After a summer of travel, I was a little done with social activities. It was wonderful reconnecting with friends and family. It was just a lot. I was looking forward for some time to process everything that had happened.
I went back to work. Around this time, I realized I wasn’t going to be working for Chevron after the contract ended in August, so I started looking for a job. Then I started on the business of getting the kids back to school – clothes, uniforms, school supplies, registrations – Justine did most of this. I also started looking for a new place to live, because it was apparent that I wasn’t going to have a roommate anymore and I hated the place we were living. It was too dirty. One of those places that will never be clean.
I had a membership at the Chevron fitness center. The building was only two miles from my home, so I walked every day. I kept some clothes in a locker so I could shower and change before going to my desk. It is very hot in Houston, especially in August, but I always try to get out in it anyway. If I don’t, then the summer is always that much hotter. Commuting on foot is the easiest way to do that.
At this time, I had been struggling with stamina and weight for about three years. As I’ve said, I blamed my struggles on age, diet, newly single over indulgence, drinking. I knew that if I just kept at it, I would build my endurance and the weight would come off easily. I coupled this with the beginning of some lifestyle changes all of which were excruciatingly difficult due to the depression and malaise. When you feel bad and run down, you just want something to stop that feeling. Food, alcohol… But I had been making changes for some time.
I had been doing the walk to and from Chevron for almost six months at this point. It wasn’t getting any easier. In June and July, when we were in town, I added five miles to my daily routine. So over nine miles of walking every day. It still wasn’t getting any easier, but since it had worked before to get back in shape, I just kept doing it.
I had some nice walks with the extra mileage. I was calling it an urban through hike. Two years ago, I had the thought that if I could just get away onto a trail for a couple months that I would be okay. That never happened and couldn’t happen. I have too much going on. Too many responsibilities. But I kept having the urge. I started meditating almost every day. This led me to think that perhaps what I wanted was the meditative experience of walking. I remember that being as important to me as the forest and the view when I was walking the Appalachian Trail. So I started walking. Rice University campus, medical center, River Oaks, Montrose, Buffalo Bayou park. Every morning, I just left very early and walked for a couple hours. I really enjoyed the experience and the city in the early morning.
But by the middle of August, I was really noticing that the walk was not getting any easier. I was waking up incredibly sore and stiff. During the walk, I was just putting my next foot out in front of me and moving. It was hot. Very hot. It didn’t seem to bother me as much for some reason. In the afternoon, I would leave the office when it was 100 degrees. I just kept my head down and kept going. Sometimes I was surprised to be home so unscathed by the heat.
On August 22, I woke to my alarm and snoozed it. As I was drifting back to sleep, I felt a really urgency. I was going to have some diarrhea. So I jumped up and made it to the bathroom. I looked in the toilet and it was full of blood. I was juicing at the time. I had beet juice the night before, so I kind of laughed at myself. I have fallen for that before and freaked out a little. It’s common to mistake beet colors in your stool for blood.
I didn’t make it back to the bed before I was running back to the toilet. I filled it with blood again. I didn’t have that much beet juice. I thought hemorrhoids, anal fissures, etc. The bleeding should stop fairly quickly if that were the case. I was back a third time.
I called my mother. She’s a nurse and one of the only people I would know that would be up at that time. I talked it through. Maybe it was nothing – hemorrhoids or something. I was going to get dressed and go in to work. If it happened again, I would go to the emergency room. I filled the toilet with blood again while I was on the phone. I said, “All right. I’m going to get off the phone and figure out how to get to the ER.”
I changed my mind and thought maybe urgent care was a good idea. I was getting an Uber to take me there when I filled the toilet a fifth time with blood. I changed my mind about the Uber and the urgent care. That’s not a very nice thing to do to someone’s car and urgent care was just going to send me to the ER. Maybe I could drive myself to the ER. Then I thought about what would happen if I lost enough blood to pass out on the way.
I called 911. The conversation on the phone was difficult. 911 wants you to be definitive. I wasn’t sure if I was going to the hospital or if I was having an emergency or if I was just freaking out.
After reaching the medical emergency line, the operator said, “What’s the emergency?”
I felt like I was in a Jerky Boys prank phone call, “Lady I’m bleeding out my ass! Send an ambulance! It’s like a murder scene in here! Oh Christ. What am I going to do?”
I didn’t actually say any of that, but that’s how the Jerky Boys would poke fun at my phone call.
