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Ode On A Colonoscopy

Posted by Dr. Suzanne Koven  February 1, 2012 10:12 AM

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colonoscopy procedure color picture500.jpgThe morning I had my colonoscopy I went to my lawyer’s office to finalize my will. No, it’s not how it sounds. This procedure, recommended for everyone over 50 (over 40 if you have a family history of colon cancer or pre-cancerous polyps) is very safe, performed thousands of times every day across America in hospitals and freestanding endoscopy units with an incidence of serious complications well less than 1%.

The reason I went to the lawyer’s office that morning was that my husband happened to be off work and so it seemed convenient to sign our wills and health care proxies (MA form here)—something we’d been meaning to do--and then for me to have the colonoscopy and for him to drive me home. (You are required to have someone drive you home after you wake up from the sedation saying, “What happened? Did you do it yet?”)

No, that’s not entirely true, either. I had privately told myself that this particular day would be “Grown Up Day,” as in me acting very grown up, planning ahead, doing unpleasant things in order to prevent even more unpleasant things, such as getting colon cancer or having Uncle Sam inherit half my estate. There was, I admit, a little masochistic pleasure in sitting at the lawyer’s conference table passing papers and hearing the phrases, “Now when you die…” and “If you die first…” uttered over and over again and then presenting my bare posterior to a team of my colleagues at the hospital where I work just down the street. Plus, I could hardly justify avoiding the very procedure I recommend to patients every day.

Boy am I mature, I congratulated myself.

The fun had actually started the night before. As everyone who’s had one knows, “the worst part” of the colonoscopy is the prep. For those of you who haven’t done it: you mix up a half-gallon of what looks like battery acid (the instructions say you can add a squeeze of lemon “to make it more palatable”) and then you warn your family away and position yourself near a toilet. After several hours you know you’re done because what comes out looks identical to what went in. You may be tempted to spill some of the battery acid down the sink but if you skimp then the gastroenterologist won’t see much, will pronounce you a “poor prep” and won’t be able to give your colon a clean bill of health. It would be as if Jacques Cousteau went deep sea diving with mud on his mask--which sounds disgusting, but, trust me, after the tenth trip to the bathroom you will lose your sensitivity about these matters.

The will was signed, the prep was good, my colon was intact. My affairs were, as they say, in order. And I got to thinking, there in recovery room as I drank the little cup of apple juice and ate the graham crackers, about the difference between pediatric and adult preventative medical care. For the most part, pediatricians try to protect kids from problems they might acquire from the outside: they immunize against viruses and bacteria, they screen for lead, they counsel about car seats and bike helmets. Adults, for the most part, need to be protected from the enemy within: our blood pressure and blood sugar are measured, our breasts imaged, our colons interrogated. Even when these tests are normal, they remind us that, especially after fifty, one of our organs may be plotting mutiny at any moment.

If you ask me, that’s the worst part.

This blog is not written or edited by or the Boston Globe.
The author is solely responsible for the content.

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About the author

Suzanne Koven, M.D. practices internal medicine at Massachusetts General Hospital in Boston. She writes a monthly column for the Globe's G Health section and her essays have appeared in the More »


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