At 16 we get our drivers license, at 18 we receive the right to vote. At 21 they allow us to legally drink. After that it goes downhill. At 26 you’re kicked off your parents insurance and at 50, well, they prod you to get prodded. I’m talking colonoscopy, here. Yes, I did turn fifty some time ago, and my doctor’s been lecturing me ever since. She gave me a pamphlet and presumably sold my number to the gastroenterologist. After they realized I wasn’t picking up, they stopped calling. I held out for five years.
It’s not that I’m afraid of the doctor or the embarrassment or even pain. I delivered four babies vaginally without meds for Christ’s sake. It’s the principle. They aren’t looking for polyps. They’re mining my intestines for gold.
The colonoscopy is the poster child for American healthcare run amok. It’s the most expensive test most of us are prescribed. Like other hospital procedures, a colonoscopy in other developed countries is a fraction of the cost we pay in the US. Here, the procedure accounts for the lion’s share of most gastrointestinal physicians’ income. Using less invasive, less painful, safer procedures would also be less expensive, but who wants that?
Sure other tests may have to be done more often, but at the cost of my prep kit (or less), some of them can be done at home and with no disruption to work or life for those of us who are at low risk.
I was told it was no big deal. Well, it was a big deal, albeit temporary. And the argument is that cancer is a bigger, potentially more permanent deal, right? And because we all know someone who has suffered and lost to cancer, we let them win that argument.
Here’s the thing. You knew I was going to tell you the thing, right? I have health insurance. It makes it easy to go to the clinic every year whether I need it or not, and order up smears and cultures, and scans and scopes whenever my doctor deems it necessary. I have a primary physician and even a phone app that will tell me the results of every test I’ve had in the last ten years. And while they go to the effort to make it all seem free it indeed is not. Healthcare is costly, and is not getting any cheaper or accessible for millions of good, hard-working Americans. If, by some miracle, they can afford the colonoscopy, it won’t matter because they can’t afford cancer treatment.
Once I booked my appointment, I had to put in for my day off of work. Not only do I have the luxury of taking a day off of work, I know someone else who is also able and willing to take a day off of work to drive me to and from the surgery center.
Four days prior to the procedure I went on a low-fiber diet. Not everyone can indulge in changing their diet for four days on a whim. They access their food from a food shelf once a month, or clean out their cupboards at the close of every week. Heck, I’ve been there — and not so many years ago. They can’t afford the $18 for the prep kit, or the two quarts of electrolyte beverage.
No one told me I should have considered taking the day before the appointment off of work, too. I was disoriented from fasting, couldn’t think or make decisions. I was ill from overdosing on mega-laxatives. When Bubba apologized for eating dinner in front of me, I told him I couldn’t eat if I tried.
However, by the time we arrived at the medical center, the illness of the power-lax had worn off and I was starving. A woman in scrubs took me to a tiny room and instructed me to change into a gown. When she came back she slapped a pressure cuff on me, inserted an IV needle in the back of my hand, and said goodbye before closing the door. That was the last person I saw for an hour and a half.
I sat in that room after not eating any solid food for 36 hours, while the staff talked audibly outside my door about who was going to lunch, and where. When finally someone came to get me, I was just about at the end of my rope. I made her wait while I slooooowly coiled my phone cord and placed it in my bag. I sauntered down the hall at my own pace, watching her surprise at how far behind her I’d fallen. You’re on MY clock now, bitch.
Apparently I get mean when I’m hungry.
No less than four people made conversation out of how to pronounce my last name. Yeah, that never gets old. The nurses complained about how cold it was and that the music had frozen. What kind of music is appropriate for a colonoscopy anyway? Dirty Deeds? Send the Pain Below?
When the doctor asked me where I’d been hiding for five years, I was thinking, “You know what? The faster we do this, the faster I can eat.” But you don’t argue with a guy who’s about to put a 6-foot tube up your backside. Mama did teach me not to say anything if I can’t say something nice, so after an awkward moment of silence he replied, “Okay . . . !”
Thanks to plenty of sedation and pain meds, the memory of the next twenty minutes is dim. I do remember the doctor asking for more Versed and the anesthesiologist telling me if I let go of her she can get me more pain medication. I remember them showing me the monitor, as if it could distract me like an episode of The Handmaid’s Tale.
Okay, okay . . I’m done going over the details of my colonoscopy like Gramma at the Thanksgiving table. In the end (pun intended), I got a clean bill of health, a free ticket to come back in 10 years, pictures — yes, pictures! — and a blue tote bag out of the deal.
Let me be clear. I’m not saying that colon screening is unnecessary. I’m saying our health system needs a good thorough check-up. If they really wanted more people to get screened so that less people would die, they would offer more convenient and less disruptive and less expensive options more readily. Healthcare would be for everyone. But then they wouldn’t have all that fun money, would they?
We are aphids blindly sucking nectar off the tender plant while they farm our backsides for the sweet honeydew.
Also, that metaphor is kind of gross.
Peace . . .