So oft it chances in particular men
That (for some vicious mole of nature in them,
As in their birth, wherein they are not guilty,
Since nature cannot choose his origin)
By the o’ergrowth of some complexion,
Oft breaking down the pales and forts of reason,
Their virtues else, be they as pure as grace,
As infinite as man may undergo,
Shall in the general censure take corruption
From that particular fault.
— Shakespeare, “Hamlet”
I
Several months ago I confessed. It was the end of an ordeal that—exacerbated by adolescent brooding and self-consciousness—lasted much longer than it should have. I expected the confession to be the most important moment of my life. It turned out to be nothing. I found out that the secret and tragic cancer I had been nursing since adolescence was not in fact cancer at all, that I had tortured myself with grief for almost a decade—indulging in youthful futilities such as sobbing in dark hallways and wandering the streets at night—all in the name of a growth as benign as my thumb. Though naturally I was pleased at the news of my health, I was also horrified to have wasted all those years in fear. Deep in my consciousness, a remnant of adolescence was even dismayed to find that, instead of being singled out for a glamorous, early, poetic and angst-driven death, I was, like almost everyone else, just a fleshy bag of smoothly functioning organs, an animal cursed to outlive its own vitality and die slowly of age. In some ways (and I admit this with all knowledge of its absurdity) it would have been better for me if the mole had been cancerous: It would have justified years of disfiguring histrionics—the foot-high pile of notebooks, for example, filled with ominous and self-important poetry that I believed would be published to great acclaim after my death. The excesses seem indefensible now. At the time they seemed like supreme style in the face of death.
II
It all began, if we can fix a starting point, when I was 15. These were the idle days before employment; my friends and I spent them trying to knock each other off our bikes with oranges stolen from a neighbor’s tree, or pounding nickels into the shapes of quarters to fool the video games at a local pizza shop. Our bodies were simply tools in the service of fun, handy for throwing jellybeans at passing cars or leaping off of roofs. We never doubted their integrity: If we had scrawny arms and fuzzy mustaches, well, that was nature’s logic. Moles and freckles were individual signatures. My mother unwittingly ended this simple era one afternoon by sending me to an appointment with the family doctor to have a mole removed from my neck.
Though it was an eyesore, perhaps, to those who knew better, I had grown accustomed to that mole. It was the shape and size of a pencil eraser, in color an even brown. To me it was just another part of my body, a button—protruding from my neck, just below the jaw— on the fun machine. I tended to play with it when I worked through math problems. Though I had been momentarily startled when, in the fourth grade, my best friend told me that someday the mole would fall off and give me cancer, I didn’t really believe him. My fourth-grade friends traded heavily in specious factoids: A large percentage believed in the government suppression of flying skateboards, while even more purported to have fathers so skilled in martial arts they could karate-chop a man in half.
I reported to the doctor, hoping merely to suffer the cosmetic procedure and hurry back to my friends, who were planning to urinate off the balcony of a nearby office building. When I arrived, however, the doctor treated me with disturbing gravity. He examined my chest and back, scrutinizing each of my visible moles, punctuating his search with worried hmms and OKs. Then he had me lie down on the crinkled paper of the exam table, where he anesthetized my neck, sawed off the offending blemish with a razor blade, and cauterized the bleeding wound with a red-hot light bulb. I smelled a faint smoke coming off of my skin, and I remember feeling alarmed to find that like a rope or a twig, I would burn, that I was not simply a human being but a flammable object.
I still carry a neat, elliptical scar on my neck as evidence of that minor surgery, which struck me as odd—the light bulb, in particular, surprised me—but not unpleasant. A bad moment came, however, when the procedure was over, after I had been cauterized and bandaged and smeared with ointment. The doctor sat down and asked me, very seriously, if I had any moles larger than the one he had just removed. He told me it was extremely important that I tell him the truth.
Before he had mentioned telling the truth, I never would have thought to lie about something so trivial. But his sudden solemnity convinced me that I should think further about the issue. So in order to buy myself some time, I lied and told him no.
