An Open Letter to the Medical Community

TMI ALERT:  This post is not for the modest nor the faint of heart, and addresses a very uncomfortable subject.  Yes, I mean colonoscopies.

NOTE: This is written from the point of view of someone who just walked someone through the process, but the idea is that I'm supposed to schedule one next.  So basically I got to see what I can look forward to.  Although I did already undergo the little cousin of said procedure, the sigmoidoscopy, so I already had an inkling.  There, see?  TMI already.


For the uninitiated, we're talking about a process here.  Twenty-four hours plus of fasting followed by industrial-strength colonics and capped off with a procedure that involves sticking a scope up an area that is usually reserved for more intimate partners.



OK.  I can get past the modesty issue pretty much because I did have two babies.  I have had to let it all hang out.  I would think women have an advantage there.


But people, we're talking almost 3 solid days of misery here.  I found myself constantly asking myself, "Really?"  This is the best modern medicine has come up with to protect us from this dread disease?  This is not minimal, I would say it is almost a maximally invasive procedure.  Hey, while you're at it, how 'bout you cut open my head and make sure I don't have a brain tumor?


Can we come up with a better way to do this?  Is that really asking so much?


What did surprise me was that my reaction to the whole thing was anger.  Especially once we got to the hospital.  I was already peeved on my better-half's behalf that his procedure wasn't scheduled until 5pm.  That automatically guaranteed that he would have to fast about 40 hours, and would get to spend much of procedure day anticipating the experience.


We checked-in at the hospital an hour early, as instructed, and the poor guy gets all (un)suited and IV'd up, and then we discovered that there were 3 unfortunate souls in line ahead of us, and things were running late.


Wow.  I did not take that well.


This was when I fundamentally realized that I was not a nice person.  I discovered that I have an impatient and mean-spirited streak, and I was desperate to channel my inner Emily Gilmore and make that staff PAY for what they were doing to my husband.  I was annoyed that they were so nonchalant, that this all gets treated as a minor inconvenience.


It's all done by snark, and I hate to brag, but I think I'm pretty good at putting out a "we-are-not-amused" vibe.  I did not attempt to hide my displeasure at finding out that we were going to be a few hours longer than anticipated.  I even told the nurse that although I had lost a very dear friend to colon cancer, this was making that look not so bad.  My poor husband suggested that I didn't need to wait with him.  I was vocal enough in my protests that when they finally took the guy away who was ahead of us, he promised he'd try to hurry!


(Oh yeah.  Another thing to enjoy about the experience was the near total lack of privacy.  Everyone was prepped and lined up in their beds waiting to be wheeled away, separated only by a fabric curtain that wasn't closed very often.  Everyone is pretty much on display and nothing is secret.  I should have just stopped the nurse when she was giving me the discharge instructions BECAUSE I'D ALREADY HEARD IT THE OTHER 3 TIMES SHE'D EXPLAINED IT TO OTHER PEOPLE.)


I was enraged.  Why?


A big part of it, of course, was the fact that this was prolonging a loved one's agony, and the timing was terrible.  The recovery from the anesthetic was a little difficult, and even the nurses had to agree that the fact that the poor guy hadn't had any sort of food for what at that point was about 44 hours, and not even liquids for 9 of that, was probably a contributing factor.


But I realized my anger was even bigger than that.  I was angry at the whole process.  What one of my friends called a "lousy rite of passage."


It certainly illustrates that for all of its intellectual elegance, medicine is really a rather nasty, brutish thing.  We attack illness with poison and knives.  Bodies exist to be poked, prodded, and manipulated.  Many times it is to cure us, which is great, but often it's just routine maintenance.  Then it is mostly annoying and intrusive, and only increases in frequency as we move along the road of life.  Yes, kids, this is what you have to look forward to. 


And perhaps that is what I was raging against most of all.  This reminder of mortality, and the fact that our bodies break down and turn against us as we age.  And the medical indignities only increase as we attempt to keep our jalopies running smoothly.


So I'm supposed to schedule my colonoscopy next.  I may be able to beg off for a few years since technically I'm on the young side, but it has already been recommended and prescribed.


So you medical providers and researchers that be:  Could you please expend some energy on making this process less uncomfortable and humiliating?  If not for me, do it for your staff.  They are going to have to take care of me, and I cannot be held responsible for what I will say or do under the influence of narcotics.  Especially if I have been convinced of the necessity of avoiding caffeine prior to the procedure.  If I have a withdrawal headache on top of everything I've outlined above, all bets are off.  The bitch will be back, baby.


And how are you?

Two Roads Diverged in a Yellow Woods...

Happy 2012, everybody!  A new year brings new possibilities, and, as if on cue, this new year is bringing changes to my life.

