Three procedures and still alive

ATLANTA (Associated Press) — Griffin Bell, 90, the shrewd Southern lawyer who grew up with Jimmy Carter and later became U.S. attorney general after Carter was elected president, died Monday in Atlanta. He was being treated for complications from pancreatic cancer, kidney disease and being 90.

From the perspective of someone still in relatively good health, it often seems like medicine can go too far in treating the ravages of time. I think there comes a point when you feel like you’ve lived a rich, full life and now it’s time to go do something else, like maybe die. Throwing the incredible expenses of the modern healthcare establishment at the elderly and infirm just doesn’t always seem wise, especially if you hit one of them in the eye with an otoscope.

I’ve been incredibly fortunate with my health for over 55 years, and haven’t spent a night in the hospital since that whole birthing thing back in 1953. I’ve had my fair share of the usual modern maladies that almost everybody goes through – measles, mumps, mole removal, molar removal. I had what we politely called a “nervous stomach” in my teens, I’ve had a couple of lower back issues that kept me prone for days at a time, and I got chicken pox as a Christmas present from my son about ten years ago. Only three times have I gone through anything more serious.

My first such episode occurred in 1989. For years, I had noticed a brownish area just inside the top of my left ear. I chalked it up to poor hygiene until one day when it started bleeding. I knew that blood was only effective when it was coursing through your veins and that having it drip off the end of your earlobe wasn’t as good. I made a visit to the dermatologist who took one look at the wound and made his frightening pronouncement – ear cancer.

Well, not exactly ear cancer. It was a skin cancer that happened to be on my ear. All those hours I’d spent on college break in Miami laying out on my parents’ patio without benefit of sunscreen hadn’t been wasted after all. I was referred to a cosmetic surgeon despite my protests that I already looked damned good, but they explained he’d be the one carving off thin layers of my cartilage until all the cancer was removed, then would rebuild what was left into some semblance of an ear. The procedure I’d be undergoing was called “Moe’s surgery,” which sounded like it might involve a conk on the head rather than traditional anesthesia, but actually turned out to be Mohs surgery.

The operation was done in a Charlotte doctor’s office while I was fully awake but feeling no pain. Everything went as planned and the doctor assured me that all the malignancy was removed. I couldn’t look at the cosmetic results right away, since they wrapped my whole upper head in a bandage. I was able to return to work the same day, looking like that guy playing a fife in the middle of that iconic Revolutionary War painting, except that I had a $4,000 doctor’s bill sticking out of my pocket. But my coworkers we really impressed at the dedication I showed by coming in with such an apparently brutal head wound.

My next significant experience came in 2003 while I was planning my first business trip to India. I had noticed occasional discomfort in my groin for a few weeks before a particularly acute episode sent me home from work to wander restlessly around my house. When I went to the doctor later that morning, he immediately recognized the wandering as a symptom of kidney stones (go figure). X-rays confirmed the presence of a crystalline mass lodged firmly in my urethra. “It’s about six millimeters in diameter,” the technician told me, but failed to note whether that was considered small, medium or super-sized. Regardless, it was bad enough to require what they refer to in the business as a urologic intervention. Unless I passed the stone naturally or wanted to risk the male equivalent of childbirth while 35,000 feet in the air over the Middle East, I needed to get this taken care of.

Shortly before the outpatient procedure, called a “simple basket extraction,” I thought I might’ve avoided it entirely. After using the urinal at work, I looked down to see a corn-kernel-sized piece lying next to the scent cake. Had I painlessly expelled the stone and avoided costly surgery? Unfortunately, it turned out to be exactly what it looked like – a piece of corn – though I fail to understand even today how it got there.

Going ahead with the physician-assisted removal turned out to be fairly simple, at least for me. The trickiest part was counting backwards from 100, and then waking up to ask when we were going to start, only to discover the doctor had not only finished but left the building. The nurses kept watch on me until I was able to wiggle my toes and pee on my own, which took only a few hours. Recovery was quick and relatively pain-free, and I’ve survived to this day without another incident.

What you’ll doubtless be glad to hear is the last experience I’ll recount was the highly recommended (by doctors, not by patients) diagnostic colonoscopy. As veterans of this wonder of medical science will tell you, the worst part comes the day before when you have to drink huge amounts of a foul liquid designed to cleanse your system of everything you’ve ever consumed. Once this is accomplished, you’re ready for your outpatient visit at the hospital. There was no backward counting this time; instead, you get an injection that puts you into a “dream sleep” where your dream consists of someone putting the proctological equivalent of a Swiss army knife (including a light, camera, scalpel, eraser, fountain pen and comb, I seem to recall) several feet up your colon. I do remember lying on my side and watching a TV show where the plot consisted of a cute little pink character named “Polyp” being snipped by a “Mr. Scissors”. The next thing I remember after that, I was arguing with my doctor about the billing.

It seems there’s a loophole in the way most insurance companies view the colonoscopy. They urge you to get one, they tell you it’s fully covered because it’s purely diagnostic in nature, but if they find anything that needs to be removed (which they apparently always do), then the diagnostic designation disappears and you’re suddenly responsible for a percentage of the $5,000 cost. Or, you could choose to have them maintain the status quo by shouting “hey, leave that thing alone” during your dream sleep. I almost came to the point of demanding that my gastroenterologist reinstall the polyp before I finally knuckled under and paid the fee.

I seriously doubt that any of these conditions, left untreated, would’ve led to my untimely demise. I suppose I could’ve had colon cancer, renal failure or an ear fall off, though chances are excellent I would’ve survived at least two out of three. Had they occurred later in life, I think I might’ve considered that option more seriously. I hope Griffin Bell didn’t suffer too much from treatments for the kidney and pancreas problems when his larger issue was that he was 90 years old. I’m not sure living to a ripe old age just for the sake of hitting a really high number is a worthy goal. It seems like the oldest living person is dying every other day anyway.