Yes, I came weeks ago with the young boys who didn’t hesitate before jumping up on the hospital table, taking the syringe from the doctor’s hands. One, two, three. They pushed the saline solution into the “ports” behind their ears and I watched as the tumor-looking bulges on their heads began to expand, stretching their skin to accommodate the inflating bags under the surface.
But Shelley is 18, and this trip would be much different than the one in the children’s ward.
But Shelley is 18, and this trip would be much different than the one in the children’s ward.
Later I will try to voice my unease about the hospital with my boss and Chris, but I know it comes out trivial. They’ve seen this before. They’ve done this a million times. They’ve seen fresh burns, smelled the melting skin and waited for surgeries that never came soon enough.
And now it’s just Shelley and me, waiting in the queue with the coughing man and the woman with gauze on her neck who walks a bit sideways… and dozens of others.
Shelley has her hat on. It’s pretty and white and frames her beautiful face. Her eyes take everything in and she is quiet. I ask her meaningless questions that I convince myself will keep her distracted from where we are and from what is about to happen. She answers me politely and concisely then says nothing more.
Tissue expansion is a simple concept. The doctor who later treats Shelley says that it originated from the novelty of a woman’s pregnant belly: when forced, skin will expand.
Many burn survivors are left with spotty hair if they’ve been burned on the scalp. Tissue Expansion is one solution to give patients back their own real hair.
First they will undergo a surgical procedure where doctors will place a silicone bag under the part of the scalp with the most hair on it. The bag is similar to a breast implant but comes in different shapes, depending on what the patient needs. In addition, there is a small tube that goes from the bag to a small port that is also strategically placed under the patient’s scalp.
Over the course of three months, the patient will visit the hospital once, twice or three times a week depending on availability and a doctor will inject saline into the port. From the port, the saline will travel through the tube and inflate the bag, stretching the skin that has the most hair. After the patient has undergone all of the injections, they will have a large tumor-looking growth on their head covered with their real hair.
For the final operation, the bag is deflated and the skin that has been stretched with the hair is put over the patient’s head, eventually giving them a full head of hair.
This is Shelley’s first saline injection since she had her second Tissue Expander (the bag) put in. I can tell she is nervous and I ask her a little bit about her history with Children of Fire. She says she likes the charity and explains a little bit about how her dad found it. I ask her if she’s had a tissue expander before and she says yes. I can sense the dread.
Watching the three boys the week before, I remember being shocked at the ease with which they injected themselves. I remember asking myself if I could hold this needle and poke it in to the back of my head knowing that it is going to push my skin further into deformity all in the hopes that it will be fixed eventually.
I don’t think I could do it.
The silence in the hospital waiting room is unbearable. The room is unbearable. I look around at the rugby player whose arm is in a splint, leg in a cast, the boy whose parents have accompanied him, most likely wanting to fix his sagging purple eye.
There is the short white man with a small tumor looking abnormality on the bridge of his nose, blocking the eyesight out of one of his eyes. There is the old albino woman with her head down, wrinkles sagging from her face and her eyes closed. Next to her a black woman has taken up the identical position.
I watch the old white couple in front of us who are trying to control an anxious three-year old colored girl who seems to have infinite energy that they may have had a handle on were they 20 years younger.
After waiting in the “Appointment” line we give our card to the receptionist and sit down. We wait.
I suggest Shelley and I play dots. She knows how and I find myself loving that the game is universal.
In between drawing lines I look up and watch an older over-weight black woman walk up and down past the waiting sick people. She has a clear tube hanging from her neck but I can’t figure out what it’s connected to on either side. She calls out names and hands out large pink folders to people waiting. When they get their folder they sit accordingly in the chairs next to the two offices where the doctors keep coming out of.
The Doctors
I would say the majority are some-what attractive Indian men. They strut up and down among the sickly, barely seeing the people suffering in front of them. Perhaps there are too many. Perhaps they have lost the sympathetic view that I can’t seem to escape. One or two cast me a glance-- they probably caught my glare.
We wait.
Half an hour goes by, an hour. An hour and a half. I ask Shelley if it normally takes this long. She says no, but says that the man with the lump on the bridge of his nose has been waiting for his folder as well.
Finally after the second game, she hears her name and takes her pink folder from the woman with the tube. We wait again outside one of the doctor’s rooms.
The other four, two kids who were getting injections and two volunteers, one of whom is writing an article about tissue expansion join us.
Shelley doesn’t seem phased and greets the kids.
