Jacob Brogan

The world is always ending

To My Surgeon

To my surgeon,

            Patients often refer to their doctors as “godlike.” When we are sick – especially when we are sick and scared, as all those with cancer must be – anyone who offers respite seems an agent of higher powers. There is something dispiriting in this conceit. When we call you divine, we are admitting we have no power of our own, that we are entirely in your hands. In doing so, we unwittingly submit to the sad cultural logic of disease, a logic that tells us we are weak, impotent before an internal evil that exceeds us in every way.

            I will not call you godlike, then. Since this began, I have struggled to retain my agency: Cancer threatened to alienate me from myself, to make my body other as it inspired cells no longer wholly my own to replicate and spread. I need to remind myself that this body is my body, that it acts under its own power. So you cannot be like a god, but I know this: I was in your hands. And I felt safe there.

            The day of my first appointment with you, one of your students struggled to locate the right nodule on my thyroid. As you pointed it out to him, he pressed in suddenly with two fingers, an accidental aggression that made me recoil in pain. Your reaction was both immediate and divided: You spun on him, saying nothing, but glaring in a way that made him shrink in shame. Simultaneously, you gently stroked my left arm, just once, a gesture of impossibly full compassion and care. In that moment I needed nothing else.

            Under those two fingers, I had felt cancer for the first time, the rounded protuberance of the tiny tumor taking concrete shape in my throat as it pushed back. This knowledge pained me more than the pressure, an unbearable substantiation of what had been abstract before. Your brief caress taught me a different lesson. I knew in an instant that I would be well. The next day, I began to write.

            A different feeling overcame me after I saw you yesterday. For most of the morning, I cried, small chirping sounds like the inchoate song of a baby bird grasping for language. I did not realize until noon that, despite my tears, this sound was not correspondent with sorrow. It was instead the stuttering start of laughter. I was happy, really happy, for the first time since my diagnosis. My joy was spontaneous, expansive, and somehow unexpected. We are never really prepared to encounter cancer. Having met it, we are still less ready for the elation that comes of knowing it is gone.

            In your office you had handed me a stack of stapled papers, five pages crowded with information. While you spoke, I scanned them as one might a heat mirage in the desert, seeking signs of life. There were none. Pointing to the first sheet, you explained that the pathologist had found very little, almost nothing, in my excised gland: Two tiny tumors, one of eight millimeters on the right side, one of two millimeters on the left. There was some cellular growth in the thyroid itself, but the lymph nodes, you said, were free of disease, as was the other surrounding tissue. What does this mean? It meant the carcinoma had not metastasized. It meant your work was done. It meant that I would need no further treatment.

To my surgeon.JPG

            I did not stop listening. I know that dangerous cells may linger. I know that my body will be studied for the rest of my life against the possibility of cancer’s return. I know that different doctors will examine me to ensure the growth you pulled out was a solitary anomaly. I know other things too. I know you were not alone in this, that others aided you, others whose names I may never learn. I know that my own case was not especially dire, that you have faced far worse. I know that I was never in much real danger, however frightened I may have been. I know all this and yet I laugh, laugh because for the first time in a month I can laugh with my whole body.

            When we tell stories about the gods, we often speak of the way they shaped the heavens. I will offer no such fables: The stars above me preceded your arrival in my life. Other forces set them alight. Your work was terrestrial, but no less meaningful to me. You removed a small thing from my body, a small thing that loomed so large it occluded the sky. You have given me back the sun.

 

            With boundless gratitude,

            Jacob