Everyone is interested in and fond of noses, am I right? Just about everyone has one; even this group of German theoretical physicists. Each and every one of them has one nose-- no more, no less. Don't believe me? See for yourself, below. Strangely, none of these people can tell you why each has ~1 nose, but they think they're pretty smart anyway. We'll explore that issue later on.

Okay, maybe you got here with a search engine or by chance, and didn't even know you had an Uncle Todd. If so, you probably don't really care about Uncle Todd's Nose 'n' Papillomas. You might not even be interested in theoretical physicists' noses. If you're interested in Noses or Papillomas in general, rather than mine in particular, you're not quite where you want to be. You might try the following places, as a graceful way out of this page:

Nasal:

Papillary:

If you've made it past those links with continued fascination, then you're probably particularly interested in Uncle Todd's very own nose 'n' papillomas. I'm sure all stories of nasal papillary disease are different, each in its own way. I know mine is. Here is my story:

Initial sufferings and early ruminations

The first signs that something was seriously wrong upstairs were probably the whining noises. I noticed that I was beginning to sound like a colleague of mine. At first I thought I might have caught the whine from a particularly truculent lot of students I was enduring in an endless freshman seminar. One of them was from Cranston RI, home of the famous and awful "Cranston Whine" which often requires surgical removal. But whines are not known to be physically contagious. A temporary infection seemed more likely, but as the flu season progressed, and all other sufferers recovered slowly, my whine endured. Weeks, then months passed between oxygen molecules in the left nostril. I developed a snore, quite similar to our springer spaniel's, or so I'm told. I was not sleeping well. My wife started to call me Sneezy. It was almost bad enough to see a doctor. I became anxious about my nose.

Primary care

My primary care physician was on vacation. I had to do something before our trip to Arizona for Christmas, so I went to see a nurse practitioner who diagnosed the problem as a sinus infection, flushed the wax from one ear, and cheerfully sent me happily off with antibiotics. Surely I would be saved by the pharmaceutical industry. But, not this time. Something far more evil than bacteria was lurking within.

After a couple of months with no improvement, I noticed a glistening white mass in the left nostril. Scary. Resembled a blowfly larva, but I've never been to the tropics. And the mass did not appear segmented or otherwise differentiated. Could it be a tumor? Some panicky late-night browsing revealed a description that matched my symptoms precisely: nasal polyps. To my relief, they were described as usually benign, and often easily removed under local anesthetic. So, it seemed safe to go to the doctor again (never go to a doctor with a serious ailment, unless it's Dr. Kevorkian). Based on my diagnosis, she could just reach in with her forceps, pull it out by the roots, and send me on my way.

We did have a pre-paid (well, pre-charged) trip to Disneyworld looming in just a few days. Surely, I would find much more pleasure at the fun-filled Magic Kingdom after proper treatment. Then it dawned on me: maybe Sneezy (the forgotten seventh Dwarf) had nasal polyps, too. I was looking forward to telling him about my recovery; this might be the key for him to reignite a hopelessly mired career, as I hoped it would be for me.

My primary care physician was on vacation. They were kind enough to let me see another doctor on an urgent care basis. I explained to this Doctor-boy, who was about the age of my cross-country skis, that I had what resembled a polyp in my nose. "What makes you think that?" he asked, with a skeptical tone. He took one look, gasped, and excused himself. I thought maybe he had been overcome by the sight, but he returned moments later, still breathless, with a colleague. He looked inside, uttered a few disturbing exclamations, gave Doctor-boy another look, and said "I've looked in about 10,000 noses, and I've never seen a polyp that big." Another colleague was invited in to see this wonder. They left me with Doctor-boy, who admitted that I might have a polyp, or a number of other things, including "something bad." He sent me off for X-rays and scheduled a visit with an ENT specialist the following day. I had their attention. Surely, Dr. Ent would remove the polyp tomorrow, and I might even be able to show it to Sneezy. Still, it might be "something bad..."

Somthing Bad?

The next day, I went to see Dr. Ent [not his real name]. He strapped on his head reflector, and got to work. "Just take it out," I thought, as he explored my left nostril with an interesting fiber-optic device, capable of suction and spraying either decongestant or anesthetic. I wondered if the endoscope had ever been used to spy on ant colonies or container-breeding mosquito larvae, but did not ask.

