Scar Tissue, by Elizabeth Colville

Skin

Basal cells form in the prickle cell layer between the dermis and epidermis. They contain fibrils within the cellular cytoplasm that helps strengthen the skin. These cells actively divide and ascend through the granular layer replacing those at the cornified layer. When damaged, the regeneration process breaks down at the site of injury. The immune system activates, protecting and cleaning through bleeding. Threads of fibrin spread out from platelets in the plasma, trapping and clotting red blood cells that scab once dry.

Newbie

I was eleven when the phagocytes rushed to the scene of the crime: my left shin. It was lunch time at Eltham Green School. I’d been there a couple of weeks. A tiny speck dwarfed by a gargantuan building. A pathetic little figure in oversized first-year blazer, ‘V’-neck jumper and regulation pleated tunic: bottle green. A snot on the landscape.

De-tagging

I’d already been de-tagged. This is when the tie-maker’s tag is ripped off—with force. The older boys and girls worked in packs. A lot of kids cried. I didn’t. Not outwardly. It was a ritual all first years went through, unless you were lucky or clever or both. I was neither.

Cell Block ‘H’

The building: an ‘H’-shaped construction, like a sprawling foal. Seven floors with two wide staircases at either end of the central cross building. A vast comprehensive in South East London, housing 2,500 children. It was a Darwinian environment. Apart from surviving, we were classified into houses. The first six spelled the town and the last two the initials of the remainder, E L T H A M G S. We were allocated a house according to the initial of our surnames. Mine began with ‘B’ so I was placed with those whose surnames began with ‘E’. I don’t know the logic behind this taxonomy, but ‘E’ stood for Endeavour, and as I’d been told I always tried hard, I was aptly placed.

Assembly Hall

Joining the cross building at lower ground level was a glass-sided assembly hall with stage and balcony. Every morning at 9am the first three years would gather for morning prayers and the daily haranguing. Fourth- and fifth-year assembly didn’t start until 9.30. And if you stayed on until the sixth form, which I did, you were absolved from this diurnal ear-bashing.

Impact

I was standing between the assembly hall and the building that housed languages, history, and geography. There was a group of four fifteen-year-old girls standing behind me at a short distance, chatting. Some boys, a mixture of ages, were playing football in front of me, also at a distance. The din from kids running around was indiscernible, full of life with differing pitches of scream and squeal. The boys were navigating a football between three randomly placed tree-seats. I was standing on my own in the middle distance between a seat and the school buildings when the ball arrived at my feet. Mother had always told me to put others first. I picked it up to hand it back to this barrel-shaped tank of a kid when he kicked me, as if striking out for a goal. His steel toe cap sank into my shin.

“Fucking leave it alone you little cunt,” he yelled, snatching it off me, his eyes black with rage.

I stood dead still, my body trembling, my leg bleeding. I wanted to cry, but didn’t because my parents used to say, “you carry on and I’ll give you something to cry for.” So I never cried. I just felt scared and stupid, and wanted my mum. I could hear the girls behind me laughing. I didn’t know if it was at me. I just wanted to disappear into the ground. But I couldn’t just let him get away with that. I had to say something to him.

So I said, “You didn’t have to do that. I was only helping you.”

“Fuck off. Cunt.” he barked, toeing the ball back to the laughing boys.

Survival

Where others fight or flight, I fright. 

Skin 2

Wounds leave scar tissue. Mine’s an atrophic scar, taking the form of a sunken recess. This occurs because the underlying structures supporting the skin, such as fat or muscle, are lost during impact. 

Skin 3

Melanin is produced by the amino acid tyrosine that synthesises proteins. This amino acid oxidises then polymerises; small molecules combine chemically to produce a large chainlike molecule called a polymer. The pigment is produced in specialized groups of cells called melanocytes. The melanocyte-stimulating hormone intensifies along with estrogen during pregnancy causing increased pigmentation of the skin.

Discovery

I was four months pregnant with my first child when I noticed this dark spot on the inside of my left knee. It was around a millimetre in diameter. I tried to think if I’d noticed it before but couldn’t be sure. Over the next couple of months I noticed it growing in tandem with the unborn baby. I knew the body changed during pregnancy, so thought no more of it.

