Friday 31 July 2015

Arse


It was Monday evening and I'd been struggling with a pain in my lower gut for most of the day. To be specific, pain should here be regarded as an overstatement, discomfort being the more accurate term. A month or so before, I'd experienced something which could be more securely identified as pain - and quite severe pain at that - in the same spot, and it was so bad that I'd ended up at the emergency medical clinic on Broadway. The doctor told me I had something called diverticulitis, prescribed codeine and antibiotics, and then sent me on my way. I stuck to the recommended diet, low fibre switching to high fibre after a few weeks. I took my medicine and everything seemed fine; and yet here I was again.

Diverticulitis results from tiny pockets developing in the wall of the lower intestine. Small items of food can become trapped in these pockets and go bad, leading to infection or worse. This was what I had, and the doctor warned me off eating anything containing small seeds. Sesame seeds seemed to be the worst. I had eaten beans on toast on Sunday evening in response to a craving, and couldn't understand why suddenly I felt unwell again after more or less a month without any trouble. One stipulation of the recommended initial low fibre diet had been the avoidance of the skin of certain vegetables, requiring for example that I peel my potatoes before boiling them. Baked beans had skins, I realised, so maybe it was that. In any case, the discomfort wasn't anything like so bad as it had been on the previous occasion, so I figured it would probably be okay. Maybe it was just good old honest indigestion.

At about eight in the evening we went back to the emergency medical clinic just in case. I would see a doctor, get another prescription for codeine and antibiotics, and everything would be fine. We sat in the waiting room for a while, my wife and myself, and then were ushered into a small room. A nurse asked me questions, took my blood pressure, and took me to have a CT scan, which was kind of unexpected. Even more unexpected was when we returned to the first room and she jabbed a massive hypodermic needle into the crook of my elbow, hooking me up to a drip of saline solution and morphine. This was something new. I was now attached to an IV buddy, a mobile stand with the bags of fluid, the tubes and so on, and I wasn't entirely sure why. This wasn't how it had happened last time.

'What do you think?'

'I don't know,' my wife told me.

The discomfort wasn't anything like so bad as it had been on the previous occasion, and yet the treatment I was receiving suggested something more serious. Furthermore, I had just discovered how much I hated hypodermic needles. I'd been inoculated plenty of times, and had of course received injections at the dentist. I imagined myself more or less without fear where needles were concerned. I now realised that this was because I'd never before been pierced by one of the big military issue fuckers tooled from sharpened lengths of steel pipe, just little pinpricks which can be ignored if you think about something else hard enough for a second or two. By way of compensation, the morphine was really beginning to kick in. I felt enveloped in psychic cotton wool, moderately euphoric, and with a renewed insight into the writing of William S. Burroughs.

'Man, this be some good shit right here,' I told Bess without any of the irony which would ordinarily have underlined such an observation. I knew the morphine and the drip meant there was a possibility of my being in serious trouble, but for the moment I didn't really mind too much.

We waited.

Eventually, as the my body metabolised the morphine - or however it works - I began to mind.

Another member of staff arrived, a woman whose name I forget played by Judith Furse who had given such a memorable performance as the evil Doctor Crow in Carry On Spying. Oddly, she was still in character. She asked me to describe my symptoms.

I began to describe my symptoms, and she started talking over me before I'd even reached the halfway point of the first sentence.

'You have diverticulitis, Mr. Burton,' she told me frostily. 'It's not just going to go away. You have it whether you like it or not, and you're going to have to take it seriously.'

I continued my statement regardless. I wasn't going to be interrupted, and certainly not by someone who had actually asked me to answer her question in the first place. Marian used to do that all the time, prompting you to speech and then speaking over you as part of some sort of passive-aggressive pissing contest. It was annoying, and I had learned to simply continue my monologue with greater force despite the interruption. Now I considered Doctor Crow's ominous warning.

You have it whether you like it or not, and you're going to have to take it seriously.

I thought back to the previous visit to the emergency medical clinic, that poor egg-headed physician stuttering his useless brainiac advice as Bess and I piled back into our hotrod.

'Whatever you say, Poindexter!' I had laughed, slamming a cassette of Link Wray's Rumble into the tape deck and spitting out a demonstrative mouthful of Wild Turkey. I turned to my wife. 'Hit the gas, baby. Let's go get us some sesame seeds and 'tater skins.'

But now I would have to take my diverticulitis seriously.

'Maybe if someone would actually tell me what the problem is,' I suggested pointedly. No-one had yet delivered anything resembling a verdict on why I should require a saline drip, morphine, or CT scan, much less whether anything had been revealed by the same.

Doctor Crow responded with further bewildering admonishments regarding the severity of my condition, whilst leaving said condition still entirely unquantified, and then she left the room. As the door was briefly opened I caught a snatch of conversation between two other members of staff, one of them being the man who had talked me through the CT scan. It sounded like something had popped, and I picked up the words trailing fat. My mind's eye formed a picture of a diverticule resembling a tiny burst balloon leaking blobs of liquefied bacon rind into the surrounding region of my abdomen.

Thankfully this wasn't what had happened, as the next nurse to arrive explained, but it was something which might happen in which case I would be in serious trouble. She began to discuss hospitals.

'I'm not going home tonight?' I still couldn't square this - whatever it was that was happening - with the fact of my not actually being in any serious amount of pain, as I had been on the previous occasion.

