preliminary diagnosis

‘Right – this is where things start to get tricky’ – Mark Burgess (The Chameleons)

Friday 26 August started off as a normal day. I was working from home so I enjoyed breakfast with my lad, showered and settled down to work at my kitchen table around 08:30. I quickly checked my personal stuff – feeds in Google Reader, overnight happenings on the identiverse and my personal email.

The house was pretty quiet as my daughter was working (lifeguard at local recreation centre) and my wife had taken my son to an open day at Southampton University.

I settled down to work (I work in a technical consulting group for Oracle UK) – processing email and trying to clear the decks before a two week holiday – nothing exotic planned apart from a few days with my parents in Cheshire. One email needed my immediate attention before I resumed work on a client report that needed to be complete before the end of the day. A client requested some urgent onsite assistance in Oslo to try to resolve a number of longstanding issues with a Siebel module that synchronises data between Siebel CRM and Microsoft Outlook.

As I had performed the original installation three years ago and was familiar with the customer and the working environment, I was happy to take this work on so I told the account manager and proceeded to book flights to Oslo and a hotel close to the offices.

Somehow, lunchtime had arrived so I quickly rustled up some soup and toast as I had an appointment with the anorectal specialist at 13:45. Still, no problem – I can still finish the report in the afternoon as I only have the technical recommendations and Exec Summary to complete.

I hate doctors and hospitals as they tend to be frequented by ill people. I drove to the private hospital, registered and was called in by the consultant. who introduced himself, read my GP referral letter and then took my medical history about my recent problems with haemorrhoids and the burst abscess.

The doctor wanted to examine me so I knew the drill and hopped onto the couch, pants down, facing the wall with knees raised up. The doctor inserted a finger up my back passage which was not so much embarrassing as very uncomfortable. He then warned me that he was going to probe a little further but I simply had to indicate if this was too painful and I wanted him to stop the examination at any point. I nodded my assent.

The pain was excruciating but I said nothing as I wanted the doctor to get as much information as possible so 20 seconds of pain would be worthwhile. At one point, I gently exclaimed ‘Fuck’ under my breath. The mind is a funny thing – I found myself randomly wondering how homosexuals tolerate the insertion of an engorged 8″ penis into the anus when I am really struggling with a gloved forefinger.

Thankfully, the doctor withdrew his finger and announced ‘The examination is now over’ as I took a seat.

I don’t really know what I was expecting – I think I was expecting him to say ‘Yes Mr. Brightside – you have a severe case of haemorrhoids that you have left untreated for too long. These are now so large and inflamed, that you will need minor surgery to remove them completely’.

Instead, he looked intently at me and said: ‘Mr. Brightside – you have a serious problem in your bottom’.

At another time, in another place, in another universe, I might have been tempted to reply ‘Doctor, you know, my wife has been telling me that for years’ but I didn’t. I sensed this was no laughing matter. This was serious.

‘You have a lump in your bottom that extends up into the lower bowel. The level of pain you experienced during the examination is unusual and caused by the presence of this lump. The abscess has probably been caused by this lump which has also now penetrated the skin wall. However, I can’t say for sure what this lump is until we have performed a biopsy’.

Now, the combination of the pain and this breaking news made me come over all faint. I am crap in hospitals. I have been known to feel faint in certain gory episodes of ‘Casualty’.

‘Mr. Brightside – are you feeling OK ? You look a little pasty. Can I get you a glass of water ?’

I gleefully accepted to cold water and immediately felt better. I spoke but it came out as a whisper – ‘Doctor, I now have to go home and summarise this meeting to my wife who is a nurse. What shall I tell her about this lump ?’

‘Well, as I said earlier we can’t confirm anything until the scans and biopsies are completed but, with my 23 years experience, I would say, in all likelyhood, the lump is likely to be malignant’.

I paused and tried to assimilate what he’d just said.

He continued – ‘The fact that the sepsis has broken the skin wall complicates the issue’.

The doctor emphasised the word ‘complicates’ in the same way I would emphasise the word  ‘suboptimal’ when I tell a customer ‘Your data integration implementation is, err, suboptimal’.

‘Suboptimal’ is a magnificent word for a consultant as it covers everything for ‘Excellent apart from inconsistent code formatting’ to ‘Woeful and needs a complete rewrite that will take months’.

The doctor elaborated ‘…which may need a simple procedure to isolate the area and relieve the bowel from further infection’.

The doctor then asked me to book myself in for an MRI scan, a CT scan and he would be in touch about a date for the biopsy to be done.

The doctor was brilliant but I suspect he could sense I was stunned and shocked. He closed with ‘Mr. Brightside – you are walking out of here the same man you walked in’.

I replied ‘ Yes – but with some rather bad news hanging over me’. I stopped as I sensed my voice wobbling and took another gulp of water.

The doctor looked intently at me again – ‘Yes – but you have presented here today and now we are rapidly putting a plan in place to diagnose and plan your treatment. That is very good news. Now, the necessary treatment is going to be a long hard slog and believe me, this will take months (not weeks) but you are going to come out the other side’.

And with that, in a very British way, I gritted my teeth, firmly shook his hand, thanked him and left the consulting room to book the MRI and CT scans for the following Thursday.

The client report never got finished.