‘You’re have a deficiency in a clotting factor. You need to have Vitamin K from a drip, otherwise there is a risk you will haemorrhage during the operation’. It’s Roberto talking to me, young general surgeon, probably from Naples judging by his accent. To me, he seems surly, he only ever says the minimum necessary. He never says more than he has to. It’s almost as though he each time he studies me with a look, without asking me too many questions. In no time at all my favourite nurse, Michela, arrives and inserts the drip. She turns off the light and lowers the blinds. She senses my uncertainty meeting my look. ‘It makes you sensitive to the light’ she says. ‘You should be in the dark for a bit’. Today is not a good day. Today only bad news. Who likes bad news? I certainly don’t. After the drip I need to see the ENT specialist. Luca takes me to the clinic. A young, unpleasant, doctor greets me. ‘Open your mouth’ and in that precise moment he puts a scoop in my mouth to check the state of my vocal chords. ‘Sorry, it’s an unpleasant feeling’. I gag and pull back. ‘Open your mouth wide’ he repeats, irritated. He puts the instrument back in, pulls my tongue and inspects my vocal chords. On instinct I try to shut my mouth. ‘I’ll need to be less polite’. He’s angry, with me. He puts two tubes up my nose. Won’t be long, won’t be long, won’t be long I repeat to myself. I close my eyes, I can’t take it anymore. I can feel the tubes moving down to my throat. ‘Done. You may go’. I leave the clinic with tears in my eyes. The discomfort mixes with dislike for that doctor. Surly. Moody. Unkind. Impatient. Who was it that said that the patient needs patience?
My check-up continues with another neck scan and the umpteenth biopsy. Another round. The hospital is a labyrinth, ten floors, lots of departments and wards, clinics, units. A place where you could lose yourself without a compass. The doctor doing the scan is quite young and luckily very nice. She moves the scan to the right, then through the middle and finally to the left. Where she pauses a bit longer. A lot longer. She doesn’t speak, doesn’t blink an eye. She takes a cell sample with the needle and when finished, she wipes the gel off and I return to the ward. The surgeon that will be operating on me tomorrow, followed by Roberto and another doctor come straight to my room, let my parents enter and close the door. I sit down on the bed and understand that they have to talk to me when they sit next to me. The others look at us. Roberto leans up against the wall, hands behind his back, leaning on his right leg.
‘The situation is a bit more complex than anticipated’ he tells me. ‘From the scan things are different to what we initially expected. There are lots of affected lymph nodes. The incision we need to perform on you is very long and will be the length of your neck. I brought you a form to sign, regarding the risks involved in that surgery’ he tells me looking me in the eyes. I look at my parents, tense and scared. A great blow to add to the pain they already suffer. I’m sorry, I would like to say to them. I would like to apologise for what I am making them go through. These are things a parent should never have to endure. Then the word metastasis links itself to my life, and I can’t do anything about it. It drops on us like a boulder. I read the paper with the doctor. He explains that because of the position of the tumour, so close to the recurrent laryngeal nerve, I risk having my left shoulder permanently lifted and suffering damage to vocal chords which are now perfectly healthy. What could I say? I had already forgotten the check up with the ENT. This news hurts a lot more than any scoop in my throat. I can only muster a feeble ‘ok, thank you’. I thank him for not having danced around the point, not for the substance of the discussion. I would rather have never heard that. I go back down the tunnel of fear for a moment. It’s another unexpected event and I am beginning to resent the things that drop into my days without warning. I look back at Roberto, he pats me on the shoulder. ‘Don’t worry, he’s the best surgeon. Everything will be ok.’ ‘Really?’ I address him formally even though he is quite young. I don’t even know if he would be 30 years old. ‘Don’t be so formal, it makes me feel old’. ‘I’m sorry’ I feel guilty and so make the same mistake again. ‘Sorry’ I say with the hint of a laugh. He understands I’m upset and repeats in a reassuring way ‘Sara, everything will be ok’. And I want to believe him.
Masks and coats. I’m tired. Flickering lights. I’m tired. Smell of disinfectant. I’m tired.
