Out, damned spot! Out, I say!…What, will these hands ne’er be clean?…Here’s the smell of the blood still.  All the perfumes of Arabia will not sweeten this little hand. Oh, oh, oh!…

This disease is beyond my practice….More needs she the divine than the physician. God, God, forgive us all!

Shakespeare, Macbeth , Act V, Scene I

Today (May 27, 2009) I go to the doctor to have this spot removed from my nose.  Skin cancer.  Pretty sobering.  She takes out a little bit.  Then I wait.  They test it to see if they got it all.  If they haven’t, she takes out a little more and so on until they get it all or there’s nothing left.  I have these visions of not having a nose anymore or worse.  You hear of people dying from this stuff.  The fatality rate is around 1 percent.  My doctor didn’t tell me that. I looked it up on the internet.  Here’s some other curious facts about skin cancer: whites have it 80 times more than blacks.  And white males 2 times more than white females.  The latter because men work more outside?  Or have shorter hair?  Or are more often bald?  I’m committed to hats from here on in.  And not those wimpy baseball caps.  I bet skin cancer has risen since we’ve given up on hats.  I saw this Mexican hat on TV.  It was 3 feet wide, a portable umbrella.  Now, that’s a hat.  Hispanics have less skin cancer than whites.  Go figure.

This is my second go around with skin cancer.  It takes the fun out of hanging out at the beach.  I’m at the doctor’s mercy here.  I could hack out the spot on my own, but I’ll pass.  Skin cancer is the kind of deal that if you treat it, it’s fine.  If you don’t…you’ll have a former face and your loved one’s get to pick out your epitaph. So you don’t mess with it.  Well, you can, but if you do, the consequences are a bit dire. So, no, I’ll let the doctor handle this one.

But there are limits.  The doctor spying on Lady Macbeth had it right when he gossiped he couldn’t remove her spot.  And he had it right when he said she needed the divine and not a physician.  And he had it right when he extrapolated Lady Macbeth’s predicament to the whole of human condition: “God forgive us all.”  But I don’t think he meant it.  He wasn’t praying it, like Daniel prayed for and confessed the sin of his people.  Lady MacBeth’s snoopy doctor is just saying it like a pithy little quote: “Birds of a feather flock together.”  It’s true, but it’s not meaningful.  We don’t see this doctor falling all his needs in prayer and humility and repentance.  It’s not a prayer at all.  It should have been.  Murder is not the only sin we can’t wash away by sleepwalking or washing your hands.

There are some spots I can remove myself, like the spot on my cast iron skillet.  A little elbow grease and maybe a S.O.S. pad in extreme cases and I’m good to go.  I need my wife for the spot on my shirt.  I use upholstery cleaner from Wal-Mart on the spot on my carpet.  This spot on my nose, I need the doctor for that.  The spot in others’ marriages?  I’ve helped a few people with those.  This spot in my soul?  That’s a different matter.


I’m done with round one.  Nurse Amy went through the procedures of removing the spot.  I had to take off my jacket so she could check my blood pressure.  She had me lay down on the operating table and takes a picture of my nose with her Nikon D80.   I suppose there will be an after picture, too?  Dr. Christensen comes in with Joy, a medical student, and asks if Joy can watch the procedures.  No problem.  The Doctor uses a blue marker to earmark the spot.  She tells it it’ll look like a canoe when she’s done even though the spot itself is the shape of and  just a hair smaller than a dime.  She shows it to me in a mirror.  She tells me if she didn’t cut it in that shape, it wouldn’t heal correctly and would bunch up like the front of a canoe.  She figured I might not like that.  She has to cut it like a canoe now so it won’t look like a canoe later.  That’s curious.  The Doctor and student leave and Nurse Amy paints my nose in Betadine and shoots my nose with some deadening medicine (you can tell I have a flair for medical jargon) and covers the area with sterile cloths.  My eyes see a sea of blue.  Dr. Christensen re-enters and says she’s going to talk to Joy in medical language while she operates.  Is that OK?  Fine.  The cutting takes a couple of minutes.  I ask fatality rates of untreated skin cancer.  It depends, she says, on which one you have, your immune system and a whole bunch of other variables, but 10 to 20 years, maybe 30, tops.  I ask how deep my spot is.  “About as thick as a quarter.”  “Is that normal?”  “Yeah.”  My spot is normal.  That’s it.  She leaves with the student.  Nurse Amy cauterizes the wound with a magic wand.  I hear little sparkly sounds and feel a shock up my leg as the smell of burnt flesh hits my nose.  “We do this to stop the bleeding,” she says, as she zaps me again.  The symbolic nature of spot removal, cutting and searing of flesh, bleeding, is not lost on me.  She cleans off the betadine and covers the wound with a band-aid and I’m off to the waiting room.  Now they check the spot they removed to see if they got all the cancer.  If not, they do it again.

So I’m waiting.  And waiting.  It’s a good thing I brought my laptop.  And they have plug-in right here.  Four times I had to go through with that: sterile blue sea, Betadine, shots of local antiseptic (I finally learn the official term), comments from the Doctor to Joy, the Student, cutting of tissue, searing of flesh, burnt smells, waiting, and then…finally, word they got it all.  Now they have to suture it up.  That hurt.  It took longer to put it all together again than the total time for all the cutting and searing of flesh.  Now my nose is bandaged up in white.  I look like a lifeguard from a distance with sunblock on his nose, sans the topless look and the youthful body.  A safe distance.

Where do spots go after they are removed?   I meant to ask, but my mind wandered.  This doctor does five of these a day three days a week.  Fifteen spots…or more.  Are they pickled in beakers?  Frozen for later research?  Tossed into the trash?  Seven hundred and fifty a year just from this doctor.  One million spots across the country.  2739 per day. More every year.

I think what I’d look like if I tried to remove the spot.  I’m glad Dr. Christensen knows what she’s doing.  I think of other spots I have that no doctor can remove and that I can’t make go away.  I’m glad there is a Great Physician who removes them.  I wonder how many of those He removes everyday…from me, let alone everyone else.

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