As I’m 50 this year, my body seems to know it’s time to speed up its degradation. No matter how hard or long I work out, my belly still flops out. My eyes have given up trying; I now have “progressive lenses,” formerly bifocals, and reading glasses to complement my contacts. Seems strange to have two sets of corrective lenses between my eyes and the monitor on which these words appear, but without the two, they wouldn’t appear.
50 also has meant the screening colonoscopy, what its providers call a “procedure.” Bad things often are called “procedures.” A “procedure” probably preceded Louis XVI’s beheading.
My internist, Dr. B, delivered the news at my recent physical that it was time for me to have a colonoscopy. “You don’t want colon cancer.” No, I don’t, although it was unclear to me throughout this process why I would go through one screening procedure but not a host of others. God knows how many illnesses Modern Medical Science can detect in their infancy, but I don’t get tested for those. More precisely, my insurance doesn’t pay for them. My insurance does pay for screening colonoscopies when unfortunates turn 50. Given that literature about My Procedure confided that one has about a five percent chance of getting colon cancer, and that for those with family histories, a large Why? loomed.
Now I understand. But later on that.
Dr. B referred me to Dr. T. Dr. T works for NW Gastroenterology Associates. This is a collective of MDs who specialize in colonoscopies. Let me rephrase that: This is a collective of MDs who specialize in sticking long tubes up people’s butts to scope ‘em out. So the other thing initially unclear to me was why anyone capable of acing the MCAT would want such a job. “How was your day, honey?” “Pretty good. Snagged a doozy of a polyp.”
Now I understand. And later on that too.
I called the clinic and made an appointment for My Procedure. A packet arrived in the mail a few days later. Several pages offered reasons to get a colonoscopy and why a full rooting through one’s intestines was preferable to a sissy sigmoidoscopy. A separate pamphlet invited me inside to learn about “bowel preparation.” Ah, I thought, that doesn’t sound so bad, “preparation” – like making a salad. I opened the pamphlet.
YOU WANT ME TO DO WHAT?!!! The pamphlet described a five-day process towards spiffy clean intestines so that Dr. T wouldn’t have poo – at least protopoo – obscuring his view. The process would start out gently enough, no aspirin and avoiding nuts and beans and other pokey things for a few days. But the day before My Procedure, I would consume only clear liquids while evacuating my bowels with help from a product weirdly called HafLytly. And THEN Dr. T would stick the long tube up my butt.
All week, I tossed and turned dreading the whole thing. My Procedure was midafternoon Friday. I got the HafLytly kit the Sunday before. It included an alarmingly large container that would hold a solution (“you have a choice of three flavors!”) I would consume early Thursday evening. The instructions said that I would drink an eight-ounce glass every 10 to 15 minutes. Soon I would have the first of several “watery bowel movements.”
Wait. I reread that. Yes, “watery bowel movements,” it actually said. Several.
Thursday came, finally. I hadn’t really appreciated how limiting a diet of clear liquids can be. I stocked up on chicken broth, apple juice, SoBe green tea, and gelatin, each of which I will not consume again this year. Out of a spirit of culinary adventure, I tried combining certain of these raw ingredients, achieving for lunch a rubbery concoction that reminded me of early childhood, when one chews things like glue, erasers, and cardboard also out of a spirit of culinary adventure.
Just after lunch, I took two pills that came with the HafLytly kit. “You will have a bowel movement within two or three hours.” I apparently am an ambitious sort. I was at the john 10 minutes later.
I spent a miserable afternoon as my stomach rebelled against this unforeseen onslaught. My body alternatively shivered with chills and flashed hot, sweat beading all over even as buried myself under a blanket.
I had mixed the HafLytly solution first thing that morning. The flavor choices were Orange Orange, Cherry Cherry, and Lemon Lime, the makers apparently unclear on the concept of species variation.
I had chosen Cherry Cherry. I drained my first eight-once glass. The liquid tasted like punishment for some past life transgression, and its glycerin-lite consistency made it feel uncomfortably comfortable going down. I didn’t make it to the second glass before the first watery bowel movement struck.
If I have learned anything, I have learned that watery bowel movements are demanding stepchildren. I spent the next three hours in the bathroom. The first hour and a half included 10 to 15 minute intervals before the next glass of HafLytly. Each tasted more sinister than the last. I kept looking at the container, thinking that the last glass was at hand, but like an endlessly refilling magic glass I had as a kid, there ever seemed another eight ounces of Cherry Cherry nausea in a glass.
Watery bowel movements. Watery bowel movements. Watery bowel movements. There was no God.
Toward the end, the watery stuff turned fluorescent yellow. Pure bile, I supposed. Now why would the body bother with so bright a color for something normally inside us? I mean, colors typically occasion warning or invitation. Assuming fluorescent yellow would strike Primitive Man as a warning, one must wonder what Primitive Man consumed.
