16.11. Royal Prince Alfred Hospital. Midday: A gentle pushing on the walls of the arse, the door to the rectum. I rise, thinking of taking a walk around the corridors before lunch. But no, shit first. Or, rather, hope for a shit first. Calmly pull open the heavy wooden door of the bathroom in my room, slump, tartan jarmies round the ankles. Aaah, release, aaah, FUCK!! A torrent of blood , gaily pink like watermelon juice, mortality pouring out of me bum. OK. Finish, wipe carefully, observe the pink spots high on the white bowl’s rim. They leapt up towards my tired old arse.
OK so I’m still dumping blood. Still I can walk. I stand, and, what is this, the word faint makes sense for the first time, nearly turning from a noun into a verb ‘I feel faint’ coming perilously close to ‘I fainted’. But no. I grab the steel bar (installed for the disabled) close my eyes, lurch out of the bathroom and fall, heavy as a sack of laundry, onto the bed.
Dee-op dee-op dee-op. The saline drip is telling the sweet dark nurse who saved me (Emma? Emily? Amanda?) a dark haired Botticelli angel with sleep deprived eyes I’ve had my 990mls and now need less, turn down the volume. That means no more food – in ward jargon, NBM, nil by mouth. Pity. Outside, meals tick off the hours and days. The food, the food, the food.
‘The damned are forbidden to forget, sleep or faint” wrote William H Gass in an essay on Stanley Elkins’ The Living End, a novel attempting to answer the question (imagined by Gass as posed by Elkin on his way to and from the bathroom in the middle of the night, a locus and time I understand deeply) ‘what if all this stuff about heaven and hell is true?’
A different response from John Gielgud’s character in David Mercer’s
film Providence (directed by Alain Resnais in 1977) whose plaintive cry “it’s hard to be an atheist with pain shooting up your arse in the middle of the night…..” has the ring of truth.
14.11. RPA Casualty 3pm: This is where it all started. The emergency ward. It doesn’t make me pine for God. It is flesh and blood and fear and mayhem and madness.
I admit myself reluctantly on a warm and bright Sunday afternoon. As bright as the blood gushing from my bum the night before, the second such incident, the first on Friday. Panic was followed by denial (always, it didn’t happen, it’s normal, it’ll go away, it was something I ate….). Come Sunday, after the 2AM recurrence, denial is not an option.
The small and serious duty GP at the Glebe clinic looked at me obliquely, worry written on her brow, arranges – urges – entry to casualty. I arrive, driven by my wife, with my little bag containing a couple of books, a magazine and a blue hand towel – I am sweating.
Mother’s maiden name, date of birth, prior illnesses, astonishingly quickly I am ushered into the ward, stripped by a phalanx of nurses of many colours shapes and sexes, wheedled into a ward strait jacket, curtains are rolled around my bed, 3M red dots stuck all over me, questions hurled at me – where are you? What day is it? What month? What year? I’m hooked up for an ECG, feeling like a car hooked into a diagnostic test machine – need a de-coke? Tappets adjusted? Bewildered – it’s my bum that’s bleeding, not my heart – a big X ray machine is wheeled in. Kerlunk – thank you.
Behind the curtain to my left Robert struggles against his saviours. Robert knows not the day, the month, the year or where he is in any sense.
“When did you start drinking Robert? How many Valium did you take?”
“Just lie still mate and we’ll get you into a gown”
“Grrrrrroff. I’m gonna call me loyer and charge yez wiv assault. Gerroff!!”
Across the aisle, the old lady sits by her bed, loudly and involuntarily emitting a sound I can only render as “Hip! Hip! Hip! Hip! Hip!” endlessly, somewhere between hiccups and a cry for help, “When they coming?” she wails to every passing nurse, “I been here since 4.30, Hip! Hip! Hip!”
Efficient hands have inserted a cannula into the back of my hand (a new word for me – Cannula: a slender tube that can be inserted into a body cavity or duct. The word “cannula” is the diminutive of the Latin “canna” (reed) = a little reed) and I’m on my first saline drip, clear liquid sliding down a thin plastic tube into me, ‘brrr huper brrr huper brrr huper” goes the machine until it finishes when it emits a plaintive ‘beep boop beep beep boop beep’ until a nurse arrives and replaces the bladder. Hospital is a cacophony of plings blings dings and beeps going off in illegal harmonies, from all the machines feeding us and measuring our vital signs. Shit. I’m scared. What’s wrong? Why me? I’m alone by choice, De dropped me off with my little bag of books and magazines. In and out I thought. A simple phrase of Borges – ‘in old age’ – saddens me.