I wake a couple of hours after the operation. In recovery I opened my eyes and I felt Roberto’s hand caress me. ‘Sara wake up’. I closed my eyes again. ‘My darling girl...’ a short time later the unmistakeable hand of my mother. I remember she was wearing a hair cap and white coat. I closed my eyes again.
Surgeons are special people. To the angel who operated on me, to their team, I gave the power to save me. To each of them I entrusted myself. I felt that profession of a surgeon was like that. Cuts, stitches and puts things back in their place. Sometimes it works, sometimes not. Sacrifice mixes with passion for the work. With success and gratification of healing a patient. Or the feeling of impotence when you are unable to do more and you have tried everything. Surgeons are real angels and that scalpel is like their magic wand. But to be a good surgeon you have to forget how to be a person. You have to leave your emotions outside the operating theatre. The room is sterile, there is no room for emotions. The more you are clinical in your cutting, suturing and stitching, the better a surgeon you will be. When you scrub for a surgery, put on your gloves and sterile shirt you prepare to transform yourself into a superhero and leave the world of simple human beings. Doctors are like this, they are always changing identity. Just like happens in those Sailor Moon cartoons where the main character becomes a heroine by pirouetting in a fraction of a second. It’s a shame their world is reality, and a tough one at that. They need to be able to go from cynicism to the world of emotions a thousand times a day without any magic powder.
‘Have you got pins and needles?’ Roberto is standing in front of me and looks me in the eye. With a tiny voice I respond ‘Yes, hands and feet, arms and legs’. ‘Lots of pins and needles then...’ he answers. I’m not overrun by an army of ants no. But it’s like I am, in every angle of my body. When you have a delicate thyroid operation that also involves the parathyroid, which produces calcium, there is a risk of hypocalcaemia. That is, a decrease in the amount of calcium in the blood, which makes you feel like you have very uncomfortable internal, uncontrollable, vibrations. This means all I do is move my legs, and open and close my fists hoping it will pass. ‘We’re taking another sample Sara, your calcium is way down’. Of course, I think to myself. This is the last thing I need. ‘I’m going to get you some yoghurt and cheese’ says Dad, even though he knows I will turn my nose up at the smell. Tourniquet, pins and needles. Blood sample, pins and needles. Pins and needles. Pins and needles. Pins and needles. ‘She’s having a tetanus attack! Get the drip!’ Roberto’s voice is commanding. I have no control over my limbs, they feel blocked, consumed by the pins and needles, intense pain, paralysing cramps. In a few seconds the umpteenth needle pierces my arm, a crowd of nurses helps me, and high doses of calcium and vitamin D feed my blood.
Peace. The pins and needles are slowly lessening. Dad arrives loaded up with dairy – 3 yoghurts and lots of hunks of parmesan. ‘I don’t feel like it, come on’. ‘You have to eat it’. ‘Your dad is right, you should eat some. You might have another tetanus episode. You have had your parathyroid removed Sara, you need to eat the right foods, otherwise you run the risk. The treatments on their own are not enough.’ Roberto seems angry. So I force myself and even though it is only 10am I start the first slab... An unusual, if necessary, breakfast.
My voice is weak but I am able to whistle and talk. The surgeon who operated on me, as soon as I woke from the anaesthetic, came up to the bed and asked me to whistle. Still a bit out of it I responded ‘what?’ and hearing him reply ‘Ok she can talk. But give me a whistle!’ I tried to blow, curling my lips and at my third attempt I did it. First danger overcome. When I got on my feet 24 hours after the operation, in spite of my tiredness, the pain, the
drainage that I carted around like two bags, I went straight to the mirror in the bathroom. I have pale skin, tired eyes and my hair down to my shoulders. Ah yes, my shoulders. The left one is not straight at all and if I want it to go back to normal I have to force myself to hold it in line with the other. I have in front of me a new image of myself. A new me. I am a bit thinner, but my smile is different, notwithstanding everything. More knowledgeable than it should be in this life. More knowledgeable of how important it is to wear everything like it is the brightest adornment of my day. The bandage where the first drainage tube sits has lifted. I can see the stitches. I seem like a little Frankenstein. I will have a scar along my neck 12 centimetres long. I don’t have a thyroid. I don’t have lymph nodes. I don’t have a parathyroid. They practically emptied me out to save my life. Each day that comes I will live with replacement medicines for those. But I will be alive, and stronger than before. That’s what counts.
