Minutes before I was about to be wheeled into the operating room, my surgeon came by to say hello. “How are you feeling?” he asked.

“I’m fine but the important thing is how are YOU feeling?” I asked him. After all, how he currently felt would determine how I might feel in the future. Had he slept well? Breakfasted abundantly? Was he satisfied with his long-distance carrier?

“I’m thinking about a change in plan,” he said. Let me assure you, this is not something you want to hear at that juncture.

Basically, when you have this kind of cancer, there is a continuum of options. At one end of the continuum, you could do nothing and hope that you die of old age before the cancer spreads. This might be a perfectly valid option; unfortunately there are no studies giving you your chances. At the other end of the continuum, you can take out the whole thyroid and all the lymph nodes in the neck area, eliminating all the places the cancer is likely to have metastasized in the early going. This increases the chance that you will get all the cancer but you risk cutting unnecessarily; the cancer from the left side of your thyroid might never have gotten to the lymph node under your right jaw anyway.

All along the continuum are other options: Take out half the thyroid; half the thyroid and the lymph nodes on the affected side; the whole thyroid and the lymph nodes on the affected side; the whole thyroid and the lymph nodes on the affected side and center (our original plan). How do you choose a course of action? It seems to be a gut instinct. If a lot of lymph nodes light up on a scan, or if the biomarkers for the cancer are high, you might assume that the cancer has spread, and you need a more aggressive approach, but on the other hand the metastases might be microscopic and won’t show up until you take the nodes out and do a path report, or the biomarker may not be indicative of the size and spread of the tumors.

My surgeon didn’t find much evidence of metastases on the scans, and my biomarkers were relatively low, but my surgeon just saw this as a chance to “cut for a cure.” He proposed changing from the “more aggressive” to the “most aggressive” surgical intervention, which would mean breaking the surgery into two parts: one surgery now, and another in six to eight weeks.

Deep sigh.

So, I’m currently in possession of half my thyroid and neck lymph nodes, which meant I was in surgery for a slightly shorter time than expected (4 hours, instead of the predicted 5). I am still generating thyroid hormone, so I feel relatively normal. It hurts a lot less to have your neck cut open and sewn back together than you would think. On the visual analog scale, my neck pain is barely registering, whereas the place they put the IV is an “oh my God you sadistic nurse how the hell could this STILL hurt a week later?”

But, hey, all in all, it’s a thumbs up. I even went running on Wednesday, one week after the surgery, and banged out three miles without too much trouble, so I guess that means I am All Better. The stitches did feel a bit weird when I was running, like I had been decapitated and had my head stuck back on with masking tape. That is, in fact, what it looks like thanks to the rank-looking steri-strips still closing the wound.

I keep trying NOT to think about the guy with the neck wound in Cold Mountain:

:At the hospital, the doctors looked at him and said there was not much they could do. He might live or he might not. They gave him but a grey rag and a little basin to clean his own wound. Those first few days, when he broke consciousness enough to do it, he wiped at his neck with the rag until the water in the basin was the color of the comb on a turkey-cock. But mainly the wound had wanted to clean itself. Before it started scabbing, it spit out a number of things: a collar button and a piece of wool collar from the shirt he had been wearing when he was hit, a shard of soft grey metal as big as a quarter dollar piece, and, unaccountably, something that closely resembled a peach pit. That last he set on the nightstand and studied for some days. He could never settle his mind on whether it was a part of him or not. He finally threw it out the window but then had troubling dreams that it had taken root and grown, like Jack’s bean, into something monstrous.

I’m curious about what will come out of my neck when the tape finally falls off. Silly Bandz and dog hair, no doubt.