An Unexpected Twist (Kindle Single)
Author: Borowitz, Andy
Date: 2012-02-15 09:00:00+01:00
Keywords: Health
Description: Andy Borowitz almost died, but lived to tell this stranger-than-fiction tale. In his first-ever work of autobiography, the comedian and New York Times bestselling author tells how a freakish medical condition descended upon him one October afternoon and led him to the brink of death – in a New York hospital “consistently rated one of the ten best in the country.” What happens when “one of the funniest people in America” (CBS News Sunday Morning) comes face to face with his own mortality? An Unexpected Twist is in equal parts harrowing and hilarious – and a moving affirmation of what it means t

An Unexpected Twist

a true story

by

Andy Borowitz

For Olivia

When my wife suggests we have sex and I turn her down, that should be a sign that something is terribly wrong.

It's a Wednesday afternoon in October 2008. Olivia and I are finishing lunch at a Mediterranean restaurant on Columbus Avenue, just around the corner from our apartment. We're both writers, a situation that has its pluses and minuses. One obvious minus is that it's harder to procrastinate when there's someone in the same apartment who can see you downloading obscure George Michael songs. But a clear plus is that you're both available during the day to do things that people with actual jobs would have to leave work to do, like go to the DMV or have a quickie.

But today I'm not feeling up to it. The last couple of days I've been having weird symptoms: bloated stomach, abdominal pains. And I've been constipated, which is odd for me, because one thing you need to know about me is that I'm very regular. (I know that sounds like bragging, but as we age we wear that sort of thing like a badge of honor.) So after I run down these symptoms for Olivia, we do what any sensible people would do in this situation: look for reliable medical advice online.

Luckily for us, the Internet tells us that there are two easy fixes for constipation: prune juice and exercise. So I'm off to the supermarket to get some prune juice, and off to the gym to run three miles on the treadmill. Then back to the apartment and to the bathroom where, contrary to everything we learned on Yahoo Answers, nothing happens. If anything, I'm feeling even more bloated than before. I lift up my shirt to check out my belly in the mirror, and I think: Where have I seen a belly like that before? Oh, right: naked pregnant Demi Moore.

At this point you're probably thinking that this would be an excellent time to call my doctor. Unfortunately, I don't have one. I stopped seeing my last doctor after I decided that he was devoting too much of my annual physical to updating me on the scorched earth battle over his child-support payments.

My wife suggests we call our health insurance company's hotline, which she does and reaches a nurse on duty. After Olivia fills her in on my symptoms, the nurse wants to know the last time I passed gas. I realize at this point that my recordkeeping in this area is terrible. So the nurse asks my wife to ask me, "Was it in the last twenty-four hours?" I think about it, and I'm like, "You know, I don't think so." After Olivia relays this information, the nurse says, somewhat ominously, "You've got to get him to an emergency room right away."

Olivia immediately knows which hospital to go to. A number of her friends did their residencies there and speak glowingly of it; plus, it is consistently rated one of the ten best hospitals in America by whatever is the Zagat of such things. So as we head over there, I feel confident that I'm going to be in good hands.

We get to the emergency room and check in at the Triage Unit, which I must say is not at all a reassuring name for a unit. I could off the top of my head think of a half dozen better names for such a unit, such as the "Help Unit" or "The Feeling Better Soon Unit" or the "Probably Nothing Terminally Wrong with You" unit, but they're going with "Triage." The intake nurse asks me, "Can you rate your pain on a scale of one to ten?" I say "six," which I soon realize is a huge mistake, because right away an enormous sense of relaxation descends upon my case as the ER staff attends to the people who said seven through ten.

I have to wait two hours before anyone sees me. Finally, they do some x-rays, and I'm taken to an examining room to wait for a doctor. The door opens, the doctor enters, and he is… twelve. I feel like I'm being waited on at the Apple store. I show him my bloated belly.

"So, Doctor," I say, trying to keep a straight face as I call him that. "What's going on here?"

"My diagnosis is distension."

"You mean my stomach is distended?"

"That is correct."

I instantly realize that I'm not dealing with Dr. House here. But he's a nice kid, and it was thoughtful of him to skip Model U.N. to see me. He orders a CAT scan, which I submit to, and for the next couple of hours a parade of other doctors comes into my room to talk to Olivia and me. Disturbingly, each new doctor is higher on the medical hierarchy at the hospital than the last, until I'm pretty sure that the next person who comes in to see me will be Hippocrates, the Father of Medicine. Finally a doctor comes in with the CAT scan results. He's around forty, with perhaps enough medical training to deliver a more nuanced diagnosis than Big Belly Syndrome. Alarmingly, he introduces himself as a Surgical Fellow. The only word that's worse than "triage" is "surgical" because you know something bad is about to happen.