I realize that the reader is not my dermatologist, but some knowledge of my moles is essential here. I am practically covered with them. While most occur as harmless constellations of über-freckles, several are large and three-dimensional, moles you might stare at on the subway. These newsworthy blemishes include the one the doctor removed from my neck, another on the lobe of my ear—which an uncharitable wit once compared to a cocoa puff—and another on my collarbone. I have a few large, flat ones—less offensive but still worrisome—as well: on a biceps, a shoulder blade, the small of my back. A borderline growth camps out below one nipple. Even after seeing all these, though, you might consider my life not too urgently in danger—might give me, say, a 50-percent chance of living to 35 without a major amputation. That optimism, however, would be woefully uninformed.
The king of all my moles, the one that dwarfs all the rest, presides outside of public view—on my inner thigh, right next to my penis. This embarrassing placement contributed greatly to the eventual crisis. What adolescent, given the chance, wants to have his crotch inspected by a bald man in a lab coat? In later years, when I started thinking too deeply about the issue, I decided that the mole was strategically placed by God or Darwin or whoever controls such things to present the toughest possible test of my character. If it had been on my cheek or my forehead, I told myself, I never would have been able to ignore it—people would have vomited at luncheons, and eventually I would have checked into a hospital. But it was totally private. It was scary, too: at least twice the size of the one on my neck, as well as scaly, with a border as irregular as a pile of beans.
Despite the large mole’s troublesome location and disturbing girth—probably because of those things—I should not have lied to the doctor. Having been raised in a deeply Christian home, my siblings and I grew up believing in the preeminence of honesty among all the virtues. My father had studied to be a Lutheran pastor before I was born, a dream my birth helped to squelch, forcing him instead to cook at a Mexican restaurant, then to stack wood at a lumber mill. Despite this forced secularization, however, the atmosphere at home remained unmistakably moral: Our eyes were shielded piously at the first hints of movie violence, and common slang such as shut up and fart earned the label of “outlaw words.” Somehow, however, in spite of the Lord’s sheltering hand, I turned out to be a habitual liar.
I say habitual, but it was never serious. I was a meticulously law-abiding child, eschewing even the least-offensive peccadilloes of youth: smoking, shoplifting, fighting. My occasional lying was probably an id-generated protest against this rampant goody-two-shoeism, but even the protest was tame. I never lied about anything important. In the second grade, for instance, I refused to admit that I had received any N’s—the grade for “Not Satisfactory”—on my report card, when in fact everyone could see that the card was littered with them. I felt that, by right, I should not have received anything less than the highest marks, and the conviction was strong enough to withstand any documentation to the contrary. In the fourth grade, I stood up and told the class I had once seen an X-ray of my finger, an admission that won me some admiration, though it contradicted my experience exactly. I managed to justify this privately with the thought that I had, in fact, fractured my finger earlier in the year; the doctors had certainly taken an X-ray, and I told myself, I could easily have seen it, though I did not.
This was the kind of harmless and inept lying I stuck to as a child. I may have inherited the tendency from my mother, who lied as a child about getting kicked in the face by a horse. I don’t know. What strikes me as oddest is how natural the lying felt, more like creativity than sin. Reality seemed like an elaborate but arbitrary system in which the things that actually happened were chosen from infinite possible variations. To my childish mind, the event that finally occurred had no more validity than the millions that did not. In lying I redeemed those other choices, gave them a private reality. I was a nervous and awkward boy: I remember crying at school, fearing I had gone deaf when I had merely been given a faulty pair of headphones. Lying, or creative recall, was a strategy to improve my chances in the world. That awkwardness hasn’t disappeared completely even today. I might be lying now, about all of this, and not even know it.
My lie to the doctor, however, turned out to be more serious than all its predecessors. I had been raised to believe that doctors, like judges and policemen, were authorities who deserved complete honesty and respect. By lying I felt I had committed a sin against all doctors everywhere. As a result I took my mole into hiding, rigorously avoiding doctors of all kinds, regardless of how far their specialties diverged from dermatology. In my mind all the authorities worked together. I decided to sacrifice the rest of my body—to let my teeth decay, my vision blur, my joints stiffen—in order to protect my secret. An optician, bound by the Hippocratic oath, might notice the mole on my ear and speak to my parents, who would usher me off to the dermatologist and discover the horrible truth—that I was dying and, far worse, that I had lied.
