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Mumps for 60 years

My first memory of the mumps is when I was 6 years old. My 4-year-old brother and 2-year-old sister and I spent much time in our parents’ bed.

My parents were probably issued with an “Exclusion from School” notice which excluded me from school for, I think, 4 weeks, allowing me to return to school after 2 weeks if I had a doctor’s certificate stating that the symptoms had disappeared.

I was too young to remember that first time. But I became familiar with the process and the form as I became older.

As a schoolchild I lived in 8 different houses, and attended 7 different schools. Every time we changed schools, or changed doctors, or had mumps cases in the school that made the teachers extra vigilant, the swelling under my left ear was noticed, and I was excluded.

The process became familiar to me. I trotted home with the exclusion notice. My mother, who had been a nurse, trotted straight back to the school and told them that a person can only have mumps once, and I had already had mumps. This never worked, and the next step was to go to the doctor. The doctor picked one of two stories - either that some people did get mumps more than once, or that the last doctor had been wrong, and it was really mumps this time. Either way, I trotted home for the duration.

When I was young my mother had a very full life. She played tennis fixtures three times a week, wrote a column for a women’s magazine, was in a short story writers guild, and enjoyed theatre and opera and the social life that went with these things, so I was left to the “aunties” (but that’s another story). When I was older, I very often had the home (and the neighbourhood) to myself.

After the fortnight off school – on to stage two. My mother would send me quietly back to school. The teacher would send me to the office. The headmaster would send me home with a new copy of the exclusion notice. My mother would send me back to the doctor, who would confirm that mumps symptoms were still present, and I was sent back home to complete my 4-week sentence, after which I was happily accepted by the school.

One exception happened in Warwick. The school would not take me back after the 4 weeks without a doctor’s certificate. Off to the doctor’s surgery. He had the latest miracle cure available – penicillin, and I was given an injection in the thigh, and told to go home for another week, then come and see him. When the swelling was still there after a week, he gave me another penicillin injection, and asked me to return after another week. Mumps that had lasted 6 weeks could be very dangerous, he told my parents, and sent me to Warwick Base Hospital, where I remained for the next 6 weeks, being given a penicillin injection every 4 hours, day and night. The swelling was still there, so the doctor gave in and wrote a certificate and I went to school after my 12 weeks break, my skinny thighs covered in bruises.

It was not until I was 15, in my sub-senior year of school, that I got some relief from this cycle. A doctor newly out of medical school felt my cheek between one finger in my mouth and his thumb on the outside. He called his practice colleagues to do the same, then proudly announced I had a stone blocking the parotid gland from time to time. He wrote out a certificate to that effect, and I was home free!

Or so I thought. The next year, on the day before the Senior Certificate examination started, I became quite ill with an abscess in one of my front teeth. The dentist drilled out the centre of the tooth, and extracted two teeth on either side of my mouth that had contributed to the overcrowding that had killed the front tooth. I turned up to the first day of my Senior examination in a sorry state, with Heinz tomato soup and a straw for sustenance. The invigilator in charge saw my state, and sent me straight away to the school nurse, who once again pronounced mumps as the cause of my condition, sending immediately for my parents to take me home.

Both parents attended. I was not present, spending the time in sick bay. Shortly afterwards, a compromise was reached. I was to be allowed to complete my examinations, but not allowed to contact the other boys. When I got back to the examination room, I found a desk and chair near the back wall, well separated from the other boys, and I started my exam much later than the others. I was not offered extra time at the end to make up for the time I had missed. At the end, the invigilator in charge admonished the other boys not to go anywhere near me. For the rest of the examinations I was admitted after everyone else was seated, and dismissed before they were.

This worked quite well, except for 2 days. On the first, my thermos flask with my soup broke on the way to school, and I had no food for that day. On the second we had a French oral examination. Only about 25 boys took French. They were gathered in the front few rows of the school hall, and I sat in the back row of the hall. The visiting French teacher called out loudly from the stage “Pouvez-vous m’entendre?” (Can you hear me?). After I answered “Oui”, he then proceeded to the dictations and translation exercises in a barely audible voice. Too scared of demonstrating my almost complete ignorance of the language by asking him to speak up, I remained silent, and wrote little on my exam paper.

But every cloud has a silver lining. Since about 8 years of age I had wanted to be a scientist. I had a lab in an abandoned chook house at one home. It moved under the house in a later home. I blew things up, and gassed myself with noxious gasses, and grew ghastly things to observe under my microscope. My father said that as I was bright enough to earn a scholarship (I had a bursary to the school for the final two years), he would not support me through university – it was a scholarship or nothing.

