Before the Fall

It was 1977 when I first lost my pride completely, medically speaking.  January 23, if I’m remembering correctly.

And as happens in so many of my stories, I was in the hospital.  This time in one outside of Boston.  Nineteen seventy-six/seven was a big year for me, my first living on my own away from my parents, my first real boyfriend, my first taste of independence.

My first time dealing with my shitty illness on my own.

This particular hospitalization (my second) was actually a pivotal experience in my life.  I came out of those doors a different person, a better person.  I think back on it fondly  This one afforded me the opportunity not just to be treated for my colitis-that-was-actually-Crohn’s, but time to reflect on life.

The hospitalization did not start out well.  It was the day after my birthday when the doctor informed me that I needed to go in.  I was terrified, because my first and only previous hospitalization was the stuff of nightmares – nearly 40 years’ worth.

Besides, I was already pretty low.  Things were already rocky with my boyfriend Mark.  When I went into the hospital he refused to come and visit me.  It was exam time, and he needed to study.  The hospital was directly in between his dorm room and the library.  Hardly a major effort was involved in stopping by, giving me a kiss, and going on his way.

So I dumped him.  (Last I heard via Google he is a senior executive for a huge tech corporation.  He is, I’m sure, now a multimillionaire asshole.)

Anyway, there I was, sick, sad, lonely.  I had just moved to Boston and knew almost no one.  Nobody came to visit me in the hospital.  I was pathetic and very lonely.

But the resident in charge of my case made up for it.  He was wonderful.  He was cute.  He was compassionate and caring and he had a mad crush on me according to the nurses who know everything.  And I, fresh from dumping an asshole was flattered by the attention.  OK, I was madly in love with him.  Dr. J. Sigh.

My treating physician was really terrific, and he had a name that began my list of weird doctor names:  “Dr. Lesser.”  If I’d have had my wits about me, I would have requested “Dr. Moore.”   But I was sick, so I didn’t.

Anyway, Dr. Lesser was examining me, and he decided to do a sigmoidoscopy right then and there in my hospital bed.  A sigmoidoscopy is a test to check out the lower colon.  I affectionately dubbed “the umbrella test” because when your lower colon is raw, as mine was, having a sigmoidoscopy is like having someone shove an umbrella up your ass, open it, and pull it out.

So anyway, Dr. Lesser had me get into position.  The knee-chest position, which is a misnomer.  It should really be called the “Swallow your pride” position.  Head on the pillow, butt, bare-assed above you in the air.

KneeChest2

Google Image. Not me. Really.
I’d be screaming bloody murder.

Dr. Lesser was putting on his gloves to start the exam when I heard a voice that made my heart pitter-patter say:

“Oh, can I do it?” said the man I had been madly in love with 30 seconds earlier.

Shit.

The new love of my life wanted to stick instruments of torture up my ass.  All I can say is he nipped that crush in the bud.  Or the butt.

That was the first time I totally lost my pride, medically speaking.

In retrospect,  I don’t really mind.  Or I’ve gotten used to it.  It makes for good stories that I can tell again and again so that I can relive the most humiliating moments of my life.

Since then there have been countless times when I lost my pride in a medical setting.  Illness does that to you – and when it is poop related, well, the opportunities for humiliation are bottomless.  You become a pin cushion, a warm body filled with vile fluids and other unfortunate materials.  A specimin.  A black hole of embarrassment.

As I said, I’m OK with that.  Because in order for doctors and other medical professionals to make me better, and for others to learn how to do that, well, they need to poke around in places where I don’t normally encourage exploration.  So I always say “yes” to the gangs of medical students that want to crowd around my bed while some doctor does something weird to me.  Pokes, prods, whatever.  (I have never had another in-bed umbrella test, though, thank God.)  “The rounds” is where doctors learn how to treat patients, what medicines to prescribe, whether they really want to spend their careers looking at the dark end of the human body.  It is helpful, and really everybody benefits.

One plus I’ve found is that these young doctors often come back around to chat with me individually.  It alleviates some of the loneliness inherent in being hospitalized.  Sometimes I have felt more comfortable telling them things I should have told my doctor – it gets filtered back through, and my treatment is adjusted appropriately.