III
Though I have never actually fainted, I have come close twice. The first time was a result of 110-degree weather and merciless calisthenics on the first day of high-school football practice. The second was the result of a line of text.
One afternoon in my junior year of high school, I decided to collect information about melanoma. What motive possessed me I do not know; I guess it was early in the cancer fiasco, before I had adopted a policy of full-scale denial. I went during lunch break to the library, found a shelf of medical reference books, and choosing one at random, opened it to the section on cancer. For a short time the investigation was rational and systematic. I looked under M and found melanoma. Then I started reading. But I stopped after one line: “Melanoma, the deadliest form of skin cancer, kills more than 4,000 people each year.”
Immediately I lost my vision: Everything in sight—the shelves lined with plastic-sheathed books, the querulous, white-haired librarian—turned gray and granular, as if projected on the fading screen of a broken TV. I staggered against a shelf; my head felt like someone had filled it with sand. I doubt anyone noticed me—I didn’t make a sound, just leaned there on the shelf, struggling to swallow air and hold down a swelling tide of vomit. Slowly my vision returned, my head lightened, and I was able to stand again.
This remains the most powerful effect a line of text has ever had on me. Having paid the penalty of unfiltered truth, I shut and reshelved the book. I never made that bold a move again. I took the opposite course of action, avoiding all mention of moles, cancer, skin, doctors, hospitals, health, medicine, dentistry and, just to be safe, melons.
After that the cancer was inevitable. Later that year, during a casual inspection of the large mole while urinating, I noticed that its color had changed: Flecks of black and red now accented what had once been an even brown. The question became who would last longer, me or the lie. I came to see myself as the legendary stoic boy who, refusing to admit he had stolen a fox, kept it hidden under his shirt during the interrogation, while it tore out his innards. My fox, I knew, was eating me, corrupting my organs one by one. Whenever I felt a pain, if only one of the twinges and aches of a teen-age growth spurt, I suffered it quietly, attributing it to the cancer. Sometimes my large mole ached, and I imagined it burrowing down in search of a nearby lymph node to corrupt. I suspected that my occasional migraine headaches were signs of an advanced brain tumor caused by a mole on my scalp.
Though I was too terrified to research the disease willingly, information came to me from every direction, and I absorbed it all. I became an unintentional savant of oncology. I remember a high-school classmate asking the biology teacher once about the danger of moles; I listened in fear as she described their corruption by sunlight, their ability to spread disease through the body. I suspected that she was secretly talking to me. News broadcasts seemed inevitably to dedicate their two-minute health warnings to the hopelessness of melanoma when not detected at the earliest possible moment. A distant family friend, I heard, had to have skin taken from the roof of his mouth and grafted onto his neck to repair the damage done by a small and barely discolored mole.
Life became my second-grade report card: The bad parts, ignored stubbornly enough, ceased to exist. I felt safe only when I wasn’t thinking about moles. In a denial this stubborn, however, it becomes impossible to keep the thing denied out of mind—the very act of denial magnifies the forbidden subject. I watched my moles constantly, especially the large one, whose irritated flecks of red increased until it looked like a smoldering coal. Moles were all I saw in the mirror. Also—and this caused me more grief than my own obsession— popular culture seemed to have become obsessed with melanoma. I see now that this was a product of my skewed vision, but at the time, every hour of television threatened harrowing allusions. In an episode of “Friends,” one of the New York socialites chided another in front of her father for neglecting to have a mole checked. Though this was intended to be funny, to me it was unspeakably horrible; it struck me as irresponsible television. One night on “Northern Exposure,” an uptight woman visiting the show’s Alaskan hamlet lectured a man about the danger of a mole on his nose, saying it showed all the signs of melanoma: It was multicolored and scaly, with an irregular border. She advised him to see a doctor, if it wasn’t too late already. That last line got me. I knew I was too late.
