A cholesteatoma is a deposit of cholesterol and dead cells in the ear which, if left unchecked, can destroy the hearing and ultimately grow into the cranial cavity and cause brain damage. Or worse.
Obviously it would have to be removed. There are two choices. The first option, as I understand it, involves scooping the whole affair out with a sharpened spoon. This leaves a big cavity behind which has to be cleaned out very regularly for the rest of the patient's life. You're encouraged to shelve your swimming career too. The second option is riskier and involves a series of three or four more delicate operations about a year apart. The risk is that damage could be caused to the facial nerve during one of these causing facial palsy. The upside is that once you're done you can swim and surf and never take your ear to the hospital again.
On the basis that we trust doctors and that we'd like our daughters to have as wide a range of options open go them as possible, we went for the second choice.
Having had a grommet fitted a few months earlier, Lulu was very relaxed about the operation. Her chief anxiety was whether one of us would be able to stay in the hospital with her and, once we'd established that we could, whom she was going to chose. Her primary concern seemed to be that the one she didn't chose would be upset. I took her to one side.
"Look, the important thing is that you feel safe and happy. Take whichever one of us will help you feel that way in hospital. If you chose Mummy I really won't be upset."
She welled up. "But I'll really miss you if you're not there," she wailed.
"If I was six and going into hospital I'd want my Mum there," I said. "Most kids would."
"Oh Daddy," she sighed, "When Mummy and Sorrel aren't here you're my favourite."
On the day, she and Helen have to be there at eight so they leave in a cab at 7.15. I'm struggling to hold it together - all the risks playing through my head. My perfect little girl is sat right here right now and shortly she's going to be taken away and may come back to me changed for ever. Sorrel is howling for less abstract reasons: Mummy will be away for a day and a night and she's being left with "stupid, ugly Daddy". I'm a mess but just manage not to let it show. Lulu looks back to me just as the door closes her little face crumpled and close to tears. Only Helen has a grip of herself. It's clear the Lulu has made the right choice.
Some hours later and Sorrel has watched every DVD in the house. I've completed chores so dull that I've been putting them off for years. Helen and I have been exchanging 'calm' texts the wall-climbing sub-text of which is clear. The op is supposed to take two hours and she's been in three then four then FIVE hours.
Poor Helen is sat by Lulu's empty bed steadily knitting a scarf for Lulu's beloved Bunny that will make him look like Tom Baker era Dr Who. I'm at home doing wall-of-death circuits like a chinchilla on amphetamines.
Eventually the surgeon emerges. The cholesteatoma has grown five-fold since the scan. It's eaten up all the bones of hearing and they've had to be removed. He's replaced them with plastic prostheses but we won't know how much hearing - if any - she'll have until all the packing in her ear is removed at the end of the month. Rather than doing the delicate paring away he was planning on, followed up
by similar ops in the years to come he's had to perform the semi-radical mastoidectomy with the spoon. So no more swimming for the dolphin-girl. We'll be seeing a lot of him over the next ten years he tells Helen.
I visit her later that night. She's in the post op ward with three very unhappy babies and an awkward looking teenager who would clearly rather be anywhere else. She has a bandage round her head and looks all puffy with a black eye on the way. But more than that... she's tiny. My tall, leggy girl who can't keep still is motionless: curled up, bandaged and tired, around her old grey Bunny - smart in his new scarf - as though he is the only thing keeping her afloat. She opens her eyes and gazes solemnly at me for a beat longer than is comfortable. "Dadda," she says and closes her pale blue eyes again.
If there was anything in me left to break it breaks now. I'm helpless to do anything for her but just be here. So I take her hand and do just that.