"Well," he says, "we have good news — in a way — which is that we know what's wrong with you."

"What is it?"

"Your colon is twisted."

Oh.

He explains that this is a condition called a Sigmoid Volvulus, which means that the colon has formed a knot. Nothing's going in and nothing's going out — it's like Midtown.

Now, Olivia is a former journalist, so she has a knack for asking the perfect question that gets right to the heart of the matter: "Is he in danger?"

"Yes."

I should probably mention that at this point Olivia and I have been married for nine months. And these have been the happiest nine months of my life; just being with her has erased the sadness of all the years that came before. And during those nine months, many times I have said to myself: "Life is so awesome right now, it would take something really freaky to fuck this up."

So I ask the doctor, "What's next?"

"Well, we have two options. The first is something we'd rather not do, which is emergency surgery. That's where we go in, cut out the part of the colon that is twisted and then sew the two ends back together." He explains that the reason this is not a good option is that the colon is a very contaminated part of the body, and when you do emergency surgery down there, the chances of infection and then sepsis setting in are pretty high. And that can kill you.

I ask, "What's the other option?"

"We take a colonoscopy tool with a camera on the end of it and insert it up your rectum and try to untwist your colon manually. If this works, we'll spend the next couple of days flushing out your system, getting your colon nice and sterile, and then we'll do the operation to remove the part that was twisted. This way the operation will be under optimal conditions and it'll be perfectly safe."

So I'm like, "Shove the camera up my ass, let's go."

They prep me for the procedure, sticking an IV needle in my arm and giving me a morphine drip. Disappointingly, the morphine isn't making me high, but at least it's helping numb the excruciating pain in my stomach. Olivia holds my hand, and I start to calm down, looking into her eyes.

She and I met two years before, at a party thrown by a mutual friend. The party had a gimmick: everyone was supposed to bring a book and leave with a book that someone else brought. Olivia brought The Things They Carried; I brought the novelization of Snakes on a Plane. When the party was over, my book was the only one that nobody bothered to take.

The first thing I noticed about Olivia was her smile. It seemed to me like a borderline superpower: She'd smile at you and you'd feel like you could never be sad again. After spending the entire party flirting with her, I went home and found her email address on our friend's party invitation. (It's handy, from a stalking perspective, when people don't use BCC.)

Over the next few weeks, we went to dinner; we played bocce in a bar; we went to the much-hyped Lizards and Snakes exhibit at the Natural History Museum; and we went to a rooftop party in Brooklyn where a bunch of us noticed a woman in a neighboring building doing housework naked. (Since this was Brooklyn, we weren't being creepy voyeurs — we were making an ironic comment about creepy voyeurism.) As we looked at the woman doing nude laundry, it occurred to me that the sudden appearance of a naked lady might be a good omen. Sure enough, after the party Olivia invited me back to her place for the first time.

When we got there, the lights were low. We sat down on her couch. She unzipped her hoodie. She reached under the coffee table and pulled out… Boggle. Yes, the word game, Boggle. We played Boggle. More accurately, she kicked my ass at Boggle. And then, perhaps out of pity for kicking my ass, she kissed me.

A few days later we were in bed at my apartment and I said: "I just want you to know that I'm open to the idea of getting married and having kids."

She said that that was very sweet, but not entirely necessary to say on a fifth date.

What can I tell you? I'm old school. I believe in letting a woman know your intentions. And I wasn't kidding around: three months later I take her to the Caribbean and ask her to marry me. She says yes. A year later we get married in my apartment. And nine months after that, here she is, holding my hand, as a doctor prepares to shove a camera up my ass.

***

The procedure takes about ten minutes, and it works.

My colon now untwisted — by hand, the artisanal way — I'm given a hospital room, where I recover from the procedure by watching a replay of the Obama-McCain "town hall" debate that took place earlier that night. Maybe it's the morphine talking, but it is the most hilarious TV show I've ever seen.