Toward the end of high school, I developed an itchy skin rash. It began on my chest as a cluster of little red patches whose intensity had the odd habit of changing with my mood. These patches spread in a few months to cover my torso and stomach, then crept over my shoulders and onto my back. I remember the worry it caused me on our high school’s senior trip: I waited on the beach while everyone swam, then, when coaxed into the ocean by friends, I waded in wearing swim trunks and a T-shirt. Like my large mole, the rash lent itself to concealment and therefore to private worry and brooding. Had it been publicly visible, someone would have talked sense and forced me to see a doctor; the whole problem, mole and all, might have been discovered and fixed. As it was, however, I just refused to take my shirt off in public.
I was sure that the rash was a symptom of the cancer, a visible sign of metastasis. When it spread onto my neck, I reached an acute stage of dread probably best described as phobic. I tiptoed through life in strict observance of ridiculous superstitions. When consulting the dictionary, for instance, I avoided the M section out of a fear of seeing the word melanoma. Every time I visited my family in Northern California, I cringed at the road signs bearing cancer-suggestive place-names: Multnomah, Sonoma, Mole-Richardson Ranch. I became acutely aware of seating arrangements in restaurants. Whenever possible I chose the chair closest to the wall, in an effort to eliminate the chance that someone would have to sit through dinner staring at the mole on my ear. Though none of my relatives had ever said anything, I feared they all had mental reservoirs of mole-exposure that, once full, would prompt vociferous speeches about seeing the doctor. Every dinner was a risk: The relative to my right, offended by the garish growth, might snap and tell everyone I was harboring a dangerous secret. They’d give the others a signal, then tie me up in dinner napkins and haul me to the doctor, where I’d be injected with chemicals and become tragically thin and bald, croaking life lessons to children forced to visit the cancer ward as punishment for shoplifting.
Seeing a doctor was unthinkable. I had waited too long. I imagined him gasping in disbelief, saying he had never seen a cancer so far advanced, because people either sought help or died before that stage. I thought I would become a medical casebook, a walking miracle. Adolescence converts everything, even tragedy, into evidence of its own importance.
IV
I have wondered at my strange behavior for years, mainly in the circular, unhealthy way typical of phobias. Only recently have I begun to see it more clearly. Throughout the crisis one thought dogged me: A normal person would have told the truth in the first place—or if not immediately, would have gone back to the doctor the next day or the next year. My consciousness of this—a “normal” person’s behavior, in direct opposition to my own—was the problem. Every day I avoided the doctor I chided myself with visions of a normal person’s calendar, its squares responsibly X’d and circled with checkups and cleanings. By constantly setting my behavior against this hypothetical ideal, I doomed myself to a loop of second-guessing, in which I was tormented endlessly by the gulfs between self and public expectation, life and death, speech and silence.
A remnant of my Christian upbringing exacerbated the problem. Though my idea of God had shifted completely since childhood, the moral framework erected through years of faithful church attendance survived. I came to see myself as the protagonist in a Biblical dilemma, a disciple tested by God. My mole was a hidden sin, totally up to me to confess. I had flubbed a clear choice between right and wrong: I was Jonah fleeing Ninevah. Soon I would be tossed off the boat of life into the dark throat of cancer. This religious drama transformed my situation from a humdrum question of human skin cells into a clash of spiritual symbols. In my private theology, I suffered moles as Christ suffered the crown of thorns. A Bible verse, of all things—one I don’t even remember learning—occurred to me frequently through these years: “For we must needs die, and are as water spilt on the ground, which cannot be gathered up again.”
I consider it no coincidence that, at the time of all this false drama and pseudo-religious self-persecution, I discovered Fyodor Dostoevsky. His work displayed all the hallmarks of my neurosis: self-consciousness, compulsion, betrayal. First I read “Crime and Punishment”; I identified strongly with its protagonist, Raskolnikov, a feverish young hermit who murders two women on intellectual pretexts and spends the rest of the novel hiding out, cultivating his guilt until finally he throws himself down in a public square and confesses. I read the novel three times. Then I encountered “Notes From Underground,” whose narrator opens the book by admitting that, though he suffers from liver pain and believes he is ill, he refuses out of spite to see a doctor. These characters were my brothers and sisters. I went on to read all of Dostoevsky s translated work. I walked to school reading “The Brothers Karamazov,” stayed home weekends doing line-by-line comparisons of the different translations. There was a good deal of adolescent pretension involved but also a spiritual kinship, a recognition. Dostoevsky s novels allowed for the contradictions of modern life, the zigzagging of self-consciousness, to an extent I had never seen before—except, of course, internally.
