Cancer Ha Ha Ha

Paul Lowinger


I looked at the photographs of my colon where there were shiny polyps that looked like red and yellow sweetmeats. Dr. Chew, the surgeon acted like it was cancer but he said he couldn’t be sure until it was biopsied. That meant the polyps had to be removed along with a lot of the colon and the lymph nodes through an abdominal incision. Dr. Chew said, “We can schedule your surgery next week.” This was simple and direct but I wanted a long rambling dialog about surgical risk and survival.

The polyps had been discovered earlier during colonoscopy. Dr. Chew had put a flexible tube into my digestive system to look at the surface of my rectum and colon and to photograph any suspicious areas. Prevention requires colonoscopy every ten years beginning at fifty even if you have no symptoms.

I feared surgery, the scarring of my smooth abdomen. The risk of general anesthesia, another heart attack, a blood clot in my brain were on a list of complications. Now I had another question that only a psychiatrist would ask: Was my fear of surgery a renewal of my castration anxiety, the infantile and largely unconscious fear of mutilation.

I reacted as many do: I put off the operation. My excuse was that I was waiting for a second opinion which I scheduled. I went to Dr. Blister at Stanford. He was a white coated, muscular and serious consultant who walked into the office with his satellites, a animated and attractive young woman who was a physician’s assistant from India and a resident physician, an Asian man who was silent and glum. Dr. Blister took the medical records that I brought with me. He said he had met Dr. Chew at Sun Valley and discussed my case.

Dr. Blister spoke, “I agree with Dr. Chew that the operation is necessary.” He went on to name the complications of surgery which I received as a verbal talisman against these dire events. He said that the length of time in the hospital would be a week not be the three or four days I imagined. He was articulate about the chemotherapy that might follow surgery if the cancer could not be completely removed, “Not as bad as the chemotherapy for breast cancer, you don’t loose your hair.” Not everything Dr. Blister said was important as he quibbled about the language used by Dr. Chew to describe the planned surgery.

Dr. Blister concluded, “The recovery from abdominal surgery is slow and may take six months or more. I’ve had fifteen operations. I recall after one operation that I had filled my cart at the supermarket but I was just too weak to finish shopping so I just left it and went home.” The imagery was compelling as I speculated about what would cause this middle aged consultant to have fifteen operations. I assumed he meant abdominal surgery rather then his knees or sinuses but I was there to worry about my case not his. The gabble of clinical talk contrasted with the parsimony of Dr. Chew’s style. My trip to Stanford was worth it and I savored the vision of Dr. Blister as a wounded healer.

The surgery went as scheduled. Dr. Chew with a surgical resident, an anesthesiologist and two nurses took an hour and a half to remove ten inches of my colon including the polyps and nearby tissues. All I remember about the surgery is a flash of consciousness afterward when I saw my cardiologist looking like a triptych of Ben Franklins from a hundred dollar bill.

I was in the surgical ward from Tuesday to Saturday with a catheter and an IV. I had a ten inch scar with my navel at its midpoint. Dr. Chew was out of town so other surgeons visited me inspecting my incision and discontent. I was on a liquid diet, apple juice and tea awaiting the passage of gas through my reconstructed colon. I waited for this event impatiently but it happened.

The five days in the hospital were a journey through the twists and turns of a hospital fun house with unpredictable events appearing and evaporating like the changing surface of a stew. There were visitors, a needle that slipped out of the vein, the removal of the catheter, using a walker, a gift plant that needed watering, the chaplain’s visit and even a call from a hospital office about my insurance.

I watched television but my roommates on the other side of the curtain in the two bed room were more entertaining. First, there was a twenty-something Filipino seaman who had injured his hand on a merchant ship and after many phone calls flew off to Japan to rejoin the crew. He was followed by a older man who couldn’t pee and was constipated following a skin graft. He needed the graft because of burns after an accident with grease cooking at home. He was improved but still in the room when I left.

Finally Dr. Chew returned and said I could go home. When I told him about Dr. Blister’s fifteen operations, one of his eyebrows went up and he said, “Not Dr. Blister.” The truth was only a twitch away. A week later I went to my office appointment and received the report of the pathologist who said the polyps removed were cancerous but it had not spread beyond the site of the operation. Dr. Chew called it a garden variety cancer, a euphemism for the more ominous language of the report: invasive colonic adenocarcinoma.

Now I was changing my bandage daily; my only restrictions were alcohol and salads. I had a 95% chance of a cure but I would need another colonoscopy in a year.

“Cancer, ha, ha, ha,” were the virtual words of Dr. Blister, the surgical Paul Bunyan. I was waiting for Babe the Blue Ox.

© Paul Lowinger 2003