biopsy

10 december 2020

SO HOW DID WE GET TO HERE ?

THESE

WISH I’D WRITTEN THESE

All original writing

2014, 2015, 2016,

2017, 2018, 2019,

2020, 2021, 2022,

2023, 2024

Dr Ian McLauchlin

2. THE BIOPSY

Early August 2018. There was something they wanted to look at. More closely. Very much more closely. "What THAT closely?" ‘Yes, under a microscope.’ I'll need a bigger pair of underpants.

Of course they meant they wanted to get a sample . . . .

Daughter Cate took me in. Arrived 7:00 am - ward not open. Hung around thinking of England and minute microscopes. Opened 7:15.

Here's your bed and there are magazines on a trolley by the entrance. Model Railway Enthusiast or similar. Very interesting. You can buy 4mm scale Ford Thames lorry door mirrors, door handles, wipers and authentic transfers. There's hope for the world yet.

Nurse came to see me with forms etc. 3-2-44. That was the first of about 2 dozen. Blood pressure, blood sugar, blood oxygen, political persuasion - no not that. "Put this gown on but don't take off your underpants. (Word must have got around.) Well you put that arm in there and the other arm through there and the third arm . . . . And I'm just going to measure you." 'What there?' "No lower down. Put on these elastic stockings. They absorb the blood and keep the theatre floor clean."

Another nurse came. 3-2-44. "I see you've brought a urine sample. That won't do, it's in the wrong container." 'Right. How long have you got. I delivered a urine sample 7 days ago, in the hospital container, complete with polythene bag and yellow hospital card, 3-2-44, to my GP as instructed. Yesterday afternoon I phoned the surgery for the result, as instructed.' "What sample?" said the Receptionist. 'The one I brought in on 2 aug, complete with 3-2-44, hospital number, official sticker, password, memorable name and name of my first pet. "Ah if it's in hospital livery it'll have gone straight to the hospital." 'Did you receive it?' . . . "Er . . . I'll have to get back to you."

Yesterday afternoon the Surgery Principal GP phoned me, sheepishly (at least they recognised the importance), to say that the surgery hadn't got it, the hospital hadn't got it, watch Bert Evans** not have it. 'Can I have a constructive word and say that the surgery needs to attend to its Quality Assurance Procedures? There should be an Audit Trail for everything that's received by the surgery and everything that's then done with it, with dates and times. To protect YOURSELF.' My consultancy fee will be £ . . . . No I waived that. Will anything change? No. Doctor suggested taking a sample in with me and that was it and he saw that it was good, no wrong. And red.

Registrar came. 3-2-44. Another lady hovered by the curtain. Whisper whisper. The lab HAD received my urine sample and it was OK. 'Would you believe that my GP had no record of having received it, nor what he'd done with it?' "I couldn't possibly comment . . . . " grin wink nudge rolls eyes.

Let's see, you're taking a, b, c etc." 'Yes.' "Stopped the clopidogrel ( a blood thinning medicine for people like me with solid blood ) ?" 'No IT stopped me. What happens afterwards?'

"Well when we have the histology results, the team assembles and discusses your case. It depends if it's cancerous. There are lots of them - all the people who've been involved - cystoscopy Doctor, Anaesthetist, Consultant, trolley man, keeper of the time (twenty-five past) and toast and marmalade lady . . ." 'Is that like getting three psychiatrists in a room and coming out with 15 opinions?'

"You're an . . . unusual case (tell me about it). Your abnormal growths aren't attached to the prostate and aren't in the bladder. We're going to try to remove them completely in one go if we can." **** 'Might you say that me taking clopidogrel may have given me an early warning?' "Mmmm . . yes . . never thought of that" said her face but not her mouth.

Anaesthetist came. I asked him to spell it. He couldn't. "Stopped your clopidogrel?" 'Yes and it's 3-2-44.' "That's not how you spell it. You'll be given a sharp scratch and I won't feel a thing."

Surgeon came. "Hello, do you know what's happening to you?" 'I thought you knew. Do you want me to explain?'

3-2-44.

Then along came the trolley man. "Do you want a wheelchair or can you walk to theatre?" 'I'll walk thanks.' "You must be retired." 'Yes.' "What did you do before you retired?" 'Applied for early retirement.' No I didn't say that. I don't push it but if someone asks outright: 'I was a Research Scientist in the Nuclear Power Industry. I devised Safety Assesment Methods for predicting the lifetime of steel components in Nuclear Reactor coolant circuits and which are used in UK, French and Japanese Nuclear Power Station Safety Cases'. "Gulp." 'Do you want a wheelchair or can you walk to theatre?'

