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Colonoscopy: (Not) The Sum of Your Fears

First off, there was no sadistic laughter. And no haunting or horrifying flashes of memory. No Farrah Fawcett-scene out of the movie “Extremities.” Nothing to be burned into the fiber of my being. And none that prompted a promise to exact my revenge. I actually don’t have any recall of it at all, save for my glance at a length of hose on a table in the moments of consciousness before the drugs kicked in.

To assert from the outset: I’m no physician, nor do I play one on TV. And I haven’t held a stiff upper lip, and haven’t endured any doses of pain that I took like a man. Just to dismiss the question most everyone might be wondering, but is too bashful to ask — I don’t reflect on any of it as having survived an anal-raping. I don’t know how else to put that, so there it is. But I can proclaim outright that I survived my first colonoscopy.

The Fear Itself

There are the misnomers about colonoscopies, and the taboos about even really talking about it. Assuredly, from me, that won’t be a problem, not with the way that I write. The events of this procedure involved no teeth clenches. Nor any demands (or kindly requests) to unclench any butt cheeks, especially mine. Also, there was no soreness. And even, unexpectedly, no limping to endure as a door prize afterward. I actually went jogging on my routine run the next day.

Hindsight 20/20, and all that — but knowing none of this ahead of time, I had been cringing, ruing, avoiding all thoughts about the procedure. But as it happens at some point for us all, the planets and stars finally aligned: I was knocking on 50 and recently had my routine physical. And my primary physician and I both knew of the inevitability. It was time. And so, he pressed “send” to submit a referral. So be it. The wheels spun into motion, beyond my control.

My thoughts drifted: Butt + hose = the procedure-whose-name-we-dare-not-speak. My thoughts drifted worse: Maybe I could have or should have done a stint in prison to get ready for this. Of course there’s the other side of this to consider: Don’t get the colonoscopy. Just don’t go. Could it be that easy? Just put it all off? And don’t worry. And then roll the dice with getting cancer.

The Reality

Rolling the dice sounds plausible in the abstract, even a bit cavalier. But there is the actuality to deal with. And actually, for years growing up, I had already been an unwitting witness to it.

During sleepovers and visits to see Grandma and Gramps growing up, I always was aware that my grandfather would quietly excuse himself to go “irrigate.” Grandma would make a “last call” for any of us to use the bathroom, and then in he would go — for more than an hour.

I didn’t quite know why he spent so much time in there, or for that matter, what “irrigation” was. But I had overheard a whoosh and a churn, continually, when I happened to be passing by the bathroom door. A mechanical churn and whoosh that I could detect in the short pauses between songs on the radio Gramps listened to, or in the moments of lull between commercials and Paul Harvey.

Practically speaking, as I would learn, he wore a colostomy. It then became clear that at some point between the Second World War and mixing vats of Vitamin A chemicals in his post-military pharmaceutical plant job, Gramps got colon cancer. And THIS was his other side of it, be it bad genes, or carcinogenic exposure, or some combo of both.

Regardless, he had it. The “it” being cancer. And he quietly survived it this way, with parts of his intestines removed and sewn closed. With him left draining and rinsing a colostomy bag — daily — for what I estimate totaled more than 40 years.

So suffice it to say, the prospect of cancer for me gets put on the table in my family medical history. And for me, that shoulder shrug to put off or ignore a colonoscopy goes right out the window. As does considering a “less invasive” measure, like Cologuard, where you essentially send in a poop sample for analysis. Based on my family history (lucky me), there would be no substituting for the real thing.

The Basics: The Hose. And Polyps.

Procedurally, a colonoscopy sends a tube-encased, surgical tool and fiber-optic camera into your lower intestines in search of irregularities — and intestinal growths, called polyps. My medical team explained that polyps are common, like facial or body moles. And that while most polyps are benign, all intestinal cancer starts as a polyp. So as a routine and precautionary component, when they go in, they remove and then biopsy all of the polyps.

And all that surveillance and recon gear fits in one tube (aka the hose). If you’re wondering diameter, think of that black hose from your junior high science class that connected the gas to the bunsen burner — ish — I didn’t get to whip out a tape measure. As it would turn out I had 8. They removed them all during the procedure. All came back negative. Eight may be a lot. But I got them when they were incidental — and benign. I imagine if I held off for 1 or 2 or 3 years or more, and wonder if “routine” have become something “complicated”.

The “Big But” = The Hardest Part

Pre-op (so to speak), the doctors and nurses, in the appointment-making-phase, all seemed to have been reading from the same script: The hard part would be beforehand, during what’s affectionately known as “bowel prep.” Lovely. And they were precisely right.

Per their instructions for the week leading up, I eased up on my intake. I forwent taking Advil — my Jiu Jitsu shoulders and knees could endure their aches until this was behind me. And likewise, I lightened up on red meats, high fiber and whole grains, which left me with the likes of the more boring fare in grilled chicken, white rice and baked fries. But in this realm, I surmised, boring is good. Very good. Better than, say, unexpected or dynamic. Not long after adapting my diet, just a day or so in, I could sense “things” moved a little more quickly, bathroom-wise. Which looked to me to mean my bowels were clearing out, nicely enough.

