred to me: MY LIFE IS HALFWAY THERE. My mind dropped to it's knees and my heart sank and I think that was the moment that I realized I was really going to have to quit drinking, I just didn't know when or how I'd be able to put the other foot down to take the full step. It would take me until 41 years and almost 8 months old to bring my feet together in that life salvaging step, and then two more years after I got sober to realize that being sober was not enough anymore, that I needed to use my sobriety as a push off point for the deeper care of myself- my body and my mind.
I finally got around to calling the dermatologist this fall, waiting three months for my appointment. The mole on my upper lip was fine, she said. The odd blurry mole on my thigh came off, and one on the middle of my back got taken off too. I got two band aids and a prescription for the weird rash around my eye and left her office happy that my favorite mole got to stay.
About a week after my appointment the dermatologist called me. She left a message. How nice of her to call, I thought, and promptly forgot to call her back. She called me again the next day and left another message. I had some time so I called her back and was put right through. I should have known that it's not good news when the doctor calls you, but I thought she was being super attentive and still had no clue something could be wrong. She started talking, saying words like "melanoma" and "melanocytes" and "dermal nests" and "severely atypical" and I still didn't understand. I asked her to say all these things in Amy Parrish language instead of doctor language and still didn't get that it could be serious until her nurse called me five minutes later and said the the doctor wanted to get me in as soon as possible to do an excision. Oh. Shit. Shit.
I Googled melanoma. Mine was a stage 0, in situ, survival rates 99-100%. I decided to freak out and also to be okay. Cancer is a big word, I am a big person, life is a big deal. I kept thinking Don't put the cart before the horse and then I'd do things like pull up to the stop sign at the end of our street on my way to pick up my youngest at school and I'd look at the traffic going by and the sun shining and I'd imagine that all of it would go on even if I didn't, that someone else would pick up my smallest boy at school and he would miss me with all of his heart and be so lonely in the world sometimes without me but he would live and go on just like the traffic and the sun.
I talked with people close to me. They had two kinds of stories: the everything was fine story and the dead in 4 months ones. I kept thinking I was going to either be okay or dead before summer.
It's a strange thing to come up against my own mortality, the breathtaking sharpness of thinking about myself dying, of no longer being, my family's empty arms longing for me. Even stranger the deep calm I felt from knowing that I am actually living now. Dying doesn't seem like such a raw part of the deal. I alternated between thinking it was no big deal and desperate that my life was over. I was mostly okay, but fearful sorrow would come on suddenly, I would burrow my face into my husband's chest and gulp out a sob and feel so bereft and he would pull my chin up and look into my eyes and say he was scared too but we were going to be fine. I knew he meant I would be well, but I prayed hard for them to fine no matter what, no matter what.
I went in for the excision on December 23rd at 2:30. I thought she was just going to take out a bigger circle around the spot she'd had tested. No problem. No biggie. There were five people in the room, my doc, her resident, three nurses. I still thought she'd be taking at most penny sized piece of my back and I'd be sewn up and out the door by 3:00.
She started with the lidocaine, about eight shots. Talked me through what she was going to do: cutting more skin around the site, there'd be inner stitches, cauterizing, outer stitches. I'd need to take it easy for 2-3 days. After a while I began to wonder what was taking so long, it couldn't possibly take this long to cut out a penny sized piece of my back. So I asked, "Hey, just out of curiosity, how big of a circle are you doing? Is it like a dime? A penny? You know- size wise." There was a pregnant pause. "More like a dollar bill," said one of the nurses. I pictured the small side of a dollar bill, but as a little rectangle of skin coming off my back. Like the white edge part of the dollar bill. No big deal.
They sewed me up, bandaged me up, let me know the pathology would be back within two weeks, maybe longer because of the holiday. I made follow up appointments, went to work, still thinking I had this slender rectangle of skin taken, wondering why it felt so sore. I left work early and Googled melanoma excisions and dollar bill measurements and figured out what had actually happened: she had taken a 2.5 inch long oval out of the middle of my back.
We spent the next day traveling to my in laws. That night my husband changed my bandage and counted 12 stitches on the outside. He took a picture with his thumb for scale. It was twice as long at least. She took a lot. She was more concerned than I had ever imagined.
Late Christmas afternoon we took the boys out to the beach while the sun was starting to set, they ditched their shoes and ran shrieking to the water, then down the beach, watching them my heart caught so hard while the cold wind whipped my hair, I reached out for my husband and sobbed out What if this is our last Christmas? What if we were too late? He held me tight, the boys ran up, my oldest asking "Mommy? Why are you crying?" stopping my breakdown, allowing me the white lie of saying something about the sunset-y beach being beautiful before he hugged me quickly and ran off.
Yesterday, the 30th of December, I got an email from my dermatologist's office. AN EMAIL.
Your surgical margins are clear, and no further treatment is necessary. We hope you are healing well and will see you at your next visit.
My margins are clear. No further treatment is necessary. I did not make it this far for it just to be over. I get to keep going. I get to live this life that I have only now just started to have the courage to live. When I thought it was possible that I might be dying the one thing that was my saving grace was the fact that my life got to be lived, that I got to be sober for these four years, that I wasn't going to head into dying never having known what it was like to live as me.
There's something about thinking I could be dying that makes it simpler to make hard decisions, to take chances, to be kinder when I would have been impatient- to look and see the good in everyone. To stop thinking there's plenty of time left and instead using the time I've got as if it's valuable currency rather than an all you can eat buffet.
I don't know how to not be preachy here, so I will just be it. If you think you should stop drinking you should stop. Today, right now, this minute. If a doctor told you that you might have a disease that could kill you how would you decide things differently? What if you could save yourself?
I realized yesterday afternoon that if I were still drinking that I would never have made the appointment with the dermatologist, that maybe if I hadn't quit drinking I would have died from skin cancer at 50, never having gotten sober, never taking the time to check out my moles, sadly ragged and hungover while going through cancer treatments and trying to make it up to my children and failing miserably. My decision to quit drinking has saved my life twice now. In all the maps that have led me to this place, the middle of my life, the clearest directions have come from my efforts to care for my own self, to save my own life.
Here's to life. Here's to living, to surrender, to finding the courage when there's none to be found, to grace. This time, it will be different. Happy New Year y'all.