What Do You Need To Do At Fifty? You Need Your Colonoscopy: No Ifs, Ands, Or Butts! by Patricia L. Raymond, MD, FACP, FACG

March 1, 2010 by admin

%nursing %humor %nurses %jokes %magazine %free %laughter %medical %healthcare %cartoons %karyn %buxman %journal %jocularity I’m proud to be a Big Buttinski. After all, I chose to become a Gastroenterologist. And I want you to get your colonoscopy now.

You think that I am going to harp on the medical reasons, don’t you? About how 40% of Americans at forty have one or more colon polyps, little fleshy mushroom–like growths, sprouting in their colon. And how these polyps, usually over a ten to twelve year span, may proceed onto cancer in 6% of us. That as our number two cancer killer, after lung, you really need your colonoscopy done to look for and remove those polyps, simply because now you’re fifty.

Nah. Too easy. Instead, I’m going to tweak most Americans two darkest desires: greed and the quest for fame.“Greed?” you echo hungrily, spittle forming at the corner of your mouth. “Colonoscopy can make me rich?”

We Gastroenterologists of course are ‘in the gravy’ with the increased application of colon cancer screening at fifty; our G.I. economic forecast is that “things are looking up”. But you can profit, too. You might choose to follow in the path of the late great Italian artist Pierro Manzoni. If you do not have your finger on the pulse of the nineteen sixties pop art movement, you may be unaware of Sig. Manzoni’s BM art. In 1961, he canned his solid excretory material, in increments of excrement of 30g each in some 90 tins. These exclusive excretory exhibits were sold to art collectors when they ‘were hot’ at peak poop prices as high as $75 thousand dollars. As Mr. Manzoni is now ‘nailed to his perch’ and producing neither art nor excrement, his prices remain high. But in an unexpected movement, this art becomes ever rarer as time passes, as half of this canned can art has exploded. That’s right, his art is not too pooped to pop.

Think you can’t get rich selling compost? That poop canning is simply an oddity, not a commodity? I beg to differ. As recently as June of 2002, the respected Tate Gallery in London excitedly announced it had purchased tin No. 004 for about $38,000. Do the calculations yourself: the purchase price for 30g of gold at that time was around $300. As most folks expel about 7lbs. of debris during their colonoscopy cleansing prep, with careful collection and skillful marketing you could hit the mother lode. Then you can sit back and rest on your laurels, or bring your laurels over for their colonoscopy.

But what if your poop products don’t become the cabbage patch doll, pet rock, or furbee of the next Christmas season? I also promised you a shot at fame, and I didn’t just mean the glare of our internal spotlight. You see, our generation is enthralled with buttocks, from the rounded slopes of J Lo, the golden globes of Mel Gibson, and South Park’s Cartman and his adventures with the alien anal probe.

However, our modern stars are nothing compared to the artistry of the great Petomaine. Monsieur H Pujol, with the stage name Petomaine, was a sensation over western Europe in the late 1800’s. A headline performer at the famed Moulin Rouge, Petomaine was known for his anal imitations, and for his ability to play wind instruments with his rectal control- you got it, this fartist was also a flautist. This legacy has not faded to oblivion. Now on the scene one may find an English former train conductor, stage name Mr. Methane, making a tidy living with what he calls “Controlled Anal Voicing”.

We will happily provide you the opportunity to test your talents at controlled anal voicing after your colonoscopy. Here’s how it goes: First we’ve got to flush you out, a universally disliked bit of extreme house cleaning. Then, after you check in and receive your IV and some really great drugs, we skillfully advance a flexible lighted endoscope around the colon to where no man has gone before, to where the sun never shines, or to where there’s no intelligent life… but where, despite what your spouse or coworkers say, where we rarely find your head. We will inflate your colon with air to inspect the colon lining. If we find polyps, we snip them on our way out…as simple as that. The part with the hose only takes about 20 minutes, the whole shebang with check-in and recovery about two hours. If we find no polyps, we’ll stop nagging you for ten years about colonoscopy; if we remove a polyp or you have a first degree relative with colon cancer, we’ll see you back for a repeat personal periscopic party in five years.