I respected the ethos of Dostoevsky’s fictional world even more because it wasn’t merely fiction: It extended to the man himself. Dostoevsky lived out all the compulsions of his novels. He habitually betrayed his friends and family: He got publicly drunk, gambled away his friends’ money, pawned his wife’s jewelry. I feel sure that, had he been covered with moles, he would have suffered ordeals similar to mine. I was particularly impressed by his miraculous reprieve from a death sentence. As a political rebel, Dostoevsky had been sentenced to execution by firing squad. He was led to a St. Petersburg square and lined up with a row of criminals to die. Just as the order to shoot was given, however, a messenger rushed in with a pardon from the czar. Dostoevsky was sent to Siberia instead; the false execution had been a government stunt intended to teach him a lesson. Occasionally I imagined a similar reprieve would arrive at my final moment—remission, a cure, a miracle.
By my first year of college, I was enough of an authority on Dostoevsky to annoy my classmates with detailed descriptions of his personal habits and minor characters. Between classes I camped out feverishly in my dorm room, just as Raskolnikov had in his dingy St. Petersburg closet. I pictured my own mole-drama ending with a dramatic confession like Raskolnikov’s: I would throw myself on the doctor’s office floor and shout my guilt to the nurses. A quote from “Crime and Punishment” haunted me and gave me hope: “Lying is a fine thing, because it leads to the truth.”
V
Melanoma is the rarest of skin cancers, but it makes up for it by being the most deadly. It is caused by the uncontrolled growth of melanocytes, the skin cells that produce melanin, a dark-brown pigment responsible for tanning. Most often the disease signals its presence through changing moles—once-innocent blemishes going through identity crises, turning scaly, puckered, oozy and mottled. Dermatologists recommend checking moles regularly for a group of symptoms they call the ABCDs: Asymmetry, irregular Border, uneven Color and large Diameter. Moles exhibiting these abecedarian flaws are at high risk for cancer.
Melanoma is often described as virulent, a word that suggests both rapid spread and malicious intent. The disease’s proliferating cells are unusually eager tourists: They quickly seek out lymph nodes, glands that serve as malignant, cellular subway stations, and spread to the rest of the body. Because of this eagerness, the disease progresses quickly from stage 0, in which the damage is limited to the mole itself, through stage IV, in which it has spread to the other organs. Stage V does not exist.
Doctors expect to discover more than 47,000 cases of melanoma in America this year; of these, almost 8,000 will prove fatal. This is despite the fact that, when found early, 95 percent of the cases could be cured. Early, however, is a relative term. Virulence doesn’t often pause to catch its breath.
VI
When rumors of sex started flying in early adolescence, I worried that the large mole, by adding a touch of ugliness to a region I saw as not particularly attractive in the first place, would ruin any chance I might have at a normal sexual experience. Though my pubic foliage had been enough to hide the mole from the cursory exams given by team doctors before football season, I doubted it was thick enough to fool a girlfriend.
There was nothing I could do about that, though, so I just hoped that, when the time came, the interested party wouldn’t notice. I was able to hide it for a while: The sheepish sexual fumblings of my early high-school relationships posed no real threat; nighttime necking in a parked car doesn’t lend itself to thorough exploration. When, by the grace of God, I experienced more serious sexuality—those paradisiacal encounters involving nudity below the waist—I was forced to deploy a ridiculous arsenal of strategic leg-contortions and hip-gyrations to hide the growth from dangerously curious hands. In retrospect this strategy seems desperate and obvious. But no one ever said anything.
Eventually when I got involved in a serious relationship—with someone, as luck would have it, who also understood Dostoevsky—I faced a difficult choice. Defensive pelvic-swiveling is at best a temporary maneuver: It was only a matter of time before it backfired, drawing attention to the area it tried to hide. But how could I tell somebody about the mole, the lies, the cancer, the death?