Have I mentioned before how much I hate change and transitions?  I'm a creature of habit.  It's even worse when big decisions need to be  made.

So what's going on?  Nothing all that exciting, really.  Brandon is transitioning to pre-school which leaves my life less focused on childcare.  In the interest of personal fulfillment (and a paycheck!) I've decided to take another leap into the world of actual, outside-my-house, employment.  Somewhat anxiety-provoking change #1. 

Anxiety #2:  I seemed to have found a job.

A brief digression here.  Employment and I have a somewhat stormy history.  My relationship with work has some eerie similarities with unstable interpersonal relationships.  I end up with jobs that start-off so good, but the ending is generally bad.  I don't think I've ever gone through the stereotypical job hunt involving want ads, resumes, and personal interviews.  That would take having an actual career path.  Instead I'll take the job that'll have me.

My first job out of college?  Working at a domestic violence shelter where I had been a student intern.  It was...an experience.  The young woman hired to replace me when I left after 3 years lasted longer than I did, but also developed stress-related health problems.  It was not a well-run program and it eventually imploded.

My next career move was becoming a legal assistant at a law office.  This job was offered to me because somebody knew I was at a loose end having left the shelter.  In fact, I was so unaware that there was a job offer in the works that I showed up at the office with my hair in cornrows, wearing a tie-dyed dress and moccasins.  It was a small firm with a staff prone to psychodrama.  I lasted about 10 years.  It all ended with a nasty business "divorce" between the firm's partners, and I realized that I am not cut-out to work in an office.

I tried returning to my food service roots.  I like to joke that I was a food service major at Oberlin College because I worked a lot of dining hall jobs to stay in school.  I've washed my share of dishes.  I know my way around a Hobart.  I enjoyed my stint as a dietary aide in a nursing home.  There is a certain satisfaction in breaking a sweat and getting dirty.  I loved my interaction with the residents.  I didn't love the new management when our department was outsourced, and I didn't do a good job keeping my opinions to myself.  That ended THAT job.  I learned that I'm not good at being treated like an expendable obstacle to company profitability.  I'm also not that good at physical labor, really.  I over-think things.  I'm not speedy and efficient.

Then there has been the childcare thing which I got into when a mom called me because she knew I was at a loose end after the law job ended.  In truth, this is a skill I didn't even know I had.  But the kid seemed to like me, although she eventually moved away.  But then a friend of mine had a baby and needed someone to care for him.  After the nursing home episode another friend of mine had a baby.  I've always felt this was karmic payback for the fact that I had been a working mother and depended on a neighborhood woman to care for my daughters.  They have been great gigs, and I was fortunate to only care for children I really cared about.  But my daughters are largely grown now, and I'm ready to interact with adults.  Babies and toddlers are sweet, but they're tyrants.  It's a good thing they grow up.

I swore to myself that when I re-entered the job market I'd put some thought into it, evaluate my strengths and interests and launch a career that would be a good fit.

Instead I've fallen into another job.  I've come full circle.  I'm poised to work at a domestic violence shelter.

It came about through connections from my first job.  It started with an innocent inquiry, and before I knew it I was signing a W-4 and undergoing training.  It's a different program and I need to learn their policies and procedures.

I know starting new jobs is scary.  But I'm not certain that I've always felt this knot in the pit of my stomach.  I don't think that the thought of the job should make me feel like crying.  It wasn't until I had actually committed to the training that I had an explosion of anxiety.  I don't know if I can do it anymore.

The first go-around was a soul-searing experience.  I was young, idealistic, and working for someone who felt that things like training and boundaries were largely unnecessary.  I'm sure I was given way more responsibility than I was really ready for.

So when I feel panic now, I don't think it's from where I am today.  The 25 year old who walked away from the job to save her mental health is still inside my head somewhere, screaming.

But this, I tell myself, will be different.  It's a new agency with better policies and procedures.  I'm 20 years older and wiser.  I'm only working very part-time.  It's a job I know.

But that might be the problem.  It's a job I know.  I know full well what a bad day can be like.  I know that 98% of the time it is fairly routine.  But that 2% can be a doozy.  This time, however, I can be confident that I won't be made to handle it alone.

But I'm also wondering if I'm ready to let the misery of the world back into my life.  It's one thing to be aware of and care about issues like poverty, homelessness, mental illness, and violence, it's quite another thing to stare them straight in the eyes.  Am I strong enough?

I guess I won't know until I try.  I'm hoping that spending more time at the shelter will set my mind at ease.  Or let me know this isn't the right direction for me.

Two paths diverged in a yellow woods.  Sorry, Mr. Frost.  It isn't the road not taken that concerns me.  It's the one I've already traveled.