Photo credit: Ann McLellan Lardas
My children introduced me to the concept of “nose goes” when I said, “Someone needs to take out the garbage.” (I used to say “We need to take out the garbage,” but my youngest coined the term “the Communist We” to describe such use of the word.) One son called out, “Nose goes!” and all four children put a finger to the side of his or her nose. Last one to touch his nose had to do the deed.
As a mother I found the concept annoying, because like the allegedly silent game “Mum Ball” played at indoor recess it led to more heated discussions than active cooperation, but it’s a wonderful concept to indicate that there’s something that has to be done, and you don’t want to be the one to do it. I have pulled it on my husband more than once.
The phrase becomes way less whimsical when you apply it to your own nose.
My nose has been bleeding on the outside when I take hot showers since I was fourteen. Since it usually healed by the time I was dressed, I thought nothing of it. As I grew older it took longer to heal, and lately it didn’t heal at all. It took a year and a half for me to see a dermatologist because three of them left their practice, one at a time, within a week of my scheduled appointment. I finally found a dermatologist, on my own, who is on my insurance but not attached to my primary care doctor’s hospital. Her office is beautiful, with purple flowers and green vines painted everywhere and interesting things to look at on the ceiling. And her manner was forthright. She stuck me with needles to numb my nose, scraped off the pesky cells, and cauterized all the points that were bleeding. For a day and a half everything I ate tasted like barbecued me. “It looks like you’ve had this for a long time. It’s probably going to turn out to be cancer. And you will need to talk about what to do next with another dermatologist.” The biopsy proved her right — I had basal cell carcinoma. “You will need MOHS surgery,” she said.
Basal Cell Carinoma
Basal Cell Carcinoma is cancer, but it’s the best kind of cancer, in that they can do something about it. The dermatologist affiliated with the hospital my doctor uses was going to do a simple MOHS procedure, where each layer of skin is scraped and examined. But that morning, I had three new lesions on my nose. So she took biopsies instead. These proved to be more basal cells. And so she set me to the surgeon.
Lack of Sugar
The surgeon she sent me to is young, and attacks cancer ruthlessly. “I don’t sugar coat,” he said. He told me what he would have to do to fix this mess, and what I would have to do to prepare. He will take cartilage from ears and use it to support skin from my cheeks or forehead to cover the nose after the middle doctor removes all the cancer. Day one is removal of cancer in the dermatologist’s office. Day Two is reconstruction of the nose, followed by 23 hours observation, at the surgeon’s hospital. But I would have to do my part to lower my A1c, and furthter he expected me to walk at least an hour every day so I would heal properly, “and not risk the chance of profound disfiguration” from poor healing.
In the days and weeks that followed, I was more careful about what I ate and took what I called “forced marches,” outdoors when the weather was good and indoors at the store or gym when it was too hot or rainy outside. I did this at home. I did this when we went to Honduras to meet my son’s fiancee’s family. I did this at airports. And it worked.
Cleared for Surgery
I am cleared for surgery, removal of the cancerous cells on 8/4 and reconstruction of my nose on 8/5. Prayers most heartily welcome.
With some trepidation, I told the son who is to be married about my upcoming adventures. He put his arm around my shoulder, looked me in the eyes with great empathy, and said, “I’ll give the doctor fifty dollars if, in the middle, he says, ‘I’ve got your nose.”
My Nose, Though…..
I made the mistake of doing an online search of images for this procedure. The before pictures all look rather like me, with more or less damage. The after pictures are truly reassuring, with the faces looking normal, perhaps with a thin scar. But the middle? The photos of faces in the middle of the procedure look like line drawings of gremlins and goblins from German fairy tales from the nineteenth century.
This would all be easier, I suspect, if the cancer were someplace that my clothing hides. This is the nose that my siblings and cousins share. This is the nose that my father stroked and my uncles “stole,” that siblings tried to nurse when Mom was out and which countless wrongdoers have accused me of sticking where it doesn’t belong. (They were, of course, wrong.)
And this is the nose that was beeped.
