Long covid diary: Cancer edition

Because of my recent posts on Israel, I have a lot of new (free) subscribers. While a lot of my pieces have a political angle, most of these digressions are nerdy exploration of old texts. Occasionally, I throw an autobiographical essay into the mix. After today’s post I’ll be away on holiday, and I don’t expect to blog for another ten days to two weeks.

It’s time for another long covid diary entry. (For my official "covid diaries" see here; here; here; here; here; here; here; here; here; here; here;  here; here; here;  here; here; here; here; here; here; here; here; here; here; here; here; here; here; here;  here;  here; here; here; here; here; here; here; here; here; here;  here; here; here; here; here; and here.)

On Monday, I had skin cancer removed from my nose by a cosmetic surgeon in Bloemendaal. During the Summer my better half had noticed what I took to be a zit that kept bleeding. She looked at it under a magnifying glass, and confidently and with downcast voice pronounced it cancerous. My GP was not entirely convinced, but only put up half-hearted resistant against my better half, who is a formidable retina surgeon and cognitive scientist. The dermatologist, who shared a practice with my cosmetic surgeon, acknowledged my wife was right and shaved some skin off for the biopsy. The news was reassuring, I had a slow growing kind that is unlikely to spread. The surgeon should be able to remove it one go. (We’ll find out in a few months if he did.)

Bloemendaal is an upper-class coastal village near Haarlem. It’s relatively new, so many homes are built in the elegant style of a confident bourgeoisie during the late nineteenth and first third of the twentieth century. I have often hiked there in the Dunes. But I didn’t recall visiting. It’s not far from Amsterdam, and before I had long covid I would have considered cycling it. (The current problem with biking is not my lung capacity, but that it generates cognitive overload and so induces a migraine.) The surgeon’s office is a pleasant seven minute walk from the train station on the lovely high/main street that has comfortable benches to sit on. I was early, and the receptionist (who later doubled as my nurse) brought out tea while I waited. It was all incredibly peaceful and civilized.

While I am not naturally a stoic about my health, I had been reassured that this cancer wasn’t a death sentence. Even so, I thought the foreign body growing on my nose a useful, narcissist distraction from the stomach curling events in Israel. I wasn’t sure yet all my friends and distant family were safe, and I had an ugly foreboding about the cycle of violence to come. I also wondered whether this would inflame passions on campus and wider Dutch society. I decided there were plenty of Dutch Islamophobes and anti-Semites who didn’t need an excuse of this magnitude to misbehave.

The surgery was completed in twenty minutes. The local anesthetic was unpleasant, and so was the smell of burned flesh and the intense pain of an occasional nerve that had remained active despite the anesthetic. But the surgeon was cheerful and kind, and I even caught a train back without having to wait much. My nose was swollen and bloodstained. It remained swollen and rather bloody for the rest of the week. I looked like a very over the hill boxer. Somewhat surprisingly, the pain kept me awake for two nights. I had to cancel classes on Tuesday and Wednesday. On Thursday I was more or less back to normal and taught the final lecture of one of my courses on “Authority, Accountability, and Legitimacy,” a required third year course for students in the politics track of our interdisciplinary PPLE major.

After the midterm in week 4, which covered materials I lectured on during the first three weeks, the students would not be quizzed on any of the material I lectured on in weeks 4-6. (They had to write a paper.) Predictably this cut turn-out for the lectures significantly. But during the last few weeks I averaged almost half the enrolled students; this group was highly motivated and smart. They would pepper me with insightful questions, and I loved it. Anyway, after the final lecture they applauded (which is not uncommon) and then surprised me with flowers, some chocolate, and a get-well card signed by the diehards who kept attending lectures. Maybe because I had felt so vulnerable all week, but I was moved to tears.

September had been very challenging. Despite having returned from sick leave, I was teaching a full load and clearly going to end up with 20% over hours for the academic year. Because the Botox had been ineffective since the middle of August, I was running into migraines on a regular level. I was pissed. My department is well-meaning, but it lacks resources to prevent the over hours and to ensure that my job fits my cognitive constraints. (I end up teaching hundreds of students with less than well-organized support, alas.) In addition, in this post-covid era we are revisiting some policies that (de facto) had made my life easier, and with new teaching directors and administrators, we get a lot of new work. By mid-September it was starting to add up, and I started to arrange for meetings with HR, the occupational physician, and the departmental hierarchy. There is no ill-will in the department, but short of me calling in sick there is little that can be done once a schedule is set. The meetings are not wholly fruitless because they will produce a better outcome downstream (say next academic year).

After discussing my situation with my Dutch GP and insurance company, I now have a referral to a Dutch migraine clinic. And so I am hoping to receive insurance coverage for my Botox injections. But that’s still a few weeks away, so at the end of September I went back to London to see my family and get my scheduled treatment there (privately). My clinician – a rather famous plastic eye surgeon -- explained that while I am only allowed to receive the Botox every three months, it’s quite normal that the effect does not last as long. (She also said, that it could vary quite a bit.) Because she knows my wife, she only charges me the cost of the Botox.

While my cosmetic surgeon in Bloemendaal was putting the sutures in, I asked him if he also treats migraine with Botox. He said it was a small part of his practice, but would be willing to help me if I needed it since I was his patient anyway. I asked him for his fees. He gave a number that was equivalent of the cost price in London. When he realized this was the case, I kind of regretted my timing because I felt his stitching of the sutures had lost some of its seamless elegance. But by the time he was done with them his cheer had returned.

Anyway, it’s been three weeks since my last Botox. And I am cautiously optimistic it’s working again. For despite the stress and sleep deprivation of the past week, I had no migraines. It would be nice to have another month or two of that. So fingers crossed. As it happens my flight is about to cross the Andes, so it’s a good moment to finish before the turbulence starts.