I lie on my bed, salt dripping into me, reading about Spain (will I see it again?) hearing the cries and whimpers dings and blings and pip pip pips around me. The casualties come and go, the old frightened by their bewildering afflictions, the young, on the whole, victims of excess.
There are exceptions. A breathtakingly beautiful Middle Eastern girl, skin of dusty rose, hair a cascade of auburn curls, is wheeled in, eyes closed, breathing laboured, followed by her mother, or at least an older stocky woman shrouded in black purdah like an Arab nun, who doesn’t leave her side, insists on the curtain being drawn around the bed even after the induction, “sorry Dear, we need to leave it open, she’ll be right”. She stands silent guard. We lie here equally, victims of frailty.
Shiny is the name of my favourite nurse, her southern Indian accent so thick I strain to hear. Her round brown face is wreathed in smiles. I ask is she from Tamil Nadu. After an emphatic no! I get a lecture on “those Tamil girls, they think only of getting married, girls from Kerala are educated.”
Her sister is a lab technician in Saudi Arabia, her two brothers, engineers, also in the Middle East.
The irony of my condition has not escaped me. The man who makes a living eating is suffering from the arse end of the process. My sarf London doctor lies me on my side “knees as high as you can” and for the second time on this sunny Sunday a finger is stuck up my bum. On the whole, I preferred the female finger. Nothing there he reports. Slightly enlarged prostate “normal for a man your age.” We chat, I tell him what I do for a living, he loves his food. Extracts his digit and tells me of a wonderful Italian restaurant he knows in Leichhardt. Strange bedside manner. He squats behind me, head level with the bed, pushing his horn rimmed glasses up his nose (looks like Ben Elton) asks direct, elliptical questions. “what volume of blood?” How would I know? “How much do you drink?” Lots. “Do you drink with every meal?” Do I what? Did I what.
6.30pm I realise I am not going home tonight. Slow learner? Bog optimist? How can I sleep in purgatory? Are you allowed to sleep in purgatory (the damned are forbidden to forget, sleep or faint)? Neon lights turn skin grey. (wait, your skin is grey) turn every image into a grainy ‘70s art photograph.
A pear shaped man with tiny hands and feet, dark hair on a smallish head, a solemn demeanour and a manila file permanently tucked under his right arm. Street clothes – short sleeved pale blue shirt and dark trousers. “I’m the duty surgeon” he says, observing me with sad eyes, “….scores of possibilities ….keep you in overnight…..colonoscopy in the morning…..probably home tomorrow.” Sad smile, rolls out of my tent on the balls of his tiny feet. Damn.
The pinging is joined by the sound of a man having a noisy orgasm. A man I had earlier identified as a ratbag (may their tribe increase) identified by standard ratbag clobber – crisply pressed shorts, long white socks, work boots and a broad brimmed white canvas hat. He came in clutching a canvas bag, was manoeuvred from the gurney by the Ambos (how quickly we immerse in the language of place, the small world that enlarges to become our whole world) and wiggled out of his work boots, dropping them neatly in the basket beneath the bed, with expertise borne of practice, laid back and loudly told the inductors of his fits and the spots before his eyes. “You must do something about them, I’m going crazy.”
Now, some two hours later, he lies on his back, staring blindly at the ceiling his right arm rhythmically stroking his right hand side from chest to crotch, groaning loudly just like –as I said – a man about to come. Nurses and orderlies scuttle past embarrassedly averting their eyes. I’m half convinced he is actually whacking off. It is disconcerting for all. The beautiful Arab girl, the drunken English girl with the broken tooth, a casualty of the Newtown Fair, (“I ‘aven’t even got a boyfriend yet” she wails as she stares at her marred beauty in a little hand mirror, “and mine is 6000 miles away” says her male friend with a lavender bandana drooping from the left hand back pocket of his baggy jeans.)
