I had a colonoscopy on September 1.
I should have gone years ago, truth be told. I’m 43 years old. The recommended age for a screening test is 50 (although there’s been a push to bring it down to 45, particularly in light of the death from colon cancer of Chadwick Boseman, who played Black Panther, at age 43). But when my grandmother died in 2003, my dad — her son — got his first scope and they found polyps. Then my dad’s gastroenterologist said his kids — me and my sister — should get our first colonoscopies at 40.
So since I turned 40, the thought’s been with me, sitting there staring quietly from the back of my brain. But it stopped staring, stood up, and began to scream when I started seeing blood in the toilet.
It was on and off. It usually followed long hikes. I went to the doctor a couple times for it, and they said to eat more fiber and drink more water. It was probably hemorrhoids, they explained, which made sense, since I’d had them in my 20s, and since I was well below the average age of a colon cancer patient.
This past February, though, the blood got worse. Fiber, water — it wouldn’t let up. I emailed my doc. She said given my charted history of hemorrhoids (never confirmed, exactly, just suspected on exam), we would treat it as such. She prescribed fiber supplements. Along with waxy suppositories. Internal hemorrhoid cream. External hemorrhoid cream. At the pharmacy, they gifted me a cloth bag for all my things.
The stuff worked, but only kind of. Every couple weeks, they’d be there, shrill and merciless: bright red, wicked streaks of blood. Logic told me the smart odds were with hemorrhoids. But I also knew that I didn’t know. And the uncertainty was gnawing at me.
Then soon the goddamn mucus started coming.
Now I couldn’t look away. Oh, I tried to, for about a month. Literally looking away was impossible, but I did try to set my mind elsewhere. Google didn’t help, of course. Blood was one thing. But mucus suggested other forms of inflammation.
Once again, I emailed my doctor.
She referred me to Kaiser’s gastroenterology department. Sight unseen, based on the symptoms I’d described, they called me to schedule a colonoscopy. I took a deep breath. The nurse offered me a June 24 appointment. I said my birthday was on the 26th, and since I wanted to enjoy it — possibly for the last time! — I’d take the opening on the 30th.
Then I counted down the days.
As the appointment got closer, I studied my prep paperwork. The night before, after having initiated a 24-hour liquid-only diet, I’d have to start chugging this saltwater-tasting potion, which would induce a string of marathon bathroom runs (pun intended) and ultimately clear my bowel. Oh, joy!
June 25, Kaiser called again. They told me my co-pay for the procedure would be $_____. Wait, what? That was way too expensive, especially for a procedure where the odds were (mucus or not) I just had a little boo-boo. So I went outside the network. I was relieved yet impatient. This whole thing was getting dragged out…
I called San Jose Gastroentology, where I’d be a self-pay patient yet the cost would be cut in half. Something also just felt better about them. At Kaiser, they hadn’t even wanted to see me. At San Jose, they wanted to begin the process with a consultation…
Bedside manner is everything when it comes to doctors. If you’re gonna get bad news, you want it to at least come from a compassionate mouth. When Dr. Abhishek Choudhary walked in, I knew he was my guy. Right away, he was so warm, upbeat. I couldn’t conceive of having that kind of energy amid so many daily patient interactions.
I told him my symptoms. He looked me in the eyes. (Eyes, of course, being all we’re working with in this pandemic.) He said it was more than likely hemorrhoids, but then again he’d been proven wrong before. The only way to know was to look. And the only way to look was with a colonoscopy.
We put it on the books for September 1.
As we neared the scheduling nurse’s station, I overheard Choudhary say to her: “As soon as possible…”
He said goodbye. He’d see me in the operating room. Then the nurse had good news for me: I wouldn’t need to drink that nasty saltwater potion. As of 2021, they offered pills! That alone validated my decision to switch providers.
There I was watching the calendar again. The only way for me to handle anxiety like that was to try and convince myself that I didn’t fear death. This was actually doable. It’s not that I’m a stoic or anything, but I do meditate daily, and I also have access to the thousands of near-death experience videos on YouTube. So I steeled myself. Told myself we all die, and if cancer was up there, then I needed to know and face it. The alternative — fearing my daily trips to the bathroom — was making me into half a person.
The prep was to begin a week before, when I stopped taking my vitamins. A few days before, I cut down on my fiber intake (ironic, since fiber was key to managing my alleged hemorrhoids; but now it’d be no good since fibrous foods can stick to the bowel and look like polyps). The day before, I started consuming only liquid — no red or purple (nothing that can be mistaken for blood). Then the night before — the big moment — those special pills.
I had to take 12 in quick succession. They were horse pills, gigantic, but not so bad. What worried me were the side effects. The brand was Sutab. Google had helped to put my mind at ease with soothing stories of people taking Sutab and vomiting blood. Omg, this was so much fun!
