Down Periscope

The most exasperating part of every scope is the urine sample. Male readers, cherish your freedom from this legal formality, for it is not easy to comply with these mercenary urinary demands when you’ve been starved of fluids for a half-day or longer.

“I’m a monogamous lesbian,” I once told a nurse at a Catholic hospital in desperation, still holding an empty plastic cup after what felt like an hour in the restroom.

“No one’s exempt,” she replied, unmoved. “Not even the nuns.”

If anything offsets the vexation of that part of the scope experience, it’s the enjoyment of people-watching as nurses show us to our curtained bays and make sure we’re procedure-ready.

“What kind of prep did you do?” they ask. “What did you last eat and drink? What time was it?” These are not trick questions; scope prep is straightforward. You’re given simple written directions beforehand, rules that hospital schedulers and registrars reiterate over the phone. If you have a colon, you’re prescribed prep mixes that also come with instructions. But I’ve never not overheard a crazy answer at these appointments, the kind of bizarro stuff that makes you wonder “How has this person survived into their fifties?”

At my previous scope, Crankenstein and I exchanged glances as a patient and her husband told an incredulous nurse “We stopped for sausage and biscuits on our way here.” They were sent home and another nurse sighed just a few minutes later when she quizzed me about food intake and I made a biscuits and gravy joke.

“There was a guy last week who had steak and eggs for breakfast,” she said. “He wanted the doctor to scope him anyway and argued about being rescheduled.”

Twice I’ve heard “I had coffee this morning,” once from a woman who also copped to feasting on ice cream before bed in violation of her prep rules.* Sometimes patients don’t drink the laxative-filled concoctions they were supposed to, which also gets them sent home. It’s crazy to me that anyone would waste their own time in such a manner, particularly when it comes to cancer-screening, but it happens frequently at the clinic I visited today.

There were hiccups this morning, as there often are, including dehydration that required some extra IV fluids. But none were schedule-derailing, which allowed Crankenstein to have an important meeting this afternoon about her next promotion. Then there was the matter of my blood, which was as slow as the rest of me and didn’t want to move.

What normally happens, since I’m a research subject in a study that requires blood and tissue samples, is they take a few vials of blood once the IV’s in. Alas, my blood was uncooperative on this occasion and the nurse kept struggling with my hand, trying to coax some out while resisting offers of help from others. The anesthesiologist who stopped by for the usual explanatory chat politely intervened, trying a trick — squeezing my arm, hard, in particular spots — that didn’t achieve the desired result.

The IV was usable, so the nurse kept it there and apologetically asked if she could draw blood from my other arm because the vein looked “nice and juicy.” I agreed but the outcome wasn’t much different and it took a long time for her to collect everything she needed. By the time I was wheeled into the procedure room, I was ready for a nap. Happily, after having trouble with anesthesia wearing off prematurely in recent years, I slept uninterrupted. When I woke up in a recovery bay, Crankenstein was at my bedside.

Not long afterward, the GI delivered precisely the news we hadn’t wanted to hear: “I don’t know what the ENT was referring to,” he said, a reference to the ENT’s contention that there was a visible esophageal narrowing. “I found no stricture, nothing to dilate,” and no signs of inflammation or scarring.** He still thinks the swallowing abnormality is a Parkinson’s-related muscle issue and wants to send me for something called esophageal manometry, a test that will involve the medical maneuver I hate the most: placing a tube down my nose.

In other words, there will be no “Hooray, I can swallow again!” celebratory pizza. Instead, I’ll drown my sorrows in pizza while trying not to choke. And ‘Niles’ and I will attempt to ignore an unsettling implication my GI didn’t seem to grasp, which is that atypical Parkinson’s is likelier than regular Parkinson’s to afflict this part of the esophagus.

* Life without a colon doesn’t come with many privileges, but here we have a rare advantage: pouchoscopy prep is a walk in the walk compared to colonoscopy prep. If you’re morbidly curious, this isn’t my clinic but its instructions are standard.

** He doesn’t expect the pathology report to yield any explanations. We should have that back within the next few days.

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