Jenifer’s Shelter Island Journal: Before

I’ve been a closet hypochondriac for nearly 70 years. 

I suspect that somewhere in the misty cardboard box world of old columns, I probably have mentioned that fact. I blame the Shelter Island Public Library and all those volumes of historical fiction it fed me during the lonely summer when I was eight. By my 4th grade Field Day, when I saw the red rash on my arms, I knew it was leprosy. It was actually German Measles but the “die,” as it were, had been cast.

In the decades that followed, I’ve had all manner of deadly diseases, in complete secret, of course, not wanting people to think I was, well, you know, a hypochondriac. I was aided and abetted  by the morbid fear of doctors that I’d also managed to develop.

I was scared I had a deadly disease, scared to have a doctor say so (or not, of course). Over and over I’d managed to trap myself into a corner of purgatorial paralysis, while appearing just fine. They say humans get a “pay-off” from even the most dysfunctional behavior. I certainly hope so, because otherwise, all my tortured imaginings amount to a decades-long exercise in terror-filled futility.

Fortunately, for many reasons, not the least of which is my unexpected arrival into serious old age, my uber-high-anxiety toward anything health-related has been assuaged. Not completely gone, but definitely … relaxed. I mean, even I have to accept the irony that for all my fear and trembling, I’ve been enjoying pretty good health my whole life. And, as I approach the Big 8-O, I want it to continue.

So, when I noticed that a flat brown spot which has been riding atop my cheekbone for nearly 20 years was looking slightly darker, it took me a while, but I finally went to the dermatologist. The very nice physician assistant examined my spot carefully, said she didn’t think it was anything, but as long as I was there, she’d snip a bit to send out for a biopsy. Ah, irony.

Two weeks later, the office called with the result. It was considerably worse than leprosy. “I’m afraid it’s melanoma,” she said, “but very, very superficial.”  Still, “melanoma” — wasn’t that a one-word synonym for “death sentence?” Maybe I was in shock, but I suspect my low-key reaction had more to do with anxiety fatigue.

That was a Friday. Monday I was in my dermatologist’s office. “You’ll be fine,” he said, reiterating that my melanoma was extremely superficial and completely curable. “I could remove it in the office,” he continued, “but my concern is it’s location.” 

Location, location, location really is everything. If it had been somewhere on the wide expanse of my back, or down one of the long peninsulas of an arm or a leg, it would be one thing, but this was on my face. He referred me to a doctor in the city, one specializing in “micrographic surgery.”

This past Thursday, I was on the Jitney headed toward Manhattan for a consultation. Bad enough that I have a melanoma, but I’m embarrassingly ignorant when it comes to the city. I’m not sure what made me more nervous: the doctor or the directions for getting there. 

The office was big and busy, almost like a bus station. I filled out a couple more forms. In advance of my visit, my daughter had guided me through the lion’s share of paperwork online. Moments later I was in an examination room. “The doctor will be right in.”

“Doctors,” more accurately. The first was a slender girl of about 14, very knowledgeable, very reassuring. “Your melanoma is extremely superficial. It’s at a Stage 0, just on the surface of the skin. Once it’s removed, the cancer will be completely gone, but it’s recommended that you see your dermatologist every three or four months.” 

Well. That didn’t sound so terrible. Too bad we couldn’t have stopped there. Suffice it to say there’s going to be a lot of slicing and dicing, especially because, unlike regular “Mohs” surgery, this one includes reconstruction. “Can I see a picture of an example?” I asked. 

There’s a reason why you don’t see albums of glossy “before and after” pictures like at a plastic surgeon’s. She showed me the first in a series of one young woman’s “results” — the raw, gaping wound at her temple right after her surgery and then a record of her healing process after one month, two months, three. Of course, there was much improvement. 

My surgeon had come in while I was staring at these photos. “It takes about a year to fully heal,” he said, “but the scars are never going to be invisible.” 

April 4 — grateful, nervous, curious — I’ll keep you posted.