Just two months ago, I was a 55-year-old ENT surgeon, in the peak of my career, on no prescription medications, and training for a Sprint Triathlon….and now I am a cancer patient.   Life can change so quickly!   I have malignant melanoma that developed under my right thumbnail.   I have had so many family members, friends, employees, and patients who have been supportive of me, walking along beside me in this new journey.  In addition, there have been so many providential moments and experiences for me I that felt compelled to journal my progress; now, I feel compelled to share some of this journey publicly for a variety of reasons.   I want to share my perspective as a physician becoming a patient, to share my progress with my friends and family, and to share my spiritual journey.  I will bridge some tender emotional moments as a physician/surgeon with similar moments that I have now experienced as a patient.  The experiences that I share will be completely transparent regarding my medical journey, and they also will be deeply personal.  If I can help one patient or person to feel comfort or feel God’s presence in their lives, then this endeavor will be worth it.  I plan to send a new episode out weekly, and it will take a few weeks to be caught up.    My story is still unfolding and still being written.  Feel free to follow along with me!  When I use names, I will either have gotten permission to use the name or changed the name for privacy reasons.

In December of 2016, I developed concern for my right thumbnail, which had an area of longitudinal redness (longitudinal erythronychia) and some splitting of the nail at the end.   I did some research and was concerned about the possibility of subungual melanoma, and so I sought a Dermatology opinion.  The Dermatology team agreed, and the Dermatologist removed part of my nail and performed a biopsy on 12/15/16.  It was negative for melanoma!  I remember getting the call while I was at work in the middle of busy clinic, and I immediately went into Exam Room 6 and wept like a baby.   I knew the serious nature the diagnosis of melanoma in the nail matrix or nailbed, which usually resulted in an amputation, and I had expressed that concern to Lindsay, my nurse of 23 years.  She also shared tears of joy with me.  I followed up several times, noting that my nail would never really grow back properly.   Over the next 5 years, I underwent several hand procedures to release trigger fingers, a hazard of the job as a surgeon.  The many years of performing surgery had taken its toll on me.   After attending Baylor University, I attended Vanderbilt University School of Medicine for 4 years followed by 2 years of General Surgery training at Vanderbilt, 4 years of training in Otolaryngology/Head and Neck Surgery at Vanderbilt, and then 23 years of private practice Otolaryngology where I had performed thousands of operations.  I also broke my left wrist while trail riding at Big South Fork and had to undergo a procedure on the wrist.  (Those of you who know me also know that I am an avid horseman and have been riding horses for over 50 years.)  So, during this 5-year period, I had 3 different hand surgeons work on me and from time to time I would ask about my thumb, because I always worried about it.   In July of 2020, one opinion was that I had a benign pyogenic granuloma from all the nail trauma and chronic inflammation, and I was instructed to cauterize it with silver nitrate intermittently.   I did that and it began to improve!   In March of 2021, I got another opinion.  Considering the benign biopsy in the past along with the chronicity of the issue, it was felt that if I had a melanoma, that it likely would have gotten much worse by now, demonstrated spread, or potentially even taken my life by now.  There continued to be a disconnect between me and the providers I had seen.

Was the call to biopsy my own thumb providential?  As you will see, there have been several moments in this journey where me and my wife Kellee felt that God had a hand of protection on us.  I had a previous biopsy in 2016.  I had seen several providers who had looked at it and were not overly concerned because it had been biopsied in the past. But on that Friday, July 16, 2021, after clinic, something in my head was telling me to follow my instinct or gestalt, and biopsy my own hand.  Only Dr. Justin Morgan, a practice partner and dear brother in Christ,  was in the office.  He was busy wrapping up.   Without any anesthesia, I basically used steel instruments to take a biopsy at the base of my nailbed on the thumb of my dominant hand, using my left hand.   I used silver nitrate to aggressively cauterize the area, as it bled profusely.   I placed the tissue specimen in a formalin filled specimen container, labeled it, and placed it beside Lindsay’s computer.  I called Lindsay, my long-time nurse who was now our Nurse Manager, and told her to send it off on Monday and have the pathologist call me directly.   So, this is how my journey started…thanks for your prayers and support.   To be continued…