It Only Hurts When I Pee Hee Hee
or How to Kill an Entire Summer—Part III
July 8, 2023
10:23 a.m. The day following the surgery, during Doctor V’s morning round: I gained his permission to record on my iPhone what he was about to tell me beside at Covenant Hospital. I later transcribed our conversation for use here:

Dr. V: … type of bladder cancer, but yeah there are other types and variants, but ninety-nine times out of a hundred, it’s transitional stuff.
RJ: Okay, so you caught it early?
Dr. V: Well, yeah, I mean, the CT does not show that there’s anything outside of that, but one of the key things about bladder cancer, you know, it comes from that transitional epithelium of lining of the bladder, but there’s a muscular wall to the bladder, so one of the key aspects of pathology: Is it just in the lining or is it also growing in the muscle …?
RJ: Mm.
Dr. V: When it’s in the muscle, that’s where the blood vessels and lymphatics are, that’s how the cancer could escape out of the bladder.
RJ: Mm.
Dr. V: So the treatment for muscle-invasive bladder cancer as opposed to what we call superficial bladder cancer is different.
RJ: Okay.
Dr. V: Muscle-invasive actually is a much more aggressive disease stage, and the treatment ideally for a relatively healthy man like yourself, is the removal of the bladder. Which is a big operation. Whereas superficial bladder cancer you trim it off, you basically instill… The drug of choice is BCG, it’s a live, attenuated form of TB, it activates your immune system, to counteract early cancer cells within the lining of your bladder, because they tend to be recurrent. By doing that, it’s not really chemo, it’s immunotherapy for your bladder. It significantly reduces your chances of recurrence.
RJ: Mm.
Dr. V: All right, sir. Fill him full. Make sure he can pee [speaking to nurse]. See me in about two weeks is our plan.

​But I must return to the day before. I was feeling quite good actually; I never experienced any pain in my bladder. But about four hours after surgery, I began to feel extreme cramps in my bowels. I suspected, as with most surgeries I’ve had, that the anesthesia had locked my bowels. A night of hell ensued, by which I could not seem to make clear to the nurses where the pain was coming from as my stomach appeared visibly to distend. They gave me everything from tramadol to a shot of morphine when I told them my pain was a “10.” I had been hooked up to a foley—a catheter that collects one’s urine in a bag. After the doctor told me I’d be going home, they disengaged it, and the nurses did fill me with water—four glasses-worth. Problem was, my urological innards were locked up, as well—I couldn’t pee!—and they sent me home with a different foley. Two sullen nurses entered the room (their routine with their patients had been disrupted) to install it because my nurse didn’t know how, and they were trying like hell to get me out of that room by ten p.m. So I was sent home with that urine bag saddled to my side like I don’t know what. Six days later, it was finally removed at Doctor V’s office, his nurse following the correct procedure (I shall spare you the description). The only problem was that after six days of that damn foley chafing my urethra, it actually hurt to pee. In situations like this you want to blame someone, but whom? The huffy nurses who might have injured me in their haste? The doctor and hospital who insisted I go home without being able to pee? The insurance company that was only going to pay for one night for a supposedly out-patient procedure?

​In any case, starting Wednesday, August 16, 2023, I will begin BCG cancer treatments, once again, in Doctor V's office. Not the hospital! BCG stands for Bacillus Calmette Guerin, a procedure by which the doctor will directly inject (by way of that still handy urethra) a “live attenuated form of TB” into my bladder. Six Wednesdays in a row, ending on one of the last days of summer, September 20. Maybe autumn will be a better time for me, for us all. I sure hope so. We shall have earned a break from the heat.

Coming Next:
TUES: A Writer's Wit | Marjorie Kinnan Rawlings
WEDS: A Writer's Wit | Barbara Delinsky
THURS: A Writer's Wit | Mark Doty
FRI: My Book World | Jhumpa Lahiri, Whereabouts

It Only Hurts When I Pee Hee Hee
or How to Kill an Entire Summer—Part II
The eighth thing the doctor’s staff was about to do to me was to take place as they escorted me down the hall to what looked like a new piece of equipment in a room tinier than the radiology room. A beautiful young woman with dark swooping hair stood by.

“This is my daughter,” Doctor V said, “blah blah blah, she’s out at the med school.” And she smiled at me.

Now, the good doctor told me to lie back in the chair. “It’s kind of like a recliner,” he informed me, “but it isn’t really built for the patient.”

No shit.