Presentation

Immediately after my daughter was born, the customary round of showing off the baby was expected. My family came to visit. His family expected our visit, not concerned for my stitched and swollen bits and leaky tits. I argued my point, but like royalty, when they called, we served.

And this thing was growing bigger.

Discovery 2

Five months later, my husband, daughter and I visited his father for a meal. I thought I’d mention this thing and showed him. By now it had doubled in size. He told a story of an aunt who’d had something similar growing, but had done nothing and after a couple of years, had died. The autopsy showed it to be a malignant melanoma. Enquiring as to what that was, he told me: a tumour. I’d always thought tumours were gristly things, not smooth and flat. He urged me to get it checked out soon. I remember thinking, Shit! I’ve got cancer.

Nightmare

My head spun. I couldn’t think of anything but death and dying. The baby was crying but I didn’t want to deal with her. I eventually changed her nappy while hubby and his father sat drinking beer.

I couldn’t wait for morning. I needed to get to the hospital now, but that wasn’t going to happen.

Night-time coverts despair. Death is comfortable in darkness, while the heart trembles in fear. I had watched this thing blossom into a black dahlia in the summer sunshine, unaware it was my nemesis. I was only twenty-six.

I got through the evening as best I could, their joviality alien to my dilemma.

Darkening

The fear suffocated me when I thought about going to hospital.

Better you know than to die—surely?

I didn’t want to know. I know I didn’t want to die.

I WAS ONLY TWENTY-SIX.

I wanted more children. I wanted to see my daughter grow into a young woman.

What had I done to deserve this?

I was giddy, felt sick, my heart pounded, my breath was short, I felt sweaty and cold.

I cried and stroked the dahlia, like a cat, through the tears.

My eyes wandered to the atrophic scar that had formed fifteen years earlier.

Lightning

Thor struck!

Of course: the trauma to my leg. My body’s way of telling me something.

I was excited.

I researched books, consulted alternative practitioners. The black dahlia was a messenger, directing me to a deeper level, which needed heeding.

I stared hard at this thing—

No, not a tumour, nor a mole, but a sign.

I smiled. A feeling filled me. A reassurance that cast away gloomy thoughts. I went to the phone, picked up the receiver and booked an appointment.

Hospital

To the right of the open-plan foyer were the lifts and staircase to the wards. To the left, the day clinics. Two main walkways, the length of the hospital, bestrode the appointment desks.

The oncology check-in was the penultimate station. I took my seat in a spacious, yet cozy, eau-de-nil waiting area with its chrome and maroon leatherette chairs in facing rows. I’d gone thinking they were going to look, pass verdict, and that would be that. I sat in silence watching other people and wondering about their fate. Someone called and I realised they were calling me. It reminded me of Cell Block H.

Investigation

Ushered into a side room with a curtain drawn around a bed, a young man in a white coat sat at his desk. He asked me questions like, how long had I noticed it and did it hurt. Then he stroked it with his thumb checking its texture and squeezing it gently between thumb and index finger.

“Okay, jump up on the bed and we’ll have that out.”

“What are you going to do?” I said.

“We’re going to take a biopsy. It won’t hurt.”

“You’re going to cut it out?”

“Yes. We need to do tests on it.”

“Is it cancerous?”

“That’s what we want to find out.”

The bed was in lounge position. I eased myself onto it and leaned back. It was covered in light blue paper. I faced the inside of my knee towards the ceiling and with my hands gripped across my chest, I closed my eyes. Metal clunked. I imagined a kidney bowl and scalpel. The smell of surgical spirit made me shiver. Something cold touched my leg. The nurse was swabbing it with anaesthetic. I wondered if they would use a 10A Swann-Morton blade like I’d used at college. I remember two types of handle. A thick one, taking larger blades, and a thinner one that I’d used for card-cutting and scoring. I’d made a Tarkus model out of card. Tarkus, from Emerson, Lake and Palmer’s second LP of the same name, was a cross between an armadillo and a tank. The caterpillar tracks were particularly tricky to make as they had to be individually crafted into letterbox-shaped treads to look authentic. I’d learned this shape originally from cutting button holes in needlework class at school.

“All done,” the nurse said, plopping a bloody segment of flesh into a specimen jar.