“A Beep on the Nose”
I won’t give his name, not online or in person over beverages, because he and I are both grandparents now and he is a grizzled clergyman and I cling to whatever gravitas I can still muster. But when I was engaged, almost forty years ago, my fiance took me to the Blini Dinner Dance at a Russian parish near New York City. Blini are the pancakes that Russian Orthodox people make before Lent starts, and the parties surrounding them are often elaborate, with many rich toppings for the pancakes (smoked salmon, caviar, chopped onion, melted butter, sour creme, pickled herring, and more) and the last real parties before Lent. This was a glorious celebration, and by the end not everyone had danced off the vodka they had consumed.
A young seminarian who had been at school with my now husband and my older brother came over to me at the end of the evening. He was very, very earnest, and was weaving a little. “Anna!” he said, “I know that you love George, and you both are getting married, and I respect that, but I, I just have to do this. I’m sorry, but I have to.”
You know how the responses to trauma are flight, flight, or freeze? Reader, I froze, wide-eyed paralysis. I had no idea what would happen next.
He gazed at me steadily. He leaned in closer. He stuck out his index finger and reached for the tip of my nose.
“BEEEEEEEP!” he said.
I didn’t think I could open my eyes any wider, but I did.
“You don’t get it?” he asked. “A beep on the nose is a sign of very great affection.”
And then I did get the reference. He was a dear boy. And now he’s a dear man.
But, my father was careful not to let me spend too much time with the seminarians, and I didn’t know all the names of my brother’s classmates and friends. And I couldn’t tell, at the time, who this one was.
Fast forward several years. I was very married, and pregnant with our second child in three years; I felt like an ugly troll. My oldest was still a baby herself. But the youngest of the bishops had come to our parish in Boston for a feast, bringing with him the youngest of the deacons, newly ordained. I didn’t get to spend a lot of time in the service, between my daughter and the usual pregnancy complaints, but at the end of the meal after I stared hard at the deacon. If I could picture him with a little less beard, he might have been the one who beeped me. But I couldn’t be sure.
The bishop blessed us all and left, and the deacon was still gathering the bishop’s things to load into the car for the ride back to New York. He came over and spoke to me kindly, with greetings and kind things to say about my daughter and husband and parish. And he paused.
“You don’t remember me, do you?” he asked.
“I…. I don’t know,” I stammered.
“That’s okay,” he said, good natured. “Just one more thing.”
His eyes flashed. He reached in.
Well, glory be to God for all things.
So, nobody should beep my nose for a while after the surgery. I can’t use my CPAP mask and for now I can’t take any pills or vitamins that are blood thinners and I am sure I will receive new restrictions in the days to come.
And frankly, I am not sure if I will be healed by my son’s wedding in September. I offered to reschedule the surgery, but he said, “Mom, it’s cancer. We want it gone. And we want you around for a long time.”
I offered to stay home but he scoffed at that. So now I am playing with ideas for what to do to hide the healing process, if I still look like a troll in September. Etruscan helmet? Face mask? Veil? Fabulous hat with a blusher veil? The answer will come. (I do have some friends who are beekeepers…..)
There are things we get to choose in this life — whom to marry, what to read, how to look at a problem — and there are things where our choices are limited. The cancer is there. I don’t want it there. It has to come off. And if it means surgery, thank God I can have the surgery. And if, in the end, I am changed, it could be for the better. And yes, I do know that I could look like Voldermort if this goes way wrong or like a Bejoran if the worry lines on my forehead are too deep. But I can’t afford to think about it. Sometimes thinking makes things better. But sometimes it’s not good. The late Fr. Theodore Shevzov told me, “I got to be a certain age by keeping straight in my mind two very different things — things over which I have some — SOME control, and things over which I have no control whatsoever. For things over which I have some control, I have a duty to exert myself. But for me to concern myself over things over which I have absolutely no control whatsover — already, this borders on sin.”
Nobody wants to border on sin. Especially when one is going to have real surgery for the first time. And so let me focus on getting exercise, preparing for surgery, keeping my sugar levels down, and saying something kind to everyone before the doctors get started, just in case.
Thank you for your patience with me and my sporadic and often rambling writing. God bless. We will keep you posted.