“Do you want me to send an ambulance?”
I paused. “Um… Maybe. Um…”
“Yeah what the hell am I going to do? Sit here? Send an ambulance.”
While I waited, I filled the toilet a sixth time. By this time, I was terrified.
I quickly got dressed. I threw on a black shirt and some black jeans. This is nothing extraordinary. If I were to close my eyes and randomly throw on some clothes, it’s very likely that I would have been clothed exactly like this.
Often people think I am being sarcastic when I’m quite serious. Often, I catch myself and try to change my inflection, but people never buy it after they think I was being sarcastic. I have also been told that I underplay some things emotionally. For example, my friend Tamara told me that it might be good to let some emotion creep into a conversation about bleeding from my ass to a 911 operator. When I told her about this next scene, meeting the EMT’s, she definitely thought it might have helped them if I could shown them a little bit of panic.
When the ambulance arrived, I walked out of my front door and paused to lock it. Then I went to the gate where the EMT’s were waiting and unlocked the gate. I closed the gate, locked the deadbolt on the gate and found the right pocket in my backpack to store the key. The EMT’s looked a little confused.
“Did someone at this address call an ambulance?”
“Yes that was me.”
“What’s the problem?”
“I’m bleeding from my ass.”
They exchanged a look. I wanted so badly to launch into my Jerky Boys impression, but I’m sure they were way too young to get a reference like that, “I’m gonna come down there with my tools jerky. I’m gonna run circles around yous. Ya hear that fruitcake”
Definitely not a good idea, but the thought made me laugh. The whole situation made me laugh. I caught myself pretty quick and didn’t keep laughing. I was having a medical emergency. It was not going to help my situation to have a laughing episode. But the EMT’s already saw it.
“Are you sure you need an ambulance.”
“I’m bleeding a lot.”
“Maybe we can do some tests and save you an ambulance bill.”
“All right. But I’m bleeding a lot.”
“Okay come over here and sit in the back. We’ll swab you. Perhaps it’s not that big of a deal.”
I agreed. I also saw what they saw. A guy just calmly walked out of his house, locked the door, locked the gate, organized his gear, and then calmly explained his medical emergency. They needed to do what they had to do. I sat in the back of the ambulance on a padded red bench along the side with the gurney right in front me as they prepared their swab test. One asked me a bunch of personal questions – name, rank, date of birth, commanding officer, date of first exposure to Danzig. The other asked me about the blood. He kept trying to get specifics.
After the fact, it might seem easy to explain hemorrhaging from my rectum in a way that EMT’s might get the picture. In the moment, it was surprisingly difficult.
“I filled the toilet with blood six times this morning.”
He seemed skeptical, “What color was it? Did it have a noticeable smell?”
“It was red. Yes it was bright. Not like the dark they describe as coming from further in. Yes it stunk. It came out of my ass.”
Sometimes talking to medical professionals can feel like you’re being interrogated. I don’t know how they could change this. An emergency is an emergency. They have to know quickly and precisely exactly what has been happening. If it really is an emergency, I could pass out before they have all of the information. Like I said, I understand, but it feels like being interrogated by a police officer when the police officer feels like you fit the description of someone that just committed a crime.
“It’s about to happen again.”
“What’s about to happen again?”
“I’m about to bleed out again.”
“Okay so you’re going to bleed out again?”
Then it happened. A pool of blood spread around me on the bench. Both of their eyes shot open.
“Oh okay. I guess we’re going to the hospital.”
They prepared the gurney and put me on it. Then they got that ambulance moving. I don’t remember a whole lot about the ambulance trip itself except that it seemed slow. I asked to go to St. Joseph’s because it was familiar and close.
An emergency room in a big city, perhaps any city, is an exceptionally cynical place to be. The staff is charged with deciding whether a situation is an emergency, merely urgent, panic, a minor doctor’s visit, or just someone needing attention. At St. Joseph’s, there is a lot of this last category. The only hospital downtown and the most accessible hospital to midtown, they are on the front line for the city’s homeless population.
The EMT’s brought me in. Some guy who seemed to be in charge of the emergency room started yelling at them as soon as he saw me. Honestly I don’t know what the hell he was yelling about. There were a couple homeless guys yelling at the same time. There were two or three security guards that seemed to be on edge – certainly alert. In general, it was a chaotic shit show, but somehow they got me into a stall, out of the ambulance gurney, and into the hospital gurney. In other words, I got up and moved to the hospital gurney.