She bandaged a large square gauze over the wound, told me to keep it dry and not to remove it for a couple of days. That meant no baths or showers; or at least, showering without the left leg, which would call on my balancing skills. I was ushered out in mirror fashion to my entrance and was told to give it a few days before ringing for results. But before I could call them, they called me.

Verdict

Greenwich District Hospital; where, twenty-six years earlier, on the same site, but in the original St Alfege’s Hospital buildings, I had entered the world.

I met with Mr Harrison, the oncology surgeon. Suave, early forties, short dark hair peppered with tiny flecks of silver. Greying sideburns emphasising his deep brown eyes. He reminded me of a young Christopher Lee. I think it was the oval face and slightly aquiline nose. He smiled at me as I entered the room. My backside had hardly touched the seat.

“I don’t want to wait,” he said.

“We’ve caught this in time and I want to make sure it’s all out. This Sunday. You’ll be in and out for Christmas.”

“That’s short notice. I’ve got a seven-month-old daughter to look after.”

“What about her dad? This is your leg we’re talking about. I don’t want to take any chances.”

I dreaded asking my husband, knowing he would not want to leave his precious metal mistress, the printing machine. I was even more gutted when he recruited his mother, much to my chagrin. Nevertheless, on the 5th December 1982, I entered theatre.

Solo

Fast forward eleven years to 1993. It was the worst of times; it was the best of times. I was thirty-seven, relieved to be separated, a single parent of four young daughters living in a detached chalet bungalow in a beautiful corner of Sidcup on income support. We had ten rooms and a park for a garden. Twenty-two trees and a vast lawn. From the mega beech that turned five colours in a season before laying down her golden rug in November to the Hadean Ficus, a fruit-bearing fig tree of epic proportions to which I played Persephone every morning from July to late September. The children were at their happiest. We played roadways, ran races, had ten-foot-high bonfires that lasted all night and the foxes even came to lay on the warm ashes. Life was good.

Return

We were two days past the Vernal Equinox. The daffodils were opening; the beech was unfurling its deep green leaves from its winter buds. I was sitting on the edge of the bed clipping my toenails when I saw it. A black thing on the sole of my left foot. It was Tuesday 23rd March. Mardi. Mars day. The day of the war god. The battle was on… again. The dread, pervasive. I wanted to cry but didn’t. Instead, I measured it assiduously.

Using a reflexology map of the foot, I noted that the melanoma and this new one were both positioned on the spleen line. I plucked up courage to visit the surgeon. I didn’t want to hear what he had to say. He told me to come back if it changed size. Changed size? I’d been watching it change size for two months.

Alternative

The left-hand side represents the feminine.

The spleen, biologically, makes defence cells, breaks down old red corpuscles and creates bile. Symbolically, it is concerned with obsession.

Cancer metaphorically represents a long-standing resentment, a deep grief or secret eating away at the self, carrying hatreds and a ‘what’s the use’ outlook.

The skin is a sense organ that protects our individuality. It is our personal boundary.

I was full of bile, over the rancorous fallout from the separation and sick of being everybody’s property. However, I was being shown where to work on myself.

I had to love me and protect me. That was paramount.

Without love, what was the point of anything?

It hadn’t grown in a year.

The last recorded measurement on 9th January 1998 showed it had doubled in size. I was now 41. What kept me going during these times were my girls, the garden, my interest in homoeopathy and astrology, the cosmos, the physical stars and planets. All the while I stayed close to the meaningful; things would work out.

This was not blind faith, but a depth of faith — in my connection to something that was not manmade. My youngest was seven, my eldest fourteen. This was a period of engagement with all things wondrous.

Comets: portents for good or evil.

Through the telescope we viewed the transit of Hale Bopp, recreating it on black sugar paper with chalk.

Crossroads

I had made a decision that I would not have this thing cut out, not even as a last resort. If I had cancer, I wanted to know where it was so I could have a relationship with it. Most importantly, to love it. I was, after all, married to it; a marriage no man could put asunder.

I believed having the melanoma removed pushed the cancer back into my body to resurface. I’d read about Dr Max Gerson’s cancer patient success rate with carrot juice therapy, but had no means of travelling to the States, so I created a raw food therapy of my own to support my body’s immune system.

This was it. No more fight, no more flight, no more fright — just love and a healthy respect for life and death in all its guises.

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