It always starts with nothing…..
It happened to be the first Wednesday of October. I had an appointment made with my doctor to discuss the results of my latest blood test results. I do that about twice a year ever since I got labelled as a type-2 diabetic seven years ago, at the age of 55. Since then I have been taking metformin as the drug for diabetes management. This time too the test results were as usual – a bit of ups and downs in this and that biomarker, but, over all, the doctor was satisfied with our continuing joint success with managing my health quite well.
And then I casually mentioned to him that for the last four or five months I have been feeling some pain in my lower back on the right hand side. I also told him that the pain does not bother me much but I surely notice it, especially when I am lying down on sofa reading books and listening to music. Maybe it is nothing…
That then prompted a process of tests and checks and counter checks, which has brought me to writing this….
Why am I writing this and for whom – I am still not sure.
After hearing about my pain, the doctor asked me to lie down on the examination bench and he hand-pressed various areas on my abdomen and the sides. I did not feel any pain or stiffness. He also asked me whether I have noticed any pattern in the pain, for example after eating a meal or during and after walking or exercising.
‘No I haven’t’.
‘So, there is nothing. But I would like to do some new blood tests and stool tests’.
He booked a time for me for the coming Monday so that I could give my blood and stool samples to the nurse in his clinic.
‘Hey hey, why are you doing these new tests if you think there is nothing?’
‘Well, now that you have told me that you have back pain, I have to go through the next steps; but there is nothing’.
I collected the stool sampling tube and the instructions. I told about all this to TH, my girlfriend of almost 10 years now, over the phone in the evening. A slight mist of silence creeped in.
The next day my son AR, his girlfriend IJ, and their 14-months old daughter MV came from Copenhagen to stay with me for two days before going away to their friends’ get-together in another town. Their visit was already planned a month ago.
MV has started to be friendlier and open with me. The three-hour distance between Aarhus and Copenhagen limits our meetings with several weeks of gap in between. That is a too long a time gap for MV to keep all the memories of her Dada-ji – me.
Those two days we all played and laughed and cooked and walked and talked. IJ took lots of nice pictures and made a few videos of MV holding my finger and walking around in the grass-court play area behind my first floor apartment – Dada-ji and the grand-daughter, both in matching purple clothes. We shared these pictures in our family group of WhatsApp. My elder sister and niece in India liked those and commented nicely.
A month earlier, at their apartment in Copenhagen, MV had shyingly held my finger for the first time and had tried to walk a bit. My son was softly softly speaking to her: ‘Hey MV, see, it is the same finger that your father also held thirty years ago…!’
I pretended as if I hadn’t heard it – but it felt sooooooo nice….
On Monday, the nurse took six samples of my blood, and I handed over to her my bit clumsily collected and very dryish, stool sample in the tube.
And then I fell into the trap… The trap of unfiltered too much information.
I googled ‘lower abdominal back pain’, and instantaneously hit 12 million and 8 hundred thousand search results in 0.54 seconds
‘Don’t go there, don’t go there’ – my heart and brain and mind were shouting.
Why shouldn’t I – I am a scientist, a very rational man; and information is power and knowledge is freedom – I must know… I ignored that mind-chatter.
I know pretty well that there can be hundreds and hundreds of known and unknown reasons for the pain – from a bit of muscle twisting owing to a wrong sitting posture, and the irritating bowel to the most advanced terminal colon cancer. In the last three years, two of my scientist colleagues – the first, my mentor who had invited me as a fresh postdoc to come to Denmark that started my career as a scientist, and the second a colleague in the department who himself was a renowned cancer specialist – had died of colon cancer within three years of diagnosis.
And so started the worst scenario circularity of mind – what if this and what if that… I did not talk to anyone about it.
Wednesday, two days later, I was on my way to lunch at the Maths canteen of the university when my phone rang, with no caller ID notice.
‘Hej, I am SO – your doctor’.
Oh dear – the phone has rung!
Exactly one year earlier, well almost exactly, the phone had rung as well. That was our institute leader, asking me to come and see him in a room different from his usual office. We were all dreading that phone call that day. I was told – in a very dry and to-the-point tone – that he has decided to start the process for the winding up of my 33 years of research and teaching at the university. I realised that the gods of money needed a sacrifice and I was one of the two chosen for that – both of us 60+. The managers had won again. The end game for my professional career had started.
Could this phone call be the other final end game of life?
I hear SO saying that the blood tests were all clear and OK, but there was some problem in the testing of the stool sample. I felt a bit relieved. I told him that I had also noticed in my stool sample the presence of some undigested seeds from the Okra-dish that I had eaten on the evening before collecting the sample. He asked me to get from his office a new tube for the new stool sample. Then he gave me the choice: ‘We can now do either a colonoscopy or a CT scan’.
My sense of relief was very short lived.
I did not feel ready for undergoing colonoscopy. I know that we all have numerous polyps in the colon. Most of them are absolutely benign and harmless, and they appear and disappear due to as many reasons. Moreover, I know that there can be more than 20% false positive results indicating the presence of colon cancer. I will rather have the CT scan first.
I went to collect the tube and just by chance met SO in the corridor.
‘Hey man, tell me how afraid I should be?’
‘No, no, no fear, there is nothing. It is just because that I have now started the process, so let us just go through it for its own sake’.
Already by that evening I got an email from the hospital for the CT scan in two days - on Friday the 13th.
Shit…, S.H.I.T. – See How It Terminates – my personal joking philosophy about what is life – life is shit.
Thursday, TH and I go to Ikea to get energy-saving and environmentally-responsible LED bulbs and some table-corner guards to protect MV from hurting when she comes the next time – perhaps at Xmas. Both of us were much quieter than usual – the misty silence of sadness had thickened.
