The missile struck me on the morning of May 18, 2010, in a hospital examination room in the presence of two people I had never met before.
But first a little background about how I got there.
It’s late March 2010. Since my 40th birthday I had been disciplined about going for my annual physical, and I had one coming up in early May. For the third time since January, I noticed I had some blood on the toilet paper after having a bowel movement. I called Dr. A, my fabulous family doctor, to report the problem and she said if it happens again come in right away, otherwise let’s have a look during your physical. Fine. Months later I would realize my body had given me a signal years earlier but I failed notice. That’s for another post though.
The physical came and Dr. A examined me as I laid there somewhat horrified, but I’d later look back and laugh at this episode as the least flagrant violation of my dignity.
“Everything looks OK, but let’s have specialist Dr. B take a look anyway. Maybe it’s a hemorrhoid or fissure or something and he can give it a little freezing and away you go.”
At this point I was moderately concerned and a little anxious I guess, but pleased to get the specialist appointment scheduled for only ten days hence. Later I would learn this isn’t because I am charming and handsome and good at euchre, but because I could be high risk for colorectal cancer and our medical system is set up to expedite cases like mine.
As an aside, I had my first lesson in how medical professionals are blase about their work versus the way a non-medical person might think about it. I called Dr B’s office to confirm my appointment, for what I thought was a colonoscopy.
“Oh no, you’re not having a colonoscopy. You’re having a sigmoidoscopy. Colonoscopy examines the entire lower intestine but for a ‘sig’ we only go up eight inches.” Ahem.
I picked up my preparation kit from Dr B’s office which consisted of a bunch of paperwork and instructions on medication I was to get, in this case a little suppository to ‘prepare’ my bowel. Where do they get these terms? Ain’t no way my bowel was prepared for what was coming.
Now, if you’ve never heard of or used a suppository before (I hadn’t), it sounds pretty simple. They are sometimes helpful to combat constipation but in my case were to clear the place out so Dr. B could get a good look. You take this slippery pill that is about the size of a multivitamin or something, and shove it up your rectum a certain distance, then sit back and wait for the fun to start a short while later.
I set up to take my suppository the morning of my sig.
Actually, the little devils are really slippery. Combine this with my usual clumsiness, lack of experience and lack of motor skills performing a task that millions of years of evolution have taught me to avoid, and you can see trouble on the horizon. And no effing way was I asking for help.
The little bitch won’t go in. My anus is tighter than Dick’s hatband and I’m failing badly, but after a few attempts I do manage to get it partway in. It feels like a hot poker from a fireplace with thorns and hot sauce on it. Hmm, that doesn’t seem right. Let’s reread the instructions. “Insert to the length of your middle finger”. Are they serious? Insert middle finger joke here.
By this point the suppository had fallen on the floor, and once I found it, it occurred to me that it might have gotten dirty, and should I wash it? Honestly. Is it OK to shove this dirty thing up my ass? I was in very unfamiliar territory here and I thought I was doing pretty well. It was on the floor after all. Does the five second rule apply? I decided to forge ahead.
The, uh, insertion was eventually successful, although followed by some muscle spasms in my lower back (don’t ask), and the suppository was fast acting and thorough in a way that would require a separate blog entry to do it justice.
I was prepared. I was so clean you could eat off my ass.
I arrived for my ‘sig’ at the Trillium Health Centre, a wonderful hospital, anxious but with no idea I was about to step off the curb in front of a bus.
A few minutes in the waiting room. Magazines exclusively geared to women’s interests, as if they are the only ones that visit doctors. It’s that or, and this has just occurred to me, all the dudes are stealing the good magazines. Or maybe they’re in the bathroom! Futz with my phone for a while. Geez this onscreen keyboard pisses me off. Cute nurse over there. Wow, that guy looks really sick. That lady can’t weigh more than 80 pounds. And what the hell is that smell?
I am called and escorted to the examination room at my precisely scheduled time by an under-appreciated volunteer.
The examination begins without fanfare.
“Hello Mr. Clement. I’m Dr. B and we’re going to do a sigmoidoscopy today to investigate the bleeding you reported. Please lower your trousers and lie face down on the examination table.”
Imagine a table only big enough for your torso, with a place to kneel at one end. Then imagine being tipped head first toward the floor. That’s right. Drawers down, ass in the air, and you know my cheeks were clenched.
“You’ll feel something a little cold now.” Understatement #1.
A medical imaging device the size of a blue ribbon zucchini with lubricant harvested from the polar ice cap of Neptune is placed against my anus, and the party starts.
My anxiousness and discomfort at this point did not escape the notice of the attending nurse, who put a gentle hand on my back and told me everything was OK. Amid all the expensive equipment, an excellent doctor, my thorough ‘preparation’ and with my best mental effort to deal with everything, what I needed most at that moment was a tender bit of human contact, even from a total stranger, to bring me back. Amazing. The laying on of hands. I hope they still teach that at nursing school.
Then, a surprised, “Oh! Forceps please.”
“Pull up your trousers and have a seat.” This was an interesting sentence. Did some people forget to pull up their trou before taking a seat, or was this just a way to say the exam was over? In hindsight, I wish I had taken a close look at the seat of the chair.
Examination elapsed time: 90 seconds.
“You have a tumour about 4 inches up your rectum which will require surgery. I don’t think you will need a colostomy bag, but I can’t be certain at this point. I believe the tumour is malignant but I will wait for the toxicology report to be sure.
“We’ll make a large incision from your navel to your pubic bone and remove a section of your colon.
“You’ll need to take a about a month off work.” Understatement #2.
He said a few other things that I can’t remember.
I fumbled my way through a few questions, trying to understand that he really said I had cancer and it was serious. Cancer? Cancer. Can-cer. /ˈkænsər/
“It can be serious if it has spread”, he said.
I shuffled out to the desk in the waiting area in a daze and waited while the nurse faxed some forms marked URGENT off to the surgical department at the hospital. “Sign here please. Take these forms to your family doctor. Are you alright?”
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 www.eatpoolove.com