Finding Your Way Home, Again

But all great voyagers return 

Home like the hunter, like the hare

To its burrow; below, earth’s axle turns

To speed their coming, the following fair

Winds bless their voyage, blow their safe return.

 Barbara Howes

Today I saw an 80 year old patient with skin cancer—not a melanoma—the dangerous one, but a routine garden variety basal cell cancer sitting right on the edge of his nose, where the nose meets the skin of the cheek. His surgeon told him that he could cut it out, but that there might have to be a flap rotation or a skin graft to fill the gap, and the patient declined surgery.  As a result he was referred to me.  After hearing about radiation, this nice man decided to go ahead with treatment, but he had one question—could he wait until after the holidays?  The reason was that all thirteen of his grandchildren were coming to visit him, and bringing his first great grandchild.  I reassured him and told him that of course he could wait—the treatment of skin cancer is never an emergency, and while he might sing “Rudolph the Red Nosed Reindeer” to his grandkids, we didn’t want him to look like that famous deer!

My daughter arrived back in Texas yesterday after travelling since Thanksgiving on the residency interview circuit.  She has covered both coasts and eight different cities since showing up on in San Diego just before the holiday. She said it was good to be home, even though she misses her cat, who remains here with me during her travels.  I sense a grown up transition in the transference of “home” from being here with her parents, to “home” being her own condominium in Houston.  Although I miss having her around, I am happy that she has found her own ground, and her own friends, and made a life for herself there. Her biggest job in the next few months will be to figure out just where her next home will be, for the next three to six years. The best advice I can give her is to choose her next move based on her comfort with the people she has met along the way.  Not only will they be her peers and her mentors, but they will most likely resemble her “family” in the coming years—she will spend more time with them in the hospital where she lands than she will with any of her real family members.  For newly minted doctors, the hospital where they do their training becomes home.

I am glad that Christmas Eve and Christmas Day fall on a Monday and Tuesday this year.  My department will be closed both days, which will give my patients a four day weekend.  For some, this means they will get to take a trip home, wherever that may be.  For others, the four day rest will give them some relief from the side effects of treatment.  For those of us not undergoing treatment, may the fair winds blow your friends and families to you, or you to them, and safely bring you home.