Big Words Can Be Scary

What You Should Expect When the Doctor Says ‘Sigmoidoscopy’Hint: It’s More Than Just a 24-Point Scrabble Word

By Jason V. Calabrese 

Truth be told, I’ve never been fond of doctor visits. I treat the majority of my office visits like a tight-jawed suspect wanted for questioning by the authorities. During the interrogations, I would keep my mouth shut and offer nothing. Thirty-two years of evasive measures finally caught up with me when I admitted to finding blood in my stool.

“If you’re thinking colon cancer,” I confidently told the doctor, “I’m too young.” 

“Cancer doesn’t really discriminate by age,” she responded. “Some people are at a disposition for it.” Having corrected my misconception, she checked my charts and inquired a little more about my history.

“I see you were in the service and spent some time in Iraq. Were you exposed to any hazardous products?”

“Does depleted uranium count?”

She nodded her head.

“Do you smoke?”

I nodded mine.

“Do you drink?”

“Of course,” I replied.

“Is there cancer in your family history?”

“Unfortunately.”

“That’s not good,” she said while setting the clipboard down. “It‘s true you’re young and there may be no cause for alarm, but I’m going to send you for a test to check for colon cancer.” 

Silence.

“What does that entail?” I finally asked.

“Something called a sigmoidoscopy,” she replied.

It was a word that no doubt struck fear in the hearts of third-grade spelling-bee finalists.

“Can you use that in a sentence?” I asked.

“Sure,” she said in a placating manner. “I’m sending you for a sigmoidoscopy.”

When asked if the procedure would hurt, she chose her words wisely: “Um … maybe a little.”

Later that night, I looked up the five-syllable enigma on the Internet. Having read the description of the procedure, I would wager I was no less horrified than Luke Skywalker when he realized Darth Vader was his father, or Oedipus when he realized his wife was really his mother.

I found a site describing the procedure of a scope being shimmied up the rectum to check the lining walls for polyps, or cancer-forming cysts. The thought of such a procedure would not have been so terrifying had the rectum in question not been my own. Luckily, my wife was there to comfort and console me through this horrible revelation.

“Oh, stop being such a baby,” she said, throwing a box of Puffs Plus tissues at me.

“I’m not being a baby,” I sobbed.

My wife tried to reassure me.

“It’s a normal procedure to check the colon. It’s not like you’re having a brain transplant,” she said. “Not that a brain transplant would be an entirely….”

About a week later, I received a letter in the mail saying I needed to attend a preparation class for the procedure. “It’s not like I’m the one performing it,” I thought. “In this case, ignorance is bliss.”

How right I was.

Part I: The Prep Class

I showed up 30 minutes early for my prep class and was seated in a waiting room filled with people about twice my age. A nurse announced names over the intercom. When mine was called, I lined up against the wall with my classmates, all men who appeared to be in the age range of 50 to 60.

A gentle-voiced woman in a white smock called for our attention and introduced herself as our instructor for the preparation course. After taking roll, she called on an elderly gentleman in the back row who had his hand up.

“Yes, Mr. Tuttle.”

Mr. Tuttle nudged the elderly gentleman next to him. “Will we be receiving a diploma when we complete this class?” he gasped out before erupting of laughter at his own joke.

Mr. Jones, the gentleman next to Mr. Tuttle, nudged him back, gave a tug on his overalls, adjusted his John Deere cap and added, “Heck. I’ve had so many of these things, I should be teaching the class myself … or giving each of you the procedure.”  He emphasized the statement by making a “J” motion with his pen.

The group laughed. I found myself momentarily distracted from my own dread and chuckled myself. Here I was at a sigmoidoscopy class with the elderly “Muppet Show” hecklers Statler and Waldorf sitting behind me!

When asked if anyone else had had the procedure previously, Mr. Tuttle mentioned his wife had her second sigmoidoscopy just before they renewed their wedding vows of 50 years. Mr. Jones told the group that he and his wife also had the procedure but added that his wife swore she’d never make that mistake again.

“The sigmoid?” asked Mr. Tuttle.

“No, the wedding vows,” shouted Mr. Jones to an audience that burst into laughter.

Regaining the attention of the group, the instructor continued with her class. “It’s very important to pay attention during this session,” she said. “If you don’t, the doctor will not be able to perform the process.

“Or worse,” she nonchalantly added, “the scope may tear your colon.” Needless to say, the instructor now had our undivided attention.

Rolling in an ancient television screen and VCR, the instructor popped a tape in the player and turned up the volume. I was teleported back to eighth-grade health class as letters flashed across a black screen boldly stating “Sigmoidoscopy: Your Rectum and You.”

A doctor on the tape explained that the process was designed to check for abnormalities and cancerous cysts formed on small polyps on the rectum walls. To illustrate this process, a cartoon probe was inserted in a diagramed anus. It made its way up the intestine walls to a polyp. It reminded me of an Atari video game such as Pac Man. Though this was a video game, the participant inevitably lost.