I chose to keep quiet. The relationship turned out to be strong— we stayed together, and year after year I swiveled my pelvis through every instance of nudity. I never mentioned the mole. This is perhaps the most ridiculous blunder of my entire, malignant tragicomedy. I believed, and deeply—had anyone told me otherwise I would have been shocked—that I could hide a mole located conspicuously next to my genitals through a long-term and sexually active relationship. It was like a professional hand-model trying to hide a sixth finger.
Even when I felt reasonably safe from detection, one thing bothered me. This relationship added a fresh betrayal to the massive heap of guilt I had already assembled. My girlfriend stood as another weeping figure at my imaginary funeral. Of all my silent betrayals—and I had a list of them—this one stung me most. I couldn’t tell her the truth for the same reason I couldn’t tell anyone else: because I hadn’t told it in the first place. You can’t tell someone after six years that you’ve been actively lying, pelvis-dodging during sex and all that. The lie accrues interest over the years.
Occasionally she mentioned my moles, asking me if I would please have them checked before they got dangerous. I always promised her I would, one of these days, and assumed she was referring to my other moles, the visible ones on my ear and neck and chest. If she had known the secret, I thought, she would have left me. I remember her dropping an offhand remark once about a celebrity we saw on TV who had hidden his cancer from family and friends. She said it was irresponsible; it made her angry. I had to agree. In a rare moment of courage one year, I decided, as a birthday gift to her, to see the doctor. As the day approached, however, I thought better of it and bought her some books and a straw hat instead.
As it turned out, I outlived my own drama. Originally I had justified my silence through the most tortuous reasoning: It would be better, I told myself, to spend the last few months of my life in blissful ignorance of my disease’s progress than to be cursed by doctors for my irresponsibility, injected with chemicals and vomiting constantly in a hospital bedpan, hoping against all odds to live one more miserable day. A few months passed, and then I thought I would live another few months—I’d have time to write a great novel and die promptly as the ink dried on the last page. I expected to live no longer than age 19, and I had ambitious plans to make sure my death would be suitably tragic. I turned 20. I adjusted my plans again, intending to die a youngish death after releasing a world-changing folk-rock album. Surely I would die in my early 20s; I had read somewhere accidentally that melanoma spread rapidly after its victim’s 20th year. After a while I noticed that I just kept living—I saw movies, took out the garbage, went to school, shopped for groceries. Very slowly I was forced to deal with the improbability of life. That’s when I started to think seriously about seeing the doctor.
I wasn’t in a hurry. After all, I’d still have to admit my lies and suffer the shame of countless betrayals. And besides, I was still sure I was dying. It was just going to take longer than I had originally planned.
Then one night my girlfriend and I were having an experience requiring full nudity. I displayed a virtuoso range of pelvic dodges—my repertoire had increased prodigiously over the years—when suddenly she pulled away from me.
I waited for a declaration of love. Instead she made the most shocking confession I have ever heard—and I believe it will remain so until the day my nipples are revealed to be government-planted microphones. My girlfriend explained that she knew the motive behind all my defensive leg-gymnastics. More shocking still, she said she had known since the first day she saw me naked, six years before. I remember one tear rolling down my cheek—which was, I believe, a final touch of histrionics in a story rife with false drama. That was my reprieve.
VII
The doctor’s office was a strange place to find myself. I had believed for so long that my next interaction with a physician would be on an autopsy table, my body cracked open and found to be stuffed with tumors. Though I hadn’t been in a doctor’s office for years, the atmosphere was strangely familiar—the crinkled paper on the exam table, the glass jars full of Q-Tips and cotton balls. I think the constant mental replay of my adolescent lie had burned the scenery into my mind.
The doctor kept me waiting for a while, and I tried unsuccessfully to pass the time reading a magazine. On the office wall, though, amid earnest signs about hand washing and patients’ rights, hung a poster I could not stop looking at: a picture of a shiny silver car dotted with a spot of rust. The caption below read, “Funny how we can panic over a strange spot on a car and ignore one on ourselves.”
That was not funny at all, I thought. That was the opposite of funny. The poster’s text went on for two paragraphs, describing the virulence of melanoma, the importance of early detection—a litany of my secret dread.
