2 years ago, towards the end of October 2020, I gathered the courage to make the first call to my GP regarding a growing melanocytic mole on the right side of my forehead at the hairline to request an urgent referral to Dermatology because it had the red flags of a melanoma- slight asymmetry, diameter of 2cm (started as a speck of barely 1mm 5 years prior when I was in my A-levels), and stinging/burning pain that started around May 2020).

I somehow knew when I made that call that things would be going downhill. After all, I made that call for a reason, didn’t I?

I was on my Elderly Care placement as a final year medical student and made the call while walking up the central corridor of Bolton District General Hospital. It was 4pm.

I remember crying after I hung up because my GP agreed with the pictures I sent and with my symptoms that it could very well be a melanoma.

I knew that.

But having my concerns voiced back to me made it sting. I remember breaking down in tears after this because I felt scared. Scared of the outcome of the Dermatology assessment. Scared of the treatment options due to the aggressivity of melanomas.

Did I delay my request for that urgent referral too much? Did the fact that I was a medical student make me blasé and in denial about my own health issues? 

During the ward round 10 days later, I got a text message regarding my Dermatology appointment that was scheduled for 3 days later. Mixed feelings. The appointment went well- 5 Dermatology consultants came to have a look at my mole with the dermatoscope because no one wanted to even entertain the possibility of a melanoma (I was young, I’ve got darker skin so it should be all good right?). But all of them did and advised further investigations. I got promptly referred to the Christie Hospital (Oncology hospital) in Manchester to be seen by plastic surgeons for a biopsy.

My brother drove me to my appointment that day but could not come in due to Covid restrictions. This was for an assessment so that they could work out which management option would work best- incision biopsy or excision biopsy or excision of the mole with a margin. It was a lot to take in. This was part of my scalp and forehead they were talking about- my hair would never grow back in that area, I might need further surgeries to expand that area of skin so that they could then have enough room for suturing since the scalp region does not have much give, and closing the surgical site back up would be a challenge.

They talked about the possibility of chemotherapy, radiotherapy depending on laboratory results.

I felt numb.

I felt so alone in that room. So uncertain about the future. About my future.

I went back to the car to my brother, called my parents, and cried.

I had the incision biopsy on Christmas eve, 24th of December 2020 - every staff member in the plastics department was wearing festive antlers, Santa hats, or garlands around their necks. That made me smile. It’s all in the little things.

Fun fact- they’re NEVER so little after all.

I was absolutely terrified- the consultant plastic surgeon held my hand for 10 mins and helped me calm down prior to the surgery, he smiled, he said I am in good hands with the plastics registrar. He was then on his way out of the theatre to go on his break, but he made a u-turn and came back in within 10 seconds and held my face in his hands and said he was going to do the surgery himself because he felt that he needed to.

I squeezed his hands back and could only let out a small “thank you”- but these were two of the words of utmost gratitude that came from my whole heart.

I had a scar with 6 stitches from that.

He held my hands after the surgery and we looked at the wound together with a mirror.

He’s an angel.

My sutures were removed 12 days later- my wound dehisced and bled. That was not meant to happen.

I cried and went to the A&E, then to the Christie hospital for assessment the next day for wound dressings.

On the 8th of January 2021, the eve of my 24th birthday, my scar was starting to scab over and heal, and I was at the Christie Hospital in Manchester, alone in a consultation room because I could not have anyone else accompany me due to Covid and social distancing measures again. I was there for my biopsy results.

I waited for about 15 minutes in that room that day.

I knew something was very wrong the minute both the consultant plastic surgeon and the registrar headed towards me with a nurse. She introduced herself as a specialist teenage and young adult liaison nurse. She looked at me with warm eyes- too warm. Too comforting.

I knew these eyes.

I knew I was about to receive bad news.

My patients see the same ones when I am the one breaking bad news to them.