The EMT’s turned me over to a nurse that said hello to me and then closed the curtain. There was a homeless guy right outside the curtain. The staff was trying to keep him calm, but he wasn’t having any of that. He was just working himself up. They were being very nice, but he had the attention of the entire emergency staff, the patients, and security. The nurse kept asking me questions, but I could tell he was really focused on what was happening outside the curtain. He kept apologizing.
I said, “That’s all right. But I’m about to bleed again.”
He looked at me, “Yeah okay.”
“I don’t think you understand. It’s a lot.”
“Okay. Well it’s from your… Where are you bleeding?”
“I’m bleeding from my ass. I’m holding onto it.”
“Okay. Well. I don’t know.”
I looked down at my black pants and realized he had no idea what I was talking about. I let my bowels go. I could feel the warmth, but the spreading pool wasn’t so apparent this time. He certainly didn’t see it. He left the room again.
When he came back, he threw me a gown, “Take your clothes off and put this on.”
“Um what should I do about all this blood.”
The nurse looked at me. Oh I’ll be right back. He slipped out and came back with a pack of hospital wet wipes. He handed them to me.
“This isn’t going to do anything.”
He handed me a towel and slipped out again. I could see there was only going to be one way to get the point across. I stood up and took off my shirt which also had a lot of blood on it. As I was unbuttoning my pants, the nurse came back in with another nurse.
“We’re going to need a sample…”
I took off my pants and the blood went everywhere. Things happened much more quickly after that. One of those things was that the homeless guy outside the curtain finally lost it and security had to intervene. So the nurses were tiptoeing around all of the blood and dodging the commotion outside. One of the nurses came over and gingerly held open a biohazard bag. I put my dripping clothes into the bag.
A medical assistant was trying to ask me questions. A hospital billing person came in and looked around, “I’ll come back later.”
A doctor came in to see me. I know he did. I can’t remember what he looked like or his name, but I do remember thinking that he looked impossibly young. He asked the questions that everyone would ask me again and again for the next eleven days:
“What brought to the hospital?”
“Where were you bleeding?”
“From my ass.”
“Are you in any pain?”
He looked around. “You had no pain?”
“No. I woke up this morning thinking I had diarrhea, but it was blood. I filled the bowl six times before the ambulance came.”
“And you were in no pain?”
“On a scale of 1 to 10, what is your pain level now?”
“Did you have any symptoms leading up to this morning?”
“Discomfort going to the bathroom?”
“All right. I’m going to give you [insert pharmaceutical name here]. It stops gastrointestinal bleeding. We’re going to try that and I’ll be back to check on you.”
The nurse came back after a while and gave me a pill. I took it. He looked stressed out. He said, “Housekeeping should be here in a minute to clean this up. I can’t do…”
“No I get it. It’s a lot of blood.”
“Is it going to happen again?”
“I don’t know. I feel some urgency, but I don’t know anything anymore.”
“I’m really sorry. I have to step out. I should be about five minutes. There’s a call button right there.”
“It’s alright. Do what you have to do.” I really should work on that panic mode.
When the nurse came back, he had a janitor in tow covered from head to toe in protective gear. Hair net. Face mask. Gloves. A plastic gown/poncho. Rubber boots. The janitor surveyed the job. I could see his face, but his whole demeanor looked like he would rather be anywhere else.
The nurse said, “We’re going to move you out by the nurse’s station while he cleans this up.”
They opened the curtain the rest of the way and moved me to the place the homeless guy had flipped out ten minutes earlier. It seemed like every eye in the place was on me. I looked down. I was covered with a blanket, but I felt very exposed.
There’s something about the concept of bleeding out of my ass that has had me hesitating to even write it down. I want to use clinical terms to euphemize my way out out of that discomfort. Honestly, I don’t think doing this serves me any purpose. Why write it down at all? I am trying to get the story outside of me, so that I can see it from a different angle. Perhaps stop feeling it as intensely as I feel it. So writing it must include the disgusting and terrifying fury that I felt.
I could write something like, “I had a rectal hemorrhage, so I called an ambulance. At the hospital, they did some blood work to check my hemoglobin levels which were normal at 14.7 grams per deciliter (g/dL). I was told this was normal for a hemorrhage event. Usually the hemoglobin takes a few hours to come down as your body compensates for the loss of fluid with water. Then the new diluted blood is sampled and they can get an idea of how much blood was lost. Hours later in my ICU, they told me that my hemoglobin levels were 9.6 (g/dL). So apparently I had lost quite a bit of blood.”
