I have scheduled this post to come online at 7:30 AM, Friday, June 29 - the very moment when my surgeon should be preparing to draw his knife across a section of my lower abdomen and to slice through my flesh to my gut. Bye, bye, colon!
Here is a bit about how this event has come to pass:
On the morning of May 25, I checked into Providence Hospital in Anchorage for a high-tech yet relatively routine and simple colonoscopic procedure I thought was going to take care of the problem. Afterward, I would leave the hospital and hopefully not worry about anything like this until after Obamacare fully kicked in and I could purchase a much better health insurance plan than the one I got forced out of after they secured six figures of income from me.
I was led to this space in a long hallway, which, once the curtain was closed, became a little hospital room of its own. I removed my street clothes, donned the gown that ties at the back, slipped my feet into the paper shoes, then lay down upon the table to wait.
Before I continue on, I must back up a bit, to March 2 in India, where I took this iPhone picture inside the colonoscopy ward of the MS Ramaiah Memorial Hospital in Bangalore. I had brought my regular camera with me but, while the people out and about in India are as enthusiastically receptive to being photographed as anyone I have ever met, institutionally, India is a much more closed society when it comes to cameras than is the US. I was not allowed to bring my camera in. They didn't think to take my phone, however.
So, while I waited my turn for a colonoscopy, I shot this iPhone picture of workers cleaning the acquarium in the waiting area for the colonoscopy ward. I thought the hose a good metaphor for what I was about to experience.
I was long overdue for a colonoscopy. I had not had one since 2008 - shortly before the health insurance company I had squandered so much of my income on for very little in return figured out that the day was coming when they might actually have to spend a bit of money on me. They drastically raised my rates until I could no longer pay - they forced me out, leaving me with no coverage at all. Obamacare came too late, too weak and too slow to do me one damn bit of good.
In 2008, just as she had in colonoscopies reaching back to 2003 or 2004 my physician, Dr. Natalie Beyeler, found some pre-cancerous polyps inside my colon and clipped them out. These are genetic to my family and have afflicted all my living siblings, at least two of whom have had parts of their colons removed and another who gets a colonscopy ever year and every year gets polyps clipped out. My grandfather on my mother's side died of cancer, as did one of my aunts and some of my cousins. I don't know how many or if any of these were colon cancers. As I grew up, the diseases that had taken my relatives had always been referred to as cancer, and nothing more.
Dr. Beyeler now wanted me to have a colonoscopy, along with an endocscopy through the throat, down the esophagus and into the stomach no less than every two years. She suggested I might even do it every year. But times were very tight. When I had had insurance, it didn't help me much. Now, I had no insurance and so had to keep putting it off. The last colonoscopy I had experienced had come to about $8000 once the hospital bill and biopsies on the polyps were added in.
But colonoscopies and endoscopies are cheap in India and I knew I would be going back sooner or later. My in-law, Murthy, set it all up - and the whole thing, biopsies included, came to about $110... according to Murthy. He would not let me pay, but paid himself, in Rupees because he said I would not get such a good exchange rate if I cashed dollars in for Rupees. I still must pay him back, but I don't know how.
To pay Murthy cash back is one of the more impossible tasks I have ever encountered. He always finds a way not to take the money - even when his action has saved my life - which in this case appears to be what he has done. You have my gratitude, Murthy. So do you, Sujitha, for having me at your wedding or I would never have been there to get the colonoscopy in the first place. And Soundarya - it was you who bound me in friend and kinship not only to yourself after we met at the wedding of Vivek and Khena, but to your entire family and your country. Had you not done so, I would still be carrying this deadly thing inside me, unknown, probably not to know until the pain came and by then it is usually too late.
The doctor in India had just about completed the colonoscopy and was telling me that everything looked normal when all of a sudden, he spotted a flat, pre-cancerous a large, flat polyp, harder to see than a regular polp - even though it was several inches long.
Had it been a normal polyp, he could have clipped it right out. He did take biopsies, which tested benign - no cancer found, but he assured me it had to come out because it would become cancerous. It was not an emergency, but even so, the sooner the better.
I thought it might be good to get the surgery done right there in India, but we were moving too fast and it did not happen. Back in Wasilla, I took the paperwork and the photos to my regular doctor. Even though the flat polyp had tested benign, she did not like the look of it at all. It was so big, she said, that even though it had tested benign, it could have a couple of cancer cells hiding inside it. In fact, she said, polyps this size usually do.