I am seated on the chairs outside the ward. Some weeks have passed since I was admitted to the Big Hospital. I have met many people, from many different places. I have listened to many stories, many voices. I have seen many new faces. I have learned to listen to myself. I have learned that I am stronger than I could ever have imagined. In front of me bored patients walk in long gowns, hair messed, with drainage tubes poking out of pockets. The elevator doors open and a 70 year old woman walks out of the doors, all made up with a small suitcase. Must be a new recruit, I think. She walks into the ward a shortly afterwards comes back out again, sitting next to me. ‘Excuse me if I am being rude darling, but have you had an operation?’ I can tell she is anxious by the way she is talking to me. ‘Yes, a few days ago now’. ‘I’m so scared!’ And before I can respond she falls on my shoulder crying. ‘I’m so scared’ she repeats again. Because sometimes fear wears you out. It tries to wipe them out. But fears need to be met head on to be beaten. ‘Don’t worry, you are in the best hands. It will all be ok’.
It will all be ok is the phrase that calmed me down when I discovered I was sick. To have someone by your side who tells you that you can do it, no matter how long it takes, and you will get out of it is the reason to never give up. ‘Luana, please go back onto the ward’ a young work-experience student calls to her from the door. She is a little bit older than me with the sweetest smile. The coat looks good on her, she has a rosy complexion and long hair that falls softly on her shoulders. I am relieved she has called her back because I was unable to stop her tears. A few moments later she meets my gaze and smiles at me ‘Sara are you here too? I was looking for you! Go! The doctor is waiting for you in your room to discharge you’. I didn’t know, I wasn’t expecting it. I am going home. After medication, operation, tetanus attacks, drugs and lots of pins and needles I am going home. My home, the best cure of all. I get straight up and with a speed rarely seen I run to my room, open the door and find Roberto sitting waiting for me. ‘So Sara this is your discharge summary. I will read you the medical report which also tells you the treatment you need’. He doesn’t look me in the eyes, I’m embarrassed. He keeps reading, not looking up from the page. ‘All clear?’ he keeps his eyes on the report. ‘Yes’ I respond. ‘Sign here. In a couple of weeks you will be admitted again. You need radiotherapy to beat the illness. Don’t worry about anything, it’s only a bit boring because the radiation is strong and you’ll have to be in isolation for a couple of weeks’. ‘I am not worried’ I respond straight away. ‘Ok even better. Enjoy your return home’. He seems hard, as though he’s annoyed at me. From the pocket of his pants a packet of Camels and a pen stick out. Not even a smile. Too serious. He signs the discharge, turns and before I can even say goodbye he grabs the door handle, makes to leave and then turns back to me.
‘I know I shouldn’t but you...you are different. 345779..’ and in one breath like an overflowing river, he gives me his phone number. He shuts the door and leaves.