Teaching is good in medicine, whether it is doctor to resident or patient to doctor.  An exchange of information benefits everybody.

I recently read an article about a woman named Martha Keochareon who has done the most amazing thing, knowing from a nursing point of view just how humiliating sickness can be.  And you know, I honestly want to be just like her, although not any time soon.

The article, entitled Fatally ill and making herself the lesson is the finest example of just caring medical professionals can be.  Because it’s about a nurse who decided to invite student nurses from her alma mater to use her as a case study.  To let student nurses learn about end of life care from someone who can give them a first-hand lesson in how to deal with death and dying from someone who is facing both.

You see, Ms. Keochareon is dying of pancreatic cancer.  The students were invited to feel her tumor, but most importantly, they were encouraged to ask her anything.  Anything at all.  How does it feel to get the diagnosis?  How does it feel to know you’re dying?  Does it hurt?  Where does it hurt?  Can I make you any more comfortable?  What can I do to help make you feel better?

Imagine the questions we all might be too uncomfortable to ask just anyone.  Ms. Keochareon is inviting a few lucky students who will benefit most from understanding those answers – they will then be better prepared to help ease others’ pain and suffering.

Throughout my many ordeals with health problems, there is one thing that always stands out.  The nurses.  Their caring, their help, their comforting touches and words, their cheerful attitudes.

But this is the most heartwarming story I’ve ever heard.

Ms. Keochareon has given these student nurses, and really the rest of us, a huge service.  With all of my heart, I am in awe of this gift, and I hope that what time she has left allows her to pass on the lessons she knows are so very important to teach.  She has opened a door to help us understand and accept dying as a real part of life.  That is something I believe our society prefers to forget.  But it doesn’t let us.

And with this gift, I’m also pretty sure Ms. Keochareon gets to keep her pride intact.

91 Comments

Filed under Childhood Traumas, Crohn's Disease, Health and Medicine, Humor

91 responses to “Before the Fall

  1. Eva

    I was laughing my arse off then crying my eyes out. That was a hilarious and beautifully written piece. I’m forwarding this off to my sister now.

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  3. When I was first diagnosed with lupus I thought I has chrons also. But it turned out to be the medications I take scrambling to get out. I know those embarrassing moments. At 52 sad to say I’m not so embarrassed. But it is wonderful that nurse allows the students use her to learn.

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  4. You have an amazing amount of courage, Elyse. Far more than I would ever have, in the ways and situations in which you have demonstrated your particular brand of courage. I haven’t read the article about Martha Keochareon yet, but I absolutely will. I just wanted you to know asap that I read your post first.

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  5. wow a lovely story, may i just say that patients (even simulated) who are not embarrassed stiff and able to respond without looking as though they are giving a polygraph are easier to take care off and learn from. and that nurse had probably been there and knew that so she took the trouble to help the students learn in the middle of feeling sick which is awesome.

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  6. Sherri

    That would be nice. Do you FB?

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  7. Sherri

    The woman in the story, Martha Keochareon, is my sister. She passed on December 30, and is now free of pain. She was always a giving person. I miss her terribly, but find comfort in knowing that others benefited from her teaching. Thank you for your kind words.

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    • Dear Sherri,
      My deepest sympathies for your loss. I’ve lost both of my sisters much too early, and I want to wrap my arms around you right now.

      Does it help to know that your sister made a difference? I hope so. What a noble, noble gesture she made.

      I am falling all over my words and my tears. May your heartache be comforted by her gesture, and may you not forget those times you wanted to throttle her — because that’s part of being sisters.

      I wish you peace, Sherri.

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      • Sherri

        I am comforted by the difference she made, through all of her life. I did not often want to throttle her. We were very close. I could talk to her about anything. It was difficult to know that she was in so much pain, so I am happy that is no longer the case. We did Skype just the day before she died, and I was able to say goodbye to her. Though I was not able to travel to the funeral, it was nice to see some images from that in the article (and some which were not published) that were given to us by the photographer. I still have a sister and two brothers, but noone can take Martha’s place.

