Its always hard to judge what to make public and what is best kept to yourself – but if you search for granuloma on the net you find some informative personal stories – I nearly wrote personal traumas – of this condition so I am adding one. This year has involved a couple of traumas for me so far but the granuloma trauma is sufficiently distant to write about it. Granulomas are a skin growth that can emerge anywhere but sometimes, for the particularly lucky, they are on the face or lip. Mine started as what first appeared to be a herpes sore on my lower lip but then outstayed the normal 5-7 days and kept growing. After 3 weeks I took it to my GP who searched on Google images but could not diagnose it. He referred me to a maxilo facial unit and an appointment was scheduled for three weeks hence. Unfortunately between then and the appointment not only did this keep growing but I had an international conference which I was organising to attend and do a great deal of appearing in public. Though I never believed that this was malignant or there to stay, this was a sudden initiation into the experience of disfigurement, of people glancing twice or of me feeling they were, of avoiding a chat with my neighbour, of sitting with my hand over my mouth at meetings. I was shocked by how powerful and constant my consciousness of this minor disfigurement was. The conference involved lots of speaking to a full auditorium with my face projected twenty feet tall on a screen behind me. This was great timing. Some people would ask me about it but most ignored it. This growth had the habit of bleeding profusely if I drank a hot drink, and in the shower and my hotel pillow would be stained with blood in the morning. This was ghastly. The conference over and, uncharacteristically for me, I lobbied my GP to try to bring my appointment at the hospital forward. Even an extra week with this would be terrible. In the meantime, because it changed from being more like a large red pea (picture 1)

into a small crusty carrot shaped thing (picture 2),

I realised, using Google again, what it was – a granuloma. The clinic said they could fit me in early and I arrived before it opened and was prepared to camp there all day if necessary. I had sandwiches, a flask and plenty of work to get on with. I was seen before 10.30. Once in the chair I was told that it was not normal to have these removed at the first visit (I don’t know why).  Again, uncharacteristically, I insisted and they agreed. An injection of lignocaine and adrenaline in my lip turned it into a large flapping piece of liver approximately a foot wide then there was the slight sawing sensation as Mr Granuloma was being separated from me, and then some unimaginably neat needlework was done, three stitches in a little quarter inch wound. At this point I started to travel somewhere very strange and was given lots of glucose drops by the surgeon and her assistant. They encouraged me not to hurry out of the chair as the paperwork would take forever anyway. In the recovery room I talked to someone who had had her jaw broken and reset for a reason I did not quite understand. See picture 3 for the finished result (of my lip, not her jaw)