'You're fine at the moment,' she told me, 'but you should probably go into hospital as a precaution in case it gets any worse.'

Shit.

I'd never been in hospital, not as a patient, and certainly not staying overnight. This was all very unexpected, and it was difficult to know what to think.

'The ambulance will be about forty minutes. Do you need to get anything from home?'

'Ambulance?' Bloody hell. I shared a look with my wife. 'Can't we just drive there.'

The nurse went back out to consult with Doctor Crow, then returned to tell us that it would be okay. She removed my drip, and I sat in the waiting room as my wife went home to pick up a few things - my diary, toothbrush, and something to read during my stay. As we left, Doctor Crow looked up from securing Kenneth Williams to a conveyor belt, bisected at halfway along its length by a huge circular saw. She smiled. 'You will be seeing Doctor Narvaez,' she told me. 'He is a great doctor. You will like him.'

'Okay,' I said, trying to work out whether she had failed to understand that we were enemies, or whether she understood it very well, and this new, friendlier tone was simply part of some strategy.

What a strange woman. How the hell did she know whether or not I was going to like the guy? How did she know that Narvaez and myself would not both perish, locked together in a fight to the death with lasers on the airless surface of some distant asteroid, our dying moments shared like dancers in some fatal ballet? Could she claim to see the future?

We drove to North East Methodist, and then spent ten minutes looking for signs of life. It was approaching midnight, and only the emergency admissions desk was still manned. After the traditional round of filling in yet more forms with the same information I had already submitted five or six times - the sort of thing you might imagine would have become unnecessary since the advent of information technology - I was dressed in one of those gowns which leaves one's arse exposed, and settled into a room. There were two beds in the room, but the other remained unoccupied during my stay, so I took the bed next to the window and was afforded a good view of the most spectacular storms to hit Texas since I moved here. A succession of different nurses came and went, asking more of the same questions, probing an agonising succession of major veins and arteries before eventually finding one in my hand which would be good for the drip.

Next day I was back on the clear liquid diet I'd been obliged to endure back in March. Bess brought her laptop in and worked at my bedside. I dozed, failed to enjoy a collection of Graham Greene short stories, and watched crap television - mostly peoples' court shows in which network appointed judges arbitrate disagreements between different groups of tattooed losers who either owe each other money or want their cars back; but I also found time to catch up with El Chavo, an eye-watering Mexican sitcom in which tiny argumentative children are played by adults in kinderwear with freckles drawn on their faces. The humour is based mainly on the premise of it being funny when people fall over or are hit in the face with a frying pan. It's like a more nightmarish version of the Benny Hill show, but all in screeching Spanish.

Eventually the fabled Doctor Narvaez turned up, and uncannily I found that I really did like him. I told him about my previous bout of diverticulitis, the low fibre diet and so on.

He pulled a face and waved a dismissive hand. 'I have my doubts as to whether any of that makes any difference,' he said. 'The jury is still out on much of this. It seems better just to remember what foods give you trouble, and then don't eat them.'

I recalled a recent indigestive flare-up immediately following the consumption of a burger bun from which I couldn't be bothered to scrape the sesame seeds. I decided that the Narvaez version rang more true than the previous advice I had been given.

Next day I was on solid but bland food, extended even to overcooked brisket and broccoli - a terrible choice for someone suffering from diverticulitis according to my earlier understanding. I ate with pleasure, having previously resigned myself to nothing but apple juice and broth for at least three days; and I experienced no ill effects.

The second evening came, and the head nurse returned to admonish me about my failure to follow her directive. She had showed me a pair of sleeves made of some material. These were to be fitted over my lower legs before I went to sleep in order to prevent blood clots.

'Blood clots!?'

'Yes, blood clots,' and she began to describe the clotting process as though I had never heard of such a thing.

'Wait. Am I at any serious risk of having blood clots form in my legs? Is this something associated with diverticulitis?'

She didn't seem to understand the question, only that I should do as told. She began to tell me about circulation.

'I'm forty-nine,' I said. 'I cycle fifteen miles a day. I think my circulation is probably okay, unless you know something that I don't.'

She didn't seem to understand this either.

I had spent the night either sweating or shivering because I found the bed uncomfortable and the air conditioning never seemed to be quite as I would have wanted. It was difficult to sleep as it was, even without nurses waking me up at 4.00AM so as to make sure I'd been sleeping properly, or to take a blood sample, or to ask whether I'd done a poo yet. I wasn't going to swathe my legs in something hot and uncomfortable as preventative to something which wasn't going to happen anyway.

Next evening, the same head nurse made an indulgent tutting noise. 'We've been a naughty boy,' she said, explaining that I would not be able to wriggle out of it for a second evening. No-one was dying of poor circulation on her watch.

I said nothing, but apparently projected a field of ambient hostility of such strength as to prevent her from further pushing the issue.

By Thursday I was deemed out of risk and well enough to return home. An orderly conveyed me to the exit in a wheelchair because patients aren't allowed to make the trip from bed to parking lot under their own steam.

'This is for legal reasons, right?'

He chuckled. 'Once you've made it outside, whatever happens to you out there is your problem.'

That seemed to be the end of it, barring a colonoscopy about a month later, the duration of which I spent under general anaesthetic. Nothing was found beyond a single small polyp - which I should probably have looked at in another five years - and that the offending diverticule is very small, and that my colon is otherwise so clean that you could probably eat your dinner off it.

So there you go.

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