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This gripping memoir tells the story of a survivor of a 32-year battle with basal cell skin cancer that required 4 major cancer removal surgeries, the amputation of her nose, and 18 reconstructive surgeries to restore it. In her youth, like many young people of the 1920s and 1930s, Carolyn Shuck underwent X-ray treatments for acne—a medical procedure that almost certainly caused the cancer that would take away her face and almost her life. Through the years of struggling with recurring cancers and devastating ...
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This gripping memoir tells the story of a survivor of a 32-year battle with basal cell skin cancer that required 4 major cancer removal surgeries, the amputation of her nose, and 18 reconstructive surgeries to restore it. In her youth, like many young people of the 1920s and 1930s, Carolyn Shuck underwent X-ray treatments for acne—a medical procedure that almost certainly caused the cancer that would take away her face and almost her life. Through the years of struggling with recurring cancers and devastating treatments, Carolyn led her life as normally as possible, raising three children and volunteering countless hours for Planned Parenthood. This account of living with skin cancer will inspire skin cancer patients and should be read by doctors, nurses, and other caregiving professionals.
It was the month of June, 1970. Had anyone asked how me I was on any of those long, golden days in my fiftieth year, I'd have told them I believed myself to be one of the most fortunate people ever to inhabit the face of the earth.
For twenty years I'd been married to DeWitt Shuck, as outstanding a husband as he was a businessman. Our large, beautiful house in Minneapolis overlooked a lake, the scene changing from a Manet watercolor in the summer to a Currier and Ives print in the winter. John and Ted, our handsome college-age sons, both had brilliant minds and solid values—demonstrably, even allowing for maternal bias. Our ten-year-old daughter Ellen was the sugar loaf angel on our cake.
Of course there were the daily irritations, but rarely did more than a fluffy white cloud float across my bright blue sky.
For years I'd done volunteer work with poverty-level women, listened to them, talked with them, spent time in their homes. The stark contrast between their lives and mine made me think about just how lucky I was.
Basal cell skin cancer had plagued me since I was thirty-two, but I saw it as more a nuisance than any cause for real concern. I'd see my dermatologist every three months, have little things cut out and promptly forget about them. Before going out on the golf course I applied the best available sunscreen for that time. It wasn't very effective, but I hoped it would cut down on the length of my dermatology visits.
Doctors had, over the years, encouraged this nonchalant attitude. "You'll probably have forty more of these during your lifetime," said the dermatologist who'd removed my very first tiny basal cell skin cancer from my forehead eighteen years before. The basis for his prediction was the X-ray treatments I'd received as an adolescent. X-rays were a popular acne cure in the 1920's and 1930's. Dermatologists did not learn until years later that nine out of ten patients receiving X-ray treatments for acne developed skin cancer.
But my dermatologist seemed perfectly confident that medical science could cure the disease it had caused. And so, without a qualm, I spent weeks on the beach in Acapulco every winter and went deep sea fishing with DeWitt off the coast of Baja. And each time we came back from Mexico, my dermatologist would remove a few more small basal cell skin cancers.
By June of 1970, I'd been out on the golf course for a month. A few marshy places served to remind us that the course had only recently emerged from its deep, white blanket. It felt great to be out running around in my golf dress and sandals, not all bundled up in coats and boots.
During my annual checkup at a well-regarded clinic in May, I'd complained about a crusting place on my nose that tended to bleed at times. A staff physician there had cauterized it, but it still troubled me a little. And so, when I read about research on a new sunscreen now being conducted at the University of Minnesota, I was immediately interested.
"Take a look at this." I passed the newspaper page to DeWitt. "Maybe this Dr. Lynch could get me some of this stuff—might be great for golf days this summer."
DeWitt shrugged. "Whatever you think. But if you go today, be back before the traffic gets bad. Remember, we're going to the Peytons' for dinner this evening."
"No problem. This shouldn't take long at all."
I washed off all my makeup and drove to St. Paul to see Dr. Francis Lynch, a prominent dermatologist on the staff of the University of Minnesota.
