only you know and I know

Both of my parents died from colon cancer in their 60s. That puts me — statistically — on the bad side of susceptibility of getting colon cancer. I have been to my doctor many, many times since my parents passed away. Whether it was for a yearly check-up or a follow-up for one of several hospital visits, my doctor has always asked me — in his run-down of "the usual questions" — "Have you had a colonoscopy?" As I shifted uncomfortably upon the examination room table, rebuttoning my shirt, my answer has always been the same. And that answer is "No." His reaction is always the same. He frowns, tells me I should really have one, and then he hands me a many-times Xeroxed list of area doctors who will happily perform the procedure. I take the paper, fold it up and, when I get home, I toss it on the pile of other copies of the same information I have received on previous visits.

It's not like I am afraid of getting a coloscopy. I'm not. Not at all. My brother — four years my senior — has had about a thousand since he turned fifty (the ideal age at which the medical profession suggests that a regimen of coloscopies begin). A friend of mine encouraged me to get one, reporting that the drugs they give you to knock you out prior to the actual procedure are — and this is a direct quote — "fucking awesome." You would think that the promise of an experience usually associated with the side effects of a Grateful Dead concert would be enticement enough to get me to make an appointment, but.... I still didn't. The actual reason (excuse?) I have been lax in scheduling a colonoscopy is convenience... or in my case inconvenience. Yeah.... I know. LAME! That is that lamest excuse. But, taking a sick day off from my various jobs has been — for lack of a better word — a hassle. When I worked at a law firm, my boss would throw so much guilt on me when I scheduled a vacation, as though the most important person at a multi-office law firm was the graphic designer. My next three jobs didn't offer as many sick days and vacation days as I would have liked, so a day off was pretty precious and I didn't feel a preventive care procedure was worth a day off from work. (Stupid, right? Yeah, I know.)

In January, I was in the hospital for a few days and, as my discharge instructions recommended, I scheduled a follow-up visit with my family doctor. As usual, as my visit drew to a close, the subject of a colonoscopy breached the line of questioning. My doctor cocked his head at me, expecting my answer to be one he had heard before. Then, he asked if I would be willing to take a Cologuard home colon cancer detection test.. He offered this alternative as sort a a "secret weapon" to counter my usual "no" response. Once I agreed to the Cologuard test, he muttered "you seem to be afraid of a colonoscopy" and he trailed off. I agreed to the Cologuard, dammit! and I'm not afraid of a colonoscopy! I thought. Instead, I forced a grin and said nothing. A Cologuard test was ordered for me and I was told it would arrive at my house in a few days.

Because of the television programming I usually watch, I have seen a lot of commercials for the Cologuard home test, mixed in with those for other prescription drugs, incontinence remedies, retirement homes, Medicare supplements and reverse mortgages. The Cologuard commercials are clear in their purpose, but are somewhat vague on the actual procedure. To be honest, I didn't pay that close attention to them. 

As promised, a few days after my doctor's visit, a plain white box arrived at my house. I actually ignored it for a couple of days. I also ignored the texts that the good folks at Exact Sciences (Cologuard's distributor) sent me on a twice-daily basis. Finally, I watched an instructional video that one of the texts contained.

I will not elaborate on the actual details of preparation, procedure, post-procedure and getting the completed test back to the company for analyzation. However, I am well aware of what everyone who has taken a Cologuard test at home has done. And, conversely, they are aware of what I did. I know what you were instructed to do and, if you followed the instructions, I know what you did. I will not say what we did. Now, we are like Freemasons. We are now part of a secret society with covert, unspoken rituals known only to those who have been let into the fold. We did these things behind closed doors. Alone... while hundreds or even thousands of other folks were doing the same thing at the same time. We don't wear a badge or any kind of insignia to identify ourselves to each other. We know that we are not the only ones who did what we did. In five years, over two million people did what we did. When we see someone at the UPS office holding that square white box, we know the sequence of events that transpired to bring you to this moment.

We just know.

My test came back negative. Let's just leave it at that.

www.joshpincusiscrying.com

needles and pins

I just returned from a three-day, unplanned visit to the hospital. I spent the first twelve hours in the emergency ward, where I was poked and stuck and prodded by a variety of apologetic medical staff wielding a variety of sharp objects. After a quick assessment by a very astute doctor, it was determined that a regimen of antibiotics would clear up the nasty pinna perichondritis (Google that. Go ahead.) from which I was suffering. 

The antibiotics would be administered intravenously and a young nurse (Who am I kidding? Everyone on staff was young!) came by to insert an IV line into the crook of my left arm. Now, admittedly, I don't like getting needles. I have been vaccinated. I have had blood taken from me. I've been hooked up to IVs. Each time I experienced one of these, I have to close my eyes and turn my head away from the arm in which the needle will be inserted. Usually the nurse or technician will offer a cute verbal warning — "Little pinch..." — before sliding that slender metal spike beneath the top layer of my skin. In reality, I don't ever feel anything. Sometimes, I don't even feel that "little pinch" that was promised. I just don't care to watch the actual process. I can't watch it happening to someone else and I can't watch it happening to me. Kind of like the teacup ride in Disneyland.

Once the IV port was inserted in my left arm, each bag of healing antibiotics would be painlessly connected to the long tube that was now securely taped to the inside of my elbow. However, after two bags were emptied into my bloodstream, the vein that had received the IV was determined to be "sluggish" — which, I have come to understand, is a medical term. Another "little pinch" warning was issued and a new IV was inserted on my forearm just a few inches closer to my wrist from the original entry point. A third IV was connected and we were back in the "getting better" business. A lot of activity at 4 o'clock in the morning.

