I never thought much about colon cancer until I was about 60 and the girl on the treadmill next to me in the gym started kvetching about her upcoming ordeal. The worst part, she moaned, was the horrendous prepwork, which involved drinking gallons of sludge to properly evacuate her bowels. She didn’t say “Gag me with a spoon,” but I got the idea.
Shortly afterward, a long-time friend was startled in the night by a tumor sticking its neck out of her anus to snap at her as she applied the Charmin. This is the kind of grisly image that has a tendency to zip around your mind like a pinball on meth and send you screaming to the doctor. “Relax,” he said, “you have no signs and you’ve been taking Metamucil since you were 29. You’ll never get colon cancer.” Okay, if you say so.
Then, about five years ago, each of my sisters came up with a benign polyp during their own colonoscopies, which is like a brisk tap on the shoulder. Not wishing to have either anesthesia or an aggressive probe snaking through my nether regions, I decided to visit Shands for a virtual colonoscopy. This one requires no knockout juice; the attendant merely inserts a gaspipe, blows you up like a Macy’s Thanksgiving Day Parade balloon and slides you into a CT scanner. This works out fine if you have no suspicious issues; if you do, you go back for a regular colonoscopy. I didn’t. The only real downside is occasional sharp pains the rest of the day as the gas escapes your body. While this is going on, you have to be vigilant to avoid small children and members of the ladies auxiliary who might be frightened by the occasional thunderclap. By nightfall, the storm will have abated and all you’ll remember are the encouraging words of your doctor: “Since you’re 77, Bill, you’ll never have to do this again.” Insert Smileyface here. But, alas, lies, all lies.
And You thought You’d Like To Be A Postal InspectorEarlier this year, I changed primary care docs when my old one started beating the tub for Trump and handing out Ivermectin samples. The new guy, of course, suggested a colonoscopy, but I demurred. “How about we just send a stool sample to Cologuard?” he suggested. A what to whom? I was vaguely aware that this sort of thing went on, but not in the better neighborhoods. The scary idea of boxes of excrement floating hither and yon through the airways of America was somehow worrisome and fascinating. Who worked at these receiving plants on the tail end of the journey? When you apply for a position there and they tell you you’ll be starting at the bottom, they’re not kidding. Imagine your first day on the job. You get dressed up in your sweaty Hazmat uniform, enter your well-lighted cubicle and start opening….well….boxes of shit. Immediately coming to mind are the wise words of your father advising you what might happen if you abstained from that college education. Remember when you used to laugh at your cousin Eddie who worked in “waste management?” Well, Eddie was a piker. You have now reached the very pinnacle of the waste management business. And don’t bother looking around for Allen Funt because no, you are not on Candid Camera. It’s real.
So one day you get a perfectly cubical little box in the mail containing all the tools of excrement gathering. The box is cleverly constructed to also act as a return receptacle for your deposit. Reams of diagrams and instructions are provided, more than they give you to construct a nuclear power plant. The box contains basically four things; a plastic piece which fits from side to side of your toilet and under the seat; a large plastic bowl which fits inside of it; a short pencil-like object for shit-scraping; a bottle of liquid which is poured over the treasure deposited in the bowl. You have your equipment, the rest is up to you. When the job is done, you reclose your little box and rush off to the UPS Store, where the smiling staff can’t wait to meet you. On the way in, you wonder if the UPS workers recognize these little charmers and have a special bin for them, surrounded by a moat. But no, they treat them the same as they would Queen Elizabeth’s Crown Jewels. You leave, hoping there are no untoward incidents which require further inspection, and you smile finally, assured you’ll never have to do that again. But sometimes, as we all know, a funny thing happens on the way to the shittery.
A Double-Shot Of My Baby’s Love
It’s not every day you get a call from the Cologuard company, but you instinctively know it can’t be good news. “We’re sorry to advise you, William, that your sample is defective,” said the sad voice on the other end of the line. “I see” said the crestfallen feces donor. “Was it something in the manufacturing?”