"Can't you get me on the guinea pig list for the new sunscreen?" I asked him.
He ignored my question. Instead, he looked very carefully at a cancer scar on my forehead and one on my chin.
"You know," he said, "these old places don't look healthy. I'd like you to see Dr. Fred Mohs—he's in Madison, Wisconsin."
"Can't you just take care of them yourself?"
"No, I want you to see Mohs. He's a specialist in the field. I'd like to have him take a look at them."
I smiled. "If I'm going to get to go somewhere, why don't you send me to New York or San Francisco? I don't know a soul in Wisconsin." Dr. Lynch overlooked my feeble joke.
"Dr. Mohs has developed a specific technique for removing skin cancers. The procedure is accepted now and he's even trained some others in his method, but he himself is still the seat of all wisdom."
"Why don't you just send me to a plastic surgeon?"
"A plastic surgeon would remove far more tissue, taking some healthy skin around the cancer to get a margin of safety." He fingered the scars. "Dr. Mohs' procedure will get out all of a skin cancer, but not cut out any healthy tissue. The way these old scars look now, I'd say the original removals weren't complete. Cancer is probably still active in those areas."
"How long do you think I'll have to stay there?"
"Only two or three days."
"Is it the kind of thing ... do you think my husband needs to go with me?"
"I don't think so," he said, and had his secretary call for an appointment.
DeWitt and I talked over everything Dr. Lynch had said and agreed that he wouldn't be sending me to Wisconsin without good reason. I telephoned Dr. Mohs' secretary in Madison and asked her to book a room for me at the Ivy Inn.
"I've heard it's very nice," I said.
"It is. Also very expensive. You could stay at Mandel House—it's only a block from our offices, and an air-conditioned room is seven dollars a night."
"Sounds like a bargain. Make my reservation there for Monday, July 27. And what time is my appointment?"
"Dr. Mohs doesn't take appointments. Get here as soon as you can. It's first come, first served. You can take the shuttle bus from the airport to University Hospitals."
"What's his office number?"
"If you ask at the reception desk just inside the lobby, they'll tell you where to come."
"Could I ask what your name is?"
"Thanks a lot, Mary Jane. I'll see you next week."
On July 27 I flew to Madison, fortified with scotch and in reasonably high spirits anyway. This would be a vacation of sorts—I could go to a movie, maybe even an R-rated movie. Something not suitable for ten-year-olds.
It first struck me this trip might not prove altogether festive when I looked at the entry door to Dr. Mohs' offices and read the large block letters on its opaque window: CHEMOSURGERY. I'd never seen the word spelled out before—had never once thought of my basal cell cancer removals as surgeries.
I entered the open doorway, and even at this early morning hour it was warm and muggy inside. The building wasn't air-conditioned; only a small electric fan moved the air. I went to a small office off the waiting room.
"I'm Mrs. Shuck. I called you last week from Minneapolis. You told me to just come in at 7:30 a.m. today, as it was first-come-first-served. Am I first?"
"I don't think so." She smiled. "I'll introduce you to Rachel, Dr. Mohs' nurse."
Rachel smiled, shook my hand and nodded toward the waiting room.
"Just find a chair; we'll call you in shortly."
The waiting room seemed ridiculously small for one in a large state-supported hospital. It was already filled to capacity, and at least twenty more patients were spilling over into the outer hospital hallway. The hall was lined with straight, stainless steel chairs—hopefully enough to accommodate the overflow.
I looked around me. The patients who had pink Band-Aidtype plasters on their faces, necks, or arms, looked like patients I'd seen in other dermatologists' offices. I'd often looked the same way myself. But there were others, with larger white bandages covering more of their exposed skin. Unlike the small-bandage patients, these were not reading or chatting. Their faces looked solemn, and I wondered if their wounds were painful.
