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MR KASEEM WELCOMED Michelle into the same clinic room she used every Thursday afternoon to see her own patients. Today it had an alien feel to it, clinical and sterile. She wondered if her patients felt this vulnerable and made a mental note to make more effort to put them at ease in the future.
As they chatted, Mr Kaseem scrutinised her face. He sprang up from his seat and picked up a small metal eyepiece from a plastic dish on a trolly. ‘The fact that you’ve had the mark for so long without it getting much bigger could be a sign it’s benign.’
Michelle breathed a sigh of relief and smiled.
‘But we can’t be sure.’ He wheeled a stool over. ‘I’m surprised you haven’t had it checked out sooner.’
‘It’s an injury from a pen. I only asked my GP for advice about a skin-tone tattoo to disguise it.’
‘Hmm...’ Mr Kaseem scooted in closer. ‘Tip your head back and look at the ceiling.’
She jumped as he placed the icy-cold eyepiece on her skin. Glancing down, she could see his scalp through wavy black hair as he scrutinised the mark. He smelled of coffee which, blended with the meaty smell wafting through the window from the canteen, wasn’t very pleasant. She made a mental note to bring an air freshener the following Thursday.
‘It is possible that the blue centre was caused by the pen. But the outer aspect of the lesion is more of a blueish-purple.’
‘Really?’ How had she missed that?
‘The good thing is that it’s only marginally raised and is smaller than six millimetres in diameter. But basal cell carcinomas tend to be red.’
She felt the space around her expand. ‘So, you do think it’s a carcinoma?’ Basal, was that the less serious type? ‘Is that the one that can be treated with a cream?’ She’d heard the cream was effective at removing wrinkles and wondered what size the tube might be. Good God, she was thinking about wrinkles when the doctor was talking about cancer.
‘Hopefully, but I can’t say for certain. My concern is that it could be a malignant melanoma.’ His voice sounded like a distant echo. ‘We need to do a biopsy to find out.’
‘Is that the serious one?’ she heard herself say from far away.
‘All skin cancer is serious. But basal cell would be easier to treat.’
‘What’s the treatment? Will I need Chemotherapy? Radiotherapy? Could it have spread? I’ve had it for years. Oh my God. I can’t believe I missed this. It’ll have gone to my brain by now. Is that why I’m so tired? Could a macrobiotic diet help?’
Mr Kaseem held up one hand. ‘Let’s not employ a scatter gun. We’ll do the biopsy first. The best-case scenario would be that it’s vascular damage from the pen injury. Even with a basal cell carcinoma, a biopsy might remove it in its entirety if it hasn’t gone into the deeper layers of the tissue.’
She pressed the skin against her jawbone with her thumb and felt the inside of her lower lip with her tongue. The tissue wasn’t very dense. Would they have to remove her whole lip? It was bound to be in her gums too. How could she have any kind of life without a jaw? For some strange reason, she wished Victor Morgan would barge in and take charge of the situation, the way he had with his Aunt Ivy.
The fluorescent ceiling light glinted off her watch – the sight of it made her feel foolish. She ran her finger over the diamantes around the gold-plated face. A cherished fortieth birthday gift from her family, she kept it for smart occasions, like a celebration, or in the case of today, a hospital appointment. She’d even polished her black ankle boots. Stupid, idiotic woman. Why hadn’t she paid as much attention to the bloody mark? She was a senior nurse for God’s sake. Health was her job. Had she learned nothing? She wanted to boot her best black patent handbag into the bin.
‘Are you available to come in on Monday? I have a cancellation,’ said Mr Kaseem.
‘I have patients scheduled all day. We have to give six weeks’ notice. We’re not allowed to cancel.’ Michelle reached into her bag for her diary. ‘By any chance are you in surgery on Fridays?’
‘This can’t wait. You’re going to have to start thinking like a patient, not a nurse.’
***
BACK IN HER OWN OFFICE, Michelle felt so tired and bamboozled she couldn’t decide whether to go home or put her head on the desk and sleep there tonight.
She picked up her mobile. Dan hadn’t texted. Why would he? He wasn’t obsessed like she was. In any case, he’d be at work. Or maybe he’d have finished early today and be drinking wine with Penny. Big things they’d said. They’d get in touch if something big happened. This was big. But she wouldn’t use this to get his attention, especially after his dismissive behaviour in the pub. No, she wouldn’t tell him. But she needed to hear his voice, or even a text message. Something to make her feel like he was still around and that he cared. Just a text. That couldn’t do any harm.
Hi Dan, still miss you.
She placed her mobile on her desk and rested her head on her arms next to it. An hour and a half later she woke up, groggy and with numb arms. Nothing from Dan.
