I've started home visits this month. A little different pace than working in the hospital. I like getting to come into people's space. Their homes tell so much about them. A little glimpse that most doctors don't get into their patient's lives.
One of my encounters yesterday stands out, not because of the appearance of the patient's home, but the appearance of the patient himself. He's had squamous cell carcinoma of his sinus for 2 years. The cancer has literally eaten away his face.
When you see him, he has something like a curtain hanging over his right cheek. Some pads are taped up to his eye brow, and then hang down over the area of destruction so you can't see. He's developed a nervous tick over these 2 years, his right hand taps the tape, while his hand conveniently covers the dressing. I assume it started whenever the first lesion appeared, kind of hiding it from people without them noticing. Now this habit is a full blown tick, he can't stop the motion.
I was amazed when the dressing came off. The perspective was something I've never seen. From below his eyebrow down to his lower lip is a large cavern. NO longer any eye, cheekbone, top lip. It's uneven and oozing, as if some creature just took a giant bite out of him. He wears dentures still to help him drink fluid (since his lip is gone). Thus peering down at him, I could see the top of the upper dentures; as he moved his jaw, they moved. The hole is the size of a grape fruit- his nose only half there. He can't take any solid food, and even fluid pours out of the right side, so that only a few ounces get in.
It must be hard for him on many levels. One, he's a prisoner of his house, to embarrassed to leave, even with the dressing, people would stare. He hasn't been out in over a year. The other hard thing is the visibility of the cancer. If there's a blessing in most cancers, it's that it's on the inside...so we don't see it's destruction. To have to feel, watch, and experience the eating away of your body must be torture.
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