She then referred me to Dr. Geronimo Sahagun in Anchorage, who removes polyps by burning them out with a laser. She mentioned another possibility - I could just cut that section of my colon out, as it was such a generator of polyps. This idea did not appeal to me. I figured it would be better to go get the polyp laser-burned out and then after Obamacare kicked fully in, I could return for colonoscopies on a more regular basis. I did not want to get a big chunk of a vital organ cut out of me.
So, jumping forward again, here I am back at Providence, going through the pre-colonscopy process with the nurse. At the moment I took the pictures, I believed that would be gone from my body in just one hour.
I was going to carry my iPhone into the colonoscopy room, but they told me the anesthesia would put me too far out to properly care for it and that I needed to leave it behind. Reluctantly, I did. I regretted this later, because while I have little memory of the beginning of the process, I became quite alert as it moved on. I could see the flat polyp in vived detail and color on the monitor, being attacked by what reminded me of little alligator heads as they bit biopsies out of it and injected it with dark, blue, dye.
The polyp proved to be too big for Dr. Sahagun to burn out, who would refer me to another doctor who would surgically remove it, along with the entire section of my colon where it lived. The biopsies he had taken would be tested for cancer and he was also sending me to radiology for a CAT scan to look into the polyp - hence, the dye.
If it was canncer, Dr. Sahagun told me, it will have been caught early. "Stage one. You'll be cured," he said. Then he walked out of the room. I have not seen him since.
Here I am, lying flat on my back, being pushed on a guerney down the hallway toward radiology.
Jacob was my driver. Lavina and Lynx came back with him to pick me up at the appointed time, but found they would have to wait while I got the CAT scan.
Here I am, going into the CAT scan machine. Above me was a backlit mural that appeared to have been taken on the Yukon River somewhere in the Yukon Flats. The tech did not know.
Finally, many hours later than I had expected to be, I was done. It was Friday, Memorial Day Weekend - which meant I could not learn the results of the tests until Tuesday - four long days away. I was told the surgery would be scheduled in two weeks. When I got out, Jacob, Lavina and Lynxton gave me this frog whose internal organs that flashed in different colors.
It is always good to be given a frog on a day you learn you might have cancer and that, regardless, you face major surgery.
It was now around two or three in the afternoon. I was starving and I wanted breakfast and coffee. Jake drove us to IHOP, where I ordered a Colorado omelette. Jake ordered lunch and Pepsi.
No cancer was found - let me stress this again - NO CANCER WAS FOUND - in the biopsies, or detected by the CAT Scan. Yet, in a polyp that size there still could well be a few cells hiding out and if not, there would be in time. The polyp had to come out, along with the place where it had taken root.
I was referred to Dr. James O'Malley, who informed me I needed a colectomy - my entire right colon had to cut out. This sounded horrible to me, but he said there is a tremendous amount of redundancy in the intestine and that, if all went well, it would only be a matter of weeks until I felt pretty normal, as if I had never had my colon removed at all. Both the doctor and the hospital were heavily booked and O'Malley at first thought I could not be worked in until early July, but then one week ago they scheduled my surgery for today - June 29, at 7:30 AM.
In the above picture, I now go back to Monday, June 25, to Alaska Regional Hospital in Anchorage to take care of pre-op issues. I need information from them, they need information from me.
The lady who sat behind this desk proudly informed me that she had corrected my name in the paperwork. It now read "William," instead of Bill.
No, I told her, "I am Bill, not William."
She did not want to believe me. She was certain I must be William. No, I insisted. I have never been a "William." I have always been a "Bill." My parents named me Bill, not William and it says so right on my birth certificate. She still did not want to believe me. We had a spirited debate about whether I knew my own name or not, but she finally yielded and changed it back to "Bill."
Next, I went into the office of a very friendly nurse to answer medical questions I had mostly already answered and will answer a few times again before this process is over, and to go over documents about this and that. I commented on the quilt. She informed me she had bought it in Missouri.
I thent to another room, answered more questions and affixed my signature to a couple of electronic documents through a computer screen. Dr. O'Malley's Office had already informed me his bill would be just under $10,000. Now I was informed the hospital bill would be $60,000 - BUT - they had a real special deal for unisured people like myself. All I needed to do was pay just $20,000 before I went into surgery and they would knock the rest off.
I told them they might as well ask me for $2 million. Add in the bills for Dr. Sahagun and Providence and the total comes to about $80,000. It wouldn't surprise me at all if it grows from here.