“It was the amount,” she advised. “There was too much in the sample for the liquid to handle.” Well, I never! It immediately occurred to me that I was going to be responsible for discriminating shit removal, not the cheeriest of thoughts. After several minutes of serious consideration and analyzation, I summed up what I would need for the next attempt at glory. I could see this going on for some time, as in an Edgar Allen Poe story in which the principal adds a little here, subtracts a little there but never gets it just right. The search for the perfect bowl might be like Goldilocks’ hunt for the most comfortable bed, only an extended version. Fortunately, everything went right the second time. Well, almost everything. A few days later I got back the good news. “Hello, William, we have your Cologuard results. Your sample is positive. Have a nice day!” I never had a minute’s doubt this would happen. Walk by the tree every day, ignore the beehive and everything goes like clockwork. Put a stick in the hive and rotate, you’re on your way to Perdition.
The weighty columns of company literature admit that 14% of the Cologuard results are false-positives, though, so buck up, deflated camper. And all they really discern is blood in the stool, the possible result of a harmless polyp, as with your sisters. Even if worse comes to worse, there are reputed to be magic medicos in today’s world who can remove defective tissue, toss it aside and duct tape 82-year-old intestines back together again. Considering all this, I maintained my usual optimism. I went outside, looked to the skies and bellowed, “Run, run as fast as you can, you can’t catch me, I’m The Gingerbread Man.” I hope I have enough of a head-start.
The Medical Rube Goldberg Machine
Remember Rube Goldberg? Rube was an American cartoonist prominent in the 1920s for certain chain-reaction contraptions designed to perform a simple task in an indirect and overly complicated way. Think the domino effect, but with traffic circles. Or recall the linguist who advised the politician never to use a simple word when a five-syllable substitute would do. This is the University of Florida Shands Medical Colossus, where seldom is heard an encouraging word and the skies are real cloudy all day.
It all starts with a simple phone call. No matter whether you are the lowest grunt on the street or the Mayor of Peoria, you will be put on hold and forced to listen to atrocious music. How come these people never play Red Headed Stranger by Willie Nelson or Unchained Melody or at least Take Me Out To The Ball Game? It’s always unidentifiable dreck piped in from Sphincterville. You can hold or leave your number and someone will call you back later in the day or as soon as Hell freezes over, whichever comes last. I put the phone on speaker, wash the curtains and feed the goats until I hear something. When someone finally deigns to answer it will absolutely not be the person you need, so you will be transferred to another party currently unavailable, which starts the merry-go-round all over again. This time we get Lawrence Welk and the Honolulu Fruit Gum Orchestra playing Tiny Bubbles In The Wine, which, believe it or not, is an upgrade over the previous number, a sad ballad of unrequited love among the swineherds of Jalisco.
Nonetheless, after endless hours of watching Shands employees place things on top of things, I finally come upon an oasis in the desert. Her name is Sendrella, she works in Radiology and has all the answers. Grateful, I promise Sendrella her weight in lemons if she will only solve my problems. She tells me she is the mistress of the maze, born to stand and deliver. We’ll see. I have dutifully bagged several dozen citrus delights, placed them in the trunk of my car and cancelled all my previous appointments. I can see clearly now, the rain has gone, and I’m sitting here hopefully, listening to the Beatles sing Don’t Let Me Down. It’s hell when the thing you need most is a virtual colonoscopy and the only light in sight is a phantom named Sendrella.
Here Comes the Sun
Oh, somewhere in this favoured land the sun is shining bright. The band is playing somewhere and somewhere hearts are light. And somewhere men are laughing and somewhere children shout. But nowhere more than Fairfield, where Bill’s schedule has come out.
By the time you read this column, I will have picked up and digested my bowel swill, tootled off to the virtual colonoscopy building and been dutifully surveyed by the Magic Eye. The day may be rainy or sunny, but I’ll have a little less money. Turns out the free virtuals of 5 years ago are now in the neighborhood of $2000. If you don’t believe me, just ask Medicare. It will be worth it, of course, if I turn out to be problem free. If not, it’s off to the man with the big snake and I don’t mean Doctor Thacker. That’s life in the big city. Either way, when it’s over I’m sure the docs will look at me, smile and say “Bill, you’ll never have to do this again.” But we all know I will. That’s the price you pay if you want to live forever.
That’s all, folks….
Afterthought: I realize my readers are very clever but nobody gets merit points for emailing me a comment like “What a shitty column.” This means you, too, Thacker.