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        • Oh Sherri, I still want to give you a big hug. I am one of five kids, too, three girls and two boys, just like your family. I am glad you were able to say good-bye; I didn’t get to say that to one of my sisters and I think it made the grief more sharp.

          It is hard to lose anybody, but someone who has always been there, someone who you expect to grow old with, well, that’s different. Yesterday was the anniversary of my sister Judy’s passing. I miss her every day; I always will. As will you.

          I wish you peace and acceptance of your loss. I am glad to know of your sister; I am glad you wrote to let me know you, too. Thank you, Sherri.

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          • Sherri

            OK, another coincidence. We are the same age. You were 54½ when you started this blog. I am the same age, born 7/5/57. Where do you fit in the family?

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  8. What an incredibly unselfish thing to do! We can only hope those lucky students will pass their teaching on to other students & so on & so on!

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    • Isn’t hers a cool story. I hope more people do what they can to help people learn how to deal with sick folks, dying folks, folks with problems. We all shut ourselves off from suffering when really, we should learn from it.

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  9. Ms. Keochareon’s story is so wonderful and uplifting it makes me cry. Your story, on the other hand, has me shedding tears of sympathy pain. Your attitude about the whole process is the mark of a true medical warrior, which is probably a big help since you can’t avoid all that hassle anyway.

    I cringe just going to my pap exam (2 days ago, BOO-yah!) which is with a woman, by the way. I can’t imagine legions of young med students trooping in during the exam. You are a better woman than I, Elyse.

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    • Peg, you may notice that all these stories take place a very long time ago. That’s because somewhere in the last 30 years I became a total baby about everything. If I think it is going to hurt, I tense up and make sure it hurts. Maybe Xanax is the answer! Or alcohol. So no — but I will let them ask me anything they want or do anything they want while I’m under anesthesia or on morphine!

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  10. You’re a good sport and a good soul, Elyse. A lot of people have just the opposite reaction to being the guinea pig for med students. I’ve only been hospitalized once, but I didn’t mind them crowding around and asking questions, I figured this is how they learn and become better doctors. Of course, I wasn’t really sick, it was just an orthopedic surgery. Still, I like to think that if I were ill, I’d feel the same way because as you said, it benefits everyone. However, I am fairly certainly I’d be permanently mortified if the med student I had the hots for was given the green light to shove something in my behind. And karma will probably be a major bitch to your ex-boyfriend the millionaire asshole.

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    • A good sport, a good soul, a bum butt. Hmmm, I’m not sure that that is the trade-off I’d make if given the option. But still, depending on the circumstances I am probably willing to offer myself up to science –I had planned to wait until I was dead, though.

      As for my handsome resident, well, I got over the trauma by never dating a doctor. Might have been nice to have the family discount, though. And as for my millionaire asshole former boyfriend, well, yes, karma will be a bitch. LIfe is good that way.

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  11. Yeah, still trying to catch up. Gotta admit, most of the nurses I’ve had were rather … grey. Not old, not young, not funny, not sad, not gorgeous, nit ugly, just – THERE. Only one I remember, and it’s what she did – took an IV straight outta the fridge and stuck it in my arm. At 2am. While I was asleep. Have you ever had 34-degree saline solution enter your veins when you’re unconscious? Now THAT i a wake-up call! 😯

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    • Ooh, that beats the nurse who pulled me by the hose that ran through my tiny nose down to my stomach like she was leading an elephant.

      But still, most of them are wonderful, helpful, comforting. I love nurses. Very giving people (and I learned that from my eldest sister, Beth, who was a nurse).

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  12. Brave, funny, and profound – you rock Elyse. That nurse story is amazing – and so necessary.

    I had a congenital eye condition that every optometrist and opthamologist I ever saw used as a teaching moment until I had it corrected in my early 40s. No visit to the eye doctor was ever brief, but I also knew that my eyes were something that they might never see again in their career – so I was happy to oblige. Glad it was my eyes and not my butt 🙂

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  13. JSD

    Thank you for sharing your story and for the story about the nurse. I wish I could be as brave as you…and as her. I’ve worked in the medical field (though not as a caregiver) and this gives me something to think about if I should ever be in her situation.

