“Mr. Jordan!” I call loudly into the groggy man’s ear. “You’re in the Recovery Room now. Surgery went fine.”
Mr. Jordan nods but won’t remember anything about this conversation. “Can you open your eyes? Show me your teeth!” His face appears to be moving although it will be difficult to tell how strong the muscles are until the anesthesia wears off.
I head downstairs to the Family Center and greet the volunteer staffing the desk. “Hello, Mary Ann. Where’s the Jordan family?”
“Hi, Doctor Campbell. They’re in Cubicle 3.”
The Family Center is busy. People read, wait, and talk. A woman finds an outlet to recharge her laptop and a man shouts into his cell phone. Kids shift restlessly between couches and chairs. People watch talk shows loaded with laughter and applause, celebrity guests, and questionable medical advice. There are coffee, cookies, and snacks. There is an illusion of normalcy.
I find my patient’s family. “Hello, Mrs. Jordan.”
“Hello, Doctor. This is my son, Craig, and his wife, Melissa. That’s my grandson, Richard.”
Craig and Melissa greet me. Richard, who is about seven, looks up briefly and returns his eyes to his video game screen.
“He’s doing very well. There were no surprises.” A sense of relief passes through the family. “We got his cancer out completely. We removed everything we could see or feel. And we were able to save the nerve that moves his face.”
Mrs. Jordan grips Craig’s hand. “Let me show you what we found.” I pull out my clipboard with sheets of paper containing a few anatomic diagrams and draw a rough outline of the surgery. “This is the spit gland and the tumor was here. There were a few enlarged lymph nodes nearby.” I sketch them in. “We found the nerve that runs through the gland” – I draw that – “and removed all of the gland sitting on top of the nerve.”
The drawing is getting a bit confusing, even to me. “In any case, all of the cancer was removed. We took it out completely.”
I write down the name of the procedure. “He had a superficial parotidectomy with facial nerve dissection and an upper neck dissection. We stage these types of cancers,” – I write this on the sheet, as well – “so this is a T2 N2b M0 Stage 4a mucoepidermoid carcinoma of the parotid.”
Mrs. Jordan frowns at what I have written. “How do you pronounce that?”
I repeat it slowly. “Now you will know what to Google.” She looks at me and, for the first time, smiles.
We talk for a few minutes about his hospital stay and what to expect when they see him. “He has a small drain under the skin. That will come out in the morning and he will be ready to go home.”
We cover what happens next. “Stitches come out next week then, depending on the pathology report, he will likely need radiation therapy.” I jot it all down. “It won’t be easy but we’re here to support you.”I hand her the diagram with my notes. She folds it carefully and slides it into her purse.
“Mary Ann will let you know when he gets to his room. I have another surgical case to perform and will stop by and talk to him later.” I pause. “What questions do you have for me?”
They look at each other. “I think you covered everything. We’ll think of something as soon as you leave.”
Richard is still playing his video game. I poke him. “Hey buddy. Do you have any questions?”
He raises his head toward me although his eyes stay glued to the game.
“No.”
“So, Richard, if you don’t ask me a question, then I get to ask you one.”
He looks at me, his eyes widening. “Ummm,” he stammers, “I can’t think of any!”
I look at him thoughtfully. “Too bad. What is fifteen minus eight?”
He gapes at his grandmother then back at me. “Ummm, seven?”
“Nice job, Richard. You’ll see Grandpa soon. You be nice to him, okay?” He nods as his attention returns to his game.
After leaving the Family Center I swing by the Recovery Room to check on Mr. Jordan. He’s awake now. “Things went great. I talked to your family. You’ll see them soon.”
He nods and smiles. Neither he nor his family will remember much of what I tell them today but I hope my drawing will help them later when questions arise. We will likely go through many of the details again. Understanding what has happened today might help them all get through the upcoming, difficult journey.
Dr. Bruce Campbell, FACS, is an otolaryngologist at the Medical College of Wisconsin. He is also a member of Surgical Products’ Editorial Advisory Board.
This column was featured in the November/ December 2015 issue of Surgical Products. To see the complete issue, click HERE.
