Prostate cancer and a little knowledge is a dangerous thing…

the windshield was broken but i love the fresh air don’t you know/ the dashboard melted but we still had the radio

Continued from the place on my face removed, retrieved from the trash, found put in formalin and then in my pocket and then to the 1994 car with old as hell tires to find that one is flat.

It is a humid but not overly hot early September day in North Georgia. Without missing a beat and not even a profanity under his breath, the car is place in park, the engine killed, the keys removed and the spare tire retrieved. It is one of the old little tires, it looked like a motorcycle tires. No change in emotion. It was if this was what he had expected, or that this type of thing happened all the time, routine, no big deal. Just take it in stride attitude. It was at the same time admirable and sad. We had talked about my brother going through a lot over the last few years and that he has said his new website was “” The life thing just go with the flow.

“What can I do to help,” I ask.

“Here, take this tool. Pop off the center piece and then use this green thing to unlock the hub cap and then put this jack under the car,” he says handing me about three instruments at once.

He begins to unscrew the midget tire out of its home and I try to pry off the center piece to in turn release the hubcap but the device doesn’t fit the space. I try several times without success. Mike comes over, places the tool in the space and pops the centerpiece off just like that. We then take this green thing and unscrew another nut off and then a bracket of sorts comes off and then viola….the wheel’s nuts are revealed. (That sounded a bit urological didn’t it?)

We jack the car up just enough to still have some weight on the tire to loosen the nuts and then the whole way. Mike loosens all the nuts and then removes the tire. He puts the new small tire on and replaces the nuts and tightens each.  We let the jack down and guess what? The baby spare ( the little tire that could) was almost flat. Not all the way flat but almost.

“The damn thing is flat John. You think we can make it to a gas station?” he says.

“It is almost rim on the ground but not quite. I think it is worth a try,” I say.

I look at Mike and he is profusely sweating from all the tire business. I mean his shirt and face are soaking with perspiration.

“Wow Mike. As a landscaping lady told me one time describing a co-worker running an aerator, ” You have worked up a lather!”

“It’s that damn blood pressure medicine. Does yours do that to you?”

Well the question gave me pause.  Mike and I lived together in medical school. The night before my wedding in downtown Augusta, Georgia and after many adult beverages he climbed to the top of a confederated statue that must have been 100 feet tall. He’d come over to our house in Augusta and climb way up in a tree to cut a limb and not think a thing about it. Hell we drove all night to ski at Beech Mountain, N.C. in jeans in and tennis shoes and then drove back. “The years are short and the days are long” the Shin’s song proclaims. The Smith’s song with the verse, “I have seen it happen in other people’s lives and now it’s happened in mine” came to mind. Cancers, divorces, health issues, money, work…as Lennon said, ” Life is what happens while you are making other plans.” I thought about having done a vasectomy on a nephew who I remember a child calling my mother during a Thanksgiving gathering in LaGrange, ” Grandma Q. Will you come get me?” My mother showed up in the drive way in five minutes and hoked. The nephew went out and off they went, “To go ride.”

“No I have not noticed that. But my skin is now much more sensitive to sun. It peels like having had a sun burn with the slightest sun exposure. Or I guess it could be the cholesterol medicine I’m taking,” now on top of everything else feeling very old and “damaged.”

I pick up the old tire to put it in the space of the little tire but it won’t fit and in the process on of the exposed wires from the “steel belted tires” punctures my thumb carrying with it dirt and grime decades old. I look down at my bleeding thumb. Now I know where the term “steel belted” comes from…I felt it.

“Mike be careful moving that tire there are exposed shards of wire,” as I begin thinking when my last tetanus shot was. When was it?We make it to gas station and put more air in the little baby tire and then begin the trip back to Gainesville. He is sweating, we both have hands covered in this 30 year old soot from these old ass tires and old ass brake dust.

We begin going up 4oo and I say, “You know we should stop at McDonald’s again and wash our hands and get some sweet tea.”

We make it to the McDonald’s that is at the exit on the way to Gainesville. We go into the restroom and there is guy in there washing his hands.

As Mike and I waited I began to tell him about a financial newsletter that I get and what stocks the guy advises.

“The funny thing Mike is that have you noticed that the economy is supposed to be so bad but all you see everywhere are cars going everywhere to buy stuff and eat out. It’s consumerism out there. That hasn’t changed. There is a disconnect between the perceived demise of the economy and yet the market is near an all time high. Did you realize that? This guy is strictly recommending consumer stocks like Tobacco, Dollar General, Autozone, Home Depot, Chipolte Grill, things like that. People aren’t building houses ,,but they are eating, watching movies and driving all over the damn place.  Have you noticed the traffic today. There is a disconnect, but maybe there is a message here in terms of investing.”

