Day Hike in the Valley of Death

There is arguably nothing worse in the medical preparation world than getting ready for a colonoscopy. Despite the demure names for the preparatory products: “GoLitely” and “Fleet” making it sound like the ensuing results will be like skipping fast through a meadow, anyone who’s crossed this rubicon knows that skipping through a meadow is just a metaphor for ….well, you know if you’ve done the hike. The last time my husband had his colonoscopy, I had also been assigned to have mine and somehow I thought it would be efficient/comforting/collegial/loving/experiential to do it together. Bad idea. But enough about the prep.

Yesterday morning, at 5:15, we did the “fleeting” part – not fleeting enough- and what I thought was how marital vows should really be a lot more specific. The “In sickness and in health” part is just not clear enough. Our vows had been two sonnets by John Donne we recited while gazing lovingly into each others’ eyes. Well actually, Jimmie had looked a little terrified, though he did manage to look fondly at me. I thought about our son’s and fiancee’s upcoming nuptuals, and I thought, “I’ll give them a little advice about this in the next months,” but then banished the thought.They’re going through potty training right now. They have a pretty good idea of the commitment involved.

Smash cut to the endoscopy center’s waiting room. I had about three hours to sit with my friend Dread nudging me in the ribs as I tried to focus on the crossword puzzles. In spite of the fact that it was Thursday, I finished both the LA Times and the NY Times puzzles. On a normal Thursday, I wouldn’t have stood a chance against Rich Norris , Joyce Nichols Lewis and Will Shortz, but the puzzle and the people watching allowed me to survive the three hour wait and quell my nerves at the same time.

I think I’ve mentioned that this new doctor is in Korea Town, and is, not surprisingly, Korean. His clientele is 99.8% Korean, if the three visits to the office are any indication. When you enter, there are two banks of seats in front of a wide marble counter, behind which sit an extremely friendly nurse/reception distaff. Behind them are arrayed the slim folders of thousands of patients, in ordered regularity. There’s no sign in sheet, you know the ones that most doctors have, with the peel-off tabs that when you sign make you feel like someone’s Medicare meal ticket? A small bowl of cellophane wrapped peppermint candies like the ones in the holiday wreath on the back of my childhood kitchen door rest in a glass bowl at the far end of the counter.

Couples, all over 60 are arrayed around the room, generally men with worried looking wives. Two 24” computer monitors adorn the corners of the room, set on low side tables, angled to the center of the room, each draped with two pairs of headphones. Periodically, the main admitting nurse comes over and instructs one of the couples to look at a video; there must be two dozen videos on the computers. They all have the same structure – a large title card with some possible gastric disease spelled out, in Korean, of course. The opening shot is of the good doctor behind his desk speaking in his direct way to you about whatever it is that might ail you. But what follows is horrible, and yet I can’t turn away. Now we are taking the incredible journey into someone’s colon, where destructive conditions await – one video shows a monstrous polyp bulging, leering almost at the camera. But soon this horror abates as we return to the doctor’s office. Each video lasts about 3 minutes. I am impressed with the efficiency of this tool.

I find myself thinking that this must also be a gross breach of the HIPAA rules. After all, I know now what most every man in the room likely has, even without reading Korean. And what will they do for us, who don’t speak Korean? The doctor, whom we’ve met twice, speaks perfect English, so I guess he’ll have to explain it all to us himself.The size of his non-Korean clientele is so small, it wouldn’t have been worth making another 24 videos in English with English title plates. I take comfort in knowing that whatever the results may be, we’ll receive them first hand.

The other people in the waiting room are so interesting. There’s a flighty 45-year-old woman wearing an elaborate sequined Mackie-like camisole peeking out from beneath a chiffon t-shirt. Both are a beautiful dove gray color, and her black tight pants hug slim ankles clad in 5” spiked heels, that current fashion in black strappy sandals with the solid back running up the Achilles tendon? You’ve seen them. This woman is urgently hurried, her large Louis Vuitton bag over her wrist, running about the office,  hair flashing around her head as she looks anxiously to the left and right. She wears drama like a perfume. Even at 8:00 in the morning. You can tell that her wake is littered with traumatized people. Something has clearly gone wrong. I feel bad for her and yet she’s so interesting that I can’t help being fascinated in the same macabre way that draws my gaze to the corner monitors.

And then, I note, all the men who come in alone have a proclivity for having missed the back loop of their pants with their belts. Is this a bachelor issue? I mean 3 out of 5 of them. I was noticing because, like Jimmie, who’s lost weight and whose wife has not caught up sartorially with the tailor, frequently has bunches of fabric around his waist. So it goes with men in the waiting room of the gastroenterologist. And the lone ones who come in without their wives are clearly the worst off, having no one to sit with in the waiting room- no one to view the screen and share the headsets with.

As Jimmie finally emerges from his procedure, the nurse hands me a xeroxed sheet about polyp prevention and cancer. I note immediately that she’s highlighted 2/3 of the paper’s heading. The word cancer is not highlighted. In times such as these, symbols take on huge significance, so I know before going in to talk with the doctor that there’s no cancer. As we sit and wait, I’m sure that Jimmie hasn’t read these signs, but the lack of privacy in the room prevents me from sharing my relief.

Sure enough, the doctor confirms that I had read the signs correctly. He seems a little surprised. The test has refuted what he’d seen in the earlier CT scan. There was only a small polyp, nothing like the leering eye in the waiting room, one which he was able to snip out during the procedure. I wouldn’t say he looks disappointed, but when he said loudly and firmly, “Good News!” there was no smile on his face. It must be difficult to be the bearer of bad news all the time. Most people having invasive tests such as these must not receive “Good News” all that often. As we gather ourselves to leave, he slips out of the room into another exam room to speak to some other patients.

My step was lighter through the day. After working at home on the couch, I walked to Whole Foods, called Chris to make sure he’d received my good news text earlier in the day. I bought some yellow sunflowers to celebrate, and returning home, I knelt at Jimmie’s feet to present them to him, gratitude and relief watering my eyes. Jimmie’s relief welled up too. We hugged, awkwardly because I was kneeling on the floor and then had trouble getting up.

In truth, we don’t have an answer for Jimmie’s weight loss. But the day before, we’d visited his GP, who changed his diabetes meds. I had consulted Dr. Google only about 10 days before all these invasive and unpleasant tests and suspected this might be the culprit. It was satisfying to see the doctor’s Aha moment as he realized it might be pharma-related. Now, in light of the test results, it seems it must indeed be.

Back to the book. No more distractions.

Really nothing’s changed. And yet everything has.  Jimmie’s still 89 with weakening mobility and the runs. But we’d both trekked deep into the valley of death, had stopped to touch the bark on the trees, to feel the reality of the journey and the destination. We’d stopped to sit side by side on the bench at the edge of the path. And we’d made it back out for another day.