I had the unhappy experience of watching a scope enter into a very long and deeply laid tube. As a medical interpreter, of course I had seen hundreds of colonoscopies, but this time it was closer to home. The scope had a light and a camera on it, one man operating it quite carefully, the other standing by and telling him to pull out, or move further along the tubular structure, while he explained to me what he was seeing and his diagnosis. There was some yellowish liquid and bits of almost dissolved fecal matter, and things were looking bad. But it wasn’t a colonoscopy. This tube was filled with invading birch roots. It was the tired and worn sewer pipe of my nearly 100-year-old home.
A century of settling earth, prying roots, and normal aging had loosened each joint along the old concrete pipe and it was no longer solid. As sewage welled into my basement, and the bile rose in my throat, I was lucky to get hold of anyone. Our plumbers have been overbooked now that everyone is at home. I was even luckier that the one who returned my call came highly recommended by several neighbors. Yet now I had to make a rushed, on the spot decision regarding a very expensive repair – projected at ten to twenty thousand US dollars. I had made the decision with another plumber to make a limited repair five years ago, and apparently that had failed.
This plumber was very friendly and approachable, and we even joked about how similar his scoping was to a colonoscopy. But I must admit that I didn’t understand everything he was telling me and I didn’t ask all the reasonable questions that an “informed buyer” would think of. I was too scared. I was literally flooded with anxiety hormones, trying hard not to choke up in front of the plumber, and feeling a huge impulse to flee and hide somewhere, sell the house and move abroad, or otherwise wash my hands of the whole problem. I was staring at the screen and hearing the plumber’s words, but too panicked to process them correctly. I felt myself free-falling into my anxious inner child, whose life is fraught with disaster scenarios out of her control, and who suffers immensely from things that never happen – but could. Oh, dear! The panic – the heart in my throat! The “sick tummy” that my mother always carefully reminded me came from my dad’s side of the family!
“This problem isn’t going to go away – it’s only going to get worse. So you tell me what you want to do.”
I was in his hands, because there was no way I could take care of it myself. And who knew when I could even reach another plumber? He offered to start the very next day, and I agreed. It wasn’t life or death, even if my trembling nerves and shaky body thought it was. It was happening in my yard, not in my body. It could have been a doctor with a scope. It could have been cancer. It could have been a forced leap of faith into the darkness of a long, drawn-out medical situation, irreversible and permanent. It could be a myriad of things outside of my control, with information I cannot process because I am in a panic, and decisions that have to be made right away – about my own health and longevity.
As I see my garden torn up and mysterious work being done, the quality and correctness of which is above my understanding, I have to trust this unknown expert with something I absolutely could not do for myself. And it gives me even more compassion for my patients, who most often get sudden, unexpected news that they have something quite serious or even fatal. The information given is overwhelming. The decisions to be made are stabs in the dark, and I truly understand why the most common response is, “you’re the doctor – you tell me!” And unlike houses, which can be sold, there is no escape from our own bodies, except for that one final journey.
So as I wait for the inspector and the final invoice next week, and make tentative plans about rebuilding my garden, I lift my gardening hat to my patients, their struggles, and their courage in adversity. And I am humbly struck by how very much we are asking of our patients when we expect them to be “informed consumers” and “ask questions” and be “proactive in taking charge of their own care” when they wish nothing more than to have their problem just disappear and leave them with the life they had right before the doctor spoke. Especially for those patients, who, like me, have an incurable nervous stomach on top of whatever ills life throws at them. It is not as easy as it looks, believe me.