I watched “The Suicide Squad” in our upstairs game room (rating: four stars; I especially enjoyed the starfish). Swallowed those monsters one by one. It was 6pm; I’d have to repeat the whole exercise again at 5am. It didn’t take long for the gurgling to hit. I was then in and out of the bathroom like a coke addict.
No side effects. I’d been expecting bloating, which I’m prone to. But all was calm. Except for, of course, the entirety of my mind.
I slept. Crack of Dawn, I woke for Round Two. Squinting, eyes half-shut, I downed the 12 remaining pills. The toilet grabbed me like steel on a magnet. I must have made about 18 more trips.
Then I was clean.
No drinking for two hours before the procedure. When I got there, Gavin Newsom was on the waiting room TV, asking the voters of California to let him stay. I wished both of us good luck.
In the prep room, they told me that the hard part — the fasting — was already over. I knew they were wrong, but didn’t disagree. For me, though, the hard part would be my blood pressure reading. I have White Coat Syndrome, the comically named condition by which one’s blood pressure readings go off the charts in the presence of doctors. Elsewhere, it’s fine. But when a professional actually needs to get the data, the numbers do me the favor of going haywire.
Holy god: it was 200 over 130! They asked me if I had any heart problems. I said (not exactly a yes) that I feared I did. That was it: they gave me an EKG. That made my blood pressure worse. I expected someone to say I was having a heart attack.
My tongue was dry as a frog’s back. I needed water. Couldn’t have any, though—not ‘til after the thing. Was told my breathing was abnormal. Had nurses gathered around me. Blue masks. Blinking eyes. Bleep-bleep-bleeping machines.
I asked to sit up. They said of course. Told me to breathe easy: in through my nose, out through my mouth. The main nurse, a Filipina (they’re among the best), told me my heart was fine. Nobody was calling an ambulance, she said. “Ok,” I nodded. In through my nose. Good. Just like that.
Out through my mouth. Phhhheeewwww…
They got my blood pressure down and wheeled me through a pair of doors.
Dr. Choudhary was waiting in the operating room. “Look who it is,” I said.
He asked me how the bleeding was. I said there hadn’t been any since our consult. He asked if there’d been any during the bowel prep. I said no. This seemed to make him happy.
The anesthesiologist (a gentleman), stuck two rubbery tubes in my nostrils, asked me to breathe in the oxygen. Right away, I was on a disco dance floor. “This is gonna get me high,” I said.
“You’re about to get a lot higher,” he assured me.
The nurse began to ask me questions. It was like an intake procedure at the gates of paradise, in the final moments of my tour on Earth. From her tone, I sensed a recorder was running…
“Is your name Eric Maxwell Shapiro?”
“Are you 43 years old?”
“What do you do for a living?”
“My wife and I own a newspaper in Milpitas.”
“Oh. What’s that? Local news?”
“You got it.”
Then—nothing. Less than nothing. Lower than zero. My innermost, most sealed void: no sound, light, motion.
I was on a playground with my wife Rhoda. Green trees. Almighty sun. She smiled. We spoke. Our kids were near. All was perfect in the world. All worlds.
Whoooooossshhh! Eyes snapped open like a doll’s. In the recovery room. Alive again. Back from the dead. Dr. Choudhary was above me. He said, “Ok, your colon looks good: No Cancer!”
The pillow grabbed my whole head. I got pinned down. I wept.
I told him I was loopy, asked him if he could repeat that. “No cancer?”
“No cancer,” he repeated. He had, however, removed a pair of pre-cancerous polyps. That means I’ll have to go back again in three years. No problem; I’ll take it.
“I was concerned about you,” Dr. Choudhary added.
“Why were you concerned?”
“Ah, you said you had mucus…” But the culprit was the hemorrhoid. Singular. Party of one.
With good news rattling around inside it, my head got even loopier. It was a party up in here for two straight days. I’m neurotic, and a stranger to the words “peace of mind.”
‘Til lately. Lately I know.
Not only was the news good, but I’d accomplished the deed. Modified diet, liquid diet, horse pills, early morning awakening, blood pressure reading, anesthesia, waking to test results. Any one of those is stressful on its own. Together, they’d made for quite the looming layer cake.
I’m an older man now, having done this thing. It’s one of those moments in life where you turn around and say, “Holy moly. I was just a child. When did I become this grown-up?”
I am, though. Elder statesman. Man who’s been there. Eaten fruit from a branch of the tree of wisdom. Become equipped to dispense advice like a neighborhood uncle. So:
Colorectal cancer is the third-leading cause of cancer deaths in the United States among men and women respectively. Among men and women combined, it’s the second-leading cause. Two hundred thousand people are diagnosed with it annually. This year, 52,980 people will die from it. But the good news is, it’s preventable. A colonoscopy is the only test on Earth that can not only detect early cancer, but literally nip it in the bud.
If you’re 50 or older, or you’re having symptoms, go get a colonoscopy. You’ll be happy you did; trust me. Just tell ‘em your Uncle Eric sent you.