A wiry grey haired and bearded doctor dressed all in black – I’ve seen and heard him, he has a booming voice and an officious manner – scuttles up to the self abuser. “What seems to be the problem Mr Taylor?”
“The fits, the fits, I just need an injection of Midazolam.”
“Now listen here Mr Taylor (this conversation is conducted at gale force) when did you decide to be the doctor and self prescribe?”
Taylor sits up and pushes his face into the doctor’s
“NOW LISTEN MISTER (a quite discernible advance in decibels) I BEEN HERE SINCE 6.30 AND NO ONE’S BEEN NEAR ME.”
“NOT MISTER – DOCTOR!” (perhaps a further ½ decibel as he pushes his face right into the patient’s) “NOW YOU LISTEN – YOU’RE BUNGING IT ON AND YOU’LL WAIT QUIETLY UNTIL WE’RE READY TO SEE YOU.” Voice dropping to a threatening growl “I know you.”
Taylor’s mouth flaps like a beached guppy. Just then a nuggety little bloke in white shorts and a white polo shirt rocks up.
“Mr Newton? I’m taking you up to the ward mate.” Saved. I’m wheeled up to Ward 9-1 and – miracle of miracles – Room 14. My own private room. Bed. Bathroom. Visitor’s chair. Wardrobe.
10.30pm 16.11: A two unit transfusion has been prescribed. I have been reading of the dangers of blood transfusions in China in a story in Harper’s.
I know it is not China, but there have been…incidents. “Is it safe?” I ask the nice Lebanese looking doctor, Neil. Soothing noises. “Has it been subjected to molecular screening?” I ask the nurse preparing my arm, a tiny bit of information picked up from thestory. “Dunno love” she wipes my arm with alcohol.
Strange seeing someone else’s life force flowing into you. I’ve never had a transfusion. Will it be fatal? Fear of blood is a new – and ancient – thing. The Vampire pre-figuring HIV by some hundred years.
4.30am 16.11.04: The last of the blood has seeped into my veins leaving an empty pouch streaked with red hanging from the metal pole. I look down and discover to my horror a nasty black blue and red bruise above the cannula entry on my right inside arm. Nurse Jason – calm, funny, mischievous, the Florence Nightingale of the ward – calmly extracts and calls Doctor.
Later, same day (time lost): I lie back, attached to my portable restaurant – meagre fare, sodium chloride, BP9G water whatever that means – and dive into Spain. So far, no clue to the mystery of the bleeding bum. I must wait for my colonoscopy. Col-on-os-copy. A word that rolls so easily off my tongue now. I doubt I had ever said it before I came in here. I’m still not sure what it means other than some sort of invasion of my rectum. Surveillance. What will they find? Chinese Cherries? Gerbils? Polyps? Possums? Or – cancer?
I am deeply immersed in the history of the Spanish Basques (“…by the time that Franco died, many of the inhabitants of the Basque country, whatever their ethnic origins, felt deeply alienated from other Spaniards.”) when in sweeps The Team, my first such visitation. I look up, startled. “Good lord!” I exclaim involuntarily as these four important looking persons headed by a man with a jovial smirk in a grey suit and red tie stand at the foot of my white metal bed, peering down, well rehearsed jovial smiles glued to their dials. They are all clutching files.
“Far from it I’m afraid” booms their leader, “I’m your humble servant, Dr Graces” (name changed et cetera). He proceeds to tell me, in a brisk style that brooks no interference, that as he has to attend a conference in Melbourne for a few days, I am to be discharged later that day and return next week for my colonoscopy. Just as I am about to question my humble servant, his mobile shrills (“no mobiles in the hospital” I had been warned, “they interfere with the equipment”) and he goes out to the corridor where he conducts a loud conversation about power point presentations. The remainder of the team make soothing noises and vanish as swiftly as they had arrived, leaving only my unanswered question and confusion in their wake. This is the ritual known as the ‘morning rounds.’ I will get used to it.
Next, I am taken off the drip and allowed to eat. Lunch followed – my first solid meal in two? three days? Thin slices of grey pork topped with many times re-heated gravy (skin as thick as a NSW Transport Minister) with scalloped rounds of still firm carrot and two boiled in their jacket baby spuds. There was a little cup of apple sauce, a dessert of stewed apples and a little Dixie cup of ice cream, the like of which I had not seen since the movie matinees of my youth (Sheena Queen of the Jungle!), a thin slice of tan coloured bread and a pattie of Meadowlea marge.
