Thursday, 24 June 2010

Yeah. What Kate said.

Last night I emailed my friends and asked what they thought of Monday night's workshop. Did watching a surgeon cutting up oranges help them get a sense of oncoplastic surgery? I got an email back from Kate, who is one of the most curious (in the discovery sense) people that I have ever met. (She also makes wicked cocktails and has been primed for developing an orange-themed drink for next time.)
"The sight of Sheikh's careful fingers slicing delicately through the orange flesh provoked strong feelings of trust in me.  His measured explanations, patience and humour brought to life the extraordinary act of reconstructing a part of the body from another part.  I wondered about the immense amount of research - decades of it - that stands at the shoulder of every surgeon who does this, guiding the hand that teases apart the layers of skin from fat from flesh.  The unimaginable was materialised with an orange and a scalpel in a lounge in an ordinary street.  
There are so many parts of myself I don't know the names of. What do I look like on the inside? How long did it take to map the pathways, channels, networks, layers, courses, connections before someone figured out that you can take the muscle from the back but you have to bring a vein with it, a hose bringing the fuel to keep the muscle going in its new habitat? 
With any luck my cells will remain well behaved, their recalcitrance held at bay by a heady combination of physiology and luck.  But if they muster into a wayward legion of cells that refuse to listen to other cells, that consume without responsibility and grow, heedless of consequences, I hope that someone like Sheikh will be on hand to discipline disorderly conduct at the cellular level."
To me, her response to hearing and watching Mr A talk about mastectomy and reconstruction sounds like poetry, but then I would think that. I'm a walking work of art, after all.

Monday, 21 June 2010

Still life with orange

Tonight was the orange surgery workshop. We filmed some of it, which will be posted as soon as we can figure out how to upload it, with some additional thoughts about how the workshop went. Some highlights:
  • Creating a nipple out of orange peel is rather tricky, so we watched Mr A create one out of a scrap of pink felt which I found in my daughters' craft box. As you do. 
  • Suturing a thick orange-peel areola to a skin envelope made out of same? Not going to happen. Think the oranges were possibly too large; satsumas might be better for the stitching part.
  • Had an amazing 'aha' moment as the back muscle and ellipse of skin (orange flesh with ellipse of peel attached) was inserted into the skin envelope (hollowed out orange with hole in the top and bottom) and created the form of a breast complete with areola, but you had to be there.
  • The Pimm's was excellent. The samosas weren't bad either.
Executive summary: the evidence reveals that the orange analogy can only go so far. I'm off to get myself another glass of Pimm's, which I hope will help me think of additional, non-food related ways we can get to grips with the craft of the surgeon. In the meantime, I leave you with the artistic remnants of our orange workshop: Still Life with Orange, Pimms...and Pink Felt Nipple.
Thanks to: Mr A, Kate, Mike, Nic, Marie and Lynne. x

Wednesday, 9 June 2010

Adding a little zest to life

It's really happening. Mr A is coming to my house so we can have a party with oranges and pretend they are breasts. We're going to make skin envelopes and fashion areolas out of the peel, and he's bringing some sutures and showing me precisely how he stitched me up. The idea of using oranges to explain reconstructive surgery emerged by accident after I blogged about the process of mastectomy and got it wrong. I wrote about scoring an orange, imagining the surgeon creating the flaps of skin in the breast to access the tissue. (You can read that post here.) Being a pernickety, detail-obsessed, surgical sort, Mr A corrected me by slicing oranges to demonstrate precisely what he had done. (Read that old chestnut here.)

I never really understood what happened to my body during surgery until the orange exchange began. Then a whole new world opened up to me. I had been feeling mutilated. Now I feel more like a work of art. The surgeons I met at the Hunterian museum a while ago made me realise that the work of an oncoplastic surgeon is like that of a sculptor; it was at the museum that I discovered "surgery" is derived from the ancient Greek words for hand work. I had a conversation with one of the breast care nurses more recently who talked about the healing intention of the surgeons - and it's a bit bonkers, but it made me think of the Buddhist concept of lovingkindness.

"Lovingkindness, an awkward and somewhat quaint term in English, is the translation of the Pali word metta, which means complete and unrestrained friendliness. The Buddha taught that when the mind is at ease, it is friendly, congenial, well-wishing. The mind at ease likes nearly everybody." (Sylvia Boorstein). It occurred to me that the act of mastectomy wasn't a mutilation, it was an act of kindness - of course it was; I still feel in deep down that Mr A saved my life. I know that's melodramatic really, but without the operation I would likely have been harbouring invasive cancer around my 40th birthday.

Which brings me back to my orange surgery party. You're all invited. Just remember to bring an orange.