Tuesday, 28 May 2013

Would be

The other day, my wife Margaret and I, together with our good friend, Rachel, were trying to come up with catchy name for a website we want to develop. We weren't having much success, so we tried to hone  what we were looking for. We decided we needed something pithy- so ‘Pithy’ came into being.
Our decision was confirmed when we looked up the dictionary definition. I'd always thought 'pithy' just meant trivial, or something quite small but in fact, by definition, it's a more powerful word. Pithy: adj. brief, to the point, forceful, meaningful, full of vigour, succinct, concise, laconic, terse, compact, trenchant, sententious, expressive, cogent, finely honed, epigrammatic.
When I started up my blogspot a few days ago, I gave it the title: Pithy Pete because I wanted my blog to be ‘pithy’. Actually I’ve now decided that Pithy Pete is a misnomer. Why? I am by nature verbose. I could never be a man of few words - concise. If something can be said in five words, I will wax lyrical and use twenty. In that sense, Tweeting is proving a useful discipline, forcing me to be concise and reduce what I want to say to attract attention to 140 characters. Blogging on the other hand, gives me the space I need to express myself. I do however want what I write to make the biggest possible impact.
So, today, I decided I needed to make a change so that my blogspot name more accurately describes the content. Therefore, from now on (until further notice), I have decided to call it 'Would-be Pithy Peter'.

I haven’t finished quite yet! This got me thinking. What’s more important, who or what I’ve been, who or what I am OR who or what I would be? I regret knowing I’ve not been the person I should have been and I regret knowing I’m not the person I ought to be. But I don’t regret being the person I would be AND I’m really glad there’s Someone who accepts me as I am because of who I would be and because of who He is.

Saturday, 25 May 2013

Time is a great healer 2

Those who have read my previous blog, ‘Time is a great healer 1’, will know that twelve weeks ago, I went into hospital for the removal of a basal cell carcinoma (BCC) from the side of my nose. My BCC (a relatively common skin cancer) was infiltrative and consequently turned out to need extensive surgery to remove it and subsequently, equally extensive reconstructive surgery to repair the damage. Yesterday, I went to see my consultant, Marc Moncrieff, who led the team which carried out the reconstructive surgery. I say ‘my consultant’ because Marc has the knack of making you feel he really is there for you.

At a time when those who are able to remember what having a ‘family doctor’ meant, are bemoaning the fact that when you go to your local GP practice, you are left feeling that no-one really knows you; it is reassuring to know that those in the caring professions who do really care, can still make you feel that when they are treating you, you are special. That’s exactly how I felt, during and after seeing Marc.

This visit, gave me the opportunity, perhaps for the first time in the process, to reflect on the treatment I had received. Inevitably perhaps, you go into a treatment programme like this, very aware of self, feeling very vulnerable and preoccupied with how you feel. And, it is scary!

Over the last few years I have had four operations, in Norfolk and Norwich Hospital. Two were minor operations, one to put in a stent and the other for varicose veins in my right leg. The other two were more major, a replacement left hip and a full right knee replacement and both required more lengthy rehabilitation. This latest series of operations though, have had more far-reaching implications.

In every other case, I wasn’t thinking about how I would look after surgery, I was simply looking forward to being free of discomfort and, in some cases, pain. Immediately after the procedures, I was not so conscious of the appearance of wounds, bruising or scars and in any case they were mainly covered by clothing. An operation on my face was something completely different however. Although it was on the surface, in a real sense superficial, somehow the surgery seemed more invasive. After all, my face is me, that’s what people recognise, attractive though the rest of my body is! This meant the treatment turned out to be more psychologically disturbing than I had realised

Although with the initial procedure (Moh’s surgery), with the effects of the local anaesthetic, I didn’t feel any pain, I was aware that parts of my beautiful nose were being pared away. When I saw the final result, I was horrified, I looked ghastly. Consequently, I faced the reconstructive surgery with some trepidation, that’s when I needed to know those who were treating me really were there for me, that they genuinely cared for me and appreciated how I must be feeling.