Was it good? Not especially. Was it bad? In parts, But imagine, if you will, the almost insurmountable problem of feeding – 1000? – people daily, whose appetites are, more than likely impaired, whose desire or ability to enjoy food is tempered by fear and preoccupation with health and mortality and you begin to understand the dilemma of the hospital cook.
The late Anders Ousback, giving me a tour of the eating sites of the Sydney Opera House upon his winning the catering contract for his client told me the problem for a caterer in such a place is that the vast and varied crowd who passed daily and nightly through the space had not come to eat, and so the food had to be subordinated to their needs, economy, speed and reliability.
Mostly, I hated the Meadowlea. If you must spread fat on your bread, why that bleached, boiled, hydrogenated artificially flavoured and coloured manufactured muck? The tiny amount used in the portion control pack would make absolutely no difference to any farcical ‘fat-free diet’ – or else just leave it out. How about some raw salad? Fibre? We lie around a lot, us patients, and lying around is better on raw green food.
No need to describe the three meals I had in detail. For dinner, chicken casserole, lemon sago (“what’s sago?” asked my 12 year old daughter) and for breakfast powdery and watery scrambled eggs and always, with each meal, the patty of marge.
That afternoon, I shat blood again, almost fainting, the episode recounted at the beginning of this tale. Back on the drip. Staying overnight. De brought in the children and Phillip Roth’s Letting Go. Spirits droop.
Tuesday 16th: The Team arrives around 10am, today headed by a chunky Aussie bloke with fair hair cut en brosse in theatre greens, Bill Green I’m told, 2IC colo-rectal. He spells it out in plain language. Can’t do a colonoscopy while you’re bleeding, like headlights in a snowstorm. One possibility – if you keep bleeding – an angioplasty – femoral probe, send ink up via the groin, where it leaks (X Ray) send up a titanium coil which irritates the colon, closes around it and seals the leak. Worst case – out with the colon, replaced by two bags. Only temporary, hopefully. Highly unlikely in my case. I fucking hope so. Decide there and then suicide if that’s the case. I am far too material and sensual a man to live with such a restriction on my mobility.
Over coffee in the Jacaranda Café, I tell De I will want her to help. With my death. She is upset. I am adamant. Still am. It’s not just life that is worth living, but what can be done with that life.
The day goes slow. I devour the Roth and live through the curiously amoral Gabe Wallach for the afternoon.
I have bought a phone card, hired the overhead television to watch the news and the final episode of MediaWatch – the end for the waspish Marr – and the copout final episode of Sex & The City, the American addiction to sweetness imposing itself on the happy families ending. And they all lived happily ever after – vomiting.
Wednesday17th: Yesterday afternoon, more bleeding. Deeply disappointing. Still, less quantity. They are now worried about my HG levels and may decide to do another transfusion. They do, 2 units, around 500/600mls of blood. I sleep fitfully through it, helped by the delightful night nurse Jason.
Around 9am the team arrives, led again by the nuggety Aussie bloke in the theatre greens. This is the picture today.
- Can’t do the colonoscopy if I’m bleeding. Maybe wait for the bleeding to stop, send me home, I come back, scour out the bum before the colonoscopy. Of course that may start the bleeding again.
- Angiogram. Can only do this if I am bleeding but must be copious and all the time.
- Once they find what they expect to find, they do nothing. Unless it happens again. Then they know when to cut.
- 90 per cent of the time it heals itself.
- And then there’s the blood test. One for each possibility.
Now I lay me down and wait to shit.
3.50pm: Still no shit. This room. Outside, the healthy march up and down, the glowing and shiny young doctors and nurses mocking us by just being. My temperature is 36.7°.
Thursday 18.11.04: Still in the RPA. A night on the drip (not the piss) and a day dispelling fear – reading reading reading. Vanity Fair (the book), Paradox of Plenty, and combing through back issues of Harper’s.
