Cancer, Catheters, and the Irish Curse.
S.E. Schaible
Just over two years ago, I noticed some blood in my urine. No pain, no symptoms of any kind – just an occasional splash of crimson. Like a half-teaspoon of Merlot in the bowl at the end of my stream. My MD’s initial suspicion was that I might be passing a small stone. By the time I was able to schedule an MRI (with contrast – instantly delivering hot earlobes and the unforgettable chemical taste in the mouth when the IV was pushed), I hadn’t had any blood for a couple of weeks. No stone – nothing of any note – was visible on the scan, leading to the plausible theory that I had passed a small stone without the typical agony upon exit.
A month later, the Merlot returned. There was no question about the next course of action; I needed to see a urologist, and I would have a cystoscopy. For the uninitiated, a cystoscopy is basically a tiny camera on the end of a catheter that – yup – gets rammed into the urethra (that’s anatomy-speak for your pee hole). There’s a bit of lidocaine gel that goes in first to make it slightly less horrible, sitting on a cold table with your pants around your ankles and a machine being driven into your bladder through your penis. Thankfully, it is not a rookie technician with a 6-month certificate operating the device – it’s the actual urologist, a medical doctor with a specialty. I heard the doctor say, “Aha, okay, take a look at the screen so I can show you something.” I peeled open one eyeball – my toes curled into clenched fists inside my sneakers. I could feel the camera moving around like a viper as he manipulated it inside of me. I reminded myself that, compared to the crude metal pipe that Doc Cochran hammered into Mr. Swearengen in HBO’s Deadwood, to dislodge the kidney stone that has him near death, my situation was more akin to missing a connecting flight; it was little more than an annoyance.
The urologist, again, coaxed me into opening my eyes. “Just take a quick peek. Right there – do you see that?” I glimpsed what looked to be a sea anemone swaying about in the saline water, making my bladder a fishbowl for the camera. “Those are tumors. I’m going to take a sample for a biopsy. We’ll be done here in a moment.”
My thoughts went to how I would tell my wife, sitting alone in the waiting room with a stack of ancient Smithsonian and Popular Mechanics magazines, the mailing labels crudely hacked off the covers. I wonder why waiting room magazine-donors do this. Are they worried that a disgruntled patient might ring the doorbell some evening and complain about their embarrassing taste in reading materials? “Hi. I just need to ask, why do you subscribe to HOIST, the magazine for factory crane professionals? Do better!”
“So, it’s probably cancer then?” I asked the doctor after undocking my dinghy from the machine, which allowed my heart rate to drop by half, back to something approaching normal.
“Oh, there is no question it’s cancerous – but I need to examine the sample to see which type and grade. Either way, you’re going to be back here next week for surgery.” I’m certain he said some other words of the you’re-going-to-be-okay variety, but nothing more was penetrating through my hull.
Numb from this news, I drifted down the brown hallway holding this diagnosis like a kid heading home from school with a note pinned to his chest; I didn’t want to hand it over, but I had no choice.
Regina took my hand, and we walked wordlessly toward the elevator, numbing gel seeping out of me and soaking into my underwear. She expected me to say something, and the seconds probably felt like hours for her. “So, what did he say?” I responded bluntly and truthfully: “I have tumors in my bladder. Some kind of cancer. I’m going to have surgery in a week or two.” I couldn’t look at her as the words came out. I couldn’t bear the combustible combination of my sudden fear and her pervasive worry.
She jerked my arm and stopped me. “You are not funny, cut this shit out and tell me what he really said,” came her tender, anxious reply. With good reason, my wife suspected I was trying to be funny. I constantly joke around and mess with her. I mess with all of my friends; it’s an East Coast Irish-American thing. It’s my love language. For example, when my daughter called home from college in Ohio and asked about her Corgi, Bruno, I replied, “Oh, shoot. Forgot to tell you. Bruno died a couple of weeks ago.” (Shut the fuck up, Dad). My wife’s Brazilian temper momentarily flared at what she assumed was an insensitive ruse, an attempt at busting her chops. I squeezed her hand and looked directly into her obsidian eyes. “Seriously. I know it’s the kind of thing I would say to be funny, but I have tumors in my bladder. He’s going to biopsy them, but it’s cancer. I wish I was joking.”
We stepped silently into the elevator, and I knew things were going to be different. The last time I felt this helpless was watching a Flight for Life helicopter bank into the sky carrying my 5-year-old daughter to the Children’s Hospital, trying to conceal my fear while driving her sisters down I-70.
