Part 1
TRIGGER ALERT: This article is the first in a series that contains graphic descriptions of violence the author experienced as a small child. Sensitive readers – especially those with a history of childhood abuse – may find the following content disturbing. Reader discretion is advised.
With businesslike precision, the sandy-haired doctor explains the basic structures and functions of the sinuses. He is aided by a series of full-color illustrations attached to the door of his office showing the structures in cross-section: red for mucus membranes, porous white for bony structures, blue for cartilage. He has given this same explanation so many times to so many patients during his years in practice that he has refined his presentation to its briefest, most crucial and most vivid elements.
He turns to a black-and-white transparency clipped to the light screen. “Now let’s talk about your CAT scan,” he says, gesturing toward the ghostly negative of a skull, eye sockets gaping, every tooth visible in jaws that are clamped shut to avoid movement while the camera captures the image. Aside from these obvious facial features, the image is mottled and streaked by white, grey and black blobs, striations and amorphous formations, the significance of which Dr. Mohs (pronounced MOZE) carefully explains.
The grey blobs are of particular interest. These show substantial infection in the sinus cavities, cheekbones, ears, eyes and forehead – the result of massive collections of mucus that fails to drain properly, becomes trapped within any interior cavity it can find, and becomes severely infected.
Dr. Mohs points to two thin black lines on either side of the septum, the bony structure that separates the two nostrils. The lines are so narrow it’s difficult to make them out at first.
“That’s the problem right there,” he says. “The reason the mucus isn’t draining properly is because the nasal passages are abnormally narrow. When you catch a virus, these passages become inflamed and swollen, which makes them even more narrow. That’s why so much mucus and fluid is collecting in the structures of your face and head.
An old wound, revealed
“Look over here on your left side,” he continues. “It’s completely closed off. You can see why: The septum visibly bends to the left, which makes that passage even narrower than the other one. Any swelling there will block that passage entirely.”
He goes on to explain how the blockage on that side means that I have only one minuscule passageway to drain an entire flu season’s worth of infected mucus, and that single inflamed passage quickly becomes overwhelmed. The result is what I have often described, after weathering many winters of these massive sinus infections, as feeling as though my entire head has burst into flames.
The bend in the septum is not a major disfigurement from a medical perspective, Dr. Mohs assures me, and will not be the focus of the surgical procedures he is proposing. The nasal passages themselves will be widened.
An unseen ghost …
But by this time I am only half-listening. What he doesn’t know – what he couldn’t possibly suspect – is that there is one more person in that office with us. He can’t see her, but she is there, behind the face of the grown woman nodding calmly and taking it all in. She is someone from another time and place, from a moment that is forever bound in the permafrost of memory. She is seldom visible but always present. And to her, the source of that medically insignificant disfigurement is the only thing that truly matters.
… and an untold secret
From the doctor’s perspective, this story begins in another doctor’s office several weeks ago. After a prolonged winter illness that included months of congestion, a violent cough, fluid in my lungs, and a sinus infection that required several rounds of antibiotics, my primary physician ordered a battery of tests to determine the underlying cause. The resulting chest X-rays and sinus scans prompted her to refer me to the ear, nose and throat specialist in whose office I am now sitting.
But from my perspective, this story begins not in a doctor’s office in 2018, but in the basement of a distant relative’s house many decades ago, at a time when no one talked about the isolated preschooler who might be experiencing rather more than the usual number of injuries. Indeed, in this particular instance, no doctor was ever consulted at all.
Even if anyone had thought to consult one, however, times were such, and my middle-class white family was such, that it’s unlikely any doctor would have noticed anything amiss. Most likely he or she would have done what they all did, unquestioningly accepting my mother’s explanation of how the injury happened.
Which, like all of her other explanations over the years, would have been a lie.
No, the real story of my sinus surgery begins many years ago with a bowling pin. Several of them, in fact, being swung tauntingly, threateningly, in my face by the three older kids surrounding me, the bowling pins drawing closer and ever closer while I struggle with my one free hand to protect my face from the blows.
(to be continued)
*The New Oxford American Dictionary defines dialectics as the art of investigating or discussing the truth of opinions. It adds: “The ancient Greeks used the term dialectic to refer to various methods of reasoning and discussion in order to discover the truth.”
The Bully Pulpit 