I've drained the last of the fuel alcohol into the silver stove and I'm heating a long, round bolt there on the fire. It hangs over the searing blue flame from the jaws of gray needle-nosed pliers. The boat is rolling gently beneath me, moored to a solid anchor system underneath the swell and slop of the green sea. An orange sun hangs low on the clouded horizon, illuminating the heavy cumulus clouds that stretch from the surface of the ocean to the thin, wispy air miles above.

There's a tumor on my left pinky finger. Pyogenic granuloma. It grew there over the course of a few weeks to about the size of a grapefruit seed. It's red, slick and pronounced. A vascular tumor -- that means it's all blood vessels.

I learned about the implications of a vascular tumor when I tried to cut it off. It bled so much I caught my breath. I was on land then, and the sink I was standing at splashed red all of a sudden so that my first reaction was to mentally locate the telephone.

I stopped the bleeding eventually and wore a bandage. But the tumor grew back, bigger and redder.

And so I went to a free clinic, knowing there was no way I could afford a regular doctor. Sarah, a young, pretty, dark haired girl who helped to qualify recipients of free care, exacted $120 from me as a sort of deposit. I only paid a small portion of the fee, promising more when I could. I then spent the entire day shuffling between waiting rooms before seeing a doctor.

"Pyogenic granuloma," she said, studying my pinky. She wore a white overcoat and she was busy. There were a lot of patients to see. "A dermatologist can remove it. We'll see if we can get you an appointment. They handle these by cutting them off and cauterizing the base. They have to be cauterized thoroughly or they'll just grow back."

I had had some experience with that growing back.

I spent another day filling out forms and listening to people cough in waiting rooms. I wrapped a make-shift bandage around my finger -- more to hide its hideousness than to protect it from agitation.

And then I was denied, with a trace of sympathy, by a baby-faced Latino office worker with gel in his hair. Without a letter from a social worker outlining my financial hardship, nothing could be done. Two days and some cash so far, and a diagnosis for my trouble.

I called some dermatologists in town and setup an appointment at a private clinic.

The doctor was young and pretty, energetic and friendly. Her practice was well furnished. There were magazines on a fashionable table, a leather couch and matching chairs. I wasn't sure how I'd pay.

I explained my plight to her with unforeseeable, surprising results. She quoted me an incredible price -- $100 -- and excellent terms. She was doing me a favor and I was thrilled. And then she cut the lump off my finger and cauterized its base while I eyed the paintings on her walls. They depicted cancers, growths and tumors at a cellular level. Oil on canvas. Her work.

I also watched her handle the tumor: an unexpected benefit of local anesthetic. Several times I nearly encouraged her to cauterize deeper. I knew that the tumor had progressed fairly deep. It was a detail that revealed itself to me the last time the tumor and I had faced off. Over the sink while the blood came out fast and red. But, I thought, She knows what she's doing. Don't bother her.

I left her office with a light chest and a new, professional looking bandage. A weight had been lifted. Now I could get to Florida and get my sailboat into safe harbor with one less thing on my mind. Soon I was on a bus headed south, and within a few days the bandage came off.

Of course, the tumor had grown back. Bigger and redder.

And so in the cabin of my Catalina sailboat I heat up a bolt until it's glowing red. I hope there will be enough fuel left to cook dinner after heating and re-heating stray bits of hardware, and then I toss two generic brand naproxin into my mouth on a sort of afterthought. Being Well All Day Pain Relief, the little bottle says. For temporary relief of minor aches and pains.

The pain is searing. It comes up my arm fast like a terrified creature, climbing my nerves feverishly like dry rotted ropes leading to safety. My hand is shaking, and it's time to heat up the bolt again. And then again.

When the area is carbon black, I cut away the brittle, cooked bits with a razor. And then I burn deeper, beyond the pink, soft tumor and to the gristly, red flesh. The skin curls up like burnt hair and I bite down hard on my teeth so they clack and breath through my nose like a dragon.

I wrap a simple bandage around the black wound. Then hope, hope, hope that the tumor is gone for good. There's enough fuel for dinner, and so I measure some beans and rice into a pot and set it on the already burning flame.

"Will the tumor return?" I ask the I Ching on a whim, tossing the three coins several times and building the hexagram.

"Approach has supreme success," the oracle responds. "Perseverance furthers."

Not-so-cryptic comfort from the ancient wisdom. I find a fork and wash it in the tiny aluminum sink, keeping my pinky extended so as not to splash it with water.