He walked . . . . "Is there any metal in that pony tail band?" 'No it's just rubber and it plays "Sergeant Pepper." '

Theatre area is HUGE and out of bounds. Lots of corridors, preparation rooms, more wards, corridors split into two, more theatres, more corridors etc. I can see why he offered a wheelchair. He found THE room. "Take your underpants off and put your bare bottom on that table . . . . . ". Now where've I heard that before.

Lying down now looking at the ceiling. I had no watch and no idea about the passage of time. It gets away from you and you really haven't a clue, no really, really. He decided to chat.

"What do you do now you've retired?" 'Oh . . er . . . design and construct websites for people . . .' "That must make you a lot of money . . " 'No I don't charge - well only out-of-pocket expenses.' "Oh" he said, non-plussed (reminded me of the Monty Python sketch). 'I do a bit of gardening, mainly watering this time of year. Daughter's been away and I've been watering hers for a fortnight and feeding the animals.' "What every few days?" 'No a solid fortnight, all day every day, and through many nights too. And it takes ages to buy nearly identical replacement rats.'

'What do YOU do in your spare time?' Totally unexpected question. "Er . . I sketch a bit, anything really." 'Do you colour them in?' "No but I'm thinking about it. I fancy watercolour. And the World Cup. Did you watch it?" 'Yes some of it. Thought Gareth Southgate was good (for the waistcoat industry), and the taker of the winning penalty, but didn't like the foul play of some of the teams . . .'

Sensing that the questions were becoming more searching, a crash team of dementors burst into the room. In costumes and brandishing machine guns. "No-one expects the Spanish Inquisition." '3-2-44'. "Oh, I'll just take your glasses off. Sharp scratch." Then 10 minutes or so of sticking plasters around the cannula to make sure it stays in place. A transparent mask held manually over nose and mouth to breathe dilute oxygen mix. "You might feel the room go blurry." I didn't, except from lack of glasses. No gradualness, no counting up to te . . . three. Nothing. Totally instant. Split second. Never had that before, and it was good.

Next thing I knew I was having a dream that featured a recovery room, a nurse and . . . . wait a minute I'm waking up . . from what . . . Oh I remember.

After a short time which, strangely, didn't involve 3-2-44, I was wheeled back to the ward. Wouldn't let me walk this time as flipflops damage the floor . . . (joke).

"Let me explain about this catheter bag. You empty it by turning the tap to right angles to the flow. 'Ah you mean the OPPOSITE of normal in-line taps!' He looked puzzled. "At night you attach this other bag which is connected to a tanker on your driveway . . . " (My email client has just asked me to add an attachment. I'll add a full urine bag . . . ) "When it comes through yellow you can think about restarting clopidogrel." When do I stop thinking about it and actually do it?' (Wonder how many catheter bags they've attached to a false leg . . .) 'Will the bag slip out?' "Not unless it's a competitor in tug-of-war. There's an inflated balloon which holds it in your bladder." 'Does it say "Welcome Home?" '

Two slices of toast and marmalade, the best I've ever tasted. Ok I've phoned your daughter and she'll come and collect you. In no time at all, daughter arrived, followed closely by blue flashing lights and wah wah sirens. They insisted on a wheel chair. After they first insisted that I put my underpants back on, carefully thread my shorts over the catheter bag, and pull the Tshirt over my pony tail. Cate left me inside the door while she got her car.

What time was it? No idea. 'Excuse me, could you tell me the time?' "Of course, it's Twenty-Five past." 'Er . . . twenty-five past WHAT?'

Turns out it was One.

Epilogue:

Bag full to bursting when arrived home. Turned tap against a) all instincts and b) the toilet bowl. Red. 600ml.

16:00 emptied bag. Red. 500ml.

16:45 emptied bag. Pink/yellow. 500ml.

18:00 emptied bag. YELLOW. 500ml.

19:30 emptied bag. STILL yellow. 500ml.

You'll have gathered that I've been drinking for England . . .

After a fortnight I was running out of catheter bags and they still hadn't called me in to have the catheter removed. There followed many phone calls to hospital and local pharmacy involving precise specification of male catheter bags, part number, availability and how to cope with overfull bags in relation to bathroom floors . . . but that's another story.

Thanks for reading so far. You haven't? Then you won't know I've thanked you. Win win.

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** Bert Evans was a secondary school maths teacher, famed for his way of teaching. The reference relates to him standing at the blackboard and saying "Euclid couldn't do it, Pythagoras couldn't do it, Newton couldn't do it. Watch me do it."

and "Watch the board while I go through it."

**** They couldn't remove it all in one go. Even though they had three people hold of it, their feet braced on the bed pulling like mad . . .

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