I want to smile at the woman in the bathroom. I want to put her at ease, let her know that the bandage covering half my nose and mouth is okay, that the orange wash of Betadine on my face is nothing to fear. I want her to know that I am not scary. I am not other. I want the bridge of connection provided by a simple exchange of smiles. But this is impossible. Because, for the first time in my life that I can remember, I am physically unable to smile.
In November, the surgeon told me that he would remove the basal cell carcinoma above the left side of my lip using Mohs surgery—a procedure during which tiny patches of skin are removed, then processed to determine if all of the cancer has been eliminated. If it has, the wound is closed. If not, another excision is performed and those cells are processed, and so on and so forth, until all of the malignant cells are gone. When, during the consult, the surgeon informed me that the recovery from such a procedure would require that I move my mouth as little as possible for a week afterward, I had thought only of the frustration of being restricted to a “mechanically soft diet” and not being able to talk.
These were indeed challenges. I experienced a second babyhood as I learned to drink from my Finding Dory sippy cup (I could not manage a regular cup or a straw) and fed myself with the silver baby spoon my father’s company had gifted to my parents on the occasion of my birth (back when companies did things like that). For many years, I had wondered why I had held onto the seemingly silly utensil that had my name engraved boldly on its handle, and now, I knew. As I pushed little pieces of flan through the small aperture not covered by bandages and scraped gently under my lip to remove the inevitable bits that fell short of their mark, again placing them mouth, I remembered the babies I had fed in just such a way.
I was thankful for the smart phone that allowed me to communicate with family members more quickly than pen and paper would have, but even with the phone’s assistance, I began to feel the isolation of not being able to jump into a conversation and insert my opinions and ‘witticisms’ in a timely fashion. I began to give up trying to express myself. What was the point? I thought, when the punch line doesn’t arrive until two minutes after the joke?
I had anticipated all of this—to some degree, anyway. But it wasn’t until the night before that I realized in a ‘duh’ moment, that, of course, since I wouldn’t be able to speak, I would not be able to sing, either. I spent a little extra time with my harp that evening, singing Christmas carols to an empty room. I thought about how it would be if this was the last time I could sing. What would I want to bring to it?—even if just for myself, without anyone else to perform to. I felt tenderness and gratitude for my voice and my harp. I wondered what it would be like if I approached playing and singing with this mindset all the time.
Another thing I didn’t expect about my recovery week, was that I would not be able to brush my teeth. I won’t disgust you with the details, but suffice it to say, it was gross.
I had not given much thought to the surgery itself, either. It was something I had to do, so it didn’t bear much thinking about. In addition to the facial surgery, I needed to have abnormal cells on my leg excised, and I observed, with interest, as the surgeon sliced open my skin, taking a football shaped patch, exposing the bright yellow fish eggs of fat beneath. I watched him stitch up the skin with what, I, as a crafter, would call a blanket stitch. I marveled at the fact that I was witnessing, with complete detachment, something that should be quite painful to me. Thank, God for anesthesia, I thought.
Later though, when it came to repairing my face, the painkiller was not enough to disengage my emotions from the procedure. I could not see the surgeon working, but I could hear the scissors snipping along my lip. I could smell my skin burning as it was cauterized. This felt personal, intimate, inescapable. I couldn’t help but worry about what I would look like after as the surgeon threw stitch after stitch. And later, when I faced my swollen visage in the mirror, I had thoughts of Frankenstein’s monster—before I reminded myself that I was being ridiculously hyperbolic.
But those moments of tension under the knife and those bloody, bloated stitches are not what I will remember most keenly. What I will remember are those moments in the bathroom mid-surgery while I was waiting for them to process the tissue from my face the second time. Instead of spending the 45 minutes by myself in the procedure room, I was allowed to use the restroom and join my mother in the waiting room. It was then, as I tried to relate nonverbally to the various people around me, I realized how meaningful, how powerful, a smile can be. The many signals such a tiny, seemingly insignificant thing can relay: friendliness, approval, connection . . . I realized how lost I felt without my smile, how alone, how helpless.
It’s now been seven weeks since the surgery. I am healing well. Though I do still have some swelling, the redness around my scar fades with every day. And I have one more aspect of my face to make me look ‘distinctive’! In a way, I am grateful for it, because it has taught me, a little, about the true worth of a smile.