The Perils of Indolent Lesions

By Pam Lemke

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1.

Scorpions have been observed surviving the radiation from nuclear weapons tests in the Sahara.
 

2.

I’ve always found the word surveillance a curious term to describe follow-up imaging in cancer patients. All the post-treatment CT scans I had after my first cancer in 2012 showed the same small cyst on my liver, a 3 mm nodule in the right lung, and a 6 mm stone in the left kidney—something that, thankfully, hasn’t caused me any grief. 

I think of these blips and bumps that don’t change over time as my unique internal landscape, kind of like a fingerprint. Every six to 12 months, a radiologist notes these lesions are unchanged from earlier scans and consistent with benign etiology. So, when I signed into the patient portal in March 2023 to read the report for the first scan completed following treatment for a new primary cancer, I felt my diaphragm catch. Then came the rapid heart thumping as I read and re-read, a 7 mm groundglass nodule is seen in the right upper lobe. I searched every previous report for documentation this lesion was not new—read all the radiologists’ notes for evidence this lesion had been seen before but described differently. I considered the possibility my memory had failed me. But the only lung lesion making an appearance in previous scans was the 3 mm nodule from 2012. There, along the perimeter of my right upper lung was a new lesion.

I thought it looked like a scorpion.
 

3.

When I first moved to the desert, I knew about scorpions, but I never imagined they would find their way into my home. I found the first one when I was filling the watering can. She was scrambling up the side of the sink, trying to move faster than the flow of water streaming from the faucet. Her pale brown, nearly translucent body was so small I almost mistook her for an insect. Then I noticed the pincers and the curved tail—a tiny land lobster, nearly unchanged in form from when she first crawled out of the sea 350 million years ago and took up residence on dry land. I panicked, turned the water on full force, and watched her swim. I called for my partner to put on gloves and bring a glass jar. We released her to the field behind our home—back to the desert where bark scorpions can be found from Arizona to Baja Sur and from southeastern California to northwestern New Mexico.

My second encounter with the bark scorpion was in the early morning. It was dark. I was making coffee. Once again, the venomous creature was so small I was almost stung trying to fish it out of the sink strainer, thinking it was a scrap of food. Realizing my error, I withdrew my hand, screamed, and placed a plate over the drain.

I started to fear these nocturnal arachnids were living in the plumbing, traveling through the pipes, and entering our home during the dark hours while we slept. I was wrong. According to the Arizona-Sonora Desert Museum, bark scorpions are agile. Our visitors were likely dropping into our sinks from the walls they were climbing. They get their name because they are often found on the bark of mesquite trees. These thirsty invertebrates are frequently seen in the wet areas in and around our homes because the bugs they eat are found there. 

Our second summer I found two abandoned exoskeletons in the chest where I store my kayaking gear. They were perfectly formed and smaller than the fingernail on my pinky. Scorpions are live-born and spend their first weeks being carried around on their mothers’ backs until after the first molt. Then, they work their way out of their hard shells to begin life as solitary hunters.

While the new shell hardens, they’re vulnerable to being eaten by tarantulas, owls, bats, and even other scorpions. I’m guessing these were two siblings hanging out together until the danger passed. Some baby scorpions are called scorplings, but bark scorpions are called nymphs—minor divinities of bark and stream, the only scorpions in North America capable of killing a human.

The most alarming thing I found on the internet about how to keep scorpions from falling into our sinks, tubs, and beds wasn’t found in an advertisement for a pest control company but was found on the website of a regional healthcare giant about how to keep scorpions out of cribs: To prevent scorpions from climbing or falling into a baby’s crib, move the crib away from the wall,  take off any crib skirts that reach to the floor, place the legs in glass jars and you might want to consider building a scorpion shield over the crib.

They say scorpions need a mere 1/16th of an inch to enter the tiniest cracks and crevices in our homes. Now, I scour the house’s perimeter, looking for possible points of entry. I read they glow green under ultraviolet light, even the fossils, so I bought a black light.
 

4.

Scorpio sits along the ecliptic in the middle of the Milky Way. The constellation’s massive heart sparkles red—not a single heart, but a binary star system so luminous that it’s easily seen with the naked eye. I think about all the summers I traveled to dark, quiet places to witness the Perseid meteor shower and sleep on the ground, watching stars fall. I never thought to let my gaze rest closer to the horizon. I never learned to find Scorpius in the sky.
 

5.

Scorpion venom is excreted through a syringe-like structure at the end of its tail, where it enters the body of its prey to paralyze and kill its victim. The venom contains a neurotoxin called chlorotoxin—a tiny protein chain comprised of 36 amino acids that can be folded in 256 ways. Only one way works to block the chloride channels in muscle cells, leading to paralysis. The relationship between chlorotoxin and chloride channels in muscle cells is one of those mysterious comings together between something in the body and something found in nature that makes for a perfect fit. In adult humans, most bark scorpion sting reactions remain local, causing pain, burning, tingling, and sometimes redness and swelling at the site. On occasion, the symptoms progress to blurry vision, a temporary inability to move the affected limb, or even seizures. The more severe reactions are generally reserved for children, the elderly, and immunocompromised individuals. 

Scorpions also use their pincers to capture prey, and it’s generally true that the smaller the pincers, the more potent the venom.

6.

The grasshopper mouse lives in the short grass prairies and desert scrub of the southwestern United States and northern Mexico. Living in burrows stolen from other animals, it subsists on a diet of beetles, spiders, centipedes, and even other mice. It’s the world’s only carnivorous rodent. Notable for its wolf-like howls and immunity to scorpion venom, this fierce, tiny predator converts the venom into an anesthetic, rendering the sting innocuous, then it eats the scorpion. 

I dreamt I was walking along the edge of something. I told my friend I thought my indolent lung lesion resembled a scorpion. She asked, might it be a talisman, a spirit guide? She told me her mind needed to believe the scorpion’s venom is poisoning the possible cancer in my lungs. I didn’t tell her I don’t believe that. This scorpion is poised to strike. I just don’t know if she will.

She reminds me I’m dying. I just don’t know when.

 

 

Pam LemkePam Lemke is a student at The Writers Studio. Her work has appeared in Unbroken and Porter Gulch Review. She lives in the desert grasslands of Southern Arizona with her partner and their two old dogs. She enjoys hiking and being on the water in her kayak.

Header image by Pike-28, courtesy Shutterstock. Photo of Pam Lemke by Wendy Islas.

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