At Large : Continuum of care
By Doug Cabral
Published: May 1, 2008
Friday, there were seven patients in the waiting room of the ambulatory surgical unit at the hospital. Six men, one woman. All of us were wearing backless johnnies. Not the best way to make a first impression on neighbors one hardly knows. Not even the costume one prefers when exchanging pleasantries with the guy you've been golfing or sailing with.
It was skin cancer day, MOHs surgery day. Take a slice, take a seat. If the surgeon did not get every cancer cell with the first slice, she took another. Each of us disappeared into the surgery and returned with a bandage on some exposed part, next time a larger bandage, and a larger, until the margins of the last slice were clear and the patching up could begin.
All the golfing, sailing, sunbathing, tennis and volleyball playing days of yesteryear had come home to roost (an obnoxious and damning phrase some ministers apparently favor) as basal and squamous cell carcinomas. These are the not usually life-threatening, but possibly disfiguring skin cancers. They are typically treated surgically, which is typically curative, but not fun, at all.
There were two wives sitting with their husbands among the waiting room flock, their eyes widening each time hubby returned from the surgery with a nose- or cheek-engulfing bandage, clutching at his back to hold onto whatever modesty might be salvaged from the occasion. The two husbands winced at the cracks their wives made about the inelegant wardrobe and the growing gauze and tape patches and how, they didn't know, but maybe it was an improvement and could the surgeon make a small adjustment to the tilt of the nose, which had always seemed more expressive than it ought to have ideally been. The husbands winced, but they didn't want their affectionate abusers to leave.
I was reminded of John Bayley, the critic and reviewer, who was the novelist Iris Murdoch's partner and sole caregiver as a withering illness drew Iris away and them together. Not that such a dreadful circumstance was common to any of us in the waiting room Friday. Mr. Bayley described his and his wife's life together in an affecting little book entitled "Elegy for Iris" (New York: St. Martin's Press, 1999). In it he describes the awakening of his love of Ms. Murdoch, as she cycled around Oxford, England, where they both studied and taught. He saw her through a window as she rolled by, and he was smitten at once. His pursuit of her affection was awkward, hopelessly unself-confident, and her response to his attentions appeared to have been indifferent at first, then obscure, then resigned, then devoted.
By the way, I know I've upset the gender order here, invoking Bayley, who was unafflicted, and Murdock, who was medically beset. But, that's all right, it would have worked between them the same way, had she been he, and well, and he she, and not. After all, at the core of their continuity were many tributaries of many affections, humor among the most prominent.
"We can still talk as we did then," John Bayley writes, "but it doesn't make sense anymore, on either side. I can't reply in the way I used to do then, but only in the way she speaks to me now. I reply with the jokes or nonsense that still makes her laugh. So we are still part of each other." Still part of one another, and as for the parts that have been cut away, neither cares.
Of the late years of his marriage to Murdock, Bayley writes, "Every day we move closer and closer together. We could not do otherwise. There is a certain comic irony - happily, not darkly comic - that after more than forty years of taking marriage for granted, marriage has decided it is tired of this, and is taking a hand in the game. Purposefully, persistently, involuntarily, our marriage is now getting somewhere. It is giving us no choice - and I am glad of that."
And, at last, evident in the habits of the two couples spending the long, uncomfortable day in waiting room of the ambulatory surgical unit, it was the continuum of caring that mattered, a happy obligation accepted.
