A small white patch on the underside of the tongue. Slightly raised and about the size of a pea. No pain. I could feel it when I swallowed and played with it with my toothbrush in the morning. I had no idea what it was, but it didn't hurt, so it was nothing and would go away. It didn't.
The first visit to the doctor was light and friendly. My little friend was a plugged mucus duct that would dissipate in a week or so. If it didn't, I could come back and have it drained. After ten days I called and was referred to an ear, nose and throat specialist for the draining procedure. Upon examination, the good doctor informed me that the original diagnosis was in error. This was not a plugged mucus duct. He didn't know what it was, but he would cut it out next week. Just to be on the safe side, he would take a little piece now and have it analyzed. He sensed my concern and assured me that at age 38, with no history of smoking or drinking, the probability of cancer was virtually out of the question. The lab results came back. I had cancer.
Alright, I have cancer. It's only the size of a pea. They will cut it out in an office visit on my lunch hour. No need to tell Kathy. It will only worry her and besides this is sort of like skin cancer. They may even burn it out. Over in five minutes. A piece of cake.
No, it won't be that simple. I have to go into the hospital. They call them margins. Although it is the size of a pea, some scattered cancer cells may be around it and they have to cut out a big enough piece of my tongue to make sure they get it all. I'll be in for two or three days. O.k., I'll wait until I have to go in and then tell Kathy. I don't want to worry her and that's what John Wayne would do. All real men don't worry their wives and besides, why make such a big deal about such a tiny tumor. I will tell Kathy that it's a minor procedure. I'm in and out in a couple of days. I can handle it. I've always managed to take care of myself. I've been doing that since I was eleven.
Mom was an alcoholic. Although Dad had a good paying job, he couldn't possibly do all that was necessary at home. We all fended for ourselves. If there was no food in the house, I could always go on a milk run. Milk runs are exciting. You follow the Milk man at 4:30 in the morning, being very careful not to be seen. Watch what he leaves. Before long, you have stocked up on bread, eggs, donuts, cheese and orange juice. That takes care of breakfast, lunch and dinner, but you have to be sure to drink all of the milk. Even if your stomach gets as tight as a drum, drink it all or your brother will. Save on your laundry by not wearing any underwear. You don't have any underwear anyway. When your front tooth gets knocked loose, Mom is drunk and Dad is at work. No problem, just get some rubber bands and brace the tooth against an adjoining one until it heals. When you want to sign up for Little League, forge the registration papers and explain to the coach that your parents both work nights and that's why they can't make it to any team functions or games. You are the only kid on the team without cleats and your glove isn't the best, but the coach sees to it that you get a better glove and he supplies the cleats. His name is Hugo and he needs you. You lead the league in hits and stolen bases. At school, you refuse to suit up for P.E. because you have no underwear. The football coach takes you to Thrifty's and buys you six pairs of shorts. His name is Coach Jacobson and he needs you. You are his Fullback and Defensive End. Whatever comes up, you can handle it. You have been doing it all of your life. Your skills, your intelligence and your resourcefulness have always been there to take care of any problem. You'll call on them once again, but this time they will fail.
Remember, you are John Wayne. You have to joke with the nurses and the doctors. You have to be a good patient. This will be over in three days. After the surgery is over, you make it a point to kid around with the nurse who brings you back to your room, but he isn't all that happy. You smile and joke with Kathy to ease her concerns, but inside you know that the lab is running more tests on the tissue sample to insure that all of the cancer is gone. The doctor has assured you that he took out enough to give you adequate margins. You go back for a follow up visit and the doctor tells you that you need more surgery. The margins were not adequate. He wants to schedule you for immediate surgery because he is going on vacation, but you are not listening to anything he is saying. Your mind is reeling with the problem, but no matter how you approach it, you can't defeat it. You can't defend against it. You can't handle it. For the first time in your life, you feel lost and helpless. You leave the office and have to pull over on the freeway because your contacts are blurred from crying. You can't stop crying. You are going to die. That little white pea is going to kill you and nothing can stop it. It will slowly spread to the surrounding tissue and little by little they will cut away your head until they can't cut anymore. Then you will die. Probably as the result of it spreading to the brain. You are a dead man living on borrowed time. You can't do anything to stop it and you have nothing you can trade to get help from anybody. You must stop crying before you get home. You can't let Kathy see you like this. John Wayne would just have an ice cold beer and kill himself, but here you sit crying your eyes out.
Kathy comes home and you can't stop crying. You are so worried about the kids and the insurance. How is your twelve year old son going to make it without you ? How can you help him when you are dead ? You don't want to be left alone. You want as much time with your wife and children as you possibly can while there is still time left. You need to call the doctor once you settle down. You need to get more information on what's going to happen to you. Kathy suggests you get another opinion to help ease your mind. Prior to that you decide to call your sister. She has had friends with cancer and maybe she can help.
Carmella is very supportive. She assures you that she will be down for the second surgery, but she also implores you to let go of the problem and let others around you help carry the burden. They will not fail you like mom did. You have to trust in the people you love and the professionals you go to. You have to let go. When you do, a mountain will be lifted off of your shoulders and you will feel relieved. Let others pour the strength into you for a change. I trust very few people in the world, but my sister loves me deeply and wouldn't lead me in the wrong direction. It's not easy, but I start to let go.
We find another doctor to do the second surgery. He is a head and neck cancer specialist in Pasadena. Because of the location of the original tumor, he elects to do a radical neck surgery. My sternomastoid muscle, which helps support the collar bone from behind my left ear will be removed. My jugular vein, the muscle and the lymph nodes are all together and the only way to check the lymph nodes is to take them out. I will lose about twenty-five percent of my neck. About one-third of my tongue will be cut away, but a section of my thigh will be grafted in its place to give the tongue mobility. I should be able to talk and eat with no problems. Based on his expertise, he feels that the cancer will not be in the lymph nodes, but the only way to make certain is to do the radical neck. I will be out of the hospital in one week and will be at home for three months. During that time, I will be exercising the left arm and shoulder to keep the shoulder from rolling to far forward. After that, there will be a five year follow-up and then I will be pronounced cured. In a worse case scenario, the cancer will be in the lymph nodes and I will be dead in about five years. I tell the doctor to go for it. It's not my problem anymore.
The nurses are great. The doctors are considerate and optimistic about my progress. People seem happier to me. They smile more than I have ever noticed before. Friends take up a collection at work and buy me $200 worth of classical music. A neighbor buys me a stereo cassette player and my son plays chess with me in the hospital. Kathy is best of all. She is taking care of everything at home and continuing to go to school. When I get home, she mimics me doing my exercises and is constantly kidding me. She says with the weight I have lost, I look five years younger and am as handsome as ever. She is absolutely certain that everything will be fine. Her outlook on life carried her through the four months of doctors and hospitals. The strength she needed was all around her as it has always been. She simply tapped into it whenever her reserves ran low. She has always been secure in the knowledge that she was never alone.
Cancer taught me that I was not alone. People did care about me. People are very important. People represent a resource that is perhaps the most precious possession that mankind has. I know it sounds silly, but in a strange sort of way, I'm grateful for having cancer.
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