January 31st is a date particularly momentous to our family. It is the two-year anniversary of Dennis’ surgery, The Whipple. We use capitalize letters, not to deify it, but because that procedure is a very proper noun. Our experience in general, and this day in particular, have been our Yale and Harvard.
Ordinarily, we would acknowledge the occasion and allow the day to slip quietly into the past. But it must be duly noted. It was a pivotal moment then, and has gained greater propriety now. This second anniversary presents a statistical shift in the landscape. From this point forward, the numbers become, if not kind, at least less unkind. The chance the cancer will recur drops dramatically. Now, the over-all odds are still arrestingly wretched, but two steps ahead and one step back is still progress.
I can chronicle the events of this episode, but not necessarily capture its soul. It is good to be free of bondage to the ghosts of past adversity. But it is not an easy task to revisit that day, nor re-live it.
However, if history makes men, men can also make history. One must look back before moving forward. So, here goes.
The Whipple operation (or pancreaticoduoemenctomy) is generally regarded as one of the most extreme surgical procedures in medicine. This complex abdominal operation is performed on a limited number of patients with cancers involving the pancreas, duodenum, and bile duct. It is not to be entered into without a great deal of thought. Not doing it is unthinkable.
Strangely, on that morning two years ago, I was not filled with dread or anguish. I was confident Dr. Mulvihill had not only the skill for this exquisitely precise operation, but a fierce determination. He was going to battle, armed and dangerous.
While Dennis was being prepped, Dr. Mulvihill reviewed what was about to take place with lavish and mind-numbing detail. He presented an auspicious inventory of every possible contingency that might arise during the course of the next 9-10 hours, and an equally ponderous list of preparations for every conceivable scenario – including buckets of blood for hemorrhage and “harvesting” body parts should the need arise. If his intention was to ensure we were clear on the concept…mission accomplished!
Dr. Mulvihill did not mitigate the peril, but I found this oddly comforting. Obviously,
neither of us likes surprises. These were the times that tried our souls. We had to confront the realities before we could deal with them. The Whipple was our only hope.
The truth was stark and sobering, but it helped us maintain our equilibrium. There was a curious solidarity within that pre-op huddle.
As Dennis was wheeled into the operation room, we watched an enthusiastic Dr. Mulvihill nearly sprinting, in spite of his cane and broken leg, eager to get this procedure under way.
When those doors closed, I felt a certain peace, assured there were multitudes surrounding us all, buoying us up.
The hours of that day passed, but we had no sense of time. At one point, Dr. Mulvihill came out to report he had achieved three negative margins. However, because the tumor was wrapped around and attached to a vital artery, that final margin was elusive, and he had to proceed with extreme caution. Nicking that vessel would be lethal.
Such a situation would have exceeded the expertise of most surgeons. But Dr. Mulvihill delicately continued to peel away malignant tissue the width of an onion skin, until the lab results returned and revealed no evidence of cancer. He got the final negative margin.
Ancient scripture tells us the world was created in six days. Then came the Sabbath, a day specifically designed for rest from the labors of the prior week, and preparation for the week to come.
And then Monday dawned – the first day of the rest of eternity – a day of promise, opportunity, inspiration, pristine possibility.
January 31st 2008 closed for us with four negative margins…and Dennis in Recovery. The world had not changed…only our perception of it. I don’t know the exact calendar date of that first Monday following The Creation, but I like to think it was February 1st.