I listened to conversations and asked a few questions. Many of these patients, I learned, had come to see Dr. Mohs from distant parts of the country. It seemed that Dr. Lynch had been right—although I wasn't in a plush office in New York or San Francisco, I was, as he'd said, at the seat of all wisdom.
When Rachel finally called me to an inner office, I sat down in what looked like a barber's chair. Dr. Mohs, a large silent man, was wearing what appeared to be a butcher's apron and had some sort of miner's lamp on his head. He struck me as relaxed and amiable, though he just nodded and smiled when Rachel introduced me. Perhaps it was the deep-furrowed laugh lines around his eyes that made him immediately seem a kind and comfortable man, just the sort you could imagine as a costumed Santa. Not a skinny little Santa, but a good, hearty one.
He looked over my face, then daubed something on several places. It stung a bit but not enough to matter.
"What are you doing? I asked.
"Getting these places ready for biopsy."
"Could I see the stuff you're daubing on?"
"Sure." It was a black paste, about the consistency of peanut butter.
"What's it called?"
"It isn't going to hurt, is it?"
Rachel gave me a quick glance and started sticking on pink bandages.
"You want us to treat you, but you don't want us to hurt you," she said.
Of course I didn't want to be hurt. I wasn't crazy. Was she trying to tell me something?
"Come back at two o'clock," she said, and she handed me a prescription for pain pills.
"Oh, I probably won't need these." I nonchalantly waved the small white paper, not wanting her to think I was a wimp.
"Maybe you should get the prescription filled. Just in case."
The waiting room was so full, I didn't feel like taking up their time with more questions. I wanted to know what, exactly, Dr. Mohs was up to—and couldn't remember his saying much of anything. Well, he had said "biopsy." I thanked them both and left.
I had four hours to kill with pink Band-Aids on my face. Not that I was in the least embarrassed. Over the past twenty years I'd had enough small cancers removed that the Band-Aid look had become almost normal. When we'd lived in Iowa, a good friend had once called across the room at a party, "There she is, plastered again."
I found the hospital dispensary, handed over the prescription, and got back a bottle of inch-long yellow capsules. I put them in my purse, wondering how I'd ever swallow them.
"What are these things, anyway?" I asked the pharmacist.
"Codempiral. A combination of codeine and emperin."
"Oh. Well, thanks." And I was off to Mandel House.
There was no lobby, just a little provisions counter on the main floor. The young man behind the counter handed me the key to Room 227.
"Here you go," he said. "And you'll need some sheets, towels, and a wash cloth."
I trundled upstairs with my gear and let myself into my room. Where was the TV? Where was the toilet paper? Maybe I had to supply my own. After all, they were selling it in that grocery store downstairs. But the thing that seemed strangest was the pay telephone on the wall.
I've always considered a little dust to be one of life's better-ignored problems, but this place was so grimy my hands were charcoal-gray after simply unpacking and plugging in my little electric typewriter. (I'd brought it along to catch up on back correspondence between movies.) I used my hand towel to wipe off the dresser and table tops. Now the hand towel was charcoal gray, so I couldn't use it to wipe out the tub.
At noon, I went downstairs where the grocery clerk leaned against the counter.
"Is there a good place to eat lunch around here?"
"Sure, there's a drug store a block away that serves great food." He pointed in the direction of Dr. Mohs' offices. "It's right on your way to the Hospital."
I ate a grilled cheese sandwich and some limp coleslaw in a fluted paper cup, then headed back to Dr. Mohs'.
Two boulevards, heavy with traffic, separated me from his office. I punched a button and when the green "WALK" sign came on, started across the boulevard—only to see the sign start blinking "DON'T WALK" when I was halfway across. What was I supposed to do, stand stock-still with cars three abreast gunning for me? I ran across, wishing I'd worn tennis shoes.
At two o'clock I was seated in Dr. Mohs' outer hallway, now more crowded than ever. While I was there, two patients on gurneys were wheeled down from the hospital upstairs. One man had a large bandage covering half his face and neck. He looked so alone, I almost rushed up to squeeze his hand, which lay on top of the sheet.
