Lea's Story, or A Navigator's Tale

September 22, 2016
Lea asked me to accompany her when she went to see the surgeon who will remove a melanoma from her arm. [Melanoma - a tumor of melanin-forming cells, typically a malignant tumor associated with skin cancer.] A scary prospect. 

Half an hour from the hospital, the interstate was closed. Police sent the traffic back north, telling us to take Highway 14 to Albuquerque. Lea would miss her appointment.

Lea called the hospital to say she ’d be over an hour late and had to reschedule.

I’d seen this movie before.

I called Tom, a man with many maps. With his directions, we drove from shady sleepy Peña Blanca along narrow two lane roads to Kewa Pueblo, where tribal police were out directing traffic, onto gravel and dirt roads to San Felipe Pueblo, along a paved road to the village of Algodones, and back to the interstate for the last miles to Albuquerque. When we called the hospital to say we would get there just a little late, they said all right.

The crawl on the waiting room TV told us that a truck leaking fluid was being handled as "a HazMat incident." The interstate was closed for several miles in both directions.

Terri introduced herself as she led us to the exam room. She told us what was going to happen – the doctor would come in to talk, he would leave while Lea put on a gown, and he would come back to do a physical exam. Terri took Lea’s blood pressure and pulse oxygen, and told us the numbers. They're good.

The doctor introduced himself and the medical student who was with him. They shook hands with Lea and with me. He asked Lea Do you have any questions? before he asked her for the history of your skin.

This is how it’s done! They greet us, they listen to us, they pay attention.

Dr. R. drew pictures for us – of the epidermis, the dermis, the melanocytes that grow above the dermis and absorb radiation, explaining as he drew. [Melanocyte - a mature melanin-forming cell, typically in the skin.] Melanomas, he said, first grow in the plane of the dermis, and only later “extend” into the “functional elements” of the skin, such as lymph nodes. Lea, he said, had pre-melanoma that “won’t jump around your body like a more invasive melanoma.”

Three little letters: P R E ! Not melanoma, but pre-melanoma.

He told us more: Lea’s chance of another pre-melanoma was 10 to 15%. She should check herself monthly, and be checked by a dermatologist at least twice a year.

He explained the surgery. In response to my questions, he drew pictures to show the “rotation flap procedure” he will do to cover the area he takes out. He went over possible complications – not necessarily what anyone wants to hear, but, should any of them occur, reassuring to think that he has anticipated them and knows what to do.

After that, a scheduler, who introduced her self and explained her role, offered us coffee and water, and asked Lea which date she wanted for her surgery. Another woman walked us through the corridors and escorted us upstairs for Lea’s pre-operative EKG.

Lea thanked me for asking questions that gave her more information, but, most of all, was grateful that I’d helped her navigate the back roads when the interstate was shut down. Without my help, she says, she'd still be waiting for the pre-operative visit.