My son came with me to the appointment the following morning and the third nurse met us with the good news that the surgeon would be able to see me.
Surgery on the skin leaves obvious scars, hence the involvement of a plastic surgeon. He seemed in a bit of a rush and no doubt needed to be in two places at once. I thought he'd probably be more comfortable in his natural environment with a scalpel in his hand and hoped he could return there soon. I was aware I'd interrupted his day and felt awkward about that. But the third nurse had done very well to divert him in my direction and I was also very grateful for that.
She found us an empty office that appeared to be available for anyone to use, and it was going to have to do. First come first served.
He got straight down to business. Glancing at my scalp, he asked: "How long have they been there?"
I was so used to recounting my entire dermatological history that I started off in 2022 and talked about the original lesions on the other side of my head.
"Yes," he said, nodding towards the lesions, "but how long have these been here?"
We then had a bit of a circular discussion that went nowhere until it dawned on me that he only needed to know about the current problem, not the history of everything. I think my son kindly prompted me towards this conclusion. From that point onwards, things went much better.
The surgeon confirmed that the smaller lesion would no longer be a suitable candidate for curettage. Instead, excisional biopsies for both lesions would be required in a skin flap procedure. He thought he might be able to do it on the Thursday or possibly the Tuesday of the following week. That was extremely good news.
In terms of any subsequent treatment, he saw radiotherapy as the most likely option. However he tempered this with an optimistic: "If I was to put money on it, I don't think you'll need anything at all." This was of course on the basis of what he could see before him, there and then.
After this he picked up the phone and asked for my notes to be made available to the computer in that room so he could update them. I hoped this would also enable him to see the photos that were taken of my scalp after the appointment with the third dermatologist some four weeks previously. This would give him clear evidence of the rapid speed of transformation of both lesions and I hoped that would be useful.
I think it must have been.
Later that afternoon I was phoned by someone from the back office team. The surgery was no longer scheduled for the following week and had now been brought forward to two days later. I was also told that the samples would not be sent to the local hospital with the contract to do the lab work. Instead, they were going to another hospital some distance away "that would be able to turn them around in three weeks" (rather than six).
After the call I sat in silence for a while, contemplating the significance of these new arrangements.
