Chapter Thirteen #2
Before I could respond, the consultation room door opened and Dr. Nathaniel Kershaw stepped into the waiting area.
He greeted Caroline warmly before turning his attention toward me, offering a handshake and the relaxed smile of someone who'd spent decades helping anxious patients through difficult decisions.
"It's nice to finally meet you, Jack. Caroline's told me a great deal about you."
I returned the handshake before Caroline and I followed him into his office.
Unlike many specialists, Dr. Kershaw wasted very little time discussing test results I'd already read for myself.
He knew my medical background meant lengthy explanations of anatomy served little purpose, so instead he concentrated on the operation itself, the realistic expectations surrounding it, and the long rehabilitation that would ultimately determine whether surgery succeeded.
He opened my scans across the computer monitor before turning the screen toward me.
"The vocal folds themselves are capable of producing sound. The problem is that the nerve damage has prevented them functioning together effectively enough to give you a usable voice."
I studied the familiar images.
I know.
"You're afraid of the outcome."
I'm scared to hope.
Dr. Kershaw leaned back in his chair.
"That's understandable. Thyroplasty can improve the mechanics and give those structures the support they need, but surgery is only part of what comes next."
He leaned back comfortably in his chair.
"For twenty years your brain has reinforced silence because silence became your normal. Surgery can improve the mechanics of your voice. It can't undo twenty years of habit. That's where rehabilitation becomes just as important as the operation."
There wasn't much he told me that I hadn't already discovered buried somewhere in a journal article or surgical textbook since becoming a medical student. I'd researched thyroplasty until I understood the procedure almost as well as any fourth year medical student could.
The difference wasn't the medicine.
The difference was that Dr. Kershaw spoke as though my twenty years of silence weren't the obstacle I'd always believed them to be.
If you genuinely believed it couldn't help me, would you still operate?
His answer came without the slightest hesitation.
"No."
The certainty with which he spoke surprised me.
"I don't perform surgery simply because somebody wants it and I don’t give false hope."
He folded his hands across the desk.
"I perform surgery when I believe the potential benefits far outweigh the risks."
He allowed that to settle before continuing.
"I believe you have a very good chance of producing a usable voice after surgery and rehabilitation."
My thoughts drifted toward specialists Dad had taken me to for the first two years after I’d become mute.
I'd lost count of how many we’d seen. Some had offered cautious optimism, while others admitted they didn't have a treatment they genuinely believed would restore my voice.
Eventually the appointments stopped, and Dad did everything he could to help me adjust to a life neither of us had expected.
Dr. Kershaw broke into those memories before they carried me too far.
"Caroline told me you've spent a great deal of time reading about thyroplasty."
Too much time, if I'm being honest. I’m not convinced anything could be successful after all this time.
"The internet can be a wonderful source of information but it can also convince intelligent people that they're experts in their own limitations."
That struck closer to the truth than I cared to admit.
I've read every paper and study I could find. Most of the outcomes are encouraging, but twenty years... I can't get past the fact it's been twenty years.
Dr. Kershaw read the screen carefully before handing the phone back.
"You're concentrating on the length of time. And I can understand why."
He folded his hands on the desk.
"If you'd walked into my office expecting guarantees, I'd have been far more concerned."
I frowned slightly.
"Medicine doesn't work that way. It deals in probabilities, not certainties." He paused before continuing. "I can't promise you'll leave this hospital speaking normally."
The honesty was oddly reassuring.
"What I can promise is that I believe you have a genuine opportunity to regain your voice. I wouldn't recommend surgery if I didn't."
The room fell quiet again.
After several moments he asked the same question Caroline had posed.
"What have you got to lose?"
I had a father who loved me unconditionally, a future career I was passionate about, and a man waiting downstairs who'd already proven he would stand beside me through absolutely anything.
Losing those things had never been the risk.
The real risk was allowing fear to convince me I didn't deserve the chance to speak again.
I want the surgery, but my father and boyfriend can't know yet.