Slept as well as possible with the lullaby of drip pump burbling away in my ear, a palimpsest of dream images: a herd of glossy white horses in the high country of northern Victoria, a cold, crisp day, galloping, manes tossing. Gawen Rudder attacking me with a fish. Laura, saving a dog from certain death in the middle of the road.
I slept and farted (the smell changing from fresh, slightly over ripe Chinese shiitake mushrooms to cabbage later in the morning) and pissed both copiously and often. The farting – a relief, no leaking – started in the afternoon and was remarked upon during her visit, somewhat unpleasantly, by De. I reminded her I am in the bum ward. It is only to be expected, indeed encouraged.
Today, the team, now headed by a handsome Indian doctor – David – told me it’s a boring waiting game, confirmed that the farting is a good sign. Blood, apparently, acts as a laxative, and if there was much around, it would out.
Hospitals. The sick and the dying lie around, assaulted by the health and vitality of their carers, the nurses especially, I have noticed, acting out this vitality and joie de vivre in a somewhat over the top manner to ward off, perhaps, the general air of gloom, despair, anxiety and fear emanating from their charges. All understandable but an environment that builds, over time, into a variation of the Stockholm Syndrome. I note my increasing dependence on Jason, the gay night nurse, his jokey nature, his bustling competence, his gentleness. He helps me through the night. I anxiously await his appearance.
Yesterday morning, after the night of blood (still strange, seeing anonymous life liquid seeping into you, mingling with the stuff you made yourself) my inner forearm was bruised, the old cannula was removed, and a new one needed to be inserted. An attractive young woman doctor, slim, dark, serious brown eyes, had two stabs at it. Painful and scary. “We’ll get Queenie to do it” she said. The legendary Queenie, head of the Vascular Access Team, who roam the wards puncturing veins, efficiently and painlessly. Sounded good. Queenie couldn’t do it so another member of the VAT team arrived, Cynthia, a wiry Chinese woman. She soothed me with her crisply efficient prep, the elegant economy of her hand movements (I’m a sucker for elegant hand movement) in putting together her equipment, the speed with which she found a vein, and her decision to use a local. This cannula entry was to be higher, in the crook of the elbow (named, I discovered, the cubital fossa) and larger, to carry more volume. It was placed, attached to the drip and she left.
Some short while later, the pump beeped, indicating it was not working. Two nurses fiddled with it, primed the pump, changed the position of my arm, to no avail. It wouldn’t work. The cannula had to go.
While I was on the phone, another nurse came in to change it, not one I knew, a burly man with a close cropped and elaborate hair cut – dipped and swirled. I was now nervous, and requested another expert. The VAT team had finished he informed me curtly, I’d have to wait for a doctor. He packed up his equipment and left with ill-concealed bad temper. “I didn’t mean to question your expertise” I said feebly to his disappearing back, which was bullshit. I just had.
This incident weighed on me, my only companions being Becky Sharp and Miss Crawley so when Nurse Nicola, who had been party to this scene came in I told her. “Do you think you hurt his feelings?” she asked, confirming that I had. “Can you speak to him?” I asked. She would.
She in turn apologised at being snappy with me over some water I had drunk while disconnected from the drip, strictly verboten. I hadn’t noticed, but accepted her apology graciously. The relations between nurses and patients are taut and complex.
The doctors bring a different set of emotions and problems to the wards. From somnolence to schoolboy (and girl) jollity, whichever, there is always solemnity, an almost visible weight on their shoulders. They steer a difficult course through dangerous waters littered with wrecks and shoals.
They know how little they know but they also know how much less we know. They must, therefore, give us the impression that they know more than they know without alienating us by unwittingly showing scorn at how little we know.
Our responses to them are many and varied, veering from total awe to informed – or even uninformed – disrespect or even scorn. And I would imagine one patient’s opinion of them could run from awe to scorn during the course of a single treatment. Why aren’t you curing me? Why am I dying?
Most disturbing to me, who is less afraid of death than pain and ignorance is being left out of the conference where my ‘case’ – treatment, prognosis – is discussed. Each morning of my stay I am confronted by a team of doctors who have discussed me without my being consulted or included. I do understand why, time, primarily, I would hope. Not contempt.
But would it be possible to offer the patient who desired it some part to play in the dialogue that leads up to treatment?