I tossed and turned all night, images of Evil Dr. T snaking yet more and more of his infernal tube up my butt.
Friday morning arrived a year or so later. I spent the morning working, thinking how sad it was that working seemed preferable to living. Shortly after noon, David drove me over to the “facility” where My Procedure would occur.
The facility happened to be in the same doctor office building where Dr. B works. I had expected something more hospitallike, so it was a surprise to walk into a waiting room decorated like a spa. A cheerful receptionist greeted me. “Have a seat. Heather will be out shortly.” Ah, I thought, Heather. Scotland. Summer. My brother and me riding bikes around Loch Ness, the scent of heather sweeping down the hillsides. Heather.
The door to the “Procedure Area” opened. A nurse sheparded out a guy about my age. He was grinning goofily. An older man got up and went to him. The older guy slapped the patient on the back. “Welcome to the club!” He boomed. “Howya feeling?” The patient smiled goofily wider. “Heh, heh,” he said.
After distracting myself with an article about Buckminster Fuller (he was severely nearsighted and believed the world was fuzzy until he first got glasses), Heather appeared. She led me into the Procedure Area. The space had several nooks that could be curtained off surrounding a central desk area. Each nook had a rather narrow hospital bed, more a gurney, actually than a bed. Heather weighed me and led me to one of the nooks. She told me to undress and put on one of those infernal hospital gowns that only contortionists can tie.
Once appropriately unattired, I lay back on the bed while Heather quizzed me about my health. She was a remarkably nice lady. “Yesterday was pretty rough, huh?” I nodded. “This will be a much better day,” she said, warmly. I wanted to hug her.
Heather instructed me on what to expect. “When you’re done, you’ll have air inside your intestines. We actually encourage you to let it pass.” To a guy raised by a British mother, the prospect of permissible gas passing was heartening. “Don’t worry,” she added, “It’ll just be air. So it won't smell.” Wow!
Heather stuck something into my wrist and attached a tube that snaked up above the bed. “It’s a catheter,” she explained. “Liquids now, but we’ll use the same catheter for the sedative. No need for another poke,” she added. She winked. Really.
I sat/lay in the bed for about 15-20 minutes. A patient was wheeled out and set up in one of the nooks across the room. A gray-haired guy, the patient’s partner, it seemed, came in. He chatted with the nurses about his upcoming colonoscopy. A nurse said, “I’ll recognize your face.” “You’ll recognize more than that,” he said.
Soon enough, Heather wheeled me into a chamber off the central room. On one side was a large machine, presumably the apparatus that had ambitions on my intestines, but for the life of me I couldn’t make out which part would go up my butt. Dr. T was in the corner, typing away on a laptop. “He’s making notes about the last procedure,” Heather advised with the tone of voice Mother Theresa must of used when trying to calm distraught lepers.
Dr. T came over. He was strikingly good looking for a guy old enough to get a colonoscopy. He too spoke calmly and warmly. They all must go through the same training. Dr. T explained that I would be given a sedative. I would be awake, but I might not remember the procedure. Sounded like seventh grade.
Dr. T had me lie on my left side. I felt a cold sensation where the catheter was installed. Then a very comfortable state of being followed. I think I remember something going on at my bum, and I think I remember images of my colon on the monitor beside the bed, but, really, I think I only think I remember. This was one very nice sedative. Nothing hurt. Nothing seemed wrong. I’d have just as soon had Good Dr. T carry on for the rest of the day.
Then I found myself in a nook across the room from where I had started. The nook had a wide window that let in the afternoon sun. It felt really good. David materialized, it seemed, out of thin air. I tried passing gas. Pbubbbh. Ah. That felt good. Pbubbbh again. Then I became conscious that others post procedure were in my vicinity. Pbubbbh, they said. Pbubbbh I echoed. We were soulmates.
I understood then what had eluded me. First, we get colonoscopies partly because shamanism still is a part of medicine. The process leaves you ending up with the sense that something has been put right, even if nothing actually happened other than getting a tube stuck up your butt. And you get to join The Club, an adult version of treehouses, secret decoder rings. Insurance limitations assure that that The Club is an exclusive one.
Second, I understood why smart cowpokes become gastroenterologists. The ones who manipulate the scopes are diagnosticians. If they find something that requires further treatment, they refer the patient on. No relationship. No grief when darkness reigns. And, at the same time, the actual scoping is, compared to the “bowel preparation,” not so bad after all. Maybe not enjoyable, exactly, but, having been in a fraternity, more enjoyable than many Saturday nights I’ve spent. Only when the patient is high as a kite does the doctor get involved. Oh, and did I mention how good looking Dr. T was?
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