After I had read the sign about 30 times, each reading yielding a new and more horrifying facet of the disease, the doctor came in. He was young and polite and could have played a doctor on TV.
“So,” he asked, “you have some moles?”
This statement struck me as completely out of proportion to the tragedy about to unfold. Though I didn’t throw myself on the office floor as I had planned, my face turned red, and tears threatened. I managed to say, through asthmatic wheezing, that indeed I had several moles worth worrying about and that they hadn’t been checked in many years. I told him they had changed, both in color and in size, and that they displayed all the hallmarks of serious cancer described so thoroughly on his poster.
He seemed disturbed by my confession, as if I had tainted the room’s precise clinical atmosphere with a sloppy outburst of human emotion, and through the rest of my visit, he spoke with the wooden detachment of a man practicing a speech in the mirror. First he looked at the mole on my ear. Keeping his impressions to himself, he asked me to remove my shirt. He breezed over my chest and back, and then, because he looked as though he might be finishing up, I forced myself to mention (again through a gasping respiratory mini-crisis) the one next to my penis.
This news shocked him. I think one of the few luxuries left for a dermatologist is the assurance that his business will be conducted outside the shorts. After a startled pause, he asked to have a look, and following some awkward pubic jockeying, he said, “Hmm. I’d like to remove this one.”
As I lay on the examination table, again I experienced a strange nostalgia. He anesthetized the area, removed the mole with a razor and cauterized it—though instead of a light bulb, he used a probe that looked like a dentist’s pick. Again I smelled my skin burning and marveled that it did so.
After the procedure he used an odd phrase. “There,” he said, “is the specimen.”
Indeed there it was. The mole—large, brain-shaped, with a few pubic hairs scraggling out of its irregular borders—lay mounted on a piece of blood-smirched gauze on a stainless-steel tray. It’s hard now to describe what it was like to see it there, detached from its secret position on my inner thigh, a spot it had occupied like an evil headquarters for over 23 years. Sitting there on its sterile napkin, it looked innocently out of place and harmless. Against the pure white background of gauze, it struck me as surreal: It could have been a scandalously avant-garde museum piece, “Cancer on a Field of Snow.”
I had thought of it in many ways over the years—as a death sentence, a tragic flaw, a mark of sin—but never as an object that could be relocated, picked up, set down on a napkin.
“I’d like to send this to the lab for a biopsy,” said the doctor.
VIII
In the two-week interim between biopsy and prognosis—while I was agonizing over issues of truth and justice and guilt, waiting for deaths official notice—my hedgehog died. First his lower jaw swelled into an oozing, infected mass that dominated his face. I waited a couple of weeks for the wound to heal. When it only got worse, I took him to the vet, where I learned that the swelling was a malignant tumor, that there was no point in removing it, and that I should have him euthanized immediately.
The hog’s name was Rodya, a terrible name for a hedgehog. Everyone just called him Hog. I had chosen the name out of “Crime and Punishment” at the height of my Dostoevsky kick, assuming, in late teen-age naiveté that, since I had read the novel three times, everyone else would be familiar with it, too—and not only with the book but also with the diminutive form of its protagonist’s first name. (Dostoevsky would no doubt be puzzled at the effect he’s had on some of his 20th-century readers.) In some ways the name fit. Like Raskolnikov, the hog was fiercely private and grumpy, spending his days packed away under a dark log at the back of his cage, venturing out only at night. He devoured mealworms with criminal fervor.
When I heard the hog’s death sentence, I found my way to the nearest bathroom, and having no idea what was about to happen, sobbed uncontrollably for 10 minutes. These were real, aggressive tears of horror, shame and disgust at death—they flowed at a rate I hadn’t felt in years. I am usually an anti-crier: I tend to gently mock my girlfriend, for instance, when she sniffles at TV dramas. A friend cried the other day at the sight of a little girl riding a horse at a rodeo, and I laughed without apology. But at the vet’s office, I couldn’t control myself: I locked the bathroom door and soaked a roll of paper towels. They wanted to hold the hog for further tests, so when I was done crying, I sneaked outside, red-faced, and walked around the block. Appropriately it began to storm. I climbed the Mississippi River levee and stared out at the turmoil, watching three horses in a muddy field try to deal with the rain. One hid behind a shed while the other two stood there getting wet. After a while I walked back to the vet and picked up the hog.