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    • For my part, I don’t think I’m being brave telling my silly stories. Nobody knows who I am.

      But the nurse — oh yeah. What a gift. I think that in many ways it will help her, but I am sure that there will be moments. I’d like to think that I’d be brave enough to do what she’s doing, under the same or similar circumstances. I think that a lot of us will be thinking about it for years to come!

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  14. Yup, that’s right up there in the humiliation department. A story well told and an important one, for any one involved in matters of heath care: the person who needs it or the person who provides it. Nice job, Elyse.

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    • Thanks, Lorna. It is right up there with the time I was held captive by a newspaper machine in terms of embarrassment.

      And I love the nurse’s story.

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  15. 1) I will not say anything about that picture because I fear the Queen.

    2) I hope I never notice Dr. Dreamboat.

    3) Cheers to your shout out to the nurses!

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    • 1) It is not an actual photo of the Queen. Note the absence of a crown.
      2) Perhaps you would notice Dr. Dreamboat if she were a woman, although that term is usually used about a man. Funny since ships are always referred to as feminine.
      3) I do love Ms. Keochareon. What an inspiration.

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  16. Elyse, you always manage to bring back such fond memories for me. You know the ones where the doctor is groping my boob demonstrating to the 12 wide eyed students behind him how to properly examine me before and after the surgery. Each one in turn grabbing said boob and showing various degrees of expertise while trying not to make eye contact with me. Ah, yes fond memories.
    The best care is usually provided in a teaching hospital in my opinion and I the fact that I got felt up more when I was in there than I ever did in high school was just an added bonus I guess. My Mother passed from my disease and I would have done anything at that point to prevent it from touching my sisters. So feel me up all you want.
    I read the article about Ms. Keochareon this weekend and was really impressed with her dedication to helping these young nurses learn more to be the very best that they could be. She gave them a gift that they will carry with them always.

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    • Glad to bring back those warm fuzzies for you, Michelle! Because it is important to never ever forget a moment of misery, don’t you think?!? I used to think that being sick in another region of my body would be less embarrassing, but you have shown me the error in my thinking. (That said, I don’t think I would have minded handsome Dr. J fondling my boob, but then again, there wasn’t anything wrong with it.)

      I absolutely agree that teaching hospitals are the way to go — do you want to be operated on by someone who has seen it done on video, or by the guy who made the video??? And those are also the folks who write it up for journals and share. Get the information out. Yup, they can man- (woman-) handle me all they want.

      And I just love Ms. Keochareon — what an inspiration!

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  17. Wonderful, the dreamy doctor wanted to see your lovely lady parts up close. That is what I would have been thinking, just to get me through the day.

    I think it is marvelous the stories you tell. The lessons you take and are willing to share. Thanks

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    • What a nice thing to say, Val. What good are funny experiences if you don’t tell anybody about them? Life is way too short.

      As for my handsome doctor, I think I kept my head under the pillow for the rest of the day. My crush never recovered. Somehow a GI exam was not what I’d had in mind for him.

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  18. Trust you to have me laughing like a fool for most of this and so moved by the end the tears still welled but for a different reason. I have a GI that manifests with flu like symptoms and sucks because stress is the real driver. I once said to the specialist, partly out of feeling awkward all upside down with gizmos in me, just looking for anything to say to ease my mental cramp: Gee, what a job you have! He turned red and said, “Well, I don’t do this all day long!” I felt sorry for “him” then and suddenly felt a whole lot better about all the “bottomless” poop-related business. My niece has Chrohn’s, my mom had what I have, I feel for you, E. Glad it never hurt your sense of humor, LOL 🙂

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    • I think my poop problems played a large part in forming my humor — certainly the dark side of it.

      Sorry to hear what you are going through. BEWARE of folks who tell you “it’s stress” — yes, it exacerbates the symptoms, but it does not cause them. When I was young, I thought that if I just relaxed (meditation? yoga? Reading Herman Hesse?) I would be fine. I was not. I was sent to psychiatrists/psychologists (another whole story) who were no help what so ever. I was very sick. I needed medicine. I ultimately needed surgery.
      I guess I went off a little bit on this, but it makes me really really mad. Stress makes things worse but it doesn’t cause the problem.

