HospitalWorld Re-Visited

Welcome to the Machine

Photo by National Cancer Institute on Unsplash

It’s easy to check into the place I call HospitalWorld. Anyone can do it. All it takes is a failed brake,  a power tool gone berserk, a pesky pimple that just won’t go away. It can happen in a moment or over a decade. Here’s how I got there:

After a solid 10 years of dilly-dallying and last-minute appointment cancellations, six months shy of my 60th birthday, I decided, against my every inclination, to allow another human being—another guy, no less—to insert a flexible plastic pipe up my butt for the purpose of confirming the nagging, circling fear that had plagued me all those years: the constant but unspoken certainty that I was seriously and irrevocably sick.

A total lack of evidence on this score gave me no comfort. Fear takes root unbidden and unburdened by fact. Nevertheless, seeking out any facts that would confirm the sheer silliness of that certainty was the last thing I wanted to do. Evidence can cut both ways.

As I said, I kept my fears to myself. The upbeat, I’m-All-Right-Jack character, whose wrinkled, whiskered visage I saw every morning in the bathroom mirror knew that I was being foolish. After all, I was still young. Ish. If my hair was gray, at least it was still there. I was a mere 20 pounds over my ideal weight, though this was, in turn, 20 pounds over what everybody else thought was my ideal weight. Didn’t I eat entire bunches of broccoli (“the scouring brush of the colon”) every week, even if they were doused in volcanic-level garlic sauce? How many news stories had I read (exactly one, in the supermarket checkout line, as I now recall) that declared science was beginning to think that being pear-shaped was as natural for a man of my years as going bald?

Hell, didn’t I go to a fancy gym every so often, especially when the fancy gym’s “Aerobic Cinema” was playing The Dark Knight? Didn’t I eat three squares a (12-hour) day and walk (sometimes skip!) up and down the stairs to and from my basement lair half a dozen times a day, the better to restock my supply of diet soda and Cheez Doodles?

Here was the bottom line: I was a guy, and guys just don’t do colonoscopies. But as the years drifted by, I found my psychological immune system had begun to break down under a barrage of dire warnings from friends, cancer researchers and the health section of the New York Times.

So, one balmy June afternoon I closed my eyes and took the plunge. I called a gastroenterologist.

By the time I’d arrived at the gastro guy’s dim, tomb-like waiting room, I was ready to bolt. What had I been thinking? What, I asked myself, had gotten me so worked up? I had better things to do than sit around leafing through back issues of Ski, Golf Digest and Outside.

The  gastro guy seemed kindly and solicitous. Avuncular. He had a heavy, handsome face with thick swatches of silvery hair swept like wings on either side of his head. Think Christopher Plummer, in one of his good-guy roles.

The kindly gastro guy asked me a few questions. He barely raised a silvery eyebrow when I assured him of how basically healthy I knew I was and I just came to be reassured. Medically.

The kindly gastro guy smiled weakly as I blathered on, burying his growing impatience by gazing down in apparent fascination at the appointment calendar that graced the vast expanse of his spotless mahogany desk. With an air of practiced aplomb, he withdrew a fountain pen from the pocket protector on his spotless white doctor’s smock, unscrewed it, pointed it at his DayMinder and smiled pleasantly at me again. I knew what he was about to say before he’d uttered a word. It went something like this:

“Well, my young friend, I’ve never seen a healthier specimen than the man I see before me today. I can tell just by your clear-eyed gaze, your ruddy complexion and relaxed posture that you’re simply not the type of man to harbor nasty, life-threatening masses in your gut. I have very little doubt that you will  probably live for a good portion of forever. Why don’t we just call this whole silly examination off? Don’t even bother with the copay. This one’s on me. A fine specimen like you, getting a colonoscopy. How amusing. Good day to you, sir, and thank you for a very pleasant visit.”

What he actually said was, “How’s Monday at ten?”

“At the, uh, hospital?”

He nodded his avuncular head and scratched my name in his book.

It was too late to stop now.

Reaching for a little packet of papers, the kindly gastro guy said there were a few things I’d need to know and do before checking in. Chief among them was the absolute necessity to ingest not one but two bottles of citric nitrate laxative the day before my inspection.

“Citric nitrate?” I said, stupidly. “Isn’t that the stuff terrorists use to make bombs with?”

He smiled tolerantly while I read a tip sheet full of warnings of what else I had to do to qualify for something I didn’t want to do in the first place.

I stared at the sheet, looking for good news of any sort. Yes, I’d have to fast a full 24 hours before the inspection. Yes, I’d have to down the laxative.

BUT! Down near the bottom of the page, it said I could eat all the lemon-flavored Italian ices I wanted, right up until midnight of the day before “the procedure.”

Hot damn!

• With that thought, and without realizing it, I’d begun to think like a patient. I’d begun, without prompting or foreknowledge, to count my blessings. To watch for silver linings, no matter how threadbare.

Go ahead, my incipient-patient-self told my unwilling, disbelieving self—enjoy!

While you can.

