«Meaning bad news. It`s a sizable melanoma, and it has spread to the nodes. The

real danger here is more distant spread, but we won`t know that till the CT scan which

I`ve arranged for tomorrow at eight.»

Two days later they continued their discussion. Bob reported that the CT scan was

negative—no evidence of spread elsewhere in the body. That was the first good news.

«But even so, Julius, this adds up to a dangerous melanoma.»

«How dangerous?» Julius`s voice cracked. «What are we talking about? What kind

of survival rate?»

«You know we can only address that question in terms of statistics. Everyone is

different. But for an ulcerated melanoma, four millimeters deep, with five nodes, the

statistical charts show a five–year survival of less than twenty–five percent.»

Julius sat for several moments with head bowed, heart pounding, tears in his eyes,

before asking, «Keep going. You`re being straight. I need to know what to tell my

patients. What will my course be like? What`s going to happen?»

«It`s impossible to be precise because nothing more will happen to you until the

melanoma recurs somewhere in the body. When it does, especially if it metastasizes, then

the course might be quick, perhaps weeks or months. As for your patients, hard to say,

but it would not be unreasonable to hope for at least a year of good health ahead of you.»

Julius nodded slowly, head down.

«Where`s your family, Julius? Shouldn`t you have brought someone in with you?»

«I think you know about my wife`s death ten years ago. My son is on the East

Coast and my daughter in Santa Barbara. I`ve said nothing to them yet; I didn`t see any

sense in disrupting their lives unnecessarily. I generally do better licking my wounds in

private anyway, but I`m pretty sure that my daughter will come up immediately.»

«Julius, I`m so sorry to have to tell you all this. Let me end with a little good news.