The Yale Journal for Humanities in Medicine
Half a Pancreas Later, Some Things are Still Hard to Digest
Lying in a sterile hospital bed, complete with wheels on the bottom and metal bars on the sides, I could no longer disregard the pressing demands of my relentlessly contracting and expanding bowels. The term “evacuation” once conjured images of large masses fleeing fires or hurricanes or nuclear disasters, blocking exits and major roadways. No longer. Now, images of the most messy and unavoidable consequences of human life have come to replace them. Images of excretion, humiliation and death.
The doctors explained pancreatitis to me as a condition in which the pancreas decides to eat itself with its own enzymes and becomes inflamed as a result. They told me that it occurred mostly in overweight middle-aged alcoholic women and that I was lucky that I was neither overweight nor middle-aged nor an alcoholic. After my first attack of acute pancreatitis, x-rays revealed a mass growing in the middle of my pancreas which the doctors presumed to be a cyst. The cyst was blocking my digestive enzymes from entering my intestines and causing them to collect in my blood, rendering them useless in performing their normal digestive functions. As a result, to my great dismay, I was no longer allowed to eat ice cream or peanut butter or anything too fatty for my pitifully deficient digestive enzymes to process. Doing so would easily trigger another attack, and after three separate attacks, I was warned that another one could wipe out my pancreas, cause organ failure and kill me. Thus, after over two years of these attacks and the cardboard diet they imposed, the doctors finally agreed that the cyst should be removed surgically, despite the risks of the decidedly complicated operation.
Writhing in this whitewashed bed awaiting this surgery, I was intensely aware of the pathetic nature of my new existence, marked by a constant preoccupation with what were previously “normal” life functions. They took place in a bathroom, a kitchen, a living room, a bedroom. Now, they all took place in a single transportable bed courtesy of bedpans, nurses and intravenous feeding mechanisms.
In this particular instance, however, my visceral needs had overcome silence, my choice response to humiliation. I had already proclaimed that a bedpan would not be necessary and to my disgrace, my proclamation had been taken seriously and observed. Having consumed three bottles of cherry-flavored magnesium hydroxide the night before in order to achieve the thoroughly barren gastrointestinal tract the surgeons insisted was essential for my “intimate” surgery, I had been “evacuating” all night, and the intestinal acrobatics continued into the morning. I was bracing myself for a final emergency landing, but I couldn’t get out of that godforsaken bed.
I sat up, pulling harder and harder on the metal bars, which the nurse had so easily pulled up and clicked into place after transporting me here just a short while before. My palms grew sweaty, and my heart began to race. My dreaded fate was rapidly approaching, and panic was the only rational resort. The four other patients in the room were so serene they looked catatonic by comparison.
I took my first real look around in desperation. What kind of room was this? Did it have some official name? For some reason, I felt that if I found out, if there were some sign above it reading “Pre-op Prep Room” or “Gastro-Intestinal Care Unit,” I would somehow feel better. Maybe then I could get out of this goddamn bed; maybe then I could take a shit without asking for help; maybe then I could swallow my pride and ask for a stinking bedpan. Maybe then one of these white coats would hold still long enough to notice me.
Was I in hell? No one seemed to notice how badly I wanted, needed out of this bed. Even if my IV weren’t caught under the bars making it impossible to climb over, I was still far too weak from the evening’s adventures to climb out. Defeated, I called for help: “Um, hello.” Nothing. Everyone was flying around this room. It seemed all they were capable of doing was pulling out charts from the bottoms of beds, running with them and replacing them. I had decided to catch the attention of the next person to pull out or replace mine. A tall, skinny resident with gold wire framed glasses, curly raven hair and transparent skin. “Um, hi. I really need—”
“The anesthesiologist should be here any minute,” she told the chart.
When people think you might die and they don’t know you in the first place and they don’t absolutely need to look at you, they do their best to look elsewhere. And if they have to look at you, they generally focus on the part of you that is presumably the most damaged.
In my case—that is, a 20-year-old, 5’6,” 120-pound, non-smoking, non-drinking, otherwise healthy female with a badly situated pancreatic mass case—the majority of my beloved healthcare providers choose to look at my pancreas, directly below the ribs, some three inches above the belly button, when addressing me. I used to move my head down to my stomach to catch their eyes, but now I just talk to their pancreas too, as though it were a conversation between organs and not individual human beings. They don’t seem to notice.
The hopeless resident replaced my chart and ran away before I could try again. I resumed pulling at the bars until I was finally shaking the bed itself. I was pulling so hard in alternating directions that the bed had started rolling back and forth on the gleaming white linoleum floor when a nurse passing by managed to notice me. She looked around and asked me what I wanted. My angel in lilac hospital scrubs. I wanted to hug her, but there was no time. “I have to go to the bathroom, and I can’t get this thing down,” I conceded. “Can you help me?” She had pulled the bars down before I had even asked. I thanked her and hobbled toward the bathroom, dragging my IV behind.
This was the first time in my life sitting on a public toilet without having my skin and the seat separated by at least three layers of toilet paper. I threw down one measly layer and collapsed, not even noticing until it was too late that I had missed the seat entirely and the toilet paper was on the floor. I figured the breach in hygiene was acceptable though, as I was facing much more serious risks upon returning to my caged bed. I used my IV to anchor myself up and make my way back to the cage, where a handsome young man was waiting for me. He was tall and his white coat contrasted beautifully with his dark skin.