The morning visit, doctors would argue, gives the patient a chance to make input. A little late. Whether true or not, the patient gets the impression that decisions have been made, and any questioning is only holding up the progress of busy people – watches are glanced at, fingers tap, smiles are set. Doors are edged towards.
4.45: One step forward, two steps back. I am put on a liquid diet. Oh joy! Custard. Soup with a liverish taste. But passing the test of food at least
ROYAL PRINCE ALFRED HOSPITAL
GLASS WHOLE MILK
SMOOTH BEEF AND VEGETABLE SOUP
9W114 9W1 * 18111030
There, as near as I can, a reproduction of the flimsy sheet on the tray bearing the food.
Progress is being made. I’m eating, albeit geriatric fare. I was able to have a latte with my wife in the Jacaranda café this morning. I feel better than I have for some days, so good, I organise the trip to the cherry farms of Young I had to cancel last weekend for next Wednesday. O frabjous joy.
And then, some 60 odd minutes after lunch, felt the stirrings and took myself to the bowl. What emerged after some small straining were small dark firm turds. No blood! Hallelujah! But then, I wiped, and a clot of dark dangerous blood came away.
Emerging from the toilet, I see a small bespectacled woman in my room. She tells me I am to be expelled from the luxury of privacy and am to be placed in a four bed ward. “You’ve had a good run” she said. Granted, but begrudged nonetheless. This is not her last appearance.
I tell the delightful Vanessa, not young, tanned and blonded, slim and vivacious, back to nursing after raising two sons. She nods and says the blood is old, residual, takes my blood pressure – important – and announces to me and Jacob who has turned up in theatre gown, that it is normal.
Jacob tells me that the still invisible Dr Graces has decided that I am to have a colonoscopy in a day or two. All very well, I say, but could I not take part in the decision making process. He looks across at me with his blue eyes and a somewhat sheepish expression and leaves.
The giver and taker of rooms arrives again. My usurper has not turned up – you may stay where you are she pronounces. I lie back in my private bed in the embrace of Thackeray.
Thirty minutes later, the saucy minx returns and I am promptly evicted, from 14 to 18-22 – with Bill, a bald man from Dubbo who sits and picks his nose and hums and a large blonde man who lies and groans and has a small Asian woman (his wife?) and a young boy named Alex (his son?) who is, rightly so, bored to his grubby white sox. O well. O dear. O shit. I have my own curtain at least.
6.30pm So much for a say in my treatment. I come back from a coffee on the verandah at the Jacaranda café with Thackeray (the battle of Waterloo, George Osborne is dead, most breath a sigh of relief) to Bill and Mrs Bill – a plump and comfy Dubbo matron – telling me two doctors were looking for me.
They were. Neil told me, when he found me, that I was on Dr Graces’ list for tomorrow. For a colonoscopy. Because the bleeding has slowed. Because my blood count is back up. Because if I go home and have another bleed, I’ll have to go through the whole process again.
In front of me are three little turquoise plastic beakers full of a powerful laxative cocktail – let’s call it Bums Away – which I am to drink rapidly. I have been told it tastes terrible, but it’s not too bad, like one of those salty sports drinks. Then the camera is to slip up my thoroughly cleaned arsehole to explore Cristobal Colon, looking for lesions, polyps, ulcers, hemorrhoids or, worst of all and what I have feared from the first bleed despite bland assurances to the contrary, cancer. To expunge, fix, or in the case of the latter, take a biopsy.
I will go home tomorrow night, sore of bum, either cleared or awaiting the results of that biopsy.
I am, of course, shit scared. Or scared shitless. The only question that remains is – what happens if I have a colossal bleed? I go and ask Diana, who I don’t think likes me – or anyone else. She says they’d they’ll take me for an X Ray and source the bleeding. Why not just do that now? Because it’s not as good as a colonoscopy. Now, I will read.
11pm: First hurdle leapt. Having swallowed all the Bums Away I shat and shat and shat and shat. And then shat some more. Until it ran clear. Nurses Seung Sung and Diana and Dr Gupti seemed as pleased as I was. I found a large and strange bathroom full of water instruments, wheelchair toilets and devices to help cripples shower. It was private, across the corridor, I could make all the noise I wanted to, wash after each marathon session. I reckon my bumhole is as clean as it has ever been.
