When Nick White had half his tongue cut out and replaced with a chunk of his arm, he was told there was a chance he would never speak again.
He was also told he had only a 50-50 chance of surviving the next five years, after the ravages of head and neck cancer.
Today the 38-year-old Wellingtonian is approaching that five-year milestone - and has taken up public speaking after learning to talk all over again.
"I will have that final checkup in June and, if that goes well, I will be out of the system and judged cancer-free permanently," he said yesterday. "I will probably cry."
Sitting at the Wellington waterfront lagoon, White speaks easily, with only a slight lisp using what, on closer inspection, is a fairly ordinary-looking tongue.
He holds out his forearm, displaying the oval scar where his muscle was removed and sewn into his mouth through a hole cut in the side of his face.
"He recommended the forearm because, despite being a bit hairy, it has the most chance of working, of binding."
His journey started in June 2009 with a small cut in his mouth, which he thought he'd sustained playing football.
A few doctor visits later, he was sitting before a medical team, including pioneering plastic surgeon Swee Tan, who told him he had head and neck cancer, and his best option was a risky and complex operation that could kill him.
White had only four days to decide. "Thankfully, I had no real choice. It was that or die."
During an eight-hour operation, Tan and his team removed more than 20 cancerous lumps from his shoulder, neck and head. Half his tongue was removed and replaced with the muscle from his left arm. When he awoke, there was a tube through his neck allowing him to breathe, and another to feed him. "I felt a lot of pain. It wasn't the tongue, it was the whole body."
For the first few weeks, he used notebooks to communicate with his family. His first word was a breathy "Hello", achieved by putting a finger over the hole in his throat.
Even as he started to recover his speech, radiation knocked him back to square one, "frying" his vocal cords. It took months with his voice and speech therapist, repeating phrases over and over, before he could recover any speech.
"The main problem was voice, and the second was articulation. There are certain sounds that are very difficult. At the time, I sounded a lot like Sid the Sloth [from the movie Ice Age]."
When he returned to work six months later, he often ran out of voice by the afternoon. "It would be frustrating in a meeting not being able to feel I could speak. When someone asked a question and you have to reply slowly."
Even when he could speak, people often treated him differently, assuming his slurred voice was a sign of intoxication or sickness.
"That is really hard for people that have speech impairments. People wonder what is wrong with you."
White's first big speech step was his brother's wedding eight months after the surgery. Since then he has barely stopped speaking, talking about his recovery and the surgery that saved him before hundreds of people.
On Wednesday, he is speaking at the New Zealand Speech Therapists Association launch of a new project to recognise communication impairments as a global health issue.
While his new tongue has given him back his speech, his ordeal has left other scars. He can only eat soft foods, and his mouth starts burning with anything remotely spicy. Even beer seems to disagree with his mouth.
"But I still have half my tongue, so I can taste flavours. The other half is just a blank piece of nothing."
- The Dominion Post
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