Phoebe, I need to talk to you,” Doctor Phillip interrupted our conversation.

She broke free of my grip, suddenly self-conscious.
Managing a small smile, she sat down facing him squarely.

“Look, now that you have developed this carcinoma…”
Her face fell again and I could see her body grow tense.

“Phoebe, I’ve told you multiple times that squamous cell carcinoma is the least dangerous of all cancer types,” Doctor Phillip scolded, seeing her unnecessary worry.

“Go on,” she mumbled.

“First of all, I took a portion of your skin from the chronic wound on your hand and it has shown localized tumour growth which isn’t quite obvious.  So I need to collect tissue samples from other such wound sites in the body and check for local spread there. This means repeated biopsies and you know it doesn’t hurt any more, does it?”

She shook her head silently.

“So, squamous cell carcinomas detected at an early stage must be removed promptly. Fortunately, there are several effective ways to eradicate that and the choice of treatment is based on the tumour’s size, location, depth of penetration as well as your general age and health status. I can perform it on you on an outpatient basis and requires only local anaesthetic,” he went on.

“That means it’s a surgery and if you just scrape out the cells, I’ll be fine.” she inferred.

“You're right. Every cancer doesn’t need to be treated as a menace. It’s the misconceptions which cause the most harm to people. The word cancer takes the toll rather than the actual disease,” he smiled.

“So what surgery does she need?” I asked.

“I could go for the simplest excisional surgery because it’s the cheapest and well, it’s where you remove the cancerous mass with a portion of good tissue and check the good tissue for signs of malignancy and if it proves to be good, then the surgery is successful. If the area is small, I may close it with stitches or else I could do a skin graft…” he paused.

“A skin graft is difficult in my case. You can’t harm any skin as each bit holds the other,” she exclaimed.

“I don’t think we may need that. Your wounds are pretty narrow and I’ll try to excise in that way, making it possible to heal by primary intent,” he picked up the papers, studying them again.

“It means if we perform a biopsy we may get other tissues which are in higher stages, maybe metastasizing through my body at this moment!” her voice was panicked. “I mean maybe it has already spread and I never knew.”

“Phoebe, why are so you pessimistic? Think positively. Everything will be fine. Moreover, we had a thorough scan six months back. I don’t think it’ll spread that fast,” the doctor tried to make her understand.

She slumped on the chair unconvinced.

“Phoebe look, there are other methods of surgery which include curettage and electrodesiccation, cryosurgery where they destroy the tissue by freezing with liquid nitrogen,” he continued. “Then there’s laser surgery, radiation therapy and phototherapy which they do with very little or no anaesthetic. We in this state have such facilities, but…”

“But what?” I interrupted, “Aren’t those better and advanced methods?”

“I can’t afford them, Daniel,” she said, her eyes moistening over.

“Doctor Phillip is already doing the biopsies and routine checkups for free and how much do you expect him to do…”

“It’s okay, girl, you’re like my daughter. I don’t mind,” he interrupted her.

“But I do mind. Once I get a job after college, if someone gives me one, I’ll repay your money,” there was a fierceness in her eyes.

“You want to repay me,” he gave a dry smile. “Is that what you’d do to your parents who have raised you? Repay their debt? Do you think that’s the way the world works? You think so low of me that you think you’re indebted to me?”

“Doc, I didn’t mean that…”

“Then what did you mean, girl?” his voice was sad.

“It’s just that,” she shrugged. "Leave it."

“Don’t say that again,” the doctor’s voice was calm.

She bit her lips.

“That reminds me, Phoebe,” he opened a drawer on his side table and took out a bunch of papers, “they came back to enquire about you. Are you quite sure you don’t want to go for complete skin grafting? It could be a permanent solution to your worries, at least superficially.”

“No,” she told firmly. “And why do you entertain these people? They do nothing but use us as guinea pigs to experiment on.”

“The Debra International has a records of every butterfly child in the country and their treatment process. I have no hand in it,” he sighed, “but I wish you could change your mind. Lots of kids in other areas have undergone it with miraculous results.”

She looked away.

“Try to  convince her if you can,” the doctor looked pleadingly at me.

“I’ll try,” I mumbled, unsure of myself.