That’s when the consultant surgeon told me about the biopsy results- melanoma in situ. But that we needed to make sure there was no spread as the biopsy results were from just one area of the 2cmx2cm mole. They kept going on and on about surgery, about how they needed to excise the mole and a margin of 1cm around it. 1cm seems tiny until you picture a circle of 2cm being excised because of the stupidly big mole AND a further 1cm margin around it to make sure the cells have not spread. A circle of 3cm in diameter from my forehead/ hairline region? That was bad enough. But nope, I knew the circle would be in the middle of an ellipse shape really, because they need to figure out a shape that would allow surgical closure of the wound.

So it would be a heck of a lot bigger than a circle.

I was told that I would need this 2nd surgery, but that a skin graft from my groin region would also be needed to close the wound site as my scalp skin would be too taught to allow closure without a graft. Even worse news- I would then need at least 3 to 4 further surgeries at 3-monthly intervals over the next year or two to go back in and try to excise part of the grafted skin every time so that by the 4th additional surgery, the scar would hopefully be less conspicuous.

Wheels were turning in my head- how would I be able to start working as a junior doctor and have regular surgeries every 3 months? How would I have enough healing time? How would I have enough annual leave for this? When would I be able to visit home? Would it affect my training? Would my wound dehisce again? Would it look okay?

I had quite a few exams coming up, and I did not want to defer my final year by a year. I knew I could do it with the right people by my side.  So the surgery, under General Anaesthesia this time around, was scheduled for 20th April 2021, after my finals and all the additional exams were over.

I came back home. I called my brother.

He left work immediately and came home. Hugged me. Cried with me.

The following weeks, I broke down in tears multiple times on the wards during my placements. During my first breakdown on the wards, my colleague/ friend kindly asked me if I wanted to get anything off my chest- and I did. I told him everything that had been going on and I felt much lighter.

I had my pre-operative assessment at the start of April.

20th of April 2021 came around and I went to the hospital. I had my nice anti-embolic stockings on and changed into my hospital gown. I was ready but so scared. Scared of what the outcome would be, and how my body would heal.

it all went well thankfully- better than expected.

The same consultant plastic surgeon held my hand at the start of anaesthetic induction and he carried out the procedure and was right there when I woke up. Holding my hand.

ALWAYS holding my hand.

It brought me so much comfort.

He was the first person I saw when I woke up I was groggy but immediately lifted the covers to see whether they took the skin graft from my left or my right groin.

“Good news,” he said. No groin graft was needed.

This absolute angel of a doctor managed to work out a way to close the surgical wound without needing a graft.

I would not be needing 3 to 4 further surgeries to revise the originally planned surgery with the groin skin graft.

I was scared to look at the wound on my forehead/ scalp but he brought the mirror in front of me and held my hand as I looked. 9 stitches.

Longer scar, but so much better than a graft.

I cried- but tears of gratitude this time.

My best friend drove me back from the hospital. She gave me the biggest hug and the biggest snack basket with the sweetest handwritten words on the prettiest card.

Looking back at my final university year, I was crying so often, I lost weight from all the constant worrying, I was constantly on edge regarding exams, further investigations and treatment. Going alone to my appointments because of Covid social distancing measures was lonely and terrifying. Covid restrictions meant that borders to Mauritius were closed, so my parents could not fly to the UK to be with me.

But it helped me become more empathetic towards the people in my life- the ones I see every day, the ones I see once in a while, and the ones I only see once in my life (a stranger on the tram, passerby when walking, you name it).

The thought that people can be going through a rubbish time and trying to hold it together still grounds me.

It is humbling.

I am grateful for this- I might never have had this if I did not go through my own medical hiccup.

The scar I see every time I look in the mirror reminds me that life is so much more than what can be seen at surface level.

The people by my side- they have been godsends- I pray that their hearts are always cuddled with the same amount of love, care and comfort they brought and are still bringing to mine.

They say that I am strong for getting through this during my final year.

But the strength?

I got it from them.

Life has a weird way of working out in the end.

A little patience, a lot of faith.

As written by: Shammah Khadaroo - LTHTR FY2 Doctor (22.11.2022)