Mohs Surgery: An Afternoon in the Twilight Zone

By Karen

In March, a tiny white bump on my lip was a basal cell carcinoma, and I had it removed by Mohs surgery on April 22.

The practice called me beforehand and said I’d be mostly sitting around waiting for results, so “bring something to read, and maybe even a snack.”

This scenario was fantasy.

I expected to find a busy office, with patients going in and out for Mohs as they got their results, but there wasn’t another patient anywhere. A nurse put me in a room with a rock-hard chair that reclined into a table so my head was on a cinder block and my feet dangled off the other end.

The doctor was running late, arrived masked, and set an icy tone by standing at the far end of the room with the nurses, brusquely stating what she was about to do. She described the numbing as “just like your biopsy.” Actually, it was MUCH worse.

Then she walked over, drew a blue line halfway across my upper lip and handed me a mirror to see it. Yeah, so — what?

A nurse numbed me by jabbing a needle into my lip multiple times, injecting something that stung like hell. I heard myself emitting the same little screams my mother had made near her end.

As far as Mohs goes, numbing is by far the worst of it.

The nurse then dropped a cloth across my face like I was being waterboarded, and the doctor quickly removed a first layer and cauterized the wound, which smelled like hair burning. It took mere minutes.

The nurse piled bandages on my lip, then left me lying there with my feet dangling, said, “Gravity isn’t our friend with bleeding,” SHUT OFF THE LIGHTS, and left.

So much for reading magazines and munching snacks between “stages” (their word for each round of Mohs). No one checked on me. They were dashing from room to room, doing their thing on others.

Eventually, they returned to say they needed another stage, dashing my hope that the biopsy had gotten it all.

The second stage was done with the same cold, impersonal efficiency. Cloth on face, cutting, burning, bandages. This time I insisted on sitting up to wait for results because lying over an hour on that table had totally fucked up my back.

Their coldness began to freak me out, and it emanated from the doctor. Each nurse on her own was OK. But when the doc was around, they treated me like a chunk of meat. This would have been annoying but tolerable if they were cutting and burning a spot anywhere but on my FACE. My very identity.

When I heard I needed a third stage and another numbing, everything below my nose checked out.

During stage 3, a silent tear slipped down my cheek. The nurse asked if I was OK, but my face couldn’t respond. I think I was going into shock. This had become torture, not from any pain, but from the attitudes.

Alone again, I tried to calm down by doing meditation breathing and reading without comprehension one of my magazines, but I was trembling all over. Remembering my father describing how callously he’d been treated in hospitals and at rehab and thinking, “Now it’s my turn.”

Suddenly, a different nurse came in and asked how I was doing, and I burst into uncontrollable tears, babbled about “total lack of empathy, caring, compassion or even recognition that they’re cutting and burning my FACE.” I kept repeating “My FACE! I feel dehumanized.”

This nurse took notes and gave the standard spiel about wanting patients “to have the best possible experience,” yada, yada. She promised to talk to the doctor, but I begged her not to until after I was out of there.

This was prescient, because I needed a fourth stage.

I concede I may have brought stage 4 on myself by rattling the doctor during stage 3. I learned later she had been the one to ask the impartial nurse to check on me.

During stage 4, now the doctor and nurse got chatty. The doctor even offered to let me see her handiwork in a mirror, but I preferred to wait until it was over.

The final result wasn’t as bad as it could have been. The doctor intended to run stitches halfway up my cheek (why so far?). Instead, she said if I could take care of the wound, she’d leave it alone. She also introduced me to a different doctor in case she and I weren’t a good match. But by now I think I’d scared her straight. She took off her mask and was acting human, so I told her I’d keep her. (She’s been very friendly on two follow-up visits).

I hobbled out of that place piled with bandages, feeling pathetic…

This is what I’ve been dealing with. I drank everything through a straw for weeks…

Now it’s been seven weeks. The crater is filling in and I have some puffiness on the right, but Mederma ointment and ScarAway are helping…

For my next follow-up in six weeks, the doctor mentioned dermabrasion and stitches on the puff because “some people keep biting that spot.” I haven’t been, so I’m going to live with however it heals. I may never want to wear lipstick again, but that’s OK.