March 29, 2011

Let’s get physical

Behind the Book by
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My new book, Physical: An American Checkup, probably sprang from an Abe Lincoln quote I first came across many years ago: I must study the plain, physical facts of the case, ascertain what is possible, and learn what appears to be wise and right. And from crazier notions I came up with on my own, such as: The truth is, I don’t think I’m going to die. Not today, not tomorrow, not in 2067. Not me.

As I reached my late 40s, I thought things like that more and more often. In April 2002, a stitch along the left side of my abdomen suddenly graduated into an aching throb. I’d turned 51 in late March and was just beginning to get my feet underneath me again after the death of my son James from a drug overdose. I had tenure as a lit and writing professor, my second marriage was flourishing, and my book about poker (Positively Fifth Street) was scheduled to be published the following March. I felt pretty good about things, as long as you didn’t count the abscess in my soul where my son lived. But within a couple of days the thorn in my side, as I thought of it, had me walking hunched over like a little old man with bad knees and end-stage cirrhosis, not exactly the image I like to project to the world. As the throbbing intensified, I gulped down more Advil and worried.

I’d been taking Zocor to lower my cholesterol for almost two years, this while neglecting to get my liver function tested. Lynn Martin, my primary care physician, had told me to have it checked after three months because the possible side effects of the medicine included nephritis and liver damage, but I somehow forgot. I knew I’d been dosing myself far too liberally with Advil for headaches and hangovers, so my self-diagnosis was liver failure, though the phrase I used with my wife, Jennifer, was some liver thing. It was only at Jennifer’s insistence that I finally made an appointment to have my liver enzymes tested. I also stopped drinking and, in spite of the crippling pain, as I phrased it to myself, stopped taking Advil, even though I understood the damage was already done. Oh, and another thing, Braino, Jennifer said after wishing me luck and dropping me off at the lab. Your liver’s on your right side, not on your left.

The first appointment I could get was with Dr. Martin’s partner, Dennis Hughes. Tallish, maybe 40, all business, Hughes glanced at the blood test results, felt around where I’d told him it hurt, asked a few questions, then told me I probably had diverticulitis. Your liver’s functioning perfectly. Hughes e-mailed scrips for painkillers and antibiotics to my Walgreen’s and recommended a CT scan of my abdomen, which would confirm his diagnosis. The colonoscopy two weeks later will confirm that it’s all healed up nicely. I nodded. Had I missed something? The practice had just been computerized, and Hughes was happy to demonstrate how my records, medications, etc., were all in the system. The referrals for your scan and colonoscopy are already at Evanston Hospital. Terrific. The antibiotics killed the infection, or at least the symptoms, in a couple of days, so I was able to squirrel the unused painkillers into my party stash. When I called to report the good news, a nurse reminded me I still needed to get a colonoscopy. I’ll make the appointment as soon as I hang up, I told her, then sat down to breakfast, all better.

Days went by. Maybe a week. The pain was long gone, and I’d heard all about colonoscopies. You fasted for two or three days while slurping battery acid; step two involved a fully articulated four-foot-long aluminum bullwhip with a search light, a video camera and a lasso at the tip getting launched a few feet up into your large intestine. Not to worry, however. They used really super-duper lubrication. While discussing some unrelated business with Lewis Lapham, the editor of Harper’s, I happened to mention my gastrointestinal adventure. Next thing I knew, Lewis was proposing that I go to the Mayo Clinic for what he called their executive physical, then write a big story about it. Now, this was a guy who had already changed my life by sending me to cover the 2000 World Series of Poker, so I had every reason to trust him. Yet the Mayo proposal triggered a whirlwind of panic. Accepting this plummy assignment would more or less guarantee I’d be told things I did not want to hear. The good news, Mr. McManus, is you’ve got almost five weeks to live. The bad news is, we started counting over a month ago. What if the Mayo clinicians discovered a tumor the size of a Titleist wedged inoperably between my pons and my creative left hemisphere? What if as they certainly would they made me swear off alcohol, tasty food and my nightly postprandial Parliament Light? It wasn’t that I didn’t understand how lucky I was to be offered a free Mayo Clinic physical, I just had too many other things on my plate turf and surf, garlic mashed potatoes, baked ziti, the take-out Mekong Fried Pork from the Phat Phuc Noodle Bar. But no! Not only would I have to drink gallons of icky stuff before I got reamed, they’d make me give up all the good stuff! To say nothing of my terror that the verdict might not be all that rosy.

Bottom line? I couldn’t get more medical treatment unless I followed up like I’d promised: my referral was already in the system, gosh darn it unless I got a colonoscopy as part of the Mayo thing. That way I could get everything checked in 72 hours, all under one roof, by the best of the best of the best. It was time to cowboy up and take my medicine.

Poker columnist for the New York Times and author of the bestseller Positively Fifth Street (2003), James McManus has also written four novels. He teaches writing and literature at the School of the Art Institute of Chicago.

James McManus

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By James McManus
Farrar, Straus
ISBN 9780374232023

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