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I've been dealing with a lot of doctors lately, urologists, GPs, sonogram technicians, and I've noticed that each of them, regardless of specialty, has raw, pink hands from the sterile ointments they rub into them, and the rubber gloves they must wear before examining someone. They're not interesting hands. You shake hands with a gardener or an auto mechanic and you find thin black arches under the nails. These hands touch the unwanted part of reality, the loam and the worms, the white roots just under the brown surface of the ground; or the black grease of an axel, a brake lining, a leaky gasket.

Doctors seem unaware of their hands, even when they rub them while talking to you. But such hands dig into the quick of your life at times, and sense strange anomalies buried in the bloody swamps of your viscera, under your ribs, in the mesh of muscle and nerve of your back. When such fingers prod you, the doctor's face is aloof and expressionless, the eyes unfocused. He's thinking, he's remembering all the other cases that felt like this, that had this peculiar density of a small globe of tissue hiding out from such a prying mind. You lie there with your malady exposed at last, as if a mole had been trapped in one of the tunnels running under your skin.

You feel guilty for having allowed such a thing to coexist with you, as if you lacked the will power to get rid of it yourself. You had to hire this man with bifocals and neck wattles, this creature with flabby muscles and odorless breath to pore over you and discover the root of your pain. When he finds it, he alters his mood slightly. A smile almost appears on his lips, but is restrained from blooming into self-congratulations. He drops behind a mask of professional indifference, except to say with his suddenly animated eyes that he has something to tell you.

I avoid doctors, always have. My family was never eager to visit one, partly for fear that it would cost too much, or that some unwanted prescription would make them dependent on a med with unsavory side effects, like nausea, upset stomach, constipation, a racing heart beat. You took your discomfort in stride, unless it was a toothache. Dentists were not to be feared, except when they took out the extraction pliers and brandished them over your bloodless expression. Otherwise, you soldiered on.

I never really had a family physician, or used the expression, "my doctor." I had no personal link with anyone in a white jacket and stethoscope. I didn't like the smell of a waiting room, or the sad looks of the people waiting for their names to be called. I hardly ever associated with really fat middle-aged men who couldn't even cross their legs or sit comfortably in a chair. Everyone seemed doomed in such palely lit rooms; the nurses were chatty and occupied with clerical busy work until it was time to call up some new patient, who might learn in the next few minutes that he or she was dying of an incurable illness.

Once inside, at the other end of a short desk, sat the doctor scrutinizing the results of your test. You had all the time in the world to study the pink, raw hands of the man, hands that looked a bit like deep-sea creatures that had slithered into a diver's lamp for a moment. After my middle brother died of testicular cancer, Lance Armstrong's teratoma, I had my own testicles examined over a flashlight to see if the doctor could spot any discolored matter in them. He found nothing. Out in the daylight, the hands of this man disappeared into the flight of a robin returning to its nest with a worm. I rejoiced in my status as a normal, healthy person.

Then my older brother came down with prostate cancer in his late sixties and chose not to have the gland removed, even though a sizeable nodule had lodged itself there. He hated what he called Cartesian medicine, allopathic remedies of all kinds, anything to do with chemicals alien to nature and the body's innate defenses. So he braved it for a few years until the cancer spread, and his leg grew to the size of an old tree and suppurated. He came to live with me and I took care of him as best I could, then the Hospice nurses arrived with their bottles of opiates and a hospital bed. He died peacefully enough, on an island in the middle of a morphine sea. He never complained or rebuked himself for ignoring the stark warnings of the doctor who put his hands under a running faucet after pulling off his rubber gloves. He had remained true to his stubborn nature, and was dying like an ordinary soldier.

Then I began to falter a little, and noticed my bladder wasn't emptying as it should. My instincts told me to weather it, to be tough, to be like my brother as much as I could. But having seen him wither away to a bony outline with the skin barely able to contain him, I had to surrender. I was in France at the time and was led to a waiting room where shy Arab men were crumpled up in chairs, avoiding everyone's prying looks. We were all the condemned in that miserably dim chamber, trying our best to sit on enlarged prostates that sent shooting pains up out of the secret hiding place where they lodged like land mines. One by one our names were called and we filed in to be interviewed, and were told to drop our trousers for a gloved inspection of our prostates. My bladder was measured from a sonogram and I was informed that I was holding three times the amount of urine the bladder was designed for. The doctor asked me in a jovial way to go to the bathroom and empty the rest of my bladder so he could measure it again. I passed a few drops and returned and he showed me the blurred picture of some tissue looking sore and inflated. I was plugged up, corked like a bottle of wine, he said.

The French urologist had an office just off the waiting room. Half of the floor was dominated by a Bhuddist altar, with a small fountain, some figures in stone with hands outstretched. He said I had no nodules to speak of, and that I was suffering from an enlarged prostate, the work of at least ten years of neglect and ignorance. I should have consulted someone long before this. My kidneys were overtaxed and possibly damaged from being submerged in ureic acid all these years. I had to be catheterized at once and to undergo a rather complicated operation to clear the urethra. He encouraged me to return to the U.S. to have the work done; I might not find French ways all that reassuring, even though he had the right hands, raw and pink, and with the same transparent cuticles as any other doctor in the world.

I was wearing diapers by then, after suffering several humiliating accidents of a distended bladder unable to contain its cargo. I agreed to return to the U.S. and to enter into the medical labyrinth ruled by a Minotaur called Big Pharma. I found a doctor soon enough, and his hands were suitably shaped and colored by the nature of his work. He made a joke as he examined my prostate with two greased and gloved fingers. "It's to get a second opinion," he said, before adding, "I believe in levity." He started from scratch, taking blood tests, biopsies of the gland, and poring over the results at a small table in the examining room. He wore short-

sleeved scrubs and scuffed tennis shoes; his arms were lean and hairy, and tapered down to those lobster-colored hands and their unworldly fingers. It would be these fingers, he explained to me, that would descend through an incision in my groin and literally pluck out the prostate. The way he crooked his fingers made me think of a Borneo hunter hooking onto a grub in a fallen tree, with its white body writhing in his hands before he swallowed it. He said the incision was about the same width as a C-section, but he didn't see the irony of his comparison. Here was the base of my manhood, my only reason for living as a reproducer of my species, being yanked out like a broken part of a car motor, whereas the other incision was to deliver a fetus into the world. We were at far ends of a spectrum, this young mother and I. I was the worn-out male, and was to undergo a kind of emasculation to allow me to grind up a few more years in my breath and heart beat.

I have my catheter hose strapped to my hip, and a night bag hung from the wastebasket beside my bed. I hear the Canadian geese flying by, chattering like old women over a backyard fence. I hear the wind rattling the last leaves in the maple trees. The rains have returned and soak the browning yards, and leave a visible trace of coyote tracks in the earth. Life pulsates and pushes immortally through the changing seasons, and the earth has no notion I am lying there trying to decide if I have finally arrived at a tragic crossroads in my life.

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