Me and my big prostate
1. I am sitting surrounded by old men, some in striped pyjamas that may have first seen service at the inauguration of the NHS, and in the background Pick up the Pieces by the Average White Band funks up the action but fails to disturb the somnambulent atmosphere. There are one or two relatives, a wife, a daughter perhaps. Poor old beggars I think. Its some time later that I realise they’re my contemporaries. The few uninteresting magazines on the table housing the water jugs, fail to distract from an endless reading of the plaque on the door opposite.
Department of Urology
Consultant Urologist Miss Nobbs
"Not here to mock, not here to dis,
But Miss Nobbs is here to take the piss."
I think to myself.
If only there were a fish tank with a plastic crocodile that periodically opens its mouth to belch a great bubble of air. That's a good way of killing time, holding your breath between exhalations of crocodile air. Makes you vaguely euphoric and past caring before they even start to invade your private places.
2. I am called to a cubicle by a young Indian or Sri Lankan nurse. She explains in formal Victorian grammar what is about to happen, and asks if I understand. (How many times will I be asked this over the next few months, and how many times will I reply inanely and inaccurately, "yes".) I consider attempting a joke but fear it will not reach the target and abort it in gestation.
An older and altogether more matronly nurse escorts me to a side room where my biopsy will take place. She is quite familiar in a "we're all in this together" kind of way. She explains again what is going to happen, and asks again if I understand. The consultant is running late, and the room fills with a trinity of nurses all in different uniforms, which I assume denotes their rank, rather than their fashion sense. The young Asian and the chunky matron have a spat about who is going to do for me. They must be having a quiet morning. "It is time for you to go to lunch, you should leave now." "No love, I'm finishing at 1.00 today so I'll just see to Mr M." I'm flattered at being the object of such attention. When he arrives, Mr. Patel looks to be about 25, and in a broad Belfast accent explains what he is about to do and asks if I understand.
I adopt the required position, trouserless, face to wall, kecks around ankles, knees drawn up to chest, but before he can start, the quiet nurse at the back, hovers over me and says sweetly, "Oh I'm sorry love, do you mind if I have a go first, I need to get an observed practice in, it won't take a second." "My sphincter is your sphincter";, I say in a flash. No I don't, I only think of his afterwards. What I do say is "are we on Candid Camera? Is there a gaggle of guffawing hospital staff observing this on a staff-room monitor, or is there a queue of junior staff outside all waiting to get an observed assessment towards their NVQ in one-finger prostate thrutching?" I offer to provide a witness statement to back up Dr Patel's assessment, I'm all for on-the-job training. I think I say this but I probably say "OK, anything to oblige." Thank God Dr Patel's hands are slim and delicate. Miss Nobb's are like a navvy's.
3. Before and after seeing anyone on the technical side, if I can put it that way, the nurse counsellor takes you to one side for a little chat to make sure you understand what's going to happen, and what they've just said. "I'm very sorry," she says in a tone that takes me aback and makes me think I'd better listen more carefully. When Mr. Hussain gave me my results, that's exactly how they came across, results, like at school, in one ear and out the other, a temporary suspension of the hearing faculty... "could do better"... "a disappointment"... "must improve"... "failed!" I just shut up shop as he reads from the technical report in front of him. I suppose it's easier than looking at you in the eyes and saying "sorry old son, you've got cancer."
4. Thank you Dr Z for being so intuitive. I only came to check up on my cholesterol level. But you'd been dying to get your finger on my prostate for months and I walked straight into it. "Just a blood test," you said. As my first consultant Mr. Kakoulis, on my very first hospital referral, exclaimed, "Christ he had you tested for everything including pregnancy, but the only thing to show was your PSA." Such flashes of humour, unlike on Green Wing, are few and far between in my short NHS experience.
Six months later you'd think I'd be an expert in the prostate and its malfunction, its symptoms and its treatments. I've read lots of leaflets, listened to nurses, doctors and consultants. I even made the mistake of going on a web-site with a chat room of prostate bores who seemed pre-occupied with outdoing each other's horror stories on what went wrong in their treatment. (It was a US site I hasten to add). Anyway I've read and listened, been offered surgery and brachytherapy, been asked if I understand the implications, and can't stop prevaricating, because frankly neither of them sounds very attractive. I could watch and wait, but no-one's sold that option very strongly. On the other hand the medical profession have to cope with the results of inaction, and having gone to the trouble of diagnosing me at an early stage, it seems churlish, let alone risky, to leave my own little growth to develop at its own unpredictable speed. Choice is such a consumerist dilemma! (2006)