This is just how this world works - if a person has money, they are given good deals on everything. Everything comes cheaper to the person with money. If a person doesn't have money, he gets hit with higher prices, right from the start. Then it only gets worse. Of course, I also know one reason the hospital gives that break to those who can pay is that many people will just walk away from the hospital and not pay at all, but if they can get $20,000 in advance... I also suspect that $20,000 might be a good representation of what a more fair cost might be. I am only expected to be in the hospital for four or five days... $60,000?
This is it. I figured. I am now financially destroyed. My life will be saved but economically I will be ruined. Obamacare came too late, too weak and too slow to do me one damn bit of good. Mike, the hospital's finance representative, told me not to worry. We will work something out, he assured me.
But I am worried.
I then went to another room for an EKG, where the tech happily told me she had corrected the paper work and had changed my name back to William. She didn't want to believe me, either, but after a short argument, she corrected her correction and restored my name to its rightful Bill. I then went to another room and got a blood draw.
When I first learned I must face this surgery, I decided to take two or three days and just take off into the country - hike, canoe, whatever. Dr. O'Malley believed the surgery would probably not take place until early July.
I was relieved to have some time. I was broke and had to get some work going. A great new project has come my way, one that should keep me going for about two years and result in a significant work of true benefit to the young people of the North Slope. I figured it would take me just about to the end of June to get things going and to get some income flowing. Then, hopefully, there would be time for such an adventure before my surgery.
It didn't work out that way. I have no such time. So, about 9:00 PM on the night of June 26, right after we ate Kalib's birthday cake, Melanie and I got into the car and drove toward this rainbow and Hatcher Pass to take a late night, token hike.
We hiked to this beaver colony, my oldest daughter and I, conversing all the way. It was pleasant. Up until a few hours previous, it had been a hard and stressful day, following a series of hard and stressful days - less because of the surgery than because of money. We have just had no money. None. And in this society, that it hell. Worse yet, for weeks and even months I had been expecting checks from a few different entitites who had accepted and used my work but the checks had not come. Finally, in the late afternoon, a check had been desposited by a client directly into my bank account and I knew another one would be coming soon behind it.
What a relief! Now I could buy food, gas, pay bills, penalities and late fees and go into the hospital knowing Margie would have what she needed.
Now, as Melanie and I hiked, I felt good. The air was cool - some folks from other places might have called it cold. It was clean. I was surrounded by the magnificent beauty of this magnificent place I am so blessed to live in. My daughter made good company.
After Melanie stepped off this rock, I handed her my main camera, shoved my iPhone camera deep into my pocket and sat down on the rock myself. I did not want to have a camera in my hands. I just wanted to look, to see, to observe, to feel, to take in the kind of quiet that can only be found in a place such as this - quiet made all the sweeter by the little noises within it - the sounds of rushing waters, the songs of birds.
I don't know how long I sat on that rock in quiet - not a long time. Five minutes, maybe - certainly no more than ten. Yet, somehow, in this very short time, as I gazed into the slightly rippled water - rippled not by wind but by tiny water creatures - my mind seemed to reach beyond my body; my soul seemed to merge into the placid, stark, reflections of mountain and snow. I became enveloped in peace.
People have their places they go to pray and worship - their churches, their temples, their synogogues, their sweat lodges, their mosques... This is the church I choose to worship in, a chapel created by The Creator. I did not vocally pray, but if what I felt inside was not prayer, then prayer does not exist. If the peace I felt descend upon me was not a special blessing, then special blessings are a myth.
I don't need a preacher to tell me any of this - the message is there, in the mountains, in the clouds and in the plants and creatures upon which they rain and nourish.
The prayers and blessings of friends and relatives are all invited and cherished.
The period of silence came to an end. My beloved daughter returned my camera and I pulled my iPhone back out. I took these last few snaps, including this one of Melanie watching a vole or some kind of tiny rodent swim at the edge of the water.
We hiked back to the car. Rain fell upon us. I felt ready to face this ordeal that has now beset me. I will come out weak on the other side, but I will grow strong. I have books to write and construct, people to love.
Among the pre-op signatures I had to sign was one in which I acknowledged the possibility of my death as a result of this procedure. I stated I would not hold such an unlikely but possible event against those giving me the care. I am confident it will go well. I am in good hands, in an excellent facility. Yet, they do require you to sign such documents for a reason. It does happen. In the unlikely event it should happen to me, then still I go in, carrying with me the peace from this moment with my daughter Melanie, given to me by my Creator through this, my most beloved of all His creations: Alaska.
How fortunate, how blessed I am, to live in this place! It is a mighty rugged and tough place, Alaska, top to bottom. It is not a place for everyone. But damn! I love it!
It is the place for me.
Colon or no colon.
Saturday, November 2, 2013 at 5:15PM 
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