As planned, I'm supposed to spend the next two days having my colon flushed out in preparation for the surgery on Friday. In addition, the day before the operation, I'm to undergo a proper colonoscopy just in case there's anything else lurking down there — like cancer, for example — that the surgeon needs to know about. In order to clean me out for this procedure, I have to drink a half-gallon of a laxative designed especially for this purpose called GoLytely™. (Presumably, the pharmaceutical company executive who named it thought that it was a good idea, right before a colonoscopy, to evoke memories of Breakfast at Tiffany's.) After I finish drinking this stuff, which on the taste spectrum is a stone's throw from orangutan pee, I wait for it to take effect. Sure enough, in a few hours something happens which might best be described as a shit tsunami. I am cleansed.

During this two-day flushing-out period I'm sharing a hospital room with an elderly Italian gentleman whose vocabulary seems to consist of exactly one word: "Nurse!" He calls out this word in regular intervals, and since he seems oblivious to the call button by his bed, the word begins to take on the character of a religious incantation.

Here's a sample of the standard dialogue that occurs between the two of us:

"Nurse!"

"Sir, there's a call button that you can press if you need a nurse."

"Nurse!"

"You see, the nurse can't hear you — she's at her station somewhere else on the floor. You really need to press the button to call her."

"Nurse!"

After about a dozen of these exchanges I realize that it will probably be less maddening if, when he says, "Nurse!" I just call for a nurse using my call button, so I get in the habit of doing that. Besides, I feel sorry for him; a lot of friends have come to visit me — not to mention Olivia, who's been at my bedside most hours of the day — but this poor old guy seems to be all alone.

I send out a mass email telling friends about my impending surgery. In response, I get a call from my friend Nina, who turns out to be something of an expert on gastrointestinal matters. (You never know this sort of thing about your friends until you have a twisted colon.) She recommends that I see her G-I specialist for a second opinion before my surgery on Friday. I reassure her, telling her I'm sure the surgeon the hospital has picked for me is fine. This is, after all, one of the ten best hospitals in the country.

She asks, "Who's your surgeon?"

"Dr. Wu."

"Are you happy with him?"

Actually, I haven't met Dr. Wu. All I know about him is that a nurse wrote the words "Dr. Wu" on the whiteboard in my room. But even if I did meet him, how would I evaluate a surgeon's qualifications? A surgeon is like a car mechanic — you only know how good he is after the job is done.

Seconds after I hang up with Nina, a group of about a dozen Italians of various ages and sizes march into the room, bearing food and a colorful assortment of get-well balloons. They're here to see my roommate: he's not alone after all! For the next thirty minutes, it's like the Feast of San Gennaro on his side of the room. They're talking, laughing and having a wonderful time — and I don't mind at all, since I'm relieved that the grim picture I had painted of this man's life turned out to be so wrong. Eventually, visiting hours end, and they all head out. All is silent again. Until a few minutes later, when I hear this:

"Nurse!"

***

The day before my operation, I am wheeled into another room to have my colonoscopy. They stick a needle in my arm to administer the anesthesia, and I begin to feel drowsy. I hear a woman's voice: "I'm Dr. Singh and I'll be doing the colonoscopy." I turn my head and see the doctor. She is thirteen. Well, at least we're moving in the right direction.

The colonoscopy doesn't turn up any nasty surprises, so my operation is set to go as scheduled on Friday. Thursday evening, I have a visit from the anesthesiologist who is going to dope me up for my surgery. It's the hospital's protocol to brief the patient on his anesthesia before the surgery and then to have him sign a release indicating that he understands all the drugs that are about to be pumped into him. My anesthesiologist explains that, in addition to the general anesthesia, I will have an epidural stuck into the base of my spine to block off any feeling in my abdominal region: "This is because there are cases of people who, despite being unconscious for their surgery, still felt the pain of being operated on."

"Really? But if they were asleep, how do they know they felt pain?"

"Because they experience memories of chronic pain for the rest of their lives."

Oh.

I sign the release. I understand.

Friday. Time for the operation. After a brief, surreal visit from therapy dogs (two Golden retrievers) I am wheeled into the OR. The epidural is inserted into my spine and I am given general anesthesia, knocking me out. When I open my eyes, the surgery is over, and I am told everything has gone as planned. I'm wheeled back into my room to recover, and a few hours later, I meet my surgeon for the first time.

Dr. Wu is a very pleasant Chinese gentleman of few words. He speaks perfect English but he's chosen to speak it in a very abbreviated, clipped fashion, sort of like Confucius on Twitter. Everything is like four characters and he's out.

I ask, "So, when you got in there, what did you do to my colon?"

"Removed two feet."

