Medical Exam Postscript
For those who have asked for a more personal HPBlvd, here is an email drafted and sent to my gastroenterologist after last week’s visit:
Dear Dr. ____ –
Post-colonoscopy appreciation and reflection.
Thanks for your – and the clinic staff’s – expertise and professionalism. You made a sphincter-tightening experience as easy and pleasant as possible.
During the car ride home, I read with some interest the paper that you handed me at the conclusion of the exam, which provided details of the procedure, including color photos from a tour that I must have slept through. The concluding sentence reads as follows: “The quality of the bowel preparation was fair.”
I will not question why anyone would want souvenir photos of their rectum and cecum. I could be smart and say that, if they were interested, they could have stayed awake, but I can understand how pictures of specific features (especially diagnostic-related features) might help to make real what is a terra incognita for anyone but medical professionals.
But the barely passing grade on bowel prep will not stand without comment.
Depending on one’s upbringing and personality, colonoscopy can be many things beyond a necessary screening (and, when necessary, harvesting) procedure. It can be a challenge, a cleanse, a discipline, an enforced fast, a nuisance, a punishment, the Day of Atonement rent free of the Hebrew calendar, a rite of passage, an expression of self-denial, and many other things, including a vain attempt to know how a car radiator feels when it downs a Prestone-size bottle of polyethylene glycol.
For those of us who lean a bit toward the OCD side of the ledger, it’s one more opportunity to perform a complicated set of instructions to the letter – and to make sure we’ve held up our end of the bargain, not to mention to get the approving pat on the head that we didn’t get as children (and that made us OCD in the first place). And in some greater cosmic court, proper behavior is rewarded, ideally in a good diagnostic outcome.
I was determined to do this colonoscopy right. I limited my diet to yogurt the day before the day before the procedure. For the fateful prep day, the instructions said drink a bottle of citrate of magnesia at 9am, so I did just that, and then followed up with exactly eight ounces of liquid every hour on the hour from 10am – 5pm. And unless my friends are lying to me, I’m the only person in my circle who downed the entire gallon of goLYTELY.
I was pleased by the clinical finding of normal, and there’s nothing I can do about the ‘abnormal’ digital rectal exam (prostate having been removed and there being no one home). But this barely passing grade on the bowel prep is unfair and I’d like to appeal to a higher court. Is there Dean or someone to whom I can bitch?
Again, many thanks.
Yours,
R










