19 June 2011

Unholy litanies

When every store in the market sells cigarettes, plastic baubles, t-shirts, household goods, and chinese bras, demand for your wares is exquisitely sensitive. Do enough people come past your door, for example? And are you able, through sheer force of personality, to lure enough of them into your store itself?

Also, do you look normal?

As unfortunate as it is, we've become pretty comfortable with the fact that appearance correlates with income. So it should come as no surprise that, when Amidu's face started swelling, the flow of traffic to his plate shop decreased. And, since plates were his livelihood, this became a problem: eventually, he had to close his shop. After all, there were enough plate-sellers without distorting (and pungent) ameloblastomas on their faces.

Sometimes it's a an unholy litany here. Ameloblastomas, lipomas, hemangiomas, neurofibromas, cystic hygromas—these are bread and butter of surgery for me here on the ship, repeated week after week. And, to a large degree (without getting into the potential for airway compromise, for metastasis, for malignant transformation), these are cosmetic masses. And so what, really, if you have a lump of fat the size of a small melon growing off the back of your neck, as one of my patients tomorrow has? Is it really important?

As a cancer surgeon, I occasionally find myself thinking the same way—these aren't cancers, after all. Isn't there more important surgery I could be doing? Until it hits me that this is more than just surgery. The cosmetic vs. "important", benign vs. malignant dichotomies are not just flawed—they're outright false.

Because every tumor in that litany is a person. And, though Amidu is still on the wards, there's a chance that when he leaves, business slowly return to his shop.

And that is important.

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