Dr. Ent remarked that this appeared to be a nasal polyp of colossal proportions. "So, would you say it's about the size of a Buick? A Roadmaster, perhaps?" He chuckled that it did appear to be about Buick-sized; I began to like Dr. Ent. He resembled the hapless resident at St. Elsewhere who eventually left the profession for veterinary medicine. "It's probably benign. Most of them are. How do I know? I don't, really, but the malignant ones usually look nastier, more aggressive. I'd like Dr. Polyp [not his real name] to see this. My specialty is really ears and throats." He proceeded to examine those with great confidence, remarking that one ear seemed much cleaner than the other. He prescribed some steroidal nose spray, and sent me off to get appointments for a CT scan and a visit with Dr. Polyp.

Dr. Polyp was on vacation, and would not return until after our Disneyworld adventure. Damn. Still, hope was in sight.

We returned penniless, one of us much amused, and me Grumpy, from Orlando. I had a mixture of reactions. Sneezy was nowhere to be found. Had he had gotten professional help, to begin a new life under a fresh identity? Goofy was also unavailable. I was cheered by rumors that he was being groomed as the next Disney CEO, and saddened by the status of some former stars of the 1950's: Mickey and Minnie were waiting tables at Epcot for minimum wage. I asked one of the human waiters what it's like to work with the Great One. He described Mickey as "a really awesome dude, but a regular guy. Great to hang out with during breaks." Most pathetically, Donald was seen panhandling somewhere between Mexico and China. But my great adventure was still ahead, with Dr. Polyp.

Fear and Loathing with Dr. Polyp
 
 

	While waiting alone in the examining room at the otorhinolaryngology clinic, I noticed that the air vent above the closed door conducted sounds from another room with remarkable clarity: sounds of screaming children.  The door flew open, and in burst the elusive Dr. Polyp, with resident in tow. He opened the envelope of CT scans, and began to examine them, streaming torrents of terminology at the resident, festooned with scary suffixes: -oid, -otomy, ectomy, -oma. The modest anatomical vocabulary I had obtained while teaching anatomy and physiology for radiation technology and dental hygiene students at an Ohio technical college was not up to this, and the cat dissections, frantically rehearsed in the apartment late the night before each lab, had not done much with the kittycat nasopharynx. He finally spoke to me: "well, Mr. Londahl, you have nasal papillary disease. It will need to come out." Somehow, "nasal polyp" sounds much friendlier than "nasal papillary disease." I thought, "yes, of course. Just take it out now, please."
Edvard Munch. The Cry. 1893. Painting stolen from the National Gallery, Oslo, ca. 1994. Make me an offer.

"Now, Mr. Lerdahl, the procedure we can use will depend on what kind of papilloma this is. If it's the ordinary variety, we can remove it with an endoscope through the nose, and no incisions will be required. But if it's an inverted papilloma, we will need to make an incision, called a lateral rhinotomy, along here." He traced the entire left side of my nose, down through the middle of the upper lip. Yikes. "Then, we will lift open your nose, and probably do some scraping of tissue from your maxillary bone." Double-yikes. "Now, Mr. Lubdahl, the possible side effects of this procedure include..." and he rattled off more than I can remember, but the list did include blindness, meningitis, loss of facial nerve function, and who knows what else. Those were enough. I grimaced at the resident, who grimaced back, rolled his eyes and looked at the ceiling. I asked about the consequences of not having that procedure, and he rattled off a very similar list, adding that these things can become malignant. The polyp had already begun to erode bone, and would continue to do more than that. Quadruple-yikes.

A surgery was chosen, but for some reason could not occur for four to six weeks. So much for the walk-in service I was hoping for. I opted for an eight-week delay, which would get me through the spring semester. How much worse could things become? There was little room for further growth. I had become accustomed to sleeping with the dog. Unfortunately, this waiting period allowed my imagination to get the best of me.

Polyp Madness, Nasal Nightmares
 

Simba: Uncle Scar, you're so wierd!

Scar: You have no idea...

