A Perfect Day for a Colonoscopy

My doctor had advised me to have this procedure done but I resisted. First, it was an act based on typical denial--of age, of the possibility that I had neoplasms growing inside my rotting guts, of the decline in my physical power, of my mortality.

Then it shifted to a child's fearful resistance against an unpleasant procedure and preparation. Prostate exams were humiliating enough with their drop-trow, bend-over, finger-butt protocol and the memento of vaseline on cheeks. The prospect of having a tube snaking a few yards up my bowel signified the end of dignity, the portal of emasculation. And if that was not enough, there came a day of fasting on the eve of the procedure like an act of contrition for the sin of eating, and a purge of vile-tasting osmotic GI flush euphemistically labeled"Golitely" (as if you could visualize Audrey Hepburn's Holly Golightly of Breakfast at Tiffany's evacuating her guts ad nauseum while singing Moon River).

Finally, a television feature on the number of New Yorkers presenting with advanced colon cancer due to a lack of screening convinced me that I was letting my fear of unpleasantness interfere with my responsibility to my wife and under-college-age daughter. I called my family physician and a gastroenterologist and scheduled a colonoscopy for five days later.

In the days between the set-up and the lie-down (which I identified in a countdown to the big day, as in 5 PC, or 5 days pre-colonoscopy) I was filled with speculative thoughts of how this procedure would play out and where it might lead me. Every passing moment increased my dread of impending death and each of my pleasant pastimes made me elegiac. By projecting myself into a hypothetical future of polyps, tumors, Gleason scores, and carcinomas I was indulging in premature nostalgic for the life I loved and would surely lose. Two days before the fateful diagnostic I met a woman while swimming who said she was afraid of getting jostled during lap swim because of her breast cancer operation. Of course, I interpreted this encounter as a portent of my fate. Had I set in motion a series of disclosures that would change my life forever?

Of course, I had no signs or symptoms of illness of any kind. In fact, I had never felt healthier. I swim a half-mile a day and eat lean protein and salads. I do not drink or smoke. (My mind is another story--that is pretty sick--but I keep a firewall between mind and body. Being Cartesian has its advantages.) However, instead of building my confidence about the test ahead, my robustitude intensified my sense of vulnerability and disaster. I have always subscribed to the pessimistic theory (irony-based) that every good day is followed by a bad one, every gain subtracted by a loss, and that you are most susceptible to catastrophe when you feel your best. "Of course, I am due for terrible health news," I thought, "I feel great."

I became more nervous by the day. But I also longed for the C-day to come so it would finally be behind me. On the eve of the colonoscopy, or 1 PC on my new calendar, I fasted. Despite the prohibition on eating I bought a pound of Napoleon cherries that I would forego for a day. Even the daily specials listed on the window of a greasy-smelling diner made me salivate. But I was strong and ate nothing. That evening I imbibed my preparation cocktails, two liters of "Moviprep." Why do they give these liquid purges Hollywood-sounding names? Is it a perverse joke to remind you how far you are at that moment from your dreams?

Colonic cleansers, such as Sonne's, work on the principle of gravity, evicting stools with heavy bulk. By contrast, osmotic sugar-and-electrolyte cleansers like Moviprep draw water out of the intestines and flush out the solid wastes. It's like pissing out of your ass. Even in the middle of the night, I was summoned out of my dreams to the lue by the inexorable pressure in my gut.

Finally, this morning I awoke, showered, and put on my best pair of underwear, which I had saved for the occasion (an epileptic co-worker once advised me to wear clean underwear in case I had to go to a hospital; as if hospital workers practiced a strange triage, treating people with good underwear better). I arrived at the GI clinic forty-five minutes early, did the paper-work, filled out a sheet on which I had to report whether my stools were solid, cloudy, or clear, and retired to the treatment area. There I was told to take off my clothes, underwear and personal effects and place them in a locker. I put on two hospital robes, one with the back open, the other with an open front, so I wouldn't have to walk around with my buttocks showing. I slipped on the little brown booties they gave me to keep my feet warm on the cold linoleum.

As I trudged out to the large room I felt like a true patient...stripped of clothes, without pockets, something now to be looked at and treated. Then I went to the chairs facing the Hudson River and looked out at the majestic view while a young nurse inserted a catheter into a vein in my hand. It popped out, so she tried it again. Another patient remarked what a beautiful day it was. To which I replied, "A perfect day for a colonoscopy."

I had never been in a hospital gown. I had never been under sedation and I did not know if I would be allergic to it. With my propensity for imagining the most twisted outcomes, I thought it would superbly ironic if I had no colon problems but went into a coma because of the sedative. So I asked the doctor to put me on the least amount and he agreed to give me only enough sedative to make me comfortable. I was eager to watch the whole procedure on the monitor. I was really enjoying it. And then it was over. And I felt sure that I had seen it all. But it went by so fast that I could not be sure. I probably went in and out of consciousness like an exhausted cinemaphile fighting to keep his eyes open for a 3 AM broadcast of Citizen Kane. At any rate, I saw enough pink muscle, yellow surfaces, and dark tunnels to know that I was looking at my guts.

The doctor pronounced that my colon was perfect. No polyps. I was wheeled out into the recovery room, which was also the dressing room and the IV-and-blood-pressure room. My wife came and I opened my eyes and read the sports section. The sedative they gave was great. It made me feel relaxed and sleepy in a warm midsummer under-the-trees rustic meadow way.
Now I feel great. I am a believer in colonoscopies. I recommend them to everyone. And the hospital where I underwent the procedure does indeed put patients first as their motto proclaims on nearly every wall. This is what a favorable diagnosis can do, how it can make you feel. This is also what happens when you approach the terrifying figure you see ahead only to realize that it is a shadow in which you have protected your fear.