Friday, November 22, 2013


... (women, please close your eyes).  May I walk you through a cystoscopy?

Okay, you have consumed your four bottles of water to ensure that you arrive ready to perform.  You have peed in the bowl with the revolving base--the one that measures the strength of your flow and the volume of your output.  You have bared your belly to the ultrasound scan, to measure the amount of urine left in the bladder after your recent effort.  And now the nurse leads you to a far corner of the urology department for your cystoscopy--the procedure that will allow the doctor to see the inside of your bladder and examine the prostate gland...

You are left in a small changing room to strip from the waist down and don the hospital gown, and stand there waiting to be called.  The room next door looks like a small operating theater, with lights above, a battery of electronics, and a lay-back seat where the nurse invites you to take your place.  She explains the procedure as she works, raising each leg into a stirrup (yes, men, now you know how it feels!) on either side and hoisting your gown to leave you exposed to her professional eye.

Next, the ablutions.  The nurse--in my case, a distractingly attractive young woman--makes a thorough job of cleaning your genitals with something cold and sterile.  You try to avoid the inappropriate wish that the circumstance were different, and that you were fifty years younger.  (By this time, all the water you consumed by way of preparation has begun to exert pressure on your bladder, but now is not the time to pee.)  Next, she covers your legs and your belly with sterile surgical wraps, and your genital area with another one of special design, with an aperture that allows only the penis to poke through.

To prepare for the procedure, the nurse explains, she will need to introduce a numbing substance into your penis.  To this end, she produces a plunger of impressive proportions and takes your penis in hand, slipping the nozzle into the narrow entry and emptying the plunger efficiently into the urethra.  The sensation is strangely pleasant...

But kiss your ego goodbye.  If you ever felt exposed, this would be the moment.  You can't see it for yourself, but your penis feels like you had just dived into a sea of icy water, a pathetic, shrunken thing exposed to the elements--and the deferentially professional gaze of your beautiful nurse.

It is now time for the doctor's entry.  He arrives in a white coat, which he sheds purposefully in favor of a surgical gown, chatting cheerfully the while.  He is armed with a black electronic probe, with cables attached.  He does not think this will cause pain.  Discomfort, perhaps, but not actual pain.  You can watch it all in color on the monitor placed at an angle, next to you.  The camera is in before you know it, making a smooth passage up inside your penis, plunging through the prostate and entering the bladder--a balloon-like chamber with veined, pink, translucent walls.  Once here, the doctor makes the necessary twists and turns to scrutinize the whole surface.  Satisfied, he withdraws, pausing at the prostate--a pink and spongy donut--to examine it with equal care.  You are alarmed, watching the image on the monitor, by an angry red excrescence, but the doctor dismisses it, to your relief, as no more than an irritation.  You had thought... well, you know what you thought.

The camera retreats smoothly back down the urethra and the screen goes blank.  The doctor is pleased. He pronounces it "an excellent exam" and strips off his surgical gown before leaving the little theater.  By now, all you want to do--and desperately--is get to the nearest toilet to relieve yourself of some of that urine that has been accumulating for an hour, and the nurse kindly sees to it that this is taken care of before inviting you back into your little changing room.  You put your clothes back on with a sense of gratitude that the ordeal is over--and that it was really not the ordeal you had feared.  Doctor and nurse have both been kind and skillful.  You survived.  You breathe a sigh of relief.  Your penis is undamaged, so far as you can tell.  Your bladder is empty.  Time for a last visit to the doctor's office for his report...

See, that wasn't so bad, was it?  Another useful lesson for the owner of one of these surprisingly tough, surprisingly fragile human bodies.  And another good time to be reminded of that fine Buddhist mantra: This is not me, this is not mine, this is not who I am.

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