--The Lion King

Much like refrigerators, noses receive little attention from most normal people, except as objects of ridicule. I recall a drug ad sent to me by my wife during our courtship, just a picture of a large green nose, with a cork in each nostril. However, I was growing more abnormal by the day, and began to see noses everywhere I looked. Not just on human faces, either. Nose images projected from trees in the forest. They were easily spotted on rocky road-cuts, and in half-eaten sandwiches. Polyps were less visible, but I was reminded of them daily by a black van always parked in front of a convenience store on my way to and from work, yellow letters dancing across a purple banner, proudly announcing: "J. Polep Distribution Services, Inc."

I began to wonder how many major historical figures had been snuffed out by rebellious nose cells. I still know of none, but such a fate is surely hidden away from history. Although there were plenty of jokes about Ronald Reagan's prostate condition, and quite a few in the wake of the completely surprising revelation of his sudden onset of Alzheimer's disease, just imagine how many jokes would have been written had he suffered from nasal polyps. There's just something funny about noses; who could attend a nose-induced funeral without snickering just a little? I would have trouble doing that, wouldn't you? For this reason, I hypothesize that nose maladies among the famous are generally kept from the public eye.
 
 

Still, unlike most problems of the thorax and below, it is difficult to conceal a major nasal problem. Consider this unfortunate man, clearly a victim of runaway papillomas of the nose (we'll take up the matter of fat lips later on). If you suffer from nasal papillary disease, and are awaiting a possible lateral rhinotomy with medial maxillectomy, you should avoid art galleries, art museums, and art books. These will only amplify your nasal fixations. Noses appear in virtually all portraits. The nose is also the most difficult facial feature to draw. At least, it is for me.  Reprinted without permission from Gary Larson's A Prehistory of the Far Side. Andrews and McMeel, Kansas City MO, 1989.

Perhaps because noses are difficult to draw, some artists feature noses rather prominently in their work, either to demonstrate their mastery of the nose (left), or their complete disdain for it (below, left). Still others have shown an apparent concern for the victims of nasal papillary disease, or for those brooding about their forthcoming procedures (below). Left: Marcel DuChamp. Yvonne and Magdaleine Torn in Tatters. 1911. This, and the next four images below, are reprinted without permission from H.H. Arneson's History of Modern Art . Harry N. Abrams, Inc., Englewood Cliffs, NJ, 1968.

Right: Carlo Carra: The Drunken Gentleman, 1917. Below: Pablo Picasso. Bust of a Warrior, 1933

A remarkable number of modern artists have depicted subjects recovering from a lateral rhinotomy with medial maxillectomy gone awry. It is not difficult to guess which of the demoiselles in Picasso's painting (below, left) is suffering from nasal papillary disease, and which had the misfortune to choose a clumsy surgeon of the nose. Antes' (below, right) surgeon may have been sued for malpractice.
 
 

Pablo Picasso. Les DeMoiselles D'Avignon.	Horst Antes: Yellow Figure with Bird. 1965

Such musings, and worse ones, haunted me throughout the spring. Psychological torment escalated with the continued growth within. I became suspicious of Dr. Polyp. Why had he forced me to endure such a long torment before the surgery? Was he waiting for a transplant donor? He had the same surname as a former graduate student of ours, who was eventually overcome by paranoid psychosis while I was department chairman. She became so frightening and aggressive to students and faculty that I eventually had to ban her from our building. She also resembled Dr. Polyp in every facial detail, and shared his nationality. Was Dr. Polyp a close relative, perhaps a brother, sent for revenge?

The surgery itself was seldom far from my thoughts. Although the endoscopic procedure sounded simple enough, I envisioned that some sort of manual might be necessary for the lateral rhinotomy. But what if there was no such manual? Dr. Polyp may have learned about this procedure at a conference, and he may have only a set of sketchy notes, e.g:

How to do a latteral rinectomy with medieval mastectomy

1. Identify posible transpant doner, in case of emegency. If no human persin is avalable, try 1 of the following: a) pig b) girafe c) springer spanel. 2. Locat planed incision with marker (n.b.: try to rember to use water-solble ink this time) 3. Open nose. (n.b.: this time, try not to open cranum in the process) 3. Remove contents. 5. Unless all goes well, atach doner nose in place of 1st nose. 7. Sow er up. 8. Find new recipent for polep.

to be continued...

Plans for future installments include: illustrations of the aforementioned manual; surgery I; recovery; "whoops, wrong procedure"-- surgery II!!!; present status; litigation plans.

You've been very brave. Few others have even dared to come here.