Friend of the blog The Poet Spiel tells me he was diagnosed with pancreatic cancer in 1996 and wrote this flash essay in 2000. What’s the secret of his immortality, I wonder? Could be his bawdy sense of humor!
Details You Just Can’t Live Without
Nurse Jonesy is rushed and red-faced as she wheels my gurney to surgery. She advises my mate Paul that I’ve been having these invasive procedures too frequently and I’m likely to become increasingly vulnerable to stirring infections which naturally lie dormant in my system.
Sharp insistent pain is shooting into the middle of my back.
I’ve just agreed in writing I will not drive a car or sign any legal document for at least 48 hours. The drugs I’ll be given will alter my judgment.
Assistants Heather and Tanya greet me like old friends in the sterile room, then drape me with an x-ray apron and begin intravenous administration of 125mcg of Fentanyl and the hypnotic sedative of 8mg Versed. As I drift into ‘twilight sleep’ they’ll be able to converse with me but I won’t have a clue what I’m saying. I insist that they save the stent which is to be replaced in my clogged bile duct. I’ve wanted to see how much crud it has collected after past procedures but somehow those loaded stents have always mysteriously disappeared.
A big color monitor hangs overhead as Doctor Lutz maneuvers his endoscope through my innards. Though I can view the process, I won’t recall what I’ve seen during my conscious sedation—or so I’m told.
As the drugs engulf me I hear his voice—remotely—as if wind blows it toward and then away from me. I can’t relate to the fact that he is talking to me. During past quarterly visits the women have shown me the gross anti-gagging device which, at this moment, persecutes my lips as they cram it against my gums. But this time I perceive it as a multifaceted stainless steel monstrosity and I believe they are pushing a shiny silver tractor down my throat. I resist vehemently. These veteran nurses strong-arm me back into working position.
From here on my awareness is nil as the side-view scope tube is advanced into the second portion of my duodenum where they’ll locate the biliary stent protruding from my papilla. This is the stent installed ten weeks ago when I was in horrendous pain. Debris occludes the stent just as it has clogged each stent for the past 16 procedures. A tiny snare is skillfully manipulated to remove the fouled stent.
It had been a close run with death—the outset of this awful process several years ago when we learned my pancreas had curiously twisted and knotted my common bile duct and since then, this never-ending series of keeping my bile duct flowing freely.
The women manhandle me again as I struggle in discomfort. Doctor Lutz uses a biliary catheter to cannulate my duct, then injects contrast iodine to obtain images that indicate a high-grade stricture in the common hepatic duct just above the cystic duct. Now he passes a guidewire through my cannula, advances it through the stricture and on up into the intrahepatic ducts. The cannula is removed over the guide wire, over which he also passes a seven centimeter 10-French Teflon biliary stent. It’s placed above the stricture in good position and finally, aha! even in my dumbed-down state, I see clear bile draining from the biliary stent at the conclusion of the procedure.
As Heather wheels me to the front curb of the hospital, I am still under the influence of the magic twilight of Versed, still babbling, making drug induced inappropriate comments about the gross size of the endoscopic tube, revealing that I’d prefer to have my mate’s dick shoved down my throat. She tolerates my rude remark as he pulls to the curb to load my dead weight into his Pontiac.
As he drives me home. I realize they’ve not shown me the fouled stent. I become paranoid. I ask him over and over again why he thinks those stents disappear. Does he suppose docs are pulling the wool over my eyes? Maybe these gadgets don’t really fill up? Disability insurance money is easy money these days.
But what about my very real pain?
Between the hospital and the 45 miles to home Paul claims I ramble at least twenty times about the size of that tube. Oh, and how the first thing I want after every procedure is a big steak dinner with plenty of mashed potatoes.
He knows I’ll forget that wanting as soon as my head hits my bed.
But the best thing about these repeat procedures: I’m certifiably not responsible for what I’ve said—or for what I say for the next forty-eight hours.