I didn't do it, of course. I couldn't. The thought of what that bandage might be covering made me swallow hard.
"Come in, Mrs. Shuck," Rachel said. Once I was back in the barber chair, Dr. Mohs pared away the chemically impregnated sections to examine under his microscope. It didn't hurt at all. Why had he bothered to prescribe those yellow horse-capsules?
Rachel gently stuck on a few bandages.
"Wait outside for the results. They'll be ready in about an hour."
I read a newspaper someone had left in a chair, but I was bored without a good book. I decided to cast the scene I'd just lived through. Walter Matthau would play Dr. Mohs, Debbie Reynolds would play Rachel, and Carol Channing would play me.
"How many of those places you tested were cancerous?" I asked when Rachel called me back in.
"Only two. Your forehead and chin."
The doctor reapplied chemical to those areas. It still didn't hurt.
"Come back tomorrow morning," Rachel said.
"Any time after seven."
I decided to go right back to Mandel House. The room might leave much to be desired, but I wanted to get back to my typewriter. The last letter I'd written was a Christmas thank-you, and it was practically July.
Before I reached the lobby, a burning pain ripped through my forehead and chin. I rushed for the drinking fountain, rummaged through my handbag, found the bottle, and gulped down one heavenly yellow capsule.
I staggered back through "WALK" and "DON'T WALK" signals to Mandel House, fell against the elevator button, and let myself into Room 227. I lay down, wished I had a pillow. Didn't care.
Burned ... Burned ... Burned ...
I woke myself up snoring. Snoring? Only DeWitt snores.
I looked at my watch. Almost six in the evening. I gently touched my chin and forehead. The burning had stopped, thank heaven.
Going down in the elevator, I met two women. One, who had a large bandage covering her nose, attempted a smile when she saw the pink plasters on my forehead and chin.
"I see we go to the same doctor," I said.
"Yours are so little," the woman said. "Dr. Mohs has had to remove a lot of my nose."
"Oh. How awful."
"I'm Margaret Murphy. I've been here two weeks. It's been horrible—without my sister here, I'd never have made it."
"Now Dr. Mohs says she'll have to have it rebuilt by a plastic surgeon," her sister said. "He recommended one here."
"We're from South Dakota," Margaret said, "and I don't want to stay in Madison any longer. I want to go home."
"I don't blame you. After two weeks here, I'd be dying to go home too. Maybe there'll be a good plastic surgeon out your way."
My heart ached for her. What could be worse than losing your nose?
"Would you like to have dinner together?" I said.
"Sure," the sister said. "I've heard there's a steak house on the outskirts of Madison that's air conditioned." The heat had been stifling all day and the evening didn't promise much of an improvement.
We hailed a taxi. Before the ride was over I could see that Margaret was not only distraught, she needed and demanded perpetual consolation. She couldn't let the conversation shift even momentarily to another topic.
When her sister said, "It's almost as easy to go back home on the train as it is to fly," Margaret said, "I think I'll try taking two codempirals tonight to see if I'll sleep any better."
I really felt sorry for her sister. Her role in this awful drama was going to be hard, in some ways harder than Margaret's. I was lucky. Rachel said my removals would just heal in and any leftover scars would be minor.
Excerpted from SAVING FACE by CAROLYN SHUCK. Copyright © 2000 by Carolyn Shuck. Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
|4. Life Resumes||41|
|5. Long, Long Ago||52|
|6. The Right Place||67|
|8. Plain As The Nose On Your Face||101|
|9. Feelings Are Real||112|
|10. Back On Track||128|
|11. Green Pastures||137|
|12. Showers Of Basal Cells||142|
|13. Mourning And Celebration||147|
|14. A New Possibility—Prevention||153|
|15. My Club||168|
|16. The Virtuoso Doctor||177|
|17. Saying The Right Thing||186|
|18. Medical Gods And Strange Things||190|
|19. Three Long Months||203|
|20. A Martian||211|