My next patient is Scott Griffith, a seventeen year old rock musician. I watch him kiss his girlfriend in the waiting room before he enters the treatment room with me. She is petite and has pink hair urging people to misjudge her on the spot.
Scott’s transfer papers indicate a deteriorating thyroid condition which needs further examination before contemplating operation. An ultrasound scan diagnosed excessive iodine production leading to an increase of thyroid hormones. According to the previous checkup, the size of his thyroid gland is still increasing. The current state of the swelling already looks as severe as I have assumed.
“Ever since these goiters, I’ve been having sore eyes, as if they were bulging.”
“It’s a symptom that occurs under very rare circumstances. I’ll give you drops.”
Toxic goiters have always repulsed me in a non-medical way; they remind me of fat people who don’t chew before they swallow, resulting the food to accumulate in their throat. Scott, on the other hand, is a handsome fellow, however, despite his tired eyes suggesting chronic lethargy. He stares deliriously at my four panel curtain, as if there was a ghost hiding behind it.
When wiping his neck with antiseptic solution, he makes no noticeable movement, not even a little reaction to the cold liquid on his skin. I wonder whether numbing his skin with some anesthetic is necessary before the biopsy.
“Is this the result of not eating healthily? My immune system’s a bitch, y’know, like life itself.”
I pause and look him in the face, but he’s still glaring at the curtains with his automaton eyes.
“It is very likely that your immune system has turned against your thyroid’s function, Mr. Griffith, and this stimulates the antibodies in your gland to a more enhanced activity.”
“A shame that antibodies can’t think, eh?” he says. “Driven by instinct.”
I prepare the syringe for the aspiration biopsy.
“Ironically it is me who produces these proteins, right? I am all those assiduous cells, but the cells aren’t me…”
Now he glances at me in a way as if he had always known me, then he looks at the fine thin needle. He slowly curls his hand around mine which is holding the needle firmly.
“I used to be a hard-working cell, Doctor Parker.”
“I’m sure you still are.”
“You don’t understand. I’m not referring to this life.”
While he shoots me a sinister look, his grasp around my hand becomes firm.
“I used to be the leader in your body when you were little, but during that particular battle you bled me out.”
I immediately let go of the needle.
“I was gazing up at the grass while resting on dark ploughed earth,” he continues, “I felt very cold. Then the earth sucked me in…my new purpose was to fertilize a daisy by offering my life.”
Before I realize it, I feel the first tear drawing a line down my cheek, and I don’t usually cry to poetry.
“Did you write a song about this?” I ask.
“Of course. It’s called ‘Innocent’.”
It’s early in the morning and I watch how Nurse Manager Judy and the scrub nurses set up the operating theatre while a few junior surgeons gather at the back of the room. During the microscopic examination, I discerned that Scott’s cells were no longer following their regulatory mechanism. On the micrograph the specimen looked like fluid cyst, but the resulting prognosis was follicular neoplasm – possible cancer due to cancerous tissues showing growth. With ambiguous diagnoses like this one, the only way to identify the illness is to check the whole capsule of the goiter.
I watch Scott’s girlfriend hold his hand in tears while the nurses push his hospital bed towards the operating room. I inhibit the girl from entering the room with her restless nature.
“You seriously have to calm down. Everything will be all right.”
“I don’t like you,” she says.
I step aside, as though allowing her to enter the operating room.
“I know about you,” she continues, “Scott won’t stop talking about you.”
“I’m just here to perform a lobectomy, Miss.”
“Yeah, do what you have to do! But don’t you dare touch his larynx!”
She knocks my arm with her shoulder as she walks past heading for the elevator. I’m sure she wishes our shoulders were the same height.
Scott gives me a delicate smile before the anesthetist puts him to sleep. The idea of me having authority over his thyroid’s hormonal function involving his body’s energy level explains Scott’s lady friend’s attitude.
I make a 3 inch incision along the mass above where the clavicle and sternum meet, and then watch the blood slowly ooze out and accumulate at the edge of the wound. So to Scott, these are living citizens in his body; inborn citizens with a right to remain in their homeland, in order to continue their vigorous work. The scrub nurse applies a self-retaining retractor to hold my fine incision open and adds another to pull back the infrahyoid muscles, allowing me an unconditional admission into Scott’s mushy little kingdom. When removing organs I tend to use the electrocautery to control heavy bleeding. As I cut through the thyroid tissue, I hear a moan. I throw a quick glance at the nurse.
“Is anything wrong, Doctor?”
I look at the bright halogen lights above me and at all surgical apparatuses that I’m surrounded by.
“It’s nothing.”
After the removal of half of the tissue I see the laryngeal nerve behind the gland, and I just can’t refrain from grinning behind the mouth mask. The nerve originates as a sort of limb of the vagus nerve, which ascends to one’s brain in the carotid sheath; the sheath that engulfs the neck’s vascular cubicle – an escapist’s playground.
In fact, now I can hear Scott’s song. His sweet, mild sounding baritone voice resembles Dave Gahan’s. I wonder whether his pink haired lady friend has touched his every part, including hidden spots of his slim body.
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