I have squamous cell skin cancer. As health issues go, it’s totally manageable and not horrible, at least for me, at least so far. Every year or so as the doctor finds more cancerous cells, I get a procedure to cut out the offending part of my skin. Mohs Surgery is the main procedure for this type of excision, and it means that more and more of my skin is trimmed away until the margins around a cancerous section test out as totally clear. It’s of course amazing and incredibly good for me that the doctors can get rid of my cancer so easily. But it surprises me every time how not easy it is for my skin.
The skin, it might surprise none of you to learn, is an organ. My first Mohs procedure cut no more than an inch or so of this organ out of my forehead. And seriously, my whole face turned black and blue for a week and I lost feeling in most of my scalp for almost a year. Apparently, the organ is more complicated than I thought, more connected, more resistant to giving itself up. I understand the way in which clear margins are beautiful. What I think about now when I find a new spot on my skin, though, is the violence that happens to my body when its margins are cleared.
It’s metaphorically dangerous and maybe even disgusting to equate cancer cells with whatever margins we might trim in our institutions in order to shore up our institutional health. But I think about the parallels in what might be unexpected ways since I’ve been dealing with my skin.
Can you think of a time in your own institution where something “marginal” was cut in order to protect the health of the larger institution, but then when it was cut, the larger institution was hurt in some unanticipated way? The funny thing about margins is that they seem to be on an edge that can be excised. But that edge is attached to another edge and that edge is up against another edge and actually all the edges are attached to all the other edges and it turns out there is no edge, only the body as a whole.
Budget cuts don’t actually cut budgets. I mean, there is either money or there isn’t, and you either spend it or you don’t. The budget is the budget. When you “cut a budget,” you cut away a part of your organization, supposedly to clear the margins and improve the core health of your organization. And maybe you need to do this. I don’t know. I know I needed to have the surgeries I had.
But when you make a cut to a margin, the rest of your organization, the rest of that organism, is affected. While it may recover some life, it will also be raw, inflamed, and probably scarred for a really long time.
So this is about cutting what’s marginal. But also about rethinking whether margins are actually margins, or just the exposed parts of the organism that are the most vulnerable and the most in need of protection. Now I wear sunblock a lot more. Because those margins? Those margins are my skin. That skin is me.
Question
Can you think of a time in your own institution where something “marginal” was cut in order to protect the health of the larger institution, but then when it was cut, the larger institution was hurt in some unanticipated way?