Converging Interiors

At the shop, Dr. Karl overhears a phone conversation and helps save a life.

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||| |---|---| | | | It was hot in the shop. It was after six on a summer Friday night and we'd driven to Lakeland, Florida, to talk to Mike about a new interior for the Cheyenne. Our interior was original and we liked the seats, but the carpet and drapes were well past their life expectancy. When the airplane was built, Jimmy Carter was president. And, to tell the truth, the seats were pretty rough once you pictured them sitting in a fine vessel of new carpet and headliner. So we were thinking of doing the seats, and I was just beginning to suspect that this might lead to new cabinetry when the phone rang.

My wife and I had liked Mike immediately. He'd been recommended by our mechanic, Turley, and he had a nice, patient way with us. He didn't press about the seats, he just sort of let us come to our own conclusion about the need to bite the bullet and buy some leather. Mike's in his mid forties, compact and soft spoken. He looks you in the eye.

We were skittish, though. We'd done an interior on our Cessna 340 years ago and had been disappointed. The seats looked tired just a few months after we did them, and no amount of leather care seemed to help. So we were being tough on Mike when he was pulled away to answer the phone.

The shop was in a hangar with an outfit that prepares general aviation airplanes to go long distances so as to take up residence in far away countries. While they install extra fuel tanks, Mike works in one bay in the hangar and out of a small shop with an even smaller air conditioner. The shop smells powerfully of paint, varnish and glue.

We looked around at a few seats he was recovering for a Cessna 414. They were beautiful. The 414's cabinets were being sanded and refinished. They glistened. Turns out that those really slick interiors you sometimes see on the ramp in fancy jets often involve plastic pieces that look like wood. Mike was doing the real thing here.

I gradually became aware that the phone call was personal, not business, and that it was serious. I heard Mike try several times to cut the conversation short as he was aware that we were waiting. "I'll call you back soon," he said.

Then he said, "I love you, too."

When Mike approached us, I could see tears forming at the corners of his eyes. "I'm sorry about the interruption," he said. "Let's look at some different types of leather and different colors. You don't want anything too light or too dark."

"I couldn't help but overhear you," I said. "Is there some trouble?"

"My folks live in North Carolina and that was my dad. My mom let the dogs out and a fence gate hit her on her right side and she's been hurting. They took her to a doctor today and they did a CAT scan and she has a liver tumor, a big one."

"Mike," I said, "you're not going to believe this, and this is none of my business, but I'm a surgeon who specializes in liver tumors. Maybe I could get her seen at Duke or the University of North Carolina. I know people at those medical schools. Maybe the problem was caused by some bleeding into the liver after the fence accident. Maybe it isn't a cancer." I came to wonder about my presumptuous interference in another man's life.

"I'll talk to my folks tonight and I'll call you," Mike said. Cathy and I left to drive home, somber about the way our visit to the interior shop had turned out. We were excited about doing the inside of our great airplane, but that enterprise had been put in perspective by Mike's misfortune.

He called a few days later. His mother would like some help. She wanted to come here, to our cancer center in Tampa. She could stay with Mike and his wife, Sharon. She'd be driving down tomorrow. I arranged to see her on the next day, now vaguely aware that I might have stuck my nose into something that wasn't really my business.

Monday brought the delightful Duncans to the office and with them Nancy's CAT scans. After some polite conversation and some mutually appreciative compliments, I looked at the x-rays and my heart sank. She had a tumor, all right, a big one. I didn't think it could be removed safely and leave enough normal liver to sustain her. I presented her case at our multidisciplinary GI tumor group meeting, and all the other surgeons and medical oncologists and radiologists agreed that the tumor was too big to operate on. We would try to shrink it by cutting off its blood supply by placing a coil in the artery leading to that part of the liver that harbored the deadly stowaway.

Meanwhile, plans proceeded apace to redo our airplane. We picked out some great colors, got a sense of how things would look and decided to go whole hog: seats, cabinets and headliner. I was now keenly aware that Mike and I were on an intersecting course. I was trying to help his mother, and he was in charge of my most favorite physical thing. He knew it, too.

His Mom had the coil placed, rebounded quickly and went back to North Carolina. I scheduled the four weeks airplane downtime for the interior work. Mike and I were both waiting to see how things would work out.

