When Anees Rahman talks about the year he was diagnosed with cancer, he keeps coming back to one regret.
"If I had to say that there's like a regret, it would be like not taking it seriously when I first noticed it."
He was 19, in his second semester of university in Pakistan, and the world had just shut down for COVID. The lump below his right knee was small. The first doctor said it was harmless. So Anees went home.
He didn't go back for months.
By the time he returned in December 2020, the lump had stopped behaving like a lump. It was growing fast enough that Anees could see the difference from day to day, the skin stretched tighter, the veins more visible. By month's end, he describes it the way only someone who has lived inside it would:
"I have a second knee right below my actual one."
Not a date. Not an apricot. Closer to a mango.
On December 27th, he went in for an MRI. The first read suggested Ewing sarcoma. The biopsy came back as something rarer: undifferentiated spindle cell sarcoma. Anees had never heard of either. He paced the hospital, Googling every word. Malignant. Malignancy. His father was with him but hadn't pieced it together yet. Anees was the one reading the reports out loud.
In Pakistan, the wait for a bone scan is usually a month or two. His came in days. So did the biopsy and the consultations. Anees doesn't describe himself as religious, but parts of that month, he says, felt like something was looking out for him.
At the first oncology appointment, Anees's brother came with him. Partway through, the doctor asked Anees to step out so he could speak to his brother alone. That's when he said the spread was too much. Anees would need an above-knee amputation.
His brother didn't tell him. Not that day. Not for another week or two. He waited, then pulled Anees aside from the family and told him he was going to lose his leg.
They didn't accept it right away. The family drove to two cities looking for another opinion. There wasn't one. The cancer had wrapped around the knee, into the bone and the soft tissue. The knee had to come out, and they couldn't take it without the leg.
Anees was in Peshawar, four hours from home, the night before the amputation. He had made his peace with it, or thought he had. Then his cousin, a doctor, called and told him about a surgery called rotationplasty. Strange thing: Anees had seen a YouTube video about it years before. He remembered exactly what his cousin was describing.
Rotationplasty is hard to explain without a picture. Surgeons remove the knee, then take the foot, rotate it 180 degrees, and reattach it where the knee used to be. The ankle becomes the new knee. It had been done in Pakistan maybe once before. The head of plastic surgery at Holy Family Hospital said he could do it.
Anees had a 13-hour rotationplasty on February 2, 2021, almost exactly a month after his diagnosis. By then, he couldn't walk from the ward to the operating theater. There were complications during surgery. He spent the next six to eight months in bed, then five rounds of chemotherapy. Chemo, he says, was the worst part.
The strangest thing about rotationplasty, Anees says, is that it still feels like his knee. When he moves his ankle in the spot where his knee used to be, his body reads it as a knee. He doesn't fully understand how the surgeons pulled that off.
A year after surgery, he got a prosthesis. The right one changed everything, turning what was technically an above-knee amputation into something closer to a below-knee one. He doesn't use a cane. He can walk, run a little, travel.
"Things have been going upwards from the time I got my prosthesis."
Five years out, Anees is a designer at PatientWing. He works from home mostly. He games. He plays sports when he can be at least a little competitive, because if he can't, he says, he doesn't see the point.
He's traveled to Qatar, Saudi Arabia, and Baku. He has plans for more. He doesn't want to settle anywhere else, but every six months or so, he'd like to take off for a few weeks and see somewhere new. The way things are looking, he thinks he can.
His friends have their own way of describing the version of him that came out the other side. They tell him he's been through, in his words,
"a lot of corrective development."
He laughs about it. He used to be scared of hospitals. He ended up living in one.
Asked how he'd sum up where he is now, he doesn't reach for anything dramatic:
"Overall, life-wise, things have been really good. Really good so far."
If he could go back and tell the version of himself who first noticed the lump one thing, it would be this: if something on your body has been there for more than two or three weeks, deal with it. Find the best possible way to deal with it. Take it seriously, even when nobody else is.
And to anyone who has just been handed the same diagnosis, Anees knows how it sounds when people tell you it gets better. He didn't believe it either. But it does.
"You lose some, but there is no limit to how much you can gain."