      It sounds like you found a gastroenterologist with a sense of humor. They are few and far between in my experience!

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      • oh gee, I was tired and it shows, I didn’t mean to say stress caused it… I meant to say I suffer most when under stress… days on the potty in a row, etc… escalates and exacerbates it is right… otherwise, I can manage it… make that could manage it… hoping to avoid the surgery … heard it’s very painful to go through… I have an actual medical diagnosis since my 30’s that says my innards are those of an 85 year old man so diverticulitis ridden are they which manifests as flu symptoms under stress because of the intestinal clenching/spasming and pockets of infection that normally are swept out so to speak, lol…now if we could just find a Doctor for the other end of me so I could handle all my stress better… lol Your giggles help a lot but please don’t send me a bill, lol, it will stress me out, thanks again, lovely xo

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        • That makes more sense. But it is one of those button issues. My late sister Beth was a nurse who trained during the “it’s all stress” period. To her dying day she believed that if I would just relax I would be fine. She was a nurse (psychiatric!)

          I don’t know what surgery they are talking about for you. But I had surgery that improved my life by leaps and bounds. Feel free to contact me about it (privately via the contact info) any time. It is not the answer for everyone, but it gave me 22 very healthy years that I would not have had.

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          • 🙂 So glad for your years and knowing you xo I get the “it’s all stress” thingy… just a cop out for underlying issues in many cases where people actually die instead… wish that one could be explained … ah well. Stress is known to exacerbate any physical condition we have. It only makes sense it would. My athsma for instance… under stress it worsens… when calm it almost goes away entirely… craziness… how I wish to be calm always. Wait. No I don’t. That’s like death. Not wishing myself to death here, lol. Thanks for your note, I might email you privately once I get more top priorities dealt with here, Elyse xo

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  19. cooper

    Illness does that to you – and when it is poop related, well, the opportunities for humiliation are bottomless.
    I’m going to pretend that was not intentional….
    No. I’m not.
    BWAHAHAHAHAHAHAHAHAHAHA

    In my travels, the good nurse/bad nurse ratio is solidly on the good nurse side – some of my personal bad nurse stories make my blood boil – and my bp is down to 116/89 according to the OUTSTANDING nurse at my doctor’s office…so we’ll skip those.

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    • There are no accidents in writing, Cooper, are there?

      My good nurse/bad nurse ratio is well on the positive side. There’ve been a few clunkers, but mostly they are a wonderful bunch of women and men. They encourage, they dry the tears. They hold your hand. The doctors are outtta there.

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  20. I know so many people who have GI problems (including myself). It really makes you wonder what is going on? Anyway, I thought the picture was you at first and I thought, Wow, that’s brave! Whew! A very lovely story about the nurse and it really underscores that we are all teachers and our lives are the lampposts that help guide others. Very nice.

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    • I’ve read a lot about GI problems and they are becoming more and more prevalent in the West. As countries develop, these problems develop. they think it has to do with the fact that we are cleaning out good parasites with the bad. (There is a GI treatment where you can drink worm larvae — I would have to be really really sick to try that one!)

      And isn’t the nurse’s story wonderful? I’m so glad you liked it.

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  21. Miss Z

    I’m not sure if I’ve already said this but I’ll say it again anyway. You’re the bravest lady I’ve ever known! You have such a fantastic attitude towards life and you’re such an inspiration. Don’t ever change. 🙂

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    • Ah, but I don’t always have that attitude — I don’t think anybody does. But like most I have my moments. And you have to laugh at bowel problems. And at life!

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      • Miss Z

        No, that’s true. But I know too many people who never ever show this sort of attitude – people who take life for granted. You’re not one of those people. It’s just so enlightening to meet people like you who don’t take life so seriously. It’s wonderful!