There’s some middle ground between the Jerky Boys – Oh Christ my ass. My ass it’s bleeding. Somebody’s got to do something. – and clinical medical records descriptions – Patient presented with rectal bleeding.
I woke up bleeding out of my ass. It was a lot of blood. Everyone involved throughout that morning, when confronted with the evidence of how much I was bleeding, was unable to hide their shock. That stall in the emergency room looked like a violent crime had taken place. I watched from the gurney next to the nurse’s station. Perhaps they weren’t looking at me, but everyone with a line of sight into that stall couldn’t help but notice, and I was in that line of sight, so anytime I looked around it felt like everyone was looking at me. I had no place to put my eyes, so I watched the man cleaning the stall.
All that red. A line from Fight Club popped into my mind, “How embarrassing. A house full of condiments and no food.”
My mother walked in at that moment which gave me a break to focus on something else. I know I had been in contact with her throughout the morning. Some part of me must have been aware that she was on her way – maybe even that she had texted from outside. I must have told her where I was. I was still surprised to see her – relieved and grateful. I don’t remember if anything was said. I must have given her a rundown at some point.
When the janitor was done with the stall, my mother walked into it for something. I think she collected the biohazard bag of clothes and my backpack. I had left things lying around the stall. I honestly don’t remember what she went in there for, but she was upset with the amount of water the janitor had left behind. Some of this had to do with her own physical condition; two replaced hips, an achilles tendon attached to her heal with a screw, a knee surgery of some sort, and the other knee ready for replacement. She is part cyborg in desperate need of some upgrades and must have been concerned for her own safety. But I could also see the level of professional disgust as she asked the nurse if we could get the janitor to come back to clean up all this water. He seemed disinclined to chase down the janitor again. He was having quite a morning. She did talk him into getting her a pile of towels to clean up the water.
I was situated back in the stall for about five minutes when a radiology technician showed up to take me for a CT scan. I remember cold. Some iodine through the IV that had magically appeared in my arm and warnings about that causing some warmth and a need to pee.
Strange how this IV could have appeared so easily when the rest of the IV insertions during my stay at St. Jospeh’s were such a big deal. There was one exception. A Filipino nurse that must have been the acknowledged expert on that shift. She had that IV inserted, taped, and the garbage cleaned up before I knew that she was doing it.
Soon after the CT scan, they moved me to ICU. My mother limped along with my bags on the way. I remember having a conversation with the people moving the gurney and a lot of laughing. Once again, I can’t tell you what was said. I do know that nothing was getting me worked up. I felt very little stress from this point forward.
The doctors and nurses in the St. Joseph’s ICU were awesome. The doctor in charge was about my age and had what I believe was a Greek accent and a lot of energy. He was loud, positive, and sugar coated nothing. I can really appreciate a person like that in any situation. He explained everything quickly and succinctly.
“We brought you to the ICU because you lost a lot of blood and we don’t know if the bleeding has stopped. You were taken for a CT scan. I do not have the results yet. As soon as I know the results, I will let you know. Please let us know if anything changes and if you need anything. You cannot eat anything because we don’t know what is happening yet. I am not sure when it will happen, but we are trying to get you a colonoscopy scheduled for the morning. Do you have any questions?”
We hit it off right away. I had him laughing. He made me laugh. He was very nice to my mother. He commended me on my attitude and demeanor.
“Stay positive my friend.”
“It’s easy for me to stay positive right now. I am not sitting in my house trying to figure out how to get to the hospital. That was terrifying. Now that I’m here, it’s not my problem. You have to figure it out.’
Some time later, the doctor came back to tell me the results of the CT scan. They could see a growth in the colon, but it wasn’t clear what was there. It appeared to be mostly confined to inside the colon. They would know more with the colonoscopy. Also there was a growth of some kind on my liver.
My reckoning with the reality of cancer began at that moment. I knew enough to know that the growth in the colon by itself could just be benign polyps, but coupled with the growth on my liver, that was cancer. The odds have to be incredibly low for two benign growths to appear on two separate organs at the same time. I tried to keep myself out of imagining the extent of the cancer, but I knew that it was cancer.