“How’s my hair?”
The atmosphere in Joanie’s room was muted that morning. Both of us were aware that we were entering into an unknown area. The only constant that remained was her attitude that this was going to end up okay. That is not to say she wasn’t concerned about the surgery she was about to undergo, but her confidence in both Dr. Linda Carson and Dr. Michael Maddaus was unshaken.
They wheeled her down to pre op for the final preparations, and as I always did, I went along with her. It was a familiar setting, and with it came the weird feeling again, of being comfortable in a place you’d rather not be.
The routine was familiar too. We had been through it enough times by now, we knew what to expect with each new face that showed up at her bedside. We were getting close to the appointed hour of the surgery, when Dr. Carson stopped by. She told Joanie she would be involved in the early part of the surgery to do a pelvic examination after they had put her under, and would be taking some biopsy specimens from the neovagina for evaluation. She said that would be her only role in the surgery today.
Shortly after Dr. Carson was gone, Dr. Maddaus showed up, and began telling Joanie what was in store. He told her the plan was to do a do a thorascopic exploration. He explained that this meant inserting a flexible scope that would give them a more precise picture of what they were dealing with. He had mentioned earlier, that it might be possible to remove the tumor without having to open the chest, however if that wouldn’t work, and they would have to open her up. With that, Dr. Maddaus smiled, squeezed her hand and told her he see her inside.
That signaled the arrival of the nurse anesthetist, and her dose of Versed. Trying to inject just a little bit of humor, I looked at both her and Joanie and said, “Take me to the isle of Versed.” She looked at me a little strange, but Joanie smiled, she’d heard me say that before, and they began to wheel her off to the operating room. I left for the surgery waiting room to check in and go for a smoke. It was 12:18 P.M.
I had long ago learned how to pass the time waiting for the door to open and see Joanie’s doctor come out to let me know what had happened. Today, I new the surgery was going to take around four hours, barring any complications, so I knew I had to make sure I was in the waiting area from four o’clock on without leaving. Earlier, I had been able to sneak out for a smoke, or make a phone call and get a cup of coffee.
Dr. Maddaus came out at 4:50 P.M., and told me everything had gone well, Joanie had come through fine and was in the recovery room where she’d probably be until around 7:00.
He told me they weren’t able to do the minimally invasive surgery, the involvement of the tumor with both the lower lobe and the middle lobe of her right lung precluded that.
Then he told me he called in a cardiac surgeon, Dr. Kenneth K. Liao, to assist, due to the fist size tumor that had invaded the pericardium, the sac that holds the heart and the ends of the major blood vessels. That procedure went without incident and after that portion of the operation was completed, Maddaus continued to finish up the removal of both the lower and middle lobes of her right lung. Maddaus also told me they had taken three lymph nodes for biopsies.
The involvement of the pericardium was something we hadn’t known about, and it wasn’t until later when Maddaus told us about it, that we became aware of how serious it was, or could have been.
Since I wouldn’t get to see her until she was back up on 7C in a couple of hours, I walked over to Sally’s for a burger and a beer, and to begin calling those people who needed to hear the news. I had already figured out a method, and outside of immediate family, John and Mikey, and some key friends in Bismarck, I had set up a telephone tree. That way, my calls were minimal, and those who needed to hear would. Of course, that didn’t preclude many from calling me, and that was okay.
As I sat there at the bar, thinking about what had taken place this afternoon, I still wasn’t sure what we were dealing with. On the one hand I felt good that whatever it was they were on top of it, and on the other hand, I was afraid of what was coming.
I think both Carson and Maddaus knew already, but it hadn’t really been explained to Joanie and me. I was still holding on the the thought it might have been non-small-cell lung cancer, but knowing that Carson wanted biopsies from the neovagina, and Maddaus had also taken lymph node samples for biopsies, I was losing my grasp on that idea. I decided I wouldn’t say anything at all about it to Joanie, and let Maddaus tell her what was going on.
The fear was metastatic cervical cancer, and if there was also lymph node involvement, the problem was systemic, and that would most likely mean chemotherapy, something Joanie dreaded.
When I got back up to 7C, Joanie wasn’t there yet. I didn’t get concerned, mainly because one of the nurses I knew from before told me she was still in recovery, but would be up in a few minutes.
When she got there, she was in a fog of morphine, and the after effects of the anesthesia. When she saw me, she smiled weakly, and asked, “How’s my hair?” I laughed when I heard those as her first words, but it didn’t surprise me. Even as she lay there with a chest tube coming of her, a Foley catheter draining her Miami Pouch, and having just endured a four hour surgery where she lost two-thirds of her right lung, the first thing she asks me is, “How’s my hair.”
She had this crown of thick, lush, wavy, and often curly, black hair that was her crown of glory, and for some reason that night, in this incongruous setting, that was all she could think about.
I told her it looked fine, and after they got her settled in her room, she was asleep. I went for a smoke.
There would be more to talk about tomorrow.