***

 Monday dawned warm and brimming with anxiety. I checked into HospitalWorld feeling all empty inside.

Once admitted, I found myself in a tiny, dimly lit double-occupancy.. I stripped off my street duds, joking with the pretty nurse who wrestled me into a backwards-buttoning gown. She asked me my birth date, looked at my chart, agreed that I’d nailed it and in a single deft move, slapped and somehow secured a plastic band around my left wrist that bore my name, a bar code and—you guessed it—my birthdate.

“In case you get lost,” she said.

If only.

Informed that the kindly gastro guy was ready to inspect me, I kissed my wife Patty so long and allowed a burly orderly named Charlie to wheel me into the operating room on a cold metal gurney. I could have walked, of course, but Charlie wouldn’t hear of it and he looked burly enough to enforce his desires.

As we arrived in the insanely bright  room and after correctly guessing my birthdate yet again, someone wearing a mask and a billowy hairnet took hold of my arm. I remember wondering idly where Patty and I would have lunch that afternoon, once this rigmarole was finally over and all my doubts had been banished forever.

***

Next thing I knew, it was three hours later and I was back in my room, which was now occupied by an elderly gentleman and his wife. They were speaking, I later learned, Ukrainian, and loudly.

I was conscious enough to remember a story my primary physician had teased me with when he urged me to get inspected: He’d told me that a number of his other colonoscopied patients had confided that they’d experienced erotic dreams during their examinations.

I have to rely on Patty’s memory for the next part of the story, because I don’t remember any of it. As I was being wheeled into my room, I told her I hadn’t had an erotic dream.

“I had a sports dream,” I said, my voice dripping, she told me, with disappointment.

It would be the last laugh we’d share for some time.

Meanwhile, back in my room, the kindly gastro guy had appeared at the foot of my bed, and he wasn’t smiling.

“We found something,” he said.

I turned my woozy head to Patty, who clutched my hand.

“Something?”

“A mass.”

“Cancer?”

“We think so.”

Stumped for a snappy follow-up, I asked how big this “mass” was, figuring that doctors have a way of describing something unusual by its comparative value, the same way newspaper reporters describe hailstones as being the size of peas. Or walnuts. Or golf balls.

“It’s ... rather large,” he said.

Visions of baseballs crowded my head. Softballs. Before I got to basketballs, I had a vision. It was a black-and-white vision from a treasured movie memory of Stairway to Heaven: A Matter of Life and Death, in which RAF Captain Peter Carter, played by David Niven, his pilot’s goggles askew on his forehead, and with the Number Three prop blazing away in the background, tries his very British best not to reveal the rather catastrophic extent of the damage to the bomber he is captaining. He struggles instead to keep his men’s spirits up at the rather bad news that their rather hopelessly shot-up jolly old plane was doing rather badly at the moment and yjay they will rather more likely than not be forced to ditch the old girl at any moment now.

It was then that I decided the Capt. Peter Carter approach to catastrophe had its merits. I didn’t really want to know the specifics of my diagnosis, and I wasn’t going to push for any further information. Cancer is cancer, whatever its size. Besides, the kindly gastro guy would probably have described the size in centimeters and I was in no mood to do the math.

The kindly gastro guy suggested I spend the night in the hospital so that a surgeon could remove that rather large certain something first thing in the morning, along with whatever section of my upper colon to which it had grown attached. Staying the night, he explained, would spare me the expense (three dollars!) and bother (considerable) of having to down another couple doses of citric nitrate.

There it was, at last: the silver lining. No more citric nitrate! I had to fight the urge to say, “Does that mean I can have an Italian ice now?”

Instead, I heard myself say, in a voice I hardly recognized as my own, “Let’s do it.”

It occurred to me much later that those were the exact words—the last words—the killer Gary Gilmore said as he stood awaiting his fate in front of a Utah firing squad.

No sooner had I agreed to spend the night than the kindly gastro guy vanished and was replaced by the pretty nurse who had banded me earlier. She said I wouldn’t be allowed to eat food the rest of the day. But I could eat all the ice chips I wanted, right up until midnight.

It was at this point that I realized I was about to say goodbye to everything that was normal and natural to the American male. I was a captive. HospitalWorld had taken my clothes, whatever money I’d walked in with (a harbinger of what was to come) and whatever dignity had survived my inspection. There would be no Cheez Doodles for me that night, no bounding up and down the basement stairs, no fooling myself about what I was facing.

I was, as Capt. Peter Carter would have put it, in rather a tight spot.

The pretty nurse got right down to business: did I have to urinate? If I did, there was something for me to use. She offered me a milky-white plastic quart bottle with a bent neck, a dangerous-looking ragged interior edge and a snap-fit cap that didn’t snap-fit. On its handle were embossed the following words:

“Welcome to HospitalWorld, dude.”

And below it, in even tinier script:

“You can check out anytime, but you can never leave.”

It was a familiar refrain, but it did nothing to cheer me up. I immediately ordered a heaping pile of ice chips and started planning my escape.