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
“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
“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
I look at him thoughtfully. “Too bad.
What is fifteen minus eight?”
After leaving the Family Center
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.
I swing by the Recovery Room to
check on Mr. Jordan. He’s awake now.
“Things went great. I talked to your
Understanding what has happened
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.
today might help them all get through
the upcoming, difficult journey.
“Mr. Jordan!” I call loudly into the
groggy man’s ear. “You’re in the
Recovery Room now. Surgery
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
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,
Richard, who is about seven, looks
“Hello, Doctor. This is my son,
Craig, and his wife, Melissa. That’s my
Craig and Melissa greet me.
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 proce-
dure. “He had a superficial parotidec-
tomy 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
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
Dr. Bruce Campbell, FACS
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
We cover what happens next.
“Stitches come out next week then,
depending on the pathology report,
By Dr. Bruce Campbell, FACS