I’ve got a gut feeling about what you’re thinking at this point: yeeeeooooooouuuuuk. Just get over it and have fun with it; colonoscopy is embarrassing but very rarely fatal. As a ‘Butt Meddler’ (you may be unaware of my hit single, “The Wind Between Your Cheeks”), I attempt to bring a sense of whimsy to colonoscopy to counteract that natural ‘ick’ factor. I encourage my patients, should their colonoscopy be scheduled for a holiday, to decorate their bottom to celebrate the day. I’ve been greeted over the years with hearts, pumpkins and black cats. I’ve even had an American Flag or two. I don’t generally get décor on lesser holidays.

Imagine my surprise when I pulled back the sheet covering an elderly lady patient on Lincoln’s Birthday and found a miniaturized version (oh, the wonder of computers) of the Gettysburg Address taped to her nether cheek.

“Of the people, by the people, and for the people”… resounding and stirring even when affixed to a vertical smile.

What can be done ‘by the people and for the people’ if you do have a polyp? Don’t panic. First, wait for the pathology, as many polyps are not the right kind to ever grow up to anything cancerous. If you do grow the premalignant kind called ‘adenoma’, diet, exercise, calcium intake and baby aspirin, that is, all the things your mother told you to do (with the possible exception of the aspirin) will reduce your odds of growing more. And what the heck, we’ve already got a date for five years to get up close and personal again.

Fame and fortune can be yours – they may be just a simple colonoscopy away. So get off your butts (as in “Butt I don’ wanna/ Butt its soooo icky/ Butt I won’t get colon cancer”) and schedule yours today!

Patricia Raymond MD FACP FACG takes medicine seriously…and herself lightly. She has taught thousands of medical caregivers to regain their passion for their medical careers through her company Rx For Sanity (RxForSanity.com), and her story on the medicinal power of words entitled “Strong Medicine” appears in “Chicken Soup for The Caregivers Soul”. The author of ‘Don’t Jettison Medicine’ and the colonoscopy joke anthologie ‘Colonoscopy: It’ll Crack U Up!’, and “Colonoscopy: It’s a Gas!” ,Dr Raymond hosts “Your Health Choice”, a funny upcoming daily 2-minute health tip. Board certified and a fellow of both the American Colleges of Physicians and of Gastroenterology, she practices Gastroenterology (SimplyScreening.com) in partnership with her patients in Virginia Beach VA.

The Peanut Gallery

One Response to “What Do You Need To Do At Fifty? You Need Your Colonoscopy: No Ifs, Ands, Or Butts! by Patricia L. Raymond, MD, FACP, FACG”