The surgery was successful (done much the same way as the cystoscopy, via scope and tools inserted in the previously described, worst-imaginable way). Mercifully – unlike the regular cystoscopies and chemotherapy procedures that now involve regular trips against the flow into my bladder - at least the surgery featured Propofol for the complete knock-out. As the nurse prepared to inject the sedative into my IV line before the surgery, she asked something that surprised me: “So, Marlboro Man, how many packs a day?” I was befuddled. “None,” I said, confused by her question. Apart from bogarting a few Parliaments with friends in 6th grade – barely inhaling and promptly getting dizzy and sick – I was never a smoker. Curiously, while most of us assumed that lung cancer is what smokers have to look forward to, it’s bladder cancer – especially for men – that has the highest correlation with smoking cigarettes.
The worst part about the surgery came 30 hours later, leaning against the cool tile in the shower with a rust-colored collection bag at my feet and a pair of kitchen scissors in my hand. I had to snip the knot on the catheter that held it in place, releasing the inflated balloon deep within, then pull it out of me. It kept coming and coming, a foot or more, tugged angrily and taking my breath, and finally it dropped to the floor. I kneeled, staring at the crimson flooding down the drain, and told myself, now I know what that’s like. While on pain opioids, I pondered if being exposed to my mother’s second-hand smoke for my first 18 years would have been sufficient to poison me this way but promptly scrapped this blame game since it doesn’t really matter. My Mom passed away in 2004 from – yes – cancer in her lungs, kidneys, pretty much all of her major organs. I remember her smoking cigarettes in the car on the way to Shop-Rite or Jack in the Box with the windows closed – until I was old enough to gag and make a scene about it, compelling her to crack the windows. If she were still alive, I’m certain she would be an amazing grandmother to my kids, and yes, I would regularly be busting her chops for poisoning me. It’s the way of my people.
Now I am midway through a year-long course of prophylactic chemotherapy. The other day, as I took off my pants and sat on the chemo table at the urology clinic, I had a chuckle about something my good friend Frankie and I empathize and bond over as much as we laugh about – our mutual and much-adored Irish Curses. We are both fiercely proud to be half Irish: He, courtesy of his mother’s family, and I, with a grandparent on each side. We first met through a mutual friend some 40 years ago, and soon after, at a party at Limelight in New York City – the bathroom line unacceptably long courtesy of all the cocaine snorting and sex going on in the stalls – we elected to save time and cross swords. At that moment, we both jokingly (and aptly) modified the phrase to “crossing daggers.” It was a humorous bonding moment in our twenties that has lasted a lifetime.
As the cold betadine swab caused me to retract (more like vanish) from a satisfactory stub to an embarrassing acorn-like nub, it occurred to me that if I were – by some actual luck of the Irish – the owner of some many-inches-flaccid member, it would seem to be far more challenging for the nurses to insert the catheter – whereas my compact unit was almost more of an “insert here” bullseye. A small but stable target.
Catching this bladder cancer as early as we did was like winning the cancer lottery. It is very much treatable with excellent prognosis scenarios, and despite getting reamed by the camera quarterly and the chemo catheter monthly for a year, my treatment is more targeted and far preferable to almost any other cancer scenario I know of.
Did being “Irish, Proud and Unendowed,” as Frankie and I say, prepare me to deal with cancer? Self-acceptance with the ability to move forward is a superpower. The shame many men feel about getting sick is oddly connected to the shame many men secretly carry about not having a porn-sized penis. Both are random; luck of the draw. What matters is having a defiant attitude, dark humor, and ride-or-die support. All three are vital. While recovering, I began to feel the weight of another ailment – the dreaded feeling of being a burden, made worse by the fact that I am a Taurus. I quickly vanquished the pity session. Perhaps aided by years of joking about the Irish Curse with my buddy somehow strengthened myself to accept it, laugh about it, and move on.
Something is going to kill me someday, but it won’t be tumors in my bladder. I am beginning to think I have more luck of the Irish than any curse. I’m still alive and making self-deprecating dick jokes. The important thing that people in their 50s and beyond need to learn is, don’t be stupid. If you have blood in your urine, you have to get it checked out. Whatever the cause, it’s not good. My own brother and a couple of friends will go a decade at a time without seeing a doctor. I can’t force them to go; I can only hope they have some of that same luck.