I had thought that after my Senior Exam disaster I would not get any scholarships. Teachers’ scholarships were awarded first (even before the Senior exam results were announced, I think), and I was offered one. I had never for one moment in my life considered teaching as a career. But here was a ticket out of an unpleasant home, away from a rather dull town, to the bright lights of the city – and an income of my own. (My father had taken all my income I had earned in my first holiday job as a postman as “board”, though we were not a poor family. Not surprisingly, I never applied for another holiday job.)

I accepted the Teachers’ Scholarship, declaring that I would study science at university at night time.

In late January, on the first day at Teachers’ College, our names were confirmed on the roll, our “Practicing School” was allocated, I was elected class president, and I sat next to a girl in our group whom I had met in kindergarten. We had both started school at Graceville State School on the same day, and had spent the first two years at the same school. She was Wendy King at that stage, but most of her life she was Wendy Marshall.

The next day we went to our “prac school”, where we remained for 3 weeks, taking detailed notes of one lesson a day (the “observation lesson”), and teaching one lesson a day. I loved it!

At the time I thought that this was because I was a “natural born teacher”. Having read the odd bit of psychology since then, and having met terms like “self-esteem”, I came to think that some contribution came from having come from a home where I was sometimes not well treated, from a school where I was sometimes not well treated, from a town where I was incapacitated often, and for long periods by asthma attacks, to being called “Mr Marshall”, and listened to and obeyed by students only 3 years my junior, to having money in my pocket, to being able to come and go as I pleased outside the 5 hours of school, and with having some old friends (like my best friend from school, John Feros, and the young lady mentioned previously) and some new friends.

Three or four weeks later I was awarded a scholarship to study industrial chemistry at the University of Queensland. There was much wailing and gnashing of teeth and flying tearful visits from my mother, an aunt and a great-aunt when I turned it down. I tried to placate them by pointing out that I was planning to enrol in evening courses in Science at UQ, starting at the beginning of first term in a few weeks. In the event, I enrolled in French, which I thought would be more useful in a teaching career. (I got a good seat for the oral French exam at university. However, I did not understand much more than I had a year before at the back of the hall.)

For the next half-century as each new doctor I met mentioned the swelling over my left ear, or asked if I had had mumps, I explained that I had a “stone in the parotid gland”, and we moved on.

Until Tuesday 10 April 2012, a few days before Easter. I was with Dr Brett Curr, the skin cancer specialist in Ipswich. He started to feel the swelling, and I said that I had a “stone in the parotid gland”, and he said “No – you have something here that needs immediate attention. It feels benign, but it must be close to blocking nerves in your face. He had me do some test blinks, smiles, frowns, and so on, then recommended I went straight to the GP next door to arrange a scan.

I was due to see my own GP the next day (Wednesday). He felt the swelling all over, said it was probably benign, but that it had recently grown in size and was now significantly behind my ear as well. He sent me for a CT scan. I was already booked in for a bone density scan later that day, and the only time available for the CT scan was after close of business Thursday – when most people had gone home for Easter. I had blood tests on Easter Sunday Morning (99% chocolate, 1% candy eggs, but otherwise all clear, including PSA, so it wasn’t a prostate cancer metastasis).

On Tuesday I saw the surgeon, who confirmed the news that my nerves were at immediate risk, and was surprised I could still use eye and mouth muscles so well. On Wednesday I had a biopsy and ultrasound, and on Friday afternoon I had the operation.

The last thing I remember is the anesthetist saying that my jaw would not open wide enough and him feeling along my neck for a good place for the tracheotomy, complaining that my voice box was awkwardly placed as well.

A week later, in the rooms of the surgeon, Dr Ryan Somerville, I found out that the tumor was a pleomorphic adenoma. Its large size and extended growth made an operation that would normally be finished in an hour by a senior experienced surgeon like Dr Somerville extend to more than 3 hours. The tracheotomy, it turned out, had not been needed.

During the operation, one major nerve had to be sacrificed. Dr Somerville chose the nerve to the neck. The only practical use of this nerve is in stretching the skin to shave under the chin. As someone who has not had a shave for about half a century, I’m not particularly worried. Some nerves controlling feelings in part of the ear are most usually lost in this kind of operation, where a 200mm (20cm) cut is made almost completely around the ear and down the throat to below the collar line. When I touch my ear, the sensation is quite odd, a little like what can happen to the tongue, lips and cheek with injections for major tooth work at the dentist.

But the results were promising. The capsule seemed intact. The margins seemed clean. The pathology confirmed that the tumor was indeed benign. So benign = won’t spread to other parts of the body. Intact capsule + clean margins = unlikely to grow back again (but if it does will be a big problem).

And after 60 years, I finally have no mumps!

 

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