At around 6:30 AM, just after I quickly finished my hospital breakfast of Rice Krispies and horrible coffee, I was moved to a regular room in a new wing of the hospital, where it was quiet, secluded and devoid of any of the loud, wet coughs and woeful moaning that were rampant in the ER.

In my new accommodations, the antibiotic procedure continued. Every so often, a new nurse would come into my room and regretfully inform me that I needed to provide serval vials of blood. Since my left arm was otherwise occupied, my right arm would be the source of the required sanguine extraction. Once again, the "little pinch" heads-up was announced, immediately followed by a faint twinge in my arm. Because my eyes were tightly shut and my head was turned away from the action at hand, I could only hear a length of medical tape being ripped from a roll to hold a wad of cotton in place over the withdrawal point. I was asked to provide blood several times during my stay, each new procedure similar to the last.

On the morning of what would be my last day in the hospital, a new nurse came in to my room to tell me that hospital policy requires all patients who are in bed for extended periods of time (like me) receive a blood thinner to combat clotting. This medication — surprise! surprise! — would be administered via a needle. And this particular needle would be delivered to my abdomen. Getting a shot in the abdomen for someone who does not possess a rock-hard, six-pack of rectus abdominis muscles is no treat. Unlike a shot in the arm, it is very difficult to brace and tighten the abdomen of someone who stretches out on a sofa rather than a rowing machine. So, while the nurse readied the sharpened syringe, I tried my best to tense up my gut. It didn't work and unlike my non-reaction to previous shots, I let out out little "JEEZ!" Well, maybe not little and maybe it was fully pronounced "JESUS CHRIST!" The nurse empathetically winced herself and said, "Oh, I'm so sorry." 

I explained that I never had an involuntary reaction to an injection before, but that one caught me off guard. I went on to say that, while I don't like needles, I can tolerate them. She laughed and said that she has had patients — brawny men whose arms and torsos are covered with intricate tattoos — wince and scream from injections. She couldn't understand how a quick tiny needle could freak out someone who obviously had to sit for a considerable length of time while needles were repeatedly inserted and extracted — over and over and over — into their skin. Getting tattooed — especially some of the more elaborate designs — requires hours and hours of needle pricks. A blood sample or vaccine takes less that two minutes.

I looked at the nurse and answered: "It's simple. Tattoos are cool. Getting blood work done.... not so much."

She laughed.

www.joshpincusiscrying.com

"M" is for the million things she gave me

As I exited the train station, I got a text message from my son that he was waiting outside of our predetermined destination — the Mütter Museum. I walked through a light drizzle to an ornate, yet unassuming collegiate-style building, nestled among the high-rises and offices on North 22nd Street. My son was pacing, hands jammed in his coat pockets, but he smiled when he recognized me approaching. Hundreds of people pass by this building daily, but how many know that just on the other side of those heavy wooden doors is a vast collection of human horrors that are capable of making one's head spin.

We entered the marble foyer that proudly displayed and acknowledged the names of those whose generosity had made the Mütter Museum an ongoing reality. Dr. Thomas Dent Mütter, a 19th century pioneer in plastic surgery, donated his collection to The College of Physicians of Philadelphia in hopes that it would be used for research and education. And, oh, the things Dr. Mütter collected. (My son, a past visitor, noted that the museum bears the good doctor's name for several reasons: it was his collection, he had a bit of an ego and, most importantly, if they called it "The Museum of Totally Fucked-Up Shit," no one would come.)

Once through the dignified reception area, past a formal sitting area replete with period furnishings, the adventure began. The subdued lighting shone down on a room lined with dark polished wood and glass showcases that stretched from floor to ceiling. Within the confines of glass and wood were examples of medical wonder ranging from the tiniest bone fragment to complete torsos, their contents splayed in preserved grisly Technicolor. The mind-dizzying accumulation includes wax replicas and actual specimens of appendages, limbs, organs and bones — some twisted and misshapen, some sprouting one or two angry red eruptions, some covered with ghastly amorphic growths rendering the specific body part unrecognizable. There is an entire wall of skulls garnered from every nook and cranny on earth, all in varying degrees of completeness and integrity, some sporting the results of poorly healed gunshot wounds. Down a flight of stairs, the exhibit continues (as my son stated in a tone of delighted caution, "Now, shit gets real!") with slices of brain, dissected spinal columns, bloated fetuses jarred and preserved in murky formaldehyde, sundry severed hands and feet, shiny with preservative lacquer, a detailed study of every conceivable eye disorder and drawers filled with various items that one doctor removed from patients over the course of his career — all numbered and cataloged. (The drawer marked "PINS" is particularly unnerving.) One wall features a graphic, yet lovingly presented overview of birth defects and adjacent to that is the pickled conjoined liver of celebrated 19th century Siamese twins Chang and Eng Bunker. Oh, and there's a forty-foot colon impossibly gorged with fecal matter.

My boy and I viewed the assorted oddities in awe, interjecting smart-ass commentary when we felt it necessary. (My son repeatedly approached the showcases and muttered authoritatively, "Now... what seems to be the trouble?") Nearly two hours later, our medical journey had drawn to a close and we were browsing the gift shop, but not before we waved "adieu" to a woman whose corpse had mysteriously turned to soap. That's right. Soap.

Philadelphia is renowned for the Liberty Bell and .... soft pretzels and cheese steaks I guess. However, if you ever get the chance to visit The City of Brotherly Love, skip that old cracked bell. Instead, I encourage you to visit the Mütter Museum and marvel at what could happen if one day, without warning, your body just turns on you. It truly is an enlightening experience.

www.joshpincusiscrying.com