My confidence rebounded. Ha, ha! What, me worry?! I got this! Bowel prep was a snap. But… here comes that big but… their instructions were clear: My bowels wouldn’t be appropriately prepped without taking the prescription-grade bowel prep medication. As in the stuff you drink that makes you $&%# your brains out — or more precisely, whatever’s left of your brains and your $&%#. Twice. THAT bowl prep. This, as it were, would be that “hard part” the medical team had been alluding to.

But (small but), as much as I want to make of that as a harrowing part of the journey, even bowel prep wasn’t all it was cracked up to be. Yes, your innards will flow like a rain gutter in a storm torrent. But not like hot lava bursting from Mt. Vesuvius. This bathroom experience was devoid of any real seismic toilet bowl destruction. It was then — in the throws of those moments of toil in toilet solitude — that I realized why those smarty-pants nurses and doctors advised lightening up on the red meat and high fiber.

Doomsday Bathroom Planning

By the time I took the prescription bowel prep liquid, I was left to encounter — exuding from me — more of a steady, controllable flow of a faucet. A faucet that leaves you 45-seconds (or less) to get in the bathroom and get settled in. A faucet that runs (and runs) for two or three hours.

I don’t want to be pegged as a doomsday prepper, but for this, I concede that I braced for the worst. I planned for a bathroom end-of-days. For me, this involved looking everyone in my house square in the eyes, and specifying which bathroom was MINE, and accordingly “out of bounds” for all them — unless they wanted to share in the experience of the aforementioned cascading waterfall effect, which none of them did.

Then, with a full roll of toilet paper installed in the dispenser, plus a spare in case things got really crazy, I checked my iPad for battery life (full charge), and verified a good signal for WiFi. And a Nalgene water bottle to keep me lucid and hydrated for this fight of fights. Thoroughly stocked, I reached a zen calm state. The moment was mine. And I was ready to face down any contingency.

My prescription called for drinking the “bowel prep” the evening before, and again the morning of, within 4 hours of the procedure. At go time, I drank the drink, somewhat dismissive of how effective it would be. I paced my living room, waiting for this storm to make landfall.

Nothing. Still nothing.

Wait. A few gurgles. Like how I remember forcing a burp with my friends when I was 10, after chugging a 2-liter of Coke. Except this was going on in my gut, and on autopilot. Then, maybe by the one-minute and 30-second mark, I shuffled quickly down the hall, and bellowed an incoherent farewell to my wife as I went. I grew hyper focused. And true to the bowel prep billing, for more than three hours, I went.

The Day Of

Times-all-that-by-two. I woke up at 4 a.m. for the repeat performance. At least then, there was no one awake, except for the dog, to witness my bug-eyed expression, once I drank the drink and that Death Star sequence in my stomach started. That burp-ish gurgle and churn. The quick shuffle. Then letting the torrent — again — run its course.

Sometimes, perhaps all of us reach points where we reflect on the emptiness in our lives. It was at this point when I reached mine. Almost to the minute, after three hours, I was confident there was physically nothing left in me. And by 8:45 a.m., I was in the car and off to the medical campus to a building that seemed poised to cater to the procedure.

Check-in was brisk, succinct, and predictable. I attested that I had my wife as a ride back home (no unaccompanied Ubers or Lyfts were allowed). I changed into a hospital gown, and was pointed to an upright hospital bed. My nurse chatted me up, making sure I was who I was and why I was here, as he inserted the IV lead into my arm. He asked what color my stool was. I told him I never looked, and he looked surprised.

We chatted on and I began noticing other guys around my same age shuffling about in their gowns too, getting situated and wheeled around in their beds. There was an assembly line vibe to it that felt oddly comforting. To me, this all drifted between momentous and intriguing and a tad bit unnerving. But to the medical staff, this was routine, everyday, and they had it down squarely, like Oompa-Loompas in the chocolate factory, but without any chocolate.

In the surgical suite, two or three technicians setting up bid me “hello”. I noticed a TV monitor and saw someone wiping down the camera feeding video to it. Yup, that was the hose. A black tube encasing the camera and surgical equipment. Some things you can’t un-see, and I saw it — the hose. They asked me to lay on my side. I thought of my dog, and felt like I imagine he felt when he went to the vet. One of the technicians connected an IV to the lead. They asked me some questions. I forgot what they said. And then…

… I woke up to the nurse asking me to slide my shirt and my sweatpants back on. I lulled in a fog. Then, I somehow found myself now in a wheelchair, on my way out to the curb. A car door is open, and my wife says hello. Off I go. All done. The sum of my fears, was just that — just fears. It’s over. I’ve done what I dreaded, all unmemorable and without scathe. Now back home to the couch and light, tasty grilled cheese sandwich, and a fade out to sleep in front of TV. The fears, now, are unmemorable.

Some people will repeat all this every 5 years. With my family history, and the amount of the polyps, my doctor recommends 3. My peace of mind all of this brought — in spite of the bowel prep and the hose and the worry — is invaluable in ways I hope carries me beyond a history, so far, that had pointed to cancer. Uncertainty and gloom now fades out to vigilance and answers, with a hope to change the variables in my fate to a long and healthful history. But perhaps most notable of all, I report and you will be relieved hearing, my affinity for quality bathroom time — irrespective of that bowel prep enduro — remains stalwart and unrelenting.

Jason James is an award-winning journalist and essayist. Follow his work on, and at


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