When my daughter was ten, doctors discovered a growth behind her middle ear. The intricate operation to remove it called for a surgeon with exceptional compassion as well as consummate skill.
There wasn’t much time to lose. The growth was a cholesteatoma, which often starts from a cyst that sheds old skin. The skin builds up, and can grow and destroy surrounding delicate middle-ear bones and cause other serious problems.
Dr. Alan Nissen, a widely respected ear surgeon, was to perform Michele’s operation. In one of several conversations we had about the procedure, he told me that a known risk of the operation is severance of the facial nerve that controls the mouth muscles. The nerve was very close to where surgeons would be cutting. When the facial nerve is cut speech becomes hard to understand, and the face is disfigured because one side of the mouth is noticeably pulled down. The risk was small, Dr. Nissen said, but he was duty-bound to inform me of all downside potential.
A few days before the surgery Dr. Nissen and I had a final conversation. I brought up facial nerve severance, which weighed heavy on my mind. I’d been pushing for an extra surgeon on the team to do one thing during the operation: observe the nearness of the cutting to the nerve and alert the team when they were getting perilously close. Dr. Nissen had told me this observing doctor was the most sure-proof way to prevent nerve severance.
“To surgeons the risk may be small,” I said. “But for Michele it’s huge. It’s one more thing on top of the other facial differences she has. She’s dealt with a lot of challenges in her young life. Her courage amazes me. But why add another challenge that is so avoidable?”
Among Michele’s other issues were her very small ears. She was also hearing impaired and wore hearing aids. She had a deviated septum—a crooked nose that twisted to the left side. That could be corrected but not until she was older. If the facial nerve was severed, she would likely be unable to form facial expressions on the left side of her face and her speech would be slurred.
As the late-afternoon sun filtered into his office that day, Dr. Nissen gave me the bad news. An observing surgeon would not be added to the team, because the group had determined that risk in Michele’s case was no more than average. He looked at me somberly. “I know where you’re coming from—a lot of love for Michele,” he told me. “But we’ve weighed all the factors and this is the soundest decision when everything is considered.”
“Maybe the risk is statistically small,” I said, “but the effects on Michele are so very large.” He looked genuinely sorry. I knew that in addition to being an extraordinary surgeon, he was a compassionate man.
“I wish I could say something that would change your mind,” I told him when I left, but I knew at that point there was no changing things and nothing more I could say. The surgery was just three days away.
Disappointed and sad, I walked to my car. I knew the growth had to be removed. I would pray that Michele’s facial nerve would not be touched. That was all I could do. Driving home I told myself the odds of severing the nerve were low. I told myself there were therapy programs to rebuild strength in damaged facial muscles. I told myself God had already brought Michele safely and successfully through four surgeries for other problems. I told myself all that and more…and I worried.
I was exhausted emotionally and physically when I got home to our cozy little apartment. Michele was at a friend’s house. We lived just a few blocks from her “mainstream” school, where she had just transferred from her special education class for hearing-impaired kids that was two towns away, an hour bus ride. It was an exciting change, especially when we walked around the neighborhood and she saw and played with kids she knew from her new school.
I went into the kitchen to start dinner and was peeling potatoes when I noticed from the corner of my eye that the answering machine was blinking. I punched the button to run the message. And there was Dr. Nissen’s voice. “I wanted you to know right away that my colleagues and I talked this afternoon and we’ve decided to add an observer to the team. We will see you both in a few days. Don’t worry, everything is going to be fine.”
He had called while I was on my way home. It was one of the most beautiful phone messages I’ve ever received. I’ll never forget that day, and I’ll never forget Dr. Nissen and his compassion and skill.
A huge and heavy burden had been lifted from my shoulders. I felt suddenly light and free as I got back to fixing dinner. I have never peeled potatoes with such joy and gusto as I did that day.
The operation was four hours long and successful in all ways. It’s been 26 years and Michele’s cholesteatoma has never come back, as they sometimes do.