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Saturday, December 15, 2012

The Foxy Nurse Will See You Now


Knowing just when to put up a new blog these days is hard. The most immediate dangers I faced are behind me unless the tumor starts to grow back. Medical updates are more general; I have good days and bad days, dizzy days, hot flash days, freeze flash days and sick days that occur more frequently because of my overall condition.

It feels wrong to write a blog every time I have a bad day because there are so many of them. Good days always follow. The other reason I haven't blogged recently relates to how fruitful the past few months have been for composing. I am writing an ambitious 35-minute cello concerto and it takes up all my spare time. Composing music requires a certain abstract mindset that is hard (for me) to nurture to a point where I can produce something good. Composing words is a jealous mistress to the other half of my creative self. Once I get going with words the music usually dries up. With a deadline and a lot left, I don't want to risk it.

But sometimes things happen that are too personal not to share.

I have had two hernia repair surgeries, in 1999 and 2005. I have barely thought about them recently but over the weekend I felt a rip, then a numb pain in my left inguinal area, which is just above the hip. In the shower on Monday I felt a bump down there. If the area had just given way again, I was done playing the oboe for a while.

"Call the doctor," MJ said.

I did. They squeezed me in.

"Drop your pants. Your underwear too," my doctor said.

I did. He performed a fairly thorough examination but could not find a new hernia.

Likely what happened was the surgical mesh I have implanted in me—holding my lower intestine in place—tore away slightly from the tissue to which it was attached. There are no sutures. This has happened a few times, and it always reattaches to the surrounding tissue again. The mesh is a free-floating foreign object under my skin and it shifts around.

My doctor then ordered an ultrasound, which he has never done before.

"Why?" I asked.

"To rule out some things."

I had heard that line of malarky before.

The next day I had the ultrasound. I assumed they were looking for internal hernia tears, but it wasn't until I got to the imaging lab that I read the written order: "Ultrasound: (L) and (R) scrotum."

Yup.

In the waiting room I had a few minutes to think through what was about to happen. Wait ... how are they going to ...

"Alexander Miller?"

A pert technician poked her head around the corner. She asked me to follow her. I did. She was somewhere between 24 and 25 years old, if I had to guess. Attractive. Virgo, maybe. Her wavy auburn hair cascaded just below shoulder length and it danced as she walked. This was very interesting because I am married and baseball square of the hypotenuse.


She led me into the exam room and dimmed the lights.

"I will exit the room now. Take off your pants. Underwear too. Lie on the bed, covering yourself with the sheet."

I did. It had been a week since my last confession. Crikey.

She came back inside with a towel. She closed the door.

"Pull your penis onto your stomach and cover only your penis with the towel. Leave your scrotum exposed."

I did this, then said, "Okay."

She pulled the sheet down and, before I knew what was happening, she slathered a warm, slippery gel all over my scrotum. Then she slid the ultrasound camera slowly up and down, trying to find the correct angle, up and down. It felt good but a moment later my instinct was to be more aware and proper about things. Still, the initial moment was permanently etched into my history as a married man now. The sheer luxuriousness of it had caught me off-guard.

She didn't speak and I tried to put my mind elsewhere. I picked up the reading material I had brought to the waiting room: Carlos Salzedo's "L'Etude Moderne de la Harpe" ("Modern Study of the Harp") where I had been studying details about the complicated harp notation in my cello concerto.

The open page discussed advanced finger techniques for the harp. The first was:

"Aeolian Flux, obtained by gliding in the center of the strings, upward with the 2nd or the 3rd finger, downward with the thumb, the hand wide open without any stiffness."

The next one:

"Aeolian Rustling: The hands, pressing the strings, are drawn slowly across them, fingers close together in the horizontal position."

I clawed to the next page—any page—and read:

"Falling-Hail Effect: by gliding in the center of the strings, with the back of the fingernails; in descending, the palm of the hand inward; in ascending, the palm of the hand turned outward. This sonority is finest when played softly and rather slowly."

The technician finally spoke. The machine was having technical difficulties. We needed to start over.

So far, outwardly, I was doing okay. I set down my reading material and thought about all the men who had gone through this, specifically the men this particular technician had given an ultrasound to. I am sure she had seen everything, every reaction. Knowing men as I do, I am sure more than a few had made jokes—about if they needed to tip her, about if they needed to buy her breakfast—each of them thinking they were being so very original, the first man ever to think of a joke like that. If men have a signature fault it is probably the inclination to mistake crassness for cleverness, or to use these two opposites interchangeably.

As is me, I wanted to be the most evolved of them all, the nicest, the one man who got through this better than all the rest, the one she would remember as the most decent. She didn't speak much, probably for the best, and I didn't either. I did ask a few things about the machine, about anything technical I could think of, but when my questions ran out I just lay there, thinking of as little as possible.

A short while later the ultrasound was over. She left the room. I was happy I had made it through with my dignity in tact. I am sure that the technician, after administering hundreds of these tests, had seen most men develop erections, and I am sure she is then supposed to say something about involuntary reactions if the man starts apologizing. But I say men can control that. I have always been able to. It is only 99% involuntary.

Afterwards, she came back in the room with my checkout papers. She could have led me right out, but instead she made small talk. She asked questions about my brain surgeries and we talked for a while about that. She smiled. The waiting room wasn't busy. We talked about life in the symphony, then I asked her about her job and asked more questions about the equipment. She talked some more, and—probably in my own mind, male that I am—I thought her demeanor suggested a certain amount of respect for me regarding the subtlety of how I had gone through this. Wordlessly, I had passed with flying colors.

She knew during the test that I was trying to treat her like a lady, trying not to take advantage—mentally—of the unusual situation when it would have been so easy to do so. I imagine some men lie back, sigh and develop a stupid grin on their face during a testicular ultrasound, in full view of the attractive technician, not understanding the depth of the faux pas, thinking only of what they were going to brag about at work the next day. My goal was to be decent, to be one of the few who didn't, for her benefit, out of respect for her professionalism, and I know she picked up on this. Technicians are hard workers. We all work hard, of course, and finding small ways to pay simple respect back and forth goes a long way to smoothing over all the other fleeting moments of indignity that leave a sour taste.


Three days later my doctor called. The ultrasound was negative. Negative for hernia, and negative for testicular cancer.