Years ago, a hulk of a man came to see me with a lump in his neck. He was as big as the lump was small, standing at least six and half feet tall with shoulders that seemed almost as broad. His lump, in contrast, was only 2 cm wide.
Wide enough, however, to warrant concern. It was firm rather than rubbery, fixed rather than mobile, and non-tender rather than painful—all hallmarks of something potentially malignant. He’d noticed it only one month prior to coming to see me, which made me think it had grown rapidly, another bad sign. He’d had no infection during that time that he could recall.
I recommended a biopsy, to which he agreed, and set up an appointment for him to see a surgeon. A week later he called me to ask some further questions. The conversation started calmly enough. He related how he’d gone to see the surgeon who’d immediately scheduled a biopsy—and then suddenly he was literally shrieking in my ear. He’d had to wait 30 minutes in the waiting room and then another 15 in the exam room before being seen! He’d expected an office procedure and instead they’d taken him to the operating room! He’d wanted general anesthesia and instead they’d used a local block! What the hell, he’d wanted to know, was wrong with these people!