BethAmy Clouse on March 28th, 2010 11:20 PM

Sorry…when you’re fat, you get more than your share of “obese patient body habitus incompatible with optimal viewing results” aka you doctors can’t seem to try & view my brain the long way around (& after the “cleansing,” you SHOULD be able to see through my eyes backwards). Also, we see, “Pt. obese, noncompliant with positioning.” No one stops to think when you have a double wide on a single wide cold slab of procedural table, repositioning takes a bit more time, which is not allotted, hence, it’s blame the pt. time as schedules (as well as the @$$e$ of a lot of folks in your profession) are tight & don’t allow the necessary time. After all, they ARE fat. So it’s their fault you have to do a half-@$$ job on a double @$$ person. Providing you survive this malpositioning & body habitus nightmare without being perforated (in a chart review of C-scopes one place I worked, fat people were perforated at an alarming rate – & blamed thoroughly, via “karma medicine,” for the problem), you can then be informed, if you end up with positive biopsy results, that it’s your own d****d fault you have colon cancer. You can be sure that, like all obese cancer pts., you are going to get the short end of the C-scope on pain & nausea control, & absolutely no sympathy. You may be otherwise pretty much heterosexual, monogamous, faithful, hard working, caring, but, you’re fat, so you deserve the disease & the pi$$poor medical tx that go with obesity.
The real risk obesity poses to healthcare is that fat people don’t want to go to doctors to be told if they follow a 1000 cal diet & exercise 4 hr or more per day, they will then, if this regimen actually results in sustained weight loss, be treated like a human being – i.e., your diseases will be treated with something other than a diet sheet, appt. with a dietitian, list of gyms to hit (for more apparently well-deserved public humiliation), & the inevitable “fat lecture.” You will, they promise, get antibiotics for infections instead of diets. If you get sick, they’ll treat you with compassion. BUTT: Since the regimen stalls metabolism (I know, trust me), the promised weight loss rarely occurs. Even if it does, you WERE fat, & therefore, even if you lose all the weight, IT’S STILL YOUR FAULT YOU GOT SICK because you USED to be fat. The promised treat-you-like-a-human-being stuff doesn’t materialize unless the doctor was never averse to fat people in the first place – in which case, they DON’T think a diet sheet & a list of gyms cures pneumonia. Those types of doctors are rare. Where they get figures that say doctors don’t advise fat people to diet, exercise, & lose weight, I don’t know. That’s all most fat people ever hear, & it’s the sum total of treatment for most obese people – who then go home & eat because they’re upset about being treated like they’re worse than drug addicts who mug & kill people for drugs, alcoholics who mug people for booze & kill them by driving drunk, promiscuous people who spread drug-resistant & carcinogenic STDs/AIDS/various forms of Hepatitis (esp. C, which can cause cancer), sex addicts/porn addicts who end up sometimes as rapists or even child molesters (added to the list for promiscuity), gambling addicts who leave families indebted & starve their kids…why fat people & smokers are considered so much more evil than these people, instead of victims of nicotine addiction or food addiction & overdieting, has to be that we are not as physically attractive. These days, even doctors seem to hate fat people because we don’t look attractive enough to inspire sexual responses (except for some ethnic groups). At least, that seems to be the only differentiating factor between addiction to food & addiction to other substances/processes.
In other words, we’re too ugly to get good care; you can’t put a bag over any ugly parts because there aren’t bags large enough (even body bags don’t come that large) to hide all of it. And since we’re ugly, no one wants to look at us long enough to treat us. When forced to do so for chronic conditions & things like cancer, doctors & RNs flee the room to avoid looking at the Fat Ugly Patient any longer than necessary – leaving us hurting & hurling (& I’ve worked oncology before; I’ve heard the “let them barf, maybe they’ll finally lose weight” thing enough to get really close to a rap for assault & battery from the sincere desire to b***h slap the body ho across the unit).
Body Nazis control the world. The war is on. And they don’t really intend to let us get thin, or the public humiliation at the gym, pushing people off bikes & skates, running them off jogging tracks/trails, trying to run them over by jumping the curb to get their ugly fat @$$e$ off the sidewalk, jumping on their heads while they’re swimming laps to take it over (or holding you under water long enough to drown you) while the lifeguard laughs, would not happen. So, we’re all getting fatter. Maybe someday, we’ll get angry enough to sit on the ones who treat us badly – might as well use that fat @$$ for something useful.
If you take a look at people, you’ll find thin people are the most aggressive at all-you-can-eat buffets; they’re the big winners in gluttony – oops, sorry, I mean eating – contests, out-munching fat people by a, well, sizeable margin. But apparently, it’s OK to be a glutton if you’re thin. But it’s not OK to be fat even if you have no metabolism left & 1200 cal a day means you simply don’t gain more weight.
So, please tell me: What is the point in fat people seeking medical attention again? And above all, why in the world would we submit to a colonoscopy only to be subjected to substandard testing & treatment for whatever’s wrong? If we deserve it, why would you care if we bothered with the screening? Won’t we die faster & get out of your hair?

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