More on last week’s story – Ice Cold in Ancona

Much as I had expected, it had been a very long nine days since my doctor had diagnosed the brown, now thumbnail-sized bump on my right temple as keratosis. A long nine days since she had assured me it was nothing serious, but recommended I have it removed anyway and referred me to a dermatologist. And the day of my appointment with that dermatologist had finally arrived.

The thing is, I am a seasoned worrier with a life-long tendency to seek out the worst-case scenario in every situation. Consequently, instead of dispelling any fears as to the nature of the growth, Dr. Rinaldi’s diagnosis and proposed treatment had simply set my internal alarm bells ringing more loudly than ever. So for nine days solid my cool-headed, rational self had been engaged in a bitter war of attrition with my fretful, emotional self, the former doing its level best to quell the mounting anxieties and darkest imaginings of the latter which had raced through the full gamut of nightmarish ‘what-ifs’ starting from mis-diagnosis and going downhill from there.

Mr Blue-Shirt kindly offered to drive me to the large, modern university hospital on the north side of Ancona and by the time we set off, the battle-weary combatants in my head had reached an impasse, though, leaving me exhausted in a vaguely fatalistic no-man’s land of ‘what will be will be’ – but with the firm conviction that this would still mean bad news (my fretful self always has to have the last word). We arrived well in advance of my 3pm appointment to allow time for the inevitable Covid-19 checks and then find the relevant clinic among the hospital’s sprawling collection of inter-connecting buildings, walkways and levels. Fortunately, both of these proved much more straightforward than anticipated: an automated temperature-check-cum-turnstile followed by a simple “over there” from the ‘meet and greet’ volunteer we asked for directions to the dermatology clinic. 

‘Over there’ was in fact the general outpatient clinic, and from reception we were directed down a short corridor to the dermatology unit. We took a seat in the deserted waiting area and completed the obligatory anti-Covid-19 health questionnaires. Then at just after 3pm a young doctor in green scrubs and black mask and holding a clipboard in his hand strolled down the corridor and called out my surname. I got to my feet and Mr Blue-Shirt gave me an encouraging thumbs-up as I followed him into his consulting room. I showed the dermatologist the growth on my temple and repeated what Dr. Rinaldi had told me. Exactly as she had done nine days earlier, he slowly and carefully examined the growth with an instrument that looked like an elongated jeweller’s magnifying glass and finally declared “She was right, it’s definitely keratosis – and nothing at all to worry about.” I exhaled deeply, unaware I had been holding my breath.
“We can remove it for you if you want, though…”
“Yes, please.”
“… But it will only be for aesthetic reasons; the growth is completely harmless.”
“I’m not worried about aesthetics, but I’d still like it removed – just for peace of mind.”
“I know what you mean. But before we make the appointment, which will probably be in September or October, I’d like my professor to take a look. I’ll just go and get her.”
He left the room and my fretful self barged in. Was he unsure of his diagnosis? Was it actually something more serious?

After what felt like an eternity, he reappeared with a reassuringly mature woman in owlish glasses who introduced herself as Professor Cellini. She examined the growth in the now familiar fashion and within seconds confirmed what her colleague had said and my fretful self retreated a little. I reiterated that I did definitely want it removed, so please could I make an appointment for September or October as her colleague had indicated?
She scanned the appointment list on the desk, glanced at her watch and then casually said “We’re not very busy this afternoon. I can remove it now if you want. We use liquid nitrogen to freeze it off so it will only take a few minutes.”
“Yes, right now. You can wait until autumn if you’d prefer, though…”
“No! I’d much rather have it done straight away.”
My rational self had finally taken charge.
“OK, just lie down on the on the couch and I’ll go and get my equipment.”

“Is that your husband out there?” asked Prof. Cellini as she re-entered the room, carrying a stainless-steel canister about the size of a thermos flask, a bundle of what looked like wooden barbecue skewers and a large wad of cotton wool. “He can come in if you want.”
I nodded and she waved Mr Blue-Shirt in. He sat down in my line of sight as I twisted my head to the left ready for the procedure, and gave me a broad wink of support. The professor and her colleague took up their positions on each side of the couch, she to my right and next to the trolley where she had placed the canister of nitrogen, he to my left with the skewers, around each of which he wound a blob of cotton wool before handing them to his boss who placed them tip down into the canister from which escaped occasional wisps of vapour. I held Mr Blue-Shirt’s gaze and swallowed hard. There was a faint hiss and out of the corner of my eye I glimpsed a sinuous plume of dry ice as the professor removed the first skewer from the canister and turned to press its now frozen cotton wool tip firmly into my temple. My heart started to race and my body tensed. The disconcertingly loud sizzling sound and accompanying cloud of vapour made Mr Blue-Shirt wince, but it was in fact almost entirely painless. Once the sizzling had stopped and the nitrogen dispersed, she handed the spent skewer to her colleague, took a fresh one from the canister and repeated the process.

And so they continued for a good twenty minutes, with the prof and her junior chatting amiably over me about placements and exams as they swapped spent skewers for fresh ones, only occasionally thinking to ask if I was all right. For the most part I was, although the longer the procedure went on the more the frozen patch on my temple began to sting, accompanied by the kind of jabbing pain you get at the bridge of your nose if you bite into a super-cold ice cream. But just as it was getting really uncomfortable, Prof. Cellini tossed her last skewer onto the trolley and declared “A posto! – All done!”
I slowly relaxed and sat up gingerly, the movement causing a surge of pain.
“I’ll prescribe you some antibiotic cream to make sure it doesn’t get infected, but it’ll be a bit sore for a couple of days in any event,” she said, pulling off her blue latex gloves.
“Should I avoid washing my hair or going swimming?” I asked as I slid down off the couch.
“No, it doesn’t matter if you get it wet. Just make sure you put some cream on afterwards,” she said. “And if you go out in the sun, use plenty of sun cream,” she added as her colleague sat down at the computer.
“We just need to book a check-up for next month,” he said, opening the calendar on his screen. “And then you’re good to go.”

By the time we got back to the car barely five minutes later, the side of my head had begun to throb as if I’d been hit with a rock wrapped in wire wool and I started to feel distinctly wobbly as my adrenaline levels crashed and relief washed through my body.
“Can we go and have an ice-cream, please? I think I need some sugar,” I said weakly, stuffing my appointment confirmation in my bag and reaching for the seatbelt.
“I bet you do! That can’t have been pleasant, but you were really brave.”
“I’m just glad it’s done and that the growth has gone. I’d got really worked up about it.”
“Yes, I know. But you got through it; I’m proud of you.”
“Thanks. I’m feeling pretty wrung out now that it’s over, though.”
“I can imagine. So let’s go and get that ice-cream, then. Mind you, I’m surprised you want anything frozen…”

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