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  22. You are more circumspect about this than I will ever be. Having worked in medical teaching environments, I have a different perspective. The story about that nurse is wonderful – doctors and nurses need to know just as much about end of life care as they do at the beginning and middle. Thanks for sharing your story as well.

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    • I hope you write about your perspective. I’ve found it wonderfully freeing, strangely, because I had spent years not talking about it.

      But isn’t the nurse’s story wonderful. I work in a medical consulting company, and a big part of what we do is teach — and this just hit me in the heart, Michelle. I’d love to hear more on your perspective.

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  23. I was sweating, actually sweating at the anticipation that Dr. Dreamboat was going to walk into your room. The fact that he wanted to perform the freaking test had me breathing into a paper bag.
    Teaching hospitals have you check your modesty at the door!

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  24. Hi Elyse,
    I don’t think I was aware of your health problem. I’m so sorry to hear of it. You are a wonderful writer, and do an excellent job raising awareness os this problem that too many people shy away from talking about.

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    • I didn’t talk about my Crohn’s for a very long time. Mostly because if it’s not active, I don’t want to think about it. If it is active, then I want to escape it. But the stories keep creeping into my psyche, so I let them out.

      Thank you for your nice comment, Naomi!

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  25. In January of 1977, I was a fetus. I love you, Elyse.

    “and when it is poop related, well, the opportunities for humiliation are bottomless.” That is one of the greatest puns ever.

    Also, that IS a great story. The nurse one, I mean. Not that your story isn’t…well, you know what I mean.

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  26. My mom spent the last days of her life in a coma in the hospital. Many times when my other family members and I were sitting in one of the waiting rooms, the nurses would come and talk with us; the wisdom they’d accumulated from dealing with other patients at the end of life was a real source of comfort.

    I’m glad you dumped that Mark guy. And I’m never going to look at an umbrella the same way again.

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    • Yes, Laura, I think that the nurses do an amazing job. When my sister died, there was a nurse there with me all the time, and I don’t know what I would have done without her. She held me as I held my sister. She was such a comfort.

      Yeah, Mark was an ass. I have never regretted that decision.

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  27. I can appreciate your story on a few levels. I’ve had some digestive issues that very few people know about me, but the pain of which dampened the bliss of my honeymoon and led to my passing out in front of my family in a busy mall.

    Secondly, and I think the first post of yours that I read was of a medical/health nature, I’ve heard some stories from my husband over the years! We got married a month before he started med school. His very first physical exam on a “standardized patient” (people who are paid to be “patients” for med students to learn on/from) was a man who disrobed for the full exam, which allowed my dear husband to see the giant eagle tattoo flanking the patient’s (ahem) man parts. What a way to start!

    I love the story of the nurse you described. She is truly giving a gift.

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    • Amphomma, I hope you have gotten help for whatever GI problem you have. I learned the hard way that it doesn’t pay to procrastinate.

      I didn’t tell any of my health-related stories for a long, long time. And then I started partially because I think it helps people think about their own stories and maybe even to get help if/when they need it. Besides, bowel trouble stinks!

      I’m glad you enjoyed the nurse’s story. It’s one of the most inspirational I’ve ever heard of, I think.

      all the best,

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  28. I had a sigmoidoscopy once – it was one of the more painful procedures I’ve ever had to endure – and they offered no medication at all…I probably did scream bloody murder. I am going to share this article with my nursing students. I think they will be touched, indeed. They love stories – real life stories and not just case studies – and death and dying is something they are always interested in, but a little (or a lot) afraid of. I wasn’t a nurse for very long before I figure out that dying wasnt the worst thing that could happen to a patient. Perhaps not the result we were hoping for, but not always the worst case scenario.

    Thanks for sharing your story, and the story of this brave a courageous woman.

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    • Since I’ve had a million of them, sigmoidoscopies only hurt if you are having problems. Then again, if you’re not, why is someone sticking something up your butt?

      I thought of you immediately after reading this article, Katy. I really want t do it, too. Hell, if someone can learn from my condition — go for it.

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  29. Jueseppi B.

    Mmmmm…..I thought that photo WAS you……. 😉 Hope you’re having a very nice quiet Sunday!!!

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Play nice, please.