Chapter 2: You’re going to put that where? Midazolam, please.

When we last left off, I was pooping incessantly and, like an Orientalist whose map coordinates had been shifted a bit too far westward, blaming the exotic peoples of Eastern (Central?) Europe for my troubles.  Of course, as the weeks and then months wore on, the effects of delicious Tbilisi chew (actual name Khachapuri, according to my friend Ayse) seemed less and less likely a culprit for my lack of intestinal fortitude.  I suggested to the Cambridge City Council that I might have been a victim of witchcraft, and that we begin post-haste weighing local women against ducks and/or very small rocks to see if we could find the root of my problems.  Alas, I was told that with post-recession austerity measures in place that this suggestion was financially exorbitant, despite my insistence–Cambridge being the home of Keynes–that it would create jobs and pump much needed capital into the local economy (where’s Paul Krugman when you really need him?  Looking out for Paul Krugman, that’s where).

With my best ideas for defeating the occult practices likely to be causing my ailments shot down, I had nowhere left to turn but back into the questionable hands of modern medicine.  My symptoms were not abating, and in fact were sometimes being accompanied by cramping that would nevertheless relieve itself on its own in less than a day or so.  I would return to my local clinic from time to time to have blood collected.  I assumed these vials were analyzed scientifically, but also hoped the procedure might double as a letting of evil spirits–no need to throw out the old rule book entirely because a few new discoveries in the field of health have been made, am I right?

Eventually I had another series of stool samples taken in 2015, the techniques for transporting and tracking faecal matter from point A to B having advanced tremendously in just a period of months since my last batch had been misplaced. The second set of results revealed that my calprotectin levels were fairly elevated, a sign I might have inflammatory bowel disease. This was in April, and I was referred to see a gastroenterology specialist by June 19 (the NHS glides at a leisurely pace befitting an honorable and refined organization.  It does not move to the hurly-burly demands of your infernal industrial timepiece, sir!)

As it turned out, other events intervened.  At the end of May I flew home to Minnesota (state motto: like if Wisconsin was livable!) for my grandmother’s 90th birthday.  The morning of my trip I started to experience stomach cramps, the sort that had gone away on their own in the past.  Undeterred, I caught the train to Heathrow, boarded my plane, and upon take off began watching Thor: The Dark WorldBut as Odin’s Ravens are my witnesses, not even the indisputable romantic chemistry between Chris Hemsworth and Natalie Portman could distract me from the increasing frequency and intensity of the stabbing pains I was experiencing in my abdomen.  After about 9 hours stuck in an aircraft testing my mettle (I got a C-, no sweat), I arrived in the Twin Cities and proceeded to the hospital.

Over the next few days, I got a CT scan and a flexible sigmoidoscopy.  The scan revealed a thickening of my colon wall, consistent with ulcerative colitis (by the way, you know you’re in a bad place health-wise when you keep thinking “I would love to have ulcerative colitis”). Surprisingly, it also revealed some odd spots scattered throughout my liver.  The report read that because of these spots the radiologist could not rule out metastases. This was my first true “what you talkin’ ’bout Willis?” moment throughout the whole affair.  The flexible sigmoidoscopy a few days later was the kicker.  It’s a fairly simple procedure to describe to a layperson.  A doctor takes a probe with a camera, or “endoscope”, has you put on a gown which exposes the entire “crack” of your butt and robs you of your “dignity,” and then sticks said probe up your backside, which makes you feel like you are going to “poop” all over the “examining table.”

When asked if I would like to face the video screen that would show what the camera was recording I foolishly said yes.  Curiosity, you know?  You don’t want to look back on your life and say you missed your one big chance to see up your own rectum and beyond. I’m not a medical doctor–I’m one of those fake doctors that spends 5+ years in graduate school so ultimately you can earn enough to go really nuts at H&M once in a while, then repress the guilt-ridden thoughts about the child laborers exploited to make those H&M garments by having a bowl-sized glass of watered-down margarita at TGI Friday’s (note to H&M and and TGIF’s:  from this paragraph and blog you should realize suing me for libel would be pointless and bad PR.  Blood, stone, squeezing, etc.)  Despite my lack of knowledge of medicine or basic physiology, however, what I saw on the screen made me think “uh, that looks like a whole mess of cancer.”

A flexible sigmoidoscopy concludes as follows.  You go back to a private waiting area which abides by the motto “[ass] crack is whack” and are allowed to change back into your clothes.  Then a very sincere and somber doctor tells you that you indeed have a big cancerous tumor obstructing your colon, which explains the painful abdominal cramping.  Then your pupils constrict to approximately the size of hydrogen molecules (or any diatomic nonmetal, really), and as you watch your parents who have come with you try to hold back their tears, you get the urge to sprint down the hallway as fast as humanly possible, realizing that your stupid primate brain’s fight-or-flight response has evolved tremendously well for dealing with pythons but is not the tops when it comes to internal disease.  Then the person at the reception desk helping you check out, through no fault of her own because she has no idea what news you’ve been told, tells you to have a nice day.  And then instead of hitting her over the head with a chair or committing some other kind of felony, you smile through gritted teeth and say “you too!” And that’s the flexible sigmoidoscopy procedure in a nutshell. As I said, pretty basic.  Your experience may vary.

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