We shift chairs as the patients in front of us go into the room. I look up at the Indian doctor guiding them in. I feel like even if I saw him on the street, without his white coat, I would still know he was a doctor.
Finally we sit in the chair next to the door and he invites us in waving the next patient on. Myself, Genevieve, Sizwe, Karabo and Maura follow Shelley into the room. She sits on the chair and takes off her hat.
Dr. M looks into her pink folder.
“Oh, you have a tissue expander.”
The doctor feels her head gently and asks her if it’s sore. She says it’s not. He feels its placement and talks to Maura about what a tissue expander is and how it works.
I watch Shelley’s face and wish I could tell her how brave she is without sounding cliché. I nod quietly at her and make eye contact. She looks at me then looks away.
Dr. M takes us in to the next room where hospital beds are separated by hanging sheets.
He continues to explain to Maura about how tissue expanders work. He draws her a diagram and then fills up a syringe. She will be getting 260ml of saline solution.
Shelley covers her face with her white hat and he sticks the syringe in the port behind her ear. She shudders.
After waiting in the “Appointment” line we give our card to the receptionist and sit down. We wait.
I suggest Shelley and I play dots. She knows how and I find myself loving that the game is universal.
In between drawing lines I look up and watch an older over-weight black woman walk up and down past the waiting sick people. She has a clear tube hanging from her neck but I can’t figure out what it’s connected to on either side. She calls out names and hands out large pink folders to people waiting. When they get their folder they sit accordingly in the chairs next to the two offices where the doctors keep coming out of.
The Doctors
I would say the majority are some-what attractive Indian men. They strut up and down among the sickly, barely seeing the people suffering in front of them. Perhaps there are too many. Perhaps they have lost the sympathetic view that I can’t seem to escape. One or two cast me a glance-- they probably caught my glare.
We wait.
Half an hour goes by, an hour. An hour and a half. I ask Shelley if it normally takes this long. She says no, but says that the man with the lump on the bridge of his nose has been waiting for his folder as well.
Finally after the second game, she hears her name and takes her pink folder from the woman with the tube. We wait again outside one of the doctor’s rooms.
The other four, two kids who were getting injections and two volunteers, one of whom is writing an article about tissue expansion join us.
Shelley doesn’t seem phased and greets the kids.
We shift chairs as the patients in front of us go into the room. I look up at the Indian doctor guiding them in. I feel like even if I saw him on the street, without his white coat, I would still know he was a doctor.
Finally we sit in the chair next to the door and he invites us in waving the next patient on. Myself, Genevieve, Sizwe, Karabo and Maura follow Shelley into the room. She sits on the chair and takes off her hat.
Dr. M looks into her pink folder.
“Oh, you have a tissue expander.”
The doctor feels her head gently and asks her if it’s sore. She says it’s not. He feels its placement and talks to Maura about what a tissue expander is and how it works.
I watch Shelley’s face and wish I could tell her how brave she is without sounding cliché. I nod quietly at her and make eye contact. She looks at me then looks away.
Dr. M takes us in to the next room where hospital beds are separated by hanging sheets.
He continues to explain to Maura about how tissue expanders work. He draws her a diagram and then fills up a syringe. She will be getting 260ml of saline solution.
Shelley covers her face with her white hat and he sticks the syringe in the port behind her ear. She shudders.
I imagine it's me. I am in the chair, with the hat over my face. Waiting for this solution to be released so the bag on my head will expand. Later everyone will leave the hospital room. Later, everyone will forget about the three syringes. But I won't. I will be reminded every time I look in to the mirror.
Where was I when I was 18? Wanting a boyfriend, shoping with my freinds, getting ready for college... where is Shelley?
I watch as he pushes the full syringe in, desperately wanting to say something to Shelley. Her face remains hidden.
When he fills up the next dose I feel the blood drain from my face. I watch as he pushes it in to her scalp. My ears start to ring and I’m fading, I know the feeling and I look away, breathing quietly.
Karabo who is 8 takes my hand. I wonder if she knows she will be next to go through all of this. Today she just asked if she would be going to sleep at the hospital. I told her no.
Dr. M takes the next syringe.
I walk in to the next room and sit down, putting my face in my hands until my mind comes back to the room. Karabo is drawing on my lap.
When I have it together I walk back to Shelley. She removes her hat from her face and puts it on over the now inflated tissue expander.
I hug her gently. She puts her earphones back in.
Her next appointment is Wednesday the 30th of September.
