MOUNT HOPE:

LIFE AND DEATH AT THE HOSPITAL

Last look? Don Townshend, 55, from Prince Edward Island, stares at his tumour-ridden arm
while he is prepared for surgery at Mount Sinai in Toronto, unsure if he’ll awake to find it gone.

SURGICAL STRIKE

It took three staff surgeons, 20 assistants, 12 nurses and five anesthetists 16 hours to operate on Donald Townshend’s cancerous arm, 10 years after he felt a twinge at home in PEI. In part 2 of a series, IAN BROWN witnesses the epic operation, and is forced to question what levels of medical care Canada really can afford. Photo essay by KEVIN VAN PAASSEN

The tumour carved out of Don Townshend’s arm looks not so much angry, as stubborn — half a fist of filet mignon, sitting up on a green sterile towel. This is a bloom of cancer, the epidemic scourge. You can’t help but look at it, but you don’t want to. It’s too private — a rogue life form that was slowly trying to kill a man, after all. It looks malignant, and it is.

But the longer you look at the tumour, the more it tells you about the man it lived in, about the doctor who took it out, about the hospital where that happened, even about the medical system that paid for the operation, what it can do and what it never will. The lump we all fear. The lump the surgeon loves to cut away. The incurable thing.

•     •     •

The pageant of surgery, the great writer-surgeon Richard Selzer called it — the holiest profession in the hospital. Still, if this is a pageant, it’s less religion than backyard barbecue. This isn’t a darkened operating theatre, hushed in contemplation of a human life lying in the balance. In OR 11 at Mount Sinai Hospital in downtown Toronto, the lights are blazing and Bruce Springsteen’s The Rising is wailing over the sound system. For Jay Wunder, 43, presiding orthopedic surgeon and all-round onco-genius, it’s surgical party time.

Four nurses are unwrapping sterilized trays of surgical instruments and arranging them in a semi-circle around the operating slab like an all-you-can-eat banquet. The anesthetist and his resident are camped out behind a makeshift sheet at the head of the table, gently pumping oxygen, morphine and isoflurane, an anesthetic, and rocuronium, a muscle relaxant, into the patient. Oh, right: the patient. There in the middle of it all, naked and plain, lying on the table as though he had been dumped by a guy hurrying off on his break, is Don Townshend.

Mr. Townshend is out cold, but it’s not like he’s asleep: This is something deeper, “the monstrous silence of anesthesia” (Dr. Selzer again), his body surrendered, his soul — this is the weird thing — somehow on vacation. Two corrugated hoses run into and out of the breathing tubes on his face. Dr. Wunder is arranging a side table especially for Mr. Townshend’s crooked arm. It’s 9:02 on a Wednesday morning.

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