reBUTTal

I've pondered about whether or not to write the sequel "butt" article ever since I made the decision to go ahead with the surgery. I finally decided to go for it -- mostly because I got such a positvie response from the first one, and because writing about a momentous event helps me to make some sense out of it.

For those who haven't followed this saga -- a brief review. In 1994, I had surgery on my rear end to remove a fistula, which is a tract the body forms to contain an infection. My ensuing article for Synapse chronicled my quest for alternative remedies to going "under the knife", ending the story with an account of the surgery and my recovery.

Because it was necessary to remove a large area of tissue in my first surgery, the incision did not heal properly, leaving a "divit" or pocket connected to my anus which needed special attention, became irritated easily and caused some incontinence. At the urging of my husband and my doctor, I reluctantly decided to undergo another surgery to fix this situation.

So, on November 19, I turned myself in, so to speak, to Munson Medical Center. Needless to say, I was apprehensive. Rather than recount a play-by-play of the days that followed, I thought I'd share some insights and revelations that came to me during the experience of being put under anesthesia, cut open, sewn up and my recovery -- which I am still experiencing. I write this in the hope that it might help someone else who has to face a medical crisis.

First, some thoughts about preparing for surgery -- or any other scary, personal event. For me, one of the very worst parts is the pre-op anxiety. The days leading up to the surgery are difficult ones. I did several things that proved useful. One was scheduling a yoga workshop at the Inn where I live, for the weekend prior to the surgery. Although there was a certain amount of work involved in getting ready for the event, I had plenty of help so I wasn't overwhelmed, and it provided a good distraction to keep my mind occupied and not dwelling on the surgery. I was also able to participate in the workshop and enjoyed the many benefits to mind, body and spirit that yoga provides. The other event I planned prior to the surgery was a healing circle in which I invited members of the community to share some positive energy in a ritual setting, also at the Inn. Based on pre-Christian, Earth-based traditions, we created a sacred space and I was able to ask for courage and healing energy from the group and from the Divine Spirit which I believe connects us all. I spoke my fears into a fire that burned them up. And I lay in the center while everyone gathered around me placing their hands on me. That feeling was something I can't put into words, but I know it helped me to walk into the hospital with a more peaceful spirit. It was hard to ask to be the focus of attention; to speak my fears out loud; to talk about a part of our anatomy that is usually only spoken of in jokes. But it was worth it.

Another very difficult time came right before the surgery. My doctor had an emergency surgery -- a car accident victim. I was all cleaned out and prepped, waiting in a small, stark pre-op room. The hours dragged by -- all seven of them. Fortunately, my husband, Bob, was with me and we had brought along a copy of the Dhammapada, a Buddhist guide to living. Bob read to me from it as I lay there on the table. Something about the eternal truths of those teachings was able to soothe my soul and lift me beyond my current circumstance. I also used deep breathing techniques which are part of my yoga practice. When they finally came for me I was relieved to finally be getting on with it -- and calm.

Following the surgery I stayed in the hospital for three days so that I could stay on IV's and give the incision a few days to seal over before I started eating solid food.

Few people actually enjoy staying in the hospital. It's not your own bed, it's noisy, the windows don't open, your room-mate may like the soaps and sit-coms, they wake you up at 4:00 a.m. to take your blood pressure and make sure you're alive, and the food is awful (even though I wasn't eating food, I bemoaned the fate of my first room-mate who was recovering from major surgery and couldn't keep any food down. Where was the peppermint tea, miso and brown rice? They kept bringing her things like salisbury steak.)

However, I have no complaints about the care I received. The doctors, nurses and aids were all cheerful, kind and attentive. I was encouraged to get up and walk around in the halls to help my circulation. So I walked the halls pushing my IV pole along beside me. As I met other patients walking and passed by doors where patients lay or sat, I thought about Western medicine. There is much that can be done to counteract illness and aging, yet Western medicine has limits. We live in a culture of denial regarding the aging process. It would be better if we were taught from the beginning to accept the fact that things go wrong in our bodies, that they wear out and Western medicine has limits. How well we hold up in our older years is determined somewhat by the habits we develop when we're younger. Fortunately, that fact is now fairly well established in our culture. But most of us still hold onto the notion that the almighty doctor can patch us up and everything will be fine.

With advances in science and technology we are able to keep people alive longer, though often the question becomes an ethical quality of life issue. This was played out poignantly in my hospital room on my last night there. My new room-mate was brought in on a cart in the afternoon. She was an elderly woman and had all kinds of tubes connected to her. Periodically, she was hooked up to some sort of breathing apparatus. I heard that she'd had surgery several weeks before and was just out of intensive care. She didn't look like she was long for this world. Most of the time she moaned -- occasionally yelling incoherent words. I knew right then that it would be a long, sleepless night. She settled down for a bit, but then at 3:00 a.m. I was awakened by her anguished cries, "Open the window! Open the window! OPEN THE WINDOW!" over and over again. I knew how she felt. I wanted to join in her chant: "Open the window!" Did she long to be carried out of the hospital and laid under a tree to enjoy her last breaths in the fresh air? At what point do we allow the natural process of death to run its course? I don't know the answer, but her tormented cries made me wonder. (The nurse came, then, and offered to switch me to another room, which I gratefully accepted.)

I am home now, perched in my loft room, looking out at the lake. One of my lessons at this point is to remember that the healing process is not linear; rather, it is uneven, with ups and downs, ebbs and flows. Patience. When I talk to people, most ask me about the pain. I have been thinking about pain myself -- first anticipating and dreading it, and wondering how bad it would be; then experiencing it as it comes and goes. In the hospital I was amazed that I had absolutely no pain, due to an epidural catheter that dripped a pain blocker into my spine. Fortunately, the worst of it came after I was home. When the pain reaches a certain level, it captures my attention completely (talk about one-pointed concentration!). More than that, pain draws me inward, until I'm face to face with my soul. It is a raw moment of truth, as one breath follows the next one. It is just something to get through. This is where the Buddhist teaching of impermanence becomes useful. The idea that nothing is constant; everything is in a state of change. This is only one passing moment in time. The pain uncovers something deep -- maybe it touches ancient memories of torture and suffering. When it subsides, I feel strong and empowered, like a warrior back from battle. Almost at once I begin to forget what the pain felt like. It fades rapidly from my memory. I can remember I had it, but not just how it felt . . . luckily.

When a significant event like this occurs, I wonder about its deeper meaning. Why did this have to happen? Was there a lesson I was supposed to learn the first time I got my butt cut open that I missed so I had to do it again? Or isn't it that simple? Maybe these events just happen, but they are opportunities for growth and deepening our understanding and compassion. I usually try to look for the silver lining at times like this. I have been given an opportunity to stop my life, take a break, and have some time for reflection and evaluation of who I am and my purpose in life. That is a big gift; it just came packaged with a little discomfort.

The best part: it looks like I'll have a working sphincter muscle again, once the healing is complete.

My deep thanks to all who wrote, called, sent flowers and prayers and love. I feel very blessed. And so glad to be alive.

Sing it out loud
Sing it in your name
Sing it like you're proud
Sing the healing game . . .

-- Van Morrison

Return to the Index of Synapse 42, Winter 1997/98