“Do you think there will be a bump in the market if Romney is elected?” Mike asks.

Well at that point we both note that the guy in front of us has been drying his hands for what seemed about 10 minutes. I mean he was using the towel to dry above his elbow, over and over, looking down and …listening. Mike and I both realize it at the same time. He thinks he is getting some sort of insider information about the stock market. He didn’t know we were in a 1994 Buick and that I had paid a $100.00 to give me advice on investing $400,000.00. I began thinking about how stupid I was.

The guy moves to the side and Mike attempts to wash his hands all the while the man continues to stand between Mike and me and incessantly drying his whole body it seemed. I think he enjoyed our company or something. Mike, my surgeon, cannot find a button to make the hand cleaner to work.

“I think this thing is out of soap or the battery has died,” as he is pushing every button on the box one of which he is repeatedly pushing is the button to open the box to change the soap. Mike is just standing there looking at it.

The ever present bathroom man says,” Just hold your hand under it. It is automatic.”

“Thanks, ” Mike says as he now is getting soap to wash his hands.

The man leaves.

“What the hell was that about?” I ask.

“I think he thought he was getting stock tips or something,” Mike responds. “That is interesting about people buying stuff they need, and eating but not buying the big ticket items or building stuff.

We go out to order our tea.

“John, did you know that tea is included in the summer special dollar menu?”

“I did not,” I say.

“May I help you?” says the teenage orange haired order person.

“How long do you suppose that y’all will have the large tea for a dollar?” Mike asks.

I say,” Mike I don’t think she is privy to McDonald’s company policy directives going forward.”

The two of them look at me like I’m a smart ass or something. A look I deserved.

Okay that was Labor Day and I  go to work on Tuesday. The following is a tally of things said to me about the stitches under my right eye. I was considering putting a circular band-aid over it but I did not have one at home or at my office.

“Did you say something to your wife and she hit you?”…80%

“Were you in a fight in a bar?” 10%

“Did you fall?”

“Did someone hit you with firewood?”

“Did a horse kick you?”

“Did a fish-hook get you?”

Keep in mind I see on average about 30 people a day and the question was repeated over and over until the stitches were removed on the Sunday following Labor day. And with each patient visit, and with a hundred people at the hospital I went through the whole process of the “dark skin place.”

People were actually very kind. ” I’ll say a prayer that it is all right Dr. McHugh,” I heard over and over again. Who would have thought a small area under the eye would generate so much interest?

Mike came over to my house with his magnifying glasses (loupes) and removed the sutures.

He and my wife and his daughter all then began to talk horses. Mike and his daughter are riding and my wife is wanting to buy a horse to learn dressage. She has been looking for a horse for about six months.

Look at this picture of my dad johnmchugh. (Mike’s children have always called me johnmchugh)

The picture is the one at the top of this post. Now that is stupid. It is more stupid than climbing a confederate statue to the top after a bachelor’s party in Augusta, Georgia in 1979. More stupid than driving daily to the Atlanta area in a 1994 Buick with 1994 steel belted tires.

No hands and the reins in his teeth. Really? My surgeon?

Anywho….I get the path report back and it is a picture of the lesion all in bold purple and red and looks horrible but reveals “inflamed actinic keratosis.” Guess I’ll live another day to do prostate exams after all!

Finally I am at the hospital this am after putting bilateral ureteral stents in a lady with bilaterally obstructed kidneys and a high Creatinine and I see one of my friends who had happened  to have looked at my skin place over the last year.

“John what happened to your eye?”

“It’s a place you looked at for me and told me it was nothing to worry about,” I say expecting to get the response I got from him, intense concern.

“Oh no big deal. It’s a melano……..just kidding. It is an actinic keratosis.

A look of concern changes to a smile.

Another doctor standing there and hearing this exchange says, “I can’t believe he did that to you.”

“Coming from Dr. McHugh, that was tame,” he says.

We talk a bit more on something else and his father’s name comes up. A general surgeon who was one of the leaders in health care in our community for decades.

“John I have a joke my father used to tell. Make a sentence with defense, defeat, and detail,” he says.

I pause and indicate for him to tell me.

“De rabbit jumped over de fence, first with de feet and then wif de tail.”

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