Countdown to Surgery

There have been many times that I’ve had to compare my personal situation to others who were fighting any sort of battle with a medical problem, and a few minutes in any hospital or doctor’s office waiting room usually gave me good reason to consider myself fortunate on balance. With this in mind I look back on that 2 1/2 weeks between being told surgery was needed and the event itself. And I would also feel grateful many times that I was made to wait just three weeks from diagnosis until surgery. We certainly hear a lot of gloomy and critical talk about our health care system in Canada, some of it justified, but I was and still am grateful to live in our wonderful country that has such a system. And, I was about to cash in big time against all the money that was put into the system on my behalf over the years. Cha-ching!

To be honest, I don’t remember too much about this time except for a few milestone events. There was a lot of staring out windows, busywork around the house, and trying to make arrangements to suspend the operation of my piano business for an uncertain period of time. I guess I watched a lot of movies. But the big ball of fear was starting to recede as preparation got underway. I had a purpose, a mission, and as crazy as it sounds, I think I felt energized because something exciting was happening to me. This idea really messed with my head, and I spent many an hour wrestling with it. What the hell was wrong with me? But sometimes a cigar is just a cigar I guess. I forgave myself and moved on.

Remember Dr. A, my family doctor? I had been in her care for about 12 years by this time: I had physicals; she sent me to a specialist for knee surgery after I wiped out on my bike, and another time to have hernias repaired; I had warts on my foot; there were colds and flus and checkups for Madeline and various other minor things over the years. But now for the first time things were really serious, and as I went to see her for my pre-op physical, it occurred to me that she may have saved my life.

We had a nice discussion during the appointment. I had just had my annual physical a few weeks prior so the whole thing was really a formality, and there was a bunch of paperwork. So we talked and she was genuinely caring and compassionate toward me. I tried to imagine how many other patients she had who had problems as serious as mine or worse, and how often she had had to tap in to some part of her that allowed her to feel for them. How many times had she had to deliver the worst possible news to loved ones or patients? It must be exhausting.

When we were done I searched for the words to express my deepest gratitude but just ended up asking for a hug instead. Tears welled in my eyes when she said yes.

I also remember starting to feel pretty upbeat by this point in time. Things were happening and I was able to take action and move things forward. There were a whole bunch of people doing things for me, many of them strangers expressing their sincere best wishes. I felt their support and strength. Dr. B told me chances for a cure were ‘very good’. The word ‘cure’ hadn’t even crossed my mind up to that point. It was starting to seem that even though I had been unlucky to get the disease in the first place, I had a real shot at a relatively good outcome. It was as good as it could be under the circumstances.

At home that weekend we really just took it easy. The Sunday would be consumed by my ‘bowel preparation’ for the colonoscopy, and I really don’t remember, but I think we had a nice big meal on Saturday, or maybe we went out somewhere. Hopefully I had cheese covered filet mignon wrapped in peameal bacon and topped with poutine and whipping cream, followed by fudge cake, Cognac and a big fat cigar. Yeah, that’s it.Before I knew it, it was the week prior to my surgery. I was to go to the hospital on Monday, June 7 for a colonoscopy, and surgery would be the next day. Sometime that week I went for my first ever CT scan. Neat-o! It’s like a great big donut on its edge that you slide into, and I guess the result is kind of 3D x-ray image, and in my case the goal was to check my entire abdomen for any other signs of cancer. I’ve always been a sci-fi nerd so it looked pretty cool to me, right out of the USS Enterprise or something. One funny thing about the experience is that they have to inject some kind of dye into you intravenously, and it makes you feel like you have wet yourself. There’s also a kind of funny taste.

This brings us to the colonscopy prep at home on Sunday, which makes my suppository story seem like a day at Disneyland. Where to begin? OK, so the facts are that for a colonoscopy, they inspect the entire length of your lower intestine with a medical imaging device, or as Billy Connolly says, “they shove a television camera up your arse”. This part of your anatomy is about 5 feet long and the preparation is meant evacuate the entire passage so the doctor is looking only at tissue and not any waste or undigested food. Colonoscopy is a routine screening test for many things, and now they are recommending that anyone over age 50 get one to screen for colon cancer. In the event, your entire digestive tract from your stomach on down is evacuated. In my case, Dr. B was going to be looking for other tumours or polyps.

I’ve tried to describe this in cold medical terms to the best of my ability, but the reality of going through it is more like a horror movie that happens in the toilet bowl. ‘Alien’ with ka-ka.