A week later, Mike started to work on the airplane. He removed the entire interior, replaced soundproofing and covered all the plastic parts with ultra leather. He rebuilt each of the seven seats in a most gorgeous leather, designed to be soft and inviting without being too frilly and cushy. I went to visit the work in progress and each time came away with a renewed sense of respect for a fine craftsman with good hands and great sensibilities.

Two weeks later, Mike called. "I hate to bother you," he said, "but she's hurting and thinks this thing is getting bigger."

"Let's get another CAT scan," I said. "You can have it done up there and FedEx it to me."

"OK," he said.

Two days later I looked at the x-rays with our best radiologist and we both knew that the tumor had grown, not shrunk. There was nothing left to do but try to operate and take it out.

"If you couldn't get it out before and now it is bigger, " asked Mike, "what makes you think you can get it out now?"

It was a good question, and I was short on good answers. But it was her only chance. And so an operation was scheduled.

I sensed that Mike was now working on our airplane as if his mother's life depended on it. I know that I had the feeling that I was about to have my abilities tested. We were two craftsmen, each hoping to please the other, each worried about our work.

I couldn't stop thinking about this operation. I do a lot of liver surgery, but this was the hardest I had attempted to do in a long while. Was my judgment clouded by my desire to please Mike? I didn't sleep well while attending a meeting in New Orleans. Friday was the day.

In the pre-op holding area, Nancy was scared and so was I. As she was getting her IVs started for her operation, she became short of breath. Pulmonary doctors were called in. She had had a clot break off from her legs and lodge in her lungs: pulmonary embolism. I cancelled the case. We put a filter in her vena cava to prevent additional emboli.

Nancy got better over the weekend, and I decided to try the following Tuesday. We were running out of choices. There was no back-up plan.

That Saturday we picked up the Cheyenne. It was astoundingly beautiful. The seats, carpet, headliner and cabinets came together to give the look of quiet, opulent taste. Mike had a surprise, too. Cathy had called and asked him to construct a pillow for our ancient lab-shepherd dog, Ubu. He loves to fly, and the matching bed for him was the perfect touch to a perfect job. I felt like a very rich man. A scared rich man with a job to do. Mike had done his part; my turn was next.

I wanted desperately to help Mike and his mother. He had done a fine job, and I felt like I owed him. But I said to him, "You need a surgeon, not a friend. You need judgment and skill. If I can't do this safely I must not hurt your mother trying to please you." I had operated on friends and acquaintances before, but this was Mike's family's first experience with such an unusual arrangement. I was admonishing myself as much as speaking to them. They probably sensed this.

Tuesday morning was a clear day. I felt better about this than I had the previous Friday when I had cancelled the operation. Nancy felt better about it, too. Somehow she knew she was better prepared this time. She asked about the pillow for Ubu, and I could see that she was clearly pleased to be in on the secret surprise dog bed. I remembered that she loves dogs, too. After she was asleep, I opened her abdomen and found a huge tumor occupying two-thirds of her liver. It was the size of a volleyball.

I started in by mobilizing the tumor, looking for familiar landmarks. I found the vena cava and the hepatic arteries, much like catching a glimpse of a familiar road or building while shooting an ILS to home on a foggy day. Things were under control, and I started gaining some optimism about our chances. Nancy's and mine. There comes a moment in such an operation when the surgeon must commit without having success assured. Sort of an equal time point.

That moment came and I took the leap. When the tumor came out you could hear the relief in the nurses' breathing. The abdomen looked empty without its evil cargo.

Four hours after we started, I walked out to Mike, Sharon and Mike's dad. I was exhilarated. I had wanted this outcome so badly.

To the group I said, "We got lucky."

To Mike I said, with a catch in my voice, "We're even now."

I knew he knew what I meant; we both work with our hands.

Nancy did well, went home and thinks I was put in her son's shop on a hot Friday evening by higher forces. The intersection of our lives was such that I don't disagree.

If you want to see what an airplane interior handcrafted by an expert who worked as if his mother's life hung in the balance looks like, click on www.duncaninteriors.com and bring up the pictures of our Cheyenne.

See what I mean?