Friday I reach the hospital punctually. Three other persons were in the same waiting area. All of them on their own - all alone. I was alone too. A radiologist BG around mid-twenties – I read her name and designation on the label she wore – came to me with a plastic jug filled with about one litre of the contrast fluid with barium-sulfate used for CT scan. I had done my homework of knowing all this. She told me to drink the whole jug-full during the next one hour or so.
I started to drink from a 200 ml plastic cup. A slightly chalk-like bland tasting water. And then I remembered my father….
He had also gone for a CT scan in a private hospital in Chandigarh, India, twenty years ago. He was 84 at that time. When I met him for the last time about a year later, he told me of his experience of having to drink a huge amount of the special water for the scan. All his life, he had never taken more than 200 ml of water in one whole day – summer or winter. And here he was asked to drink several glassfuls. He could see that several other persons were finding it very difficult to drink all that water in a short period.
Father told me: ‘I just said waheguru, waheguru and kept on drinking whatever I was supposed to drink’.
He was a believer. A Sikh. He could recite to himself the words of praise for God, and doing so helped him accept the reality.
I could not do that. I will not do that. It won’t even work on me.
From the age of about 15, I had chosen to become an atheist. The more I studied biology and evolution, the easier it became to undo the effects of my religious “child abuse” that happened during my bringing up.
I know, I know, this is a term that usually refers to the terrible acts of sexual abuse of children. Yet, I am using it knowingly. Religious faith was put into my brain without my consent or choosing.
I have read that the brain synapses and connections created in the first seven years of life take a lifetime to undo them, if you want to do so. You may never be able to delete them or get rid of them completely. At best you can keep them suppressed and quiescent.
It is not easy, and it requires a lot of self-analysis and control and confidence. I chose to keep those religious-synapses quiescent. Not letting those childhood synapses take over again requires a constant and conscious effort on my part. I have lived through that in my atheistic life of almost five decades until now: a long prolonged diabetes- and heart problem-related death of my mother when I was twenty; the sudden death of my father just three weeks after I had met him last when I was forty; and the sudden death of my three year younger sister owing to diabetes five years ago; and other marital, financial and job-related issues - I have succeeded so far in keeping those religious faith-based synapses suppressed.
I drank the whole one litre of barium in about half an hour while remembering my father.
In that waiting area of the hospital, I felt lonely as well. Everybody around there was alone. No family or friends to accompany. If I was in a hospital in India, it would never be like that.
But then a lot of other things would also have to happen there. I would have needed somebody who knows somebody to speed up getting an appointment for the CT scan; for an efficient and trustworthy scanning I would have gone to a private hospital paying a lot from my own pocket; and there would still be a lurking suspicion of everybody not doing their job honestly and properly. Here I was feeling a bit lonely, but I was also confident and assured in my mind that the system is working as best as it could. I have been honestly paying the high Danish taxes all these years. I felt much better.
The CT scan process went smoothly. Both radiologists were jovial and supportive and made me feel relaxed. Although it took them three or four attempts to find a suitable vein in my arms to insert a catheter for letting a radioactive iodine-containing contrast fluid run through my blood circulation. I told them about my unique blue blood due to a mutation in my haemoglobin, which gives a dark bluish tinge to my blood, and that this mutation has been in our family for three generations, starting with my father. The young radiologists showed no further curiosity in that. Anyway, a bit of extra needling was not that bad.
The results were supposed to be sent to my doctor in 3 to 4 days. But the whole week 42 was, as always, the autumn holiday week in Denmark.
TH, her niece DH and I drove around in North Jutland during the first part of this holiday week. We saw the controversial art exhibition Blasphemy in Viborg; we vainly searched for fossils in the island of Fur; we got drenched in the rain at the Northern-most tip Grenen near Skagen where the two seas Skagerrak (North Sea) and Kattegat (Baltic Sea) meet; and we saw a play Dansk about what does it mean for a refugee from a war-torn region to be accepted as an equal human being in today’s Denmark. I had almost forgotten everything about the tests.
Friday was the last day of the holiday week. I knew that on Monday or Tuesday next week, my doctor will see the CT scan results and will inform me. But that again started this sad sad feeling in the body; and I started again watching every small symptom in my gut, on my skin, in my mind. The monkey mind was jumping from one worst scenario to the other. I had to keep bringing it back to its rational state with some extra effort of the brain.
And so I started to type “Living in Old Age” on my PowerMac in my office. I reached so far in about 80 minutes. I decided to stop here and go home via my detour of about 50 minutes of brisk walking through the botanical gardens nearby and the downtown.
Walking briskly away from death or walking towards health – I am not sure.
The Monday after the autumn holidays of the week 42.
The weekend passed with re-anxiety and a re-feeling of sadness going round and round in the stomach and the solar plexus. I am waiting for doctor’s phone call and checking my email every few minutes from about 9 AM.
At 10:58 AM my Gmail inbox shows an incoming mail from the doctor. I am a bit relieved that that must be a good sign that he has not phoned me, but at the same time the fear has also re-emerged.
I log into the website, and open the mail:
‘Hej – CT scan is fine’.
I feel a tear swelling up in my left eye. I read the report underneath: ‘nothing abnormal, nothing malignant, a bit of hardening/calcification of the lung, and a mild steatosis fatty acid deposit in the liver’.
Typical age-associated and diabetic scars of long life of six decades so far.
That is what old age is. That is what I have learnt, studied and researched for the last 35 years.
I must now Live in Old Age….
The future begins now.
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