7.30am Friday November 19th: It should be recorded that, according to
The Sydney Morning Herald, today is World Toilet Day.
Now is the time for the Newton Doctrine ‘I’m Not Afraid of Death Only Pain’ to be put to the test. Yes, I am calm, resigned even, but still scared – of the unknown, the unwillingness of Dr Graces to look me in the eye, even the continual refrain ‘It’s Unlikely to be Cancer.’ I’ve outlasted my dear old Mum by four years, but she did have cancer. That is at the back of my mind. Or deeper.
A new arrival in 18-22. Any previous illnesses? Two heart attacks, cirrhosis, hep C. He has just had an endoscopy. To find out about his new disease, pancreatitis. It transpires that he drinks.
Over the way the Stocks family, the tattooed Dad – Daryl – and Mum, constantly drinking Coke and munching Cheezels and chips. “Don’t throw yer food” admonished one wizened aunty to a little snuffling boy who chucked a Cheezel at her.
12 Midday: I am wheeled, by another nuggety bloke in white, this one an ex-hippy, through the bowels of the hospital, down where the pipes run, to the other side of Missenden Road, and into a little room in an old part of the hospital fitted with a large TV screen and a tray of instruments. There I am left for half an hour. “Dr Graces will be along in a minute” chirped the nurse. He wasn’t. I read two New Ideas, one Woman’s Weekly and was starting on The Glebe when he finally bustled in.
They rolled me on my side, “legs up” – I’m getting used to that position – and injected me with 5mg of Midazolam – “This will help you forget what’s happened to you” – and 100ugm of Fentanyl, an analgesic with 80 percent of the potency of morphine. Wow.
And that’s the last I really remember. I have a vague recollection of something going on up my bum, but, hey, who cares? The next thing I know is that I am lying, confused and awake, in the corridor outside the room. I am left there for some 15 minutes. Dr Graces appears again, sits with his back to me and types something into a computer. He tells me I’m OK, and, as they suspected, I have diverticulosis.
Relief washes over me, followed by curiosity. What is diverticulosis exactly? I am wheeled back to the ward, discharged, shake hands all around, and De arrives to take me home.
Outside, dressed, I am confused and slightly nervous. Only a week, but I have been institutionalised.
Below a copy of the Colonoscopy Report
The bowel preparation with Colon Prep A was good. The Instrument was inserted to the caecum which was identified by the ileo-caecal valve and the appendiceal orifice. In the distal sigmoid colon multiple diverticular openings were found, with a degree of muscular hypertrophy, but no signs of recent bleeding were found. The large bowel was otherwise normal.
There were also large internal haemorrhoids.
Return to ward
And what of this diverticulosis? From a pamphlet handed me by Dr Graces in his rooms, some time after the colonoscopy:
‘It is accepted as a “Western Society Disease” thought to be related to an over-refined diet lacking in fibre. The consistency of stools is such that high pressures develop in the left colon which over a period force the mucosa through the muscle wall and alongside small blood vessels. This forms the diverticula.
It is suggested that for patients with asymptomatic or mild disease, a high fibre diet with or without a stool softener laxative is usually sufficient, and that an attack of inflammation can be cured with a bland diet and a short course of antibiotics. Only in the gravest cases do they snip out the infected bit of colon. Most heartening is this sentence: ‘Bowel function and general health return to normal after operation and recurrence of symptomatic diverticular disease or complications are rare.’
Postscript 5 years later October 2009: correct, and one hint for the sufferer. A doctor at the Glebe Family Practice (name forgotten, a remarkably attractive blonde, like a pocket Julie Christie) told me about psyllium when
I presented with a minor but unnerving bleed.
‘Psyllium seed husks also known as ispaghula, isabgol, or simply as psyllium, are portions of the seeds of the plant Plantago ovata, (genus Plantago), a native of India and Pakistan. They are soluble in water, expanding and becoming mucilaginous when wet.’ From Wikipedia. Curiously, 90 per cent of world production comes from Rajasthan.
This dry husky stuff, taken daily in a glass of juice firms the stools and exacerbates the problem. It is my new best friend.
One more curious observation. I can handle chilli, but not the complex spicing of Indian or Pakistani food. Probably why the stuff is grown there.