It was fucking hard—unforgiving, like a seat pulled from an old MG Midget—and I swear I think I remember there being stirrups for my legs. Of course, my pants were pulled down, and the good doctor seated, manning his equipment as if he were a jet pilot, pulling at this lever and that knob, typing shit onto his keyboard. He wrapped a piece of pale blue paper around my wee cock so that that was all that was showing, as if my cock were a discrete sort of apparatus—something in his way, not a precious portal to my innards. Doctor V injected some deadening gel into my cock, unfortunately not deadening enough. Before I could scream or in any way protest this brutal, barbaric treatment of my member, he slid a probe in there and kept shoving it inside until . . . then he brought to my attention two computer monitors joined together in a “vee” . . . and he, oh, by the way, it felt like my wee cock had been connected to an electric socket, especially when the flow of water meant to cool things down surged all around my wee urethra. Anyway, he talked me through it, narrating as everyone in that tiny room, including the doc’s daughter, for Christ’s sake, listened:

“Here’s your prostate,” he said, pointing to the monitor. “Except for being about twice as large as it was four years ago, it looks to be in good shape.” (Is this yet another problem I’ll have to face in the years to come?)

By then I realized my hands were grasping—no gripping—the armrests, reentering the earth’s atmosphere. Sweat flying from my forehead, challenging my deodorant. Then the doc gave me a good view of my bladder. It just appeared like pink skin to me.

Then, he announced, “I don’t like this,” and he made me turn my head while my hips make their Saint-Vitus-dance my hips dance so I could view the monitor to my left. “This is not good,” he said, pointing out a whitish, lacey-looking growth. “We’ll have to shave it off.”

“Today?” I asked, alarmed that I might have to squirm through yet another procedure.

“No,” he said, looking at me funny. “No, we’ll set up a hospital appointment. You’ll be sedated.”

“Thank Christ,” I mumbled, hoping my curse hadn’t offended anyone.

All in all, I was in that office for nearly three hours. Must have been sixty of us being shuffled in and out of those wee, antiseptic rooms like Marx Brothers’ characters—peeing in cups, giving up blood, having x-rays taken, being prodded and poked—then escorted back to what nurses kept referring to as the lobby, as if we were guesting ourselves at the Waldorf-Astoria—made to sit and wait (it was a waiting room, let’s be clear) for the next round of torture.

But then, there was no more. I was told I would appear at Lubbock's Covenant Hospital on July 7, where the doctor would “shave” the tumor and have it biopsied. Yippee!

NEXT TIME: In “It Only Hurts When I Pee, Part III,” I give you Dr. V’s blow-by-blow description of what is to come.

It Only Hurts When I Pee Hee Hee
or How to Kill an Entire Summer—Part I
No, I do NOT have an STD, but ha! I hope my title got your attention. This post is about something perhaps just as menacing: cancer.

I wasn’t sure I was ready to blog about my bout with this disease. Most of my posts share quotes from others more eloquent than I, “A Writer’s Wit,” or ascribe my take on literature, “My Book World.” But if I don’t write about my cancer, it might otherwise wind up as something-swept-under-the-carpet—mentally, emotionally—something I wish to avoid. Must I share? you might wonder. Yes.

The turmoil began when I noted blood in my urine. Knowing better than to fool around with a symptom as obvious as that (never a good one), I immediately made a quick appointment with my urologist, whom I’ve consulted for over twenty years.

My appointment with Doctor V began at 9:30 a.m. on June 13, two days after my seventy-fifth birthday. I mean, I had to stop and think. Edith Wharton lived to be seventy-five. Penny Marshall lived to be seventy-five. So too, her once-upon-a-co-star, Cindy Williams. I’ve had a great life, I say, trying to bolster myself. Anyway, the doctors and his staff did at least eight things to me while I was present for my two-hour-and-forty-minute appointment.

1) They took an EKG.
2) They took and tested my urine.
3) Took and examined my blood sample.
4) & 5) Gave me an antibiotic shot in EACH buttocks.
6) & 7) The office was a sprawling building. My doctor and a second urologist maintain their own radiology lab, employ their own radiologist, who x-rayed my kidneys. (I think this is right. Things moved so quickly.) The rugged man with a gray beard but the hardbody of one who works out at Golds told me mechanically (because he must repeat the same words thousands of times a day) to lay on the table. It was a high, narrow sort of table, with a footstool to help me up. And above me loomed that X-ray machine, threatening to create solarized pictures of my organs. The radiologist entered the adjacent room, his office, to execute the x-rays (Hold your breath please|click|you may breathe).

When done, he determined all the images were viable. The radiologist disappeared into his office again. He emerged and informed me both kidneys and prostate were healthy. Yay. 

This same man then slathered cold gel over parts of my body, injected it up my rear end, and stuck a probe up there to take sonograms of my kidneys, my prostate? (Again, I know he told me, but I couldn’t seem to retain the information.) I just wanted the barrage against my body to be over. When finished, he handed me the large, gel-soaked piece of paper I’d been laying on, and pointed also to the cute stand with rolls of toilet tissue. 

     “There’s more paper over there,” he said, “if you should need it to wipe off the gel. Put all that paper stuff over there in that big red container, not in the trash can, and I’ll leave you to get dressed.” 
NEXT TIME: In “It Only Hurts When I Pee, Part II,” I share the gruesome details of another test, the one that reveals I have a bladder tumor.