Up like a bolt at 4:30 today when my alarm rang. Despite going to sleep at 11:30 (because I was waiting to see Mom when she arrived), I felt pretty rested. Good thing, since I took 2 mg of Decadron last night. I’m experimenting this time around with taking it earlier in the evening, around 7 pm, to see if that helps with the sleeplessness. I’m experienced now.

Waiting for the car we called, I looked out and saw things I would not have noticed if I were not up at that hour. A thin rib of golden leaves still clinging to the nearly-nude ginkgo tree out front. Our neighbor waved as he passed, walking his fluffy, adorable Samoyed, Onslow, way before sunrise (mental note: another reason not to get a dog).

This early time of day plus hospital still calls to mind more Labor & Delivery than cancer surgery. Though I’ve been up this early for surgery once before, of course – just this past June. I enjoyed my ride in the gamma knife machine that time perhaps too much, so now I’m going again. Maybe I grasped some titanium ring and no one told me that that meant another ride.

Even though I was going into this knowing the entire process, I still didn’t quite attain the degree of performative spectacle that came naturally to one of my sisters in melanoma, Kate Boone, who has cheekily bedecked her titanium frame with garlands, sparkly things, and lights. I didn’t really have much time to plan, this time around. I did, however, make the same tired joke the neurosurgeon and the nurses probably hear all the time as they are affixing frames to people’s skulls, tightly: “So… is that a Phillips head or a flat head?” (One of the nurses snorted. It was enough for me.) After that, it was no joke. It really actually hurts when you are jabbed with two needles in the forehead and two on the back of your head, and then screws get tightened and tightened beyond belief and you can feel some blood squirting out as they affix your titanium crown. Here’s me today (no blood!):

There were a couple of innovations today. The thing under my nose – I definitely didn’t remember that from last time, and neither did J. The green cloth around me – apparently to give me some privacy. Totally not effective, and who cares if anyone stares? We are in a hospital and I have a titanium frame bolted to my skull. What of it, good sir?

Things went much more quickly when I stated my intention to not have any sedation today. I did take the Ativan that melted under my tongue, but I didn’t get anything through the IV except contrast during the MRI before surgery. My refusal of sedation helped me jump the queue to first (there were three in line for gamma knife today). I almost leapt from the gurney when I heard I was first.

This reminded me of showing up to labor & delivery when Young J was about to be born. I had quietly and painlessly dilated to 8 cm and was told by my OB to tell the nurse on duty I’d been having “cramps.” I had not been having cramps. But being that far along, with fake “cramps,” meant I got in before everyone there to be induced, and within about three and a half hours, I had a baby on the outside. I don’t know if living in New York City has made me extra attuned to opportunities to jump the queue, but it can’t be discounted…

Today, we arrived at the hospital at 5:30 a.m., I registered with the lovely British-accented trans person who works registering people at 5 a.m. (I remembered them from last time). And by 9 a.m. we were on the outside of the hospital, me with a gauze-wrapped head like I’d been in a bar fight, stepping into a cab. No baby to show for it, but hopefully, we killed something bad on the inside.