He was 4 years old. For the first three years of his life, I had pampered him, insofar as a nocturnal insectivore covered with quills will allow himself to be pampered. Every day I gave him an hour to play in the house or the back yard; I stroked his nose and fed him mealworms, which he swallowed with impolite, happy smacks. But then we got a dachshund puppy and—since the puppy was new, plus responsive and intelligent and emotional in a way the hog was not—he garnered most of our attention. The hog, I’m ashamed to say, was forced to live a repetitive and neglected, cage-bound life of shitting and wheel-running. I always planned to make it up to him in the next few years; according to my hedgehog reference book, he would live to be 8. So when his early doom arrived, I was shocked, then devastated that his final year had been so lonely and boring, that I would never be able to make it up to him. I tried, during those last few days, soaking his food in pain medication and the liquid drained from a can of corn, mixing in tiny flecks of ham. But he could hardly eat. Probably his last pleasure was lying outstretched in the pine shavings of his cage-bottom, positioning himself in the beam of a heat lamp we had bought to help get him through the winter.
My girlfriend, who had done her share of bonding with the hog, certainly wasted no tears on the matter. She consoled me through three or four days of erratic sobbing fits until, finally having had enough, she laughed and asked if I needed some Pampers.
When we had to put him to sleep a few days later, I asked her to take him in for the shot. I was embarrassed about the crying, which still hadn’t stopped.
IX
My biopsy came back negative. The mole, that lifelong obsession, was probably tossed into a bag of excised human offal, some of it cancerous, some of it not, and piled in a biohazard bin behind the pathologist’s lab. It was nothing. An elliptical, reddish scar now occupies the spot next to my penis, a scar impossible to find unless you’re looking for it, and tough to find even then. There is nothing left to hide. I reach down sometimes out of habit and am surprised to find the landscape flat. The rash turned out to be a run-of-the-mill fungus, totally unrelated to any cancer. I cured it quickly with a spray designed to stop athlete’s foot.
This will sound stupid, but in rare moments, and in a limited way, I miss the mole. A good friend told me that the mole on my ear— which I have since had removed, along with the large one on my collarbone—was my only distinctive feature. She said that without it I’m just an ordinary guy, that the mole was the only thing she liked about me. She was joking, but I wonder if there’s something in this. The excision has certainly made me behave more normally: I am easier in crowds, no longer sensitive to restaurant-seating arrangements or place-names ending in noma. Every section of the dictionary is open to me now. In the mirror I see a face much like anyone else’s. Sometimes it feels fraudulent, as if I’ve only purchased a dermatologist-inspired illusion of normalcy. After all, it was my mind—which is still with me—and not my moles that managed to conjure the disease.
Socrates said that the unexamined life is not worth living. He had a point. The chunk of life I spent lying and avoiding doctors, cringing in public out of fear of being exposed, were years I should have spent engaging the world and trying to find my place in it. In my Dostoevskian isolation, I missed all my peers’ bonding and riotous parties. I am still a practical idiot in many areas of common knowledge.
Having lived the unexamined life for so long, however, I feel some obligation to speak in its defense. Limited by denial and dread, I nevertheless managed, through emotional compensation, to live something near a full life. The horror touched every part of me, but it also granted odd, new strengths, the way an injured muscle forces its neighbors to work harder and thereby grow stronger. Often a week of gloom gave way to solid days of ecstasy. As a teen-ager, my capacity for carpe-diem risk-taking far outdistanced that of my classmates. (Dostoevsky, I remember, relished his epilepsy for the flash of euphoria it gave him just before the seizures.) The cancer scare lent my life immediacy; it allowed me to take chances that others did not: I went to school in a dress, stayed up all night walking the empty streets. Emotional volatility is a common symptom of adolescence, but my fear of cancer exaggerated the typical shifts, simultaneously lowering the lows and boosting the highs. Surely this trip to the emotional thresholds, however ignoble and cowardly its cause, was worth a few years of my life. After all, there’s innocence in denial. Once you’ve been examined, you’ll never be unexamined again.