After explaining the dangers and precautions, the film ended. The instructor turned off the television and asked if there were any questions. Hearing none, she moved on to the last section of the class, which described the preparations we were to strictly adhere to the day before the procedure. These included 24 hours of fasting, drinking two bottles of a lemon-flavored potion that “cleaned you out” and, finally, giving oneself an enema two hours before the procedure. We were informed that, while fasting, we could drink only water, soda, black coffee and Gatorade. We were forbidden from consuming any liquid that contained dye such as Kool-Aid, or red-colored beverages, or (duh) food.

Part II: Fasting Before the Procedure

I had a one-week wait between the class and the actual appointment. The mere mention of the sigmoidoscopy instilled dread in me, so I gave little thought to the final obstacle between myself and the event: namely, the day of fasting. I was so preoccupied, this 24 hours of unbearable hunger and deprivation snuck up on me like a lion on daydreaming gazelles.

I don’t know how Gandhi did it, but it took every ounce of willpower and restraint to avoid ripping the hinges off the refrigerator and gorging on its delicious spoils.

To make matters worse, I needed to clean out my system with two bottles of liquid that could best be described as lemon-scented, rancid seltzer water. The label on the bottle claimed it was “new and improved.” I couldn’t help but wonder what the “old and declined” version tasted like. Regardless of taste, the diuretic elixir served its purpose well.

When I wasn’t trying to pry open the refrigerator door, I was paying a personal homage to the porcelain god.

By the end of the day, I was so eager to have the whole sordid affair over with that I would have performed a tracheotomy on myself with a can opener and X-Acto knife if only to eat food and once again experience the blessed joy of constipation.

Part III: The Procedure

As previously mentioned, on the morning of the appointment I was to give myself an enema two hours before leaving for the doctor’s office. The instructions on the box recommended having a “significant other” help facilitate the event. The last time I was on bended knee for my wife was when I proposed. Somehow, this event lacked the same romance and didn’t seem nearly as nostalgic, so I decided to go it alone.

Upon arriving at the doctor’s office, my medical information was recorded and I was instructed to have a seat in the waiting room where I, well, waited patiently. When a nurse called my name, I was taken to a small room with a large black medical table positioned beneath a television monitor. The nurse asked me take off my clothes and put on a blue paper smock. When she returned, she was accompanied by the doctor.

“Dr. Jellyfingers,” as I’ll affectionately refer to him, introduced himself and extended a warm hand to shake. I hesitated given his occupation, but shook his hand to be civil.

“I guess this is just another day at the office for you,” I said, trying to make small talk.

“Sure is,” the doctor said. “My occupation is always the butt of people’s jokes. No pun intended,” he added, barely able to control his laughter.  “This job can be a real pain in the @*s,” he continued once again, following his joke with a hearty “No pun intended.”

“Yeah, funny,” I replied. “I just hope everything comes out OK.”

“No pun intended?” the doctor asked. Having exchanged witty quips, we finally got down to business. He gelled up his hands and did things to my private parts that I had previously only assumed took place in Turkish prisons. Next, he took the small, pinky-sized probe from the tray and attached it to a wire. He then directed my attention to the television monitor and asked if I had brought popcorn for the movie as the monitor sprung to life, revealing everything the small scope in his hand was observing.

The doctor informed me that in order to begin the process, he would need to fill the lower part of my intestines with air to enlarge them and make travel easier. With a simple push of a button and a bloated pain in my extremities, I saw the narrow path of my insides converted to a four-lane highway.

We both stared at the television set as he maneuvered the remote controls that guided the invasive scope of fiber optics. He navigated the scope all the way up to the first bend in my intestine. The further it journeyed, the more unbearable the pressure became. The pain made me woozy, and the specific details of the event summon the same response to this day.  Skipping to the finale, the doctor decided I had endured enough and began to bring the explorer out. As the scope receded, I felt an immediate release of pain in my abdomen and breathed a huge sigh of relief.

He backtracked to a small polyp. “I want to take a sample of this to make sure it’s benign,” he said. I watched on the screen as microscopic scissors sprung from the tip of the scope and cut a small sample from the intestinal lining – my intestinal lining.

As quickly as the process had begun, it was over. I felt violated, happy, shamed and relieved at the same time.

Part V: The Aftermath

Pain and horror aside, I was amazed at the scientific marvel and medical mystery of the experience. I was filled with awe and glad to have observed the wonder of modern science. It was a very educational experience and a valuable learning tool. I’m not suggesting a ride at Disney be built in my honor or anything, but it was neat to see the inside of my own body.  

Luckily, the results of the biopsy came back negative. I’ve made a firm commitment to change my lifestyle – not so much for my life’s longevity, but as to avoid ever undergoing that particular invasive procedure again.

Andy Warhol once said that everyone will be famous for 15 minutes. So it’s a shame that to date, my rectum boasts of more television time than myself. In retrospect, the nightmares have subsided, so I’ve come to view the sigmoidoscopy as a necessary evil. I’m just glad that the whole experience is behind me now. No pun intended.