Neither Caroline nor Dr. Kershaw tried to change my mind. Both understood that telling the people closest to me was a decision I needed to make in my own time.
"Then let's give you every opportunity to regain the power of speech that we can."
Within fifteen minutes the paperwork had been completed, consent forms signed, and a surgical date arranged for the following week after another patient postponed an elective procedure. Looking down at the confirmation sheet resting in my hands, I realized something extraordinary.
For the first time since I was six years old, I wasn't wondering whether I'd ever speak again. I was wondering what my voice would sound like.
***
The week leading up to my surgery passed beneath a constant weight of deception that grew heavier with every passing day.
Lying to Dad felt wrong.
Lying to Mason felt worse.
Medical conferences weren't unusual for senior students, particularly those already committed to a specialty, so neither questioned my explanation when I told them an otolaryngologist I'd met during one of my clinical rotations had recommended a two-day conference focusing on advances in reconstructive airway surgery.
Dad actually encouraged me to attend, reminding me opportunities to learn from respected surgeons often opened unexpected doors later in a career.
Mason agreed immediately, insisting I'd regret turning down something that could ultimately make me a better doctor.
The conference explained my absence to the people who mattered most, but the university required something different.
A brief email to the course coordinator advising that an unexpected medical emergency required a short hospital admission ensured my professors understood why I'd miss two days of classes.
They didn't ask for details, simply wishing me a speedy recovery and assuring me any missed material could be made up once I returned.
Every word of encouragement tightened the knot already sitting in my stomach.
If the operation failed, neither Dad nor Mason would ever know I'd spent those two days lying in a hospital bed recovering from surgery.
If it succeeded...
The thought never progressed any further because I refused to let myself imagine success.
Hope still frightened me far too much.
The morning I left, Mason walked me to my car before heading across campus for his morning lecture.
Four weeks of steady rehabilitation had transformed his recovery.
The limp that had followed him home from hospital had almost disappeared and, after being cleared to return to the ice for gentle skating the previous week, he seemed happier than I'd seen him since the night of the injury.
He still had weeks to go before hockey became part of his life again, but for the first time he could finally see the finish line instead of simply trusting it was there.
Watching him recover reminded me daily why I'd refused every attempt he'd made to persuade me we could resume the physical side of our relationship before his body was ready.
He teased me mercilessly about behaving more like his physician than his boyfriend, yet every time I looked at him I remembered the sight of him lying unconscious on the ice and knew I'd make exactly the same decision again.
He stopped beside my car and reached for my hand.
"You'll text me tonight?"
I nodded.
"I don't care if you're surrounded by a hundred surgeons discussing fascinating new procedures. I expect at least one message."
You'll be lucky to get rid of me after one message.
He stepped closer and kissed me slowly, his lips lingering against mine long enough to make climbing into the driver's seat unexpectedly difficult.
"I'm going to miss you."
I rested my forehead gently against his.
I'll miss you too.
He squeezed my hand once more, then stepped back so I could leave.
The drive across town seemed far longer than it actually was.
Every mile placed another layer of distance between the lie I'd told everyone and the truth waiting at Providence Sacred Heart.
By the time the hospital finally came into view, my palms had become so damp against the steering wheel that I found myself sitting in the car for several minutes simply trying to slow my breathing before forcing myself through the main entrance.
Caroline was already waiting outside Surgical Admissions. She'd arranged to take a couple of days off so she could be by my side.
The moment she saw me, she crossed the foyer without hesitation before wrapping me in a brief hug that somehow managed to calm the panic threatening to overwhelm me.
"I wasn't completely sure you'd come."
Neither was I.
She laughed quietly, although emotion softened her eyes almost immediately.
"I'm proud of you."
I looked away.
Don't be unless this works.
Her expression became unexpectedly firm.
"I'm proud of you because you found the courage to try."
No journal article, medical textbook, or specialist I'd ever met had managed to express the situation more simply…I was trying. It was all any of us could really do.
Everything else was up to the surgeon.