In the really comprehensive and very useful information about the reconstructive surgery on the surgeon’s website (http://skincancersurgery.co.uk/Info/forehead_flap_info.html ), I read: “You may look very bizarre to other people at this stage of the treatment and you will want to avoid most social engagements.” Boy was that true! Whenever I did venture out for the next month or so, it was only to go to the dressing clinic at the hospital, once a week and I certainly felt a freak.

Small children were the worst! I was so conscious of them, in all innocence, staring wide-eyed at me. That’s when I needed the reassurance from the nurses in the Dressing Clinic, that all was going to plan and the healing process was well underway. They always succeeded in this, fleshing out the encouragement on the website:  “Remember that this is only a temporary phase in your treatment and you will be back to normal soon.”

Now, as I reflect on the last few months, one incident stands out more than any other. It was in the Anaesthetic Room prior to going into theatre to have the skin flap cut. More than at any other time, I needed to know that I was in safe hands and that someone was there for me. All the staff I spoke with before this op, especially the anaesthetist, were very caring but none of them had physically touched me. Despite all the reassurances, I still found waiting for the needle to be put in quite scary.

It was at this point, Marc, as the leader of the team, came in from the theatre, sporting his Norwich City bandana (obviously sterilised). This in itself, lowered my emotional temperature. Somehow, it conveyed an air of quiet confidence and relaxed authority, whilst letting me know he was human. It seemed an intimate revelation, which I took to indicate his desire to connect at a more personal level. After an exchange of pleasantries, he asked what he could do to help and was informed that he could hold my arm, whilst the injection was carried out. The strong, yet gentle way, in which he held my arm, in both hands, impacted me greatly and meant I drifted off with complete confidence that I was in safe hands.

My conversation with Marc yesterday, served to show that here was someone who had a tremendous capacity to show that he cared about me. The quietly confident and authoritative way in which he talked me through the continuing healing process, was in itself cathartic.  I appreciated again that I was being treated in a dignified way and with respect, by a very caring and sensitive person. There was no air of superiority, rather a display of genuine humility, without being self-effacing. But I’m still left wondering, how did someone not lacking in machismo, learn to nip and tuck and sew like that?

Thursday, 23 May 2013

Time is a great healer 1

This is how I like to be remembered and hope I will be again!!

On Wednesday 27th February 2013, I went into hospital for Moh’s surgery for the removal of a basal cell carcinoma, from the side of my nose. This is a procedure which involves scooping out an area of flesh around the carcinoma and then sending it off to the lab to see whether all of the cancer has been removed. All that could be seen on the surface was a small scab, no more than 3 mm by 1 mm, so my expectation was that one scope about twice that size would be sufficient. In the event it took five scoops.  I believe the surgeon’s record was seven but I was relieved not to equal it! In all, they had to scope out a large area of about 60 mm by 30 mm, the whole of the bottom of a nostril and well into the cheek. Even the surgeon expressed her surprise that it had travelled so far into the cheek. The resulting reconstruction plastic surgery, a week later, left me looking like a Picasso portrait.


This is how I looked one week after reconstruction surgery  

This was how I looked about four weeks later.


I had to go back to hospital at the end of each week, to have the dressing changed. This was a heavily jellied gauze dressing wound round the flap of skin from my forehead to keep it alive and healthy, whilst the graft takes on my new nostril, which is built around a piece of cartilage taken from my ear.  I went back to hospital for more reconstruction surgery on 12th April, when the flap was cut off and my face returned to near normal.

This is how I look today (May 23rd) and honestly, I was trying to smile!!


Tomorrow I see the consultant, to learn what the prognosis is. I cannot speak highly enough of the standard of care I received at Norfolk and Norwich Hospital. The medical, nursing, care and domestic staff were wonderful and I am extremely grateful for the treatment I received.

If you want to know about moh’s surgery and the reconstruction surgery plus the surgeons Jennifer Garioch MD FRCP and Marc Moncrieff MD FRCS, who carried out these procedures on me, see: http://skincancersurgery.co.uk/Info/Mohs.html and http://skincancersurgery.co.uk/Info/forehead_flap_info.html

I suppose the moral of the story is either ‘Beauty is only skin deep’ or ‘Sometimes a basal cell carcinoma, like Dr Who’s Tardis, can be much bigger on the inside than the outside.