A week has passed since I left the hospital. Seven days so fast that seem to have flown with the wind. I am going back to the ward to remove the stitches. In front of me a back and forth of people of every kind: patients in gowns looking for a walk to stretch their legs and clear the head. Visiting relatives with worry on their faces, doctors at the bar for a brief coffee break. And then there’s me. Still a kind of patient, without a gown and looking for a bit of clarity. I head towards the lifts and I press ten again. I go into the ward and look for a nurse. And then I see him. Roberto. I’m at the head of the corridor, he’s at the end. In these past days I did think of him, I admit it. He was a permanent presence for me. He is amongst colleagues, in line to the head physician. They are doing rounds before going to theatre. But for me it’s as if we’re alone, he and I. This, ‘the rounds’ they call it, is the moment a patient waits for anxiously. Early in the morning, after breakfast, when you see the crowd of white coats in single file you always hope they bring good news. You see them enter and exit rooms, clipboard in hand, consulting each other in a low voice. They are owners of great knowledge of the life of every patient. They are training and are required to prove they are capable of becoming surgeons one day. Of being worthy of wearing that coat and that green outfit. Who deny being tired when all they want to do is sleep. But who are ready to put their hands without fear into a patient at any moment from the passion that drives this work. They pass sleepless nights, on guard, ready to run in an emergency. They are tomorrow’s heroes, to whom each patient, like me, feels indebted for life. And today I only see him amongst the rest. And he saw me from a distance and then he looked at me. He turned towards me, with a quick step and before I could think what to say to him he was already in front of me. ‘I’ll remove your stitches’ he says. ‘Follow me’. He takes me to a treatment room on the ward, signals for me to lie on the bed while he gets the necessary instruments. Tweezers to pull the stitches out, scissors for cutting. He is not wearing gloves and freehand begins to detach the string that sealed my skin. He is looking at my neck. I can feel his breath, he is close to me. I hope only that he can’t feel how fast my heart is beating, while he rests his arm on my chest. I don’t say anything and neither does he. Stitch after stitch we remain in silence, without looking in each other’s eyes. As soon as the stiches are out I get up, put on my jacket and say an embarrassed ‘thanks’. ‘I’ll walk you to make a radiotherapy appointment’. I leave the ward with him, oblivious to the world around us. It feels like time is standing still. I feel like next to him no disease can harm me. I feel like if he is there, there is no room for anything else. He fills me completely.
‘The radiotherapy appointment is fixed for July. It will be an admission to a protected area’ the nuclear physician checks his diary. ‘What do you mean July?’ Roberto responds immediately. It’s like he has question marks all over his face. ‘Doctor, do I need to remind you that there is a protocol to follow?’ the nuclear physician looks at him with an air of defiance. ‘I don’t mean that, I know there is a protocol. It’s her birthday in July’. Now it’s my turn to look at him surprised. How does he remember my birthday is in July? The physician looks at us for answers. Then he looks again at the diary. ‘There is no other availability. The admission is in July. Good day’. Not bad I think. I don’t care about spending my birthday in hospital. More than that I am interested in how Roberto knows my birthday off by heart. ‘How do you know my birthday is in July?’ I smile as I ask him. I am trying to pretend I’m easy-going, available, a patient who isn’t hard to treat. ‘I have your medical file, you didn’t make it a mystery’. Attempt failed. Congeniality is not his strong point. He walks me to the exit, we get to the glass doors of the hospital. I’m curious to know how he will say goodbye, what he will say. ‘Take care’ His tone is cold, he limits himself to treating me superficially. I don’t understand his behaviour and while I think how to respond he has already blended into the crowd at the entrance. Damn, do you always have to be like this? Not a bye, not a see you again. Always with the phrases that leave me dumbfounded and are not normal.
I cross the threshold, the border between pain and hope for freedom. I take my phone from my bag, look in the contacts for Roberto and quickly send him a text.
Thanks for everything you’ve done for me. I am really grateful. Sara Even if it is peevish it’s true. Professionally he was excellent. In human terms he was another shoulder to lean on.
Immediately I received a reply. I didn’t do anything special, only my job. Roberto.
Rigid as ever, always in one piece, I still am left feeling a bit deflated. Sunglasses, telephone in my bag and I move towards a new day.
I have learned that there will always be new opportunities. That behind every test of courage is a lesson. I have learned that life gives and life takes and when life takes a smile away, it gifts another. When it takes some calm, it gives back some too. That if life gives you pain, it will also give you joy. I have learned that the lessons to learn are sometimes bitter but we almost always come out the other side stronger. Different. Profoundly changed, on the inside. And that change was necessary to help us understand really who we are. Days have passed since I last saw Roberto. I dedicated my time outside of the hospital to normal life, the best life: a film at the cinema, pizza with friends, walking my beloved dogs. I am seated on a bench in Piazza Navona. This is my favourite spot in Rome. The serenity that it conveys in spite of the passing crowds is absolute. Throngs of tourists from every corner of the globe pass in front of me with their noses in the air. Chinese, French, Japanese, English and Americans. Their languages mix, as does their origin. These different races, nationalities and countries are worlds apart but they all come to Rome with the same goal. To love, admire and appreciate the amazing art and the magic of the Eternal City.
All Things in Their Place Page 2