Monthly Archives: May 2018

Letter 55: Reflections on a Colonoscopy

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I was early and the doctor was late. There I sat, naked to the world but for the flimsy gown, on the eve of my birthday wondering if they would find anything, again. The fact that the doctor found an adenoma six months ago is the reason I was now sitting there waiting.

Statistically, I am now in the back half of my life. So one gets reflective. I remember my pediatrician, Dr. Horton. He wore a white lab coat and smoked a pipe, I believe. It was his office, and unless he was sick or on vacation, you saw him. I don’t think he had a nurse, only a receptionist. Nurses still wore white uniforms with white stockings and shoes. I can recall the small stinky bottles of special shoe polish for white shoes, complete with the image of a nurse on it. I can’t recall seeing any nurses with the hat or the cape, but the image was still present.

You got a fairly thorough exam. Tongue depressor, rubber hammer to test reflexes, a look in the ears and the nose, and follow the penlight with your eyes. And of course, he stuck a glass thermometer under my tongue to check my temperature. He was authoritative. He drew his own blood.

In smaller towns, such persons were respected members of the community. Together with the local attorney, he served on the board of the local bank, with either the local insurance agent or the local grocer. Chances are they served on various advisory boards as well. Looking back on those days, nearly everything was local.

I was called out of my reverie by a commotion outside. Something had happened. Something not good. I heard muffled comments, and scurrying feet. I would later learn this was part of the reason my doctor was late.

One of the peculiarities of modern medicine is the obsessive need to confirm that that you are you and why you are there. Apparently, this is state law. Every interaction began with some variation of the litany. I was there for a colonoscopy. Who, pray tell, was going attempt to sneak in and steal a colonoscopy?

I understand that times have changed. The technologies available and the number of conditions doctors can treat have expanded. Insurance companies’ efforts to keep costs down have perversely have had the opposite effect—it’s all about maximizing billing opportunities. My annual physical will consist of a few checks, and an order of a blood test. I’ll have to come back for my doctor to read me the results I’ve already looked at online. The physical is “free.” They can bill for the second visit.

Is it better to have that sense of continuity and familiarity or the panoply of treatments? I wonder. I apparently share the “Comstock Colon.” I’m not sure when my grandfather was first diagnosed with colon cancer. It was the slow-growing variety, and so every few years they would remove a bit of his colon. This continued for some time until he ran out of colon. Would the earlier availability of colonoscopies have allowed him to live longer and healthier? I don’t know. He died three weeks after his 90th birthday.

Teach us to number our days,” concludes the Psalmist, “that we might apply our hearts unto wisdom.”

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