My preparation would consist of drinking a large quantity of something with the jaunty but somehow inappropriate name of Colyte (actually it could be worse: a similar product is called Golythly, in what has to be the biggest un-truth in advertising ever), a ‘colon lavage’, about the size of a jug of windshield washer fluid, followed by a small bottle of Citromag laxative, just for good measure I guess. My wife and daughter laughed out loud when I came home from the pharmacy and plopped down this big white jug of fun on the counter. This whole stoicism thing seemed to have some kind of evil twin.

It’s pretty hard to describe the experience that follows, but imagine those blast off engines on the space shuttle firing poo. For four hours. It is without question the mother of all shits. And I have to tell you, there is some indescribably nasty stuff going on in your digestive tract, that we thankfully don’t have to know anything about most of the time. This video of comedian Billy Connolly describing his colonoscopy is hilarious but quite accurate (R rated – beware).

My loving, supportive and stoic family and I laughed and laughed at the absurdity of it all every time I sprinted for the bathroom. Tears of laughter were on my face even as I was on the toilet, literally holding on for dear life.

I had a good sleep and went in to the hospital for the colonoscopy in pretty good spirits but some understandable concern simply based on heading into the unknown. The lead up to the procedure went without a hitch; the signing in, the paperwork, changing into those fabulous gowns and paper slippers they give you, and waiting on a stretcher in the pre-op area where it was so cold I could almost see my breath. Looking around this area was instructive for me. It’s the ‘endo’ area, or endoscopy, where they do a few different procedures like colononscopy and EDG, which is like a colonscopy only down your esophagus. So there were plenty of other patients that morning getting a look up the rear or down the hatch. Gee, that guy looks pretty good; I wonder if he had cancer? That lady not so much. And this little kid here is having both a colonoscopy and EDG today, the poor little guy. He was there with his teddy in his wee hospital gown and smiled shyly at me from behind his mother’s skirt. I wanted to know everyone’s story.

The nurses were wonderful, and I marveled at their skills of being caring and warm, but also all business at the same time.

For these types of procedures they usually do what they call a conscious sedation, which is a way of saying you’re knocked out but they can rouse you out of it if need be. I had my IV all hooked up and was wheeled in to the operating room right on schedule, and looked around at all the equipment. No wonder hospitals are so expensive. I was kind of surprised to see Olympus makes a bunch of the imaging equipment but I guess it makes sense given their core expertise as a company. Dr. B was there and greeted me cheerfully and then took me through what was going to happen.

They have you lay on your left side for the procedure, with the doctor and nurse behind you, which means that all of us face the monitors that show the view from the camera that goes up your rear. Everything was turned on, and at one point Dr B laid the camera down on the stretcher behind me. I don’t want to tell you what I saw, but let’s just say I got a view of myself that would be impossible under normal circumstances. I managed a little chuckle as I imagined the sun shining out of there.

Dale has often told me that many surgeons, especially some of these GI guys, are sort of techno-nerdy in a way when it comes to the human body and some of the equipment they get to use. As they started the IV drip of the anesthetic, Dr. B thought it might be neat to show me my tumour before I went to sleep. I looked but I wish I hadn’t.

I woke in the recovery area later and was told again to lie on my left side and pass gas, because part of the procedure is for them to kind of inflate you so they can have a look. In due course I was passing wind at a rate suitable to propel a sailboat, and was laughing again as the ‘choir’ of other patients did the same. I thought it might be fun to try to get a little ‘call and response’ action going, but thought better of it. Can you imagine being a nurse in there and listening to that all day? They don’t get paid enough.

A while later Dr. B came to my bed and told me the best possible news: neither the colonoscopy nor the CT scan showed any other signs of trouble, not even any other polyps. We would be dealing only with the one tumour, and things were looking promising for a good outcome. Why couldn’t I be one of those 73% of people that survive? Someone has to, right? Right?

It had been a physically and emotionally draining couple of days, but somehow I went to bed in good humour on the eve of a defining moment in my life, and to my utter surprise, I wasn’t afraid.

Goodnight moon.

EAT, POO, LOVE is a comedy based on Paul Clement’s journey through colon cancer, from diagnosis to recovery. With a balance of humour and humility, it explores the fears, complexities and realities of dealing with cancer. Our patient surrenders his dignity with grace and insight, facing his doctors, his family, his own mortality, and even his tumour and all it represents. For Ticket and Fringe Festival information visit