"Why so much?"

"Colon was redundant."

And that is the extent of my conversation with Dr. Wu. He's gone, out to tweet something to somebody else.

Olivia takes me home and we're both feeling like we really dodged a bullet. This feeling, unfortunately, is short-lived. Once I'm home I begin to notice that I'm not feeling so great. I have chills and I climb into bed, pulling the covers up to my chin. Every time I sit up I vomit, and this gets worse and worse. I've vomited in my day, in college mainly, but this is continuous vomiting, uncontrollable, like I've just seen a Matthew McConaughey movie or something.

We know something is majorly wrong so Olivia calls Dr. Wu's office. His nurse says we should come in and see him. Dr. Wu examines my belly and sees that it's bloated again. Not in Demi territory yet, but definitely a baby bump. He says this may be because the large intestine and the small intestine aren't working in concert yet. Okay, so what we have, basically, is a syncing problem. But why am I so bloated? Dr. Wu explains that when you breathe, you take in air that eventually is expelled when you pass gas, and I'm not passing gas yet. I ask, what can I do about that?

Dr. Wu: "Maybe don't talk so much."

Easy for him to say.

I ask Dr. Wu if he's worried that something has somehow gone wrong. He says he is "concerned," but not enough to admit me to the hospital right away. He says there's a long line at the ER right now; better to go home now and see if I'm better in the morning. He writes me a prescription. I ask him what it's for.

"Enemas."

He tells Olivia that she needs to give me one enema at night and one in the morning to see if this relieves the bloating. We leave his office and wait for a taxi in the hospital's circular driveway. As we wait for a taxi, Olivia looks over at me. I look gray.

We stop at a CVS near our apartment to get the enemas, and a few minutes later I'm on our bathroom floor, naked on all fours, waiting for insertion to commence. Nine months earlier, when Olivia and I were exchanging wedding vows, we made absolutely no mention of shoving enemas up each other's asses. And yet here we are. This is what it means to love and be loved.

If you have never had an enema before, all I can tell you is that it feels… amazing. Well, that may be overselling it. I feel a cool sensation back there, and maybe it's just the novelty factor, but it momentarily distracts me from my nausea. Other than that brief enema high, though, nothing about my overall condition seems to change. I vomit throughout the night, and after Olivia administers the second enema at 7 AM, we both decide it's time to get back to the ER, line or no line. As I step out onto the sidewalk, everything goes white. Not the "white light" we've all heard so much about, but the lightheadedness that comes from having zero blood pressure.

At the emergency room we head straight for the Triage Unit. The intake nurse on duty says, "Can you rate your pain from one through ten?" And I'm like, "Ten, motherfucker!" Which turns out to be the correct answer, by the way, for future reference.

They take my vitals. I am so dehydrated from all of the vomiting that my heart rate at rest is 120. My blood pressure, as I suspected on the sidewalk, is crashing. I am in a medical state known as "organ failure": my organs are now failing. They strap me to a gurney, put an IV in me, and start pumping me with fluids. They thread a tube up my nose and down my throat. My entire gastrointestinal system is backed up, not functioning at all, and my stomach has filled with bile. They start pumping it out of me and it just keeps on coming, quarts and quarts of bile. They do an emergency x-ray of my abdomen, and a few minutes later, in comes Dr. Wu.

He explains what he saw in the x-rays: When they sewed my colon back up, it somehow sprang a leak. They can identify escaping gas in the vicinity of my liver. And the stuff that's in my colon is now, as we speak, leaking into the rest of my body. So at this point "Shit" is both a justifiable response and an accurate diagnosis.

Dr. Wu says he has to operate.

I say, "Are we going to do that thing we did before where we flush out my body first and we get things nice and clean and then you operate?"

Dr. Wu says, "No time for that."

In this instance, Dr. Wu's abbreviated mode of speech is appropriate to the situation, that is, global organ failure. But his news is unmistakably dire: this is going to be emergency surgery, exactly what we were trying to avoid last Wednesday night. Because it can kill you.

We made a huge mistake. We should have checked into the emergency room the day before, at the first sign of trouble. Now, after a night of vomiting and dehydration, my entire body is struggling to survive, and it may be too late.

I can see that Olivia has another one of her journalistic questions coming on, but this time she takes one of the residents outside and asks it out of my earshot. When she comes back in, there are tears in her eyes.

I say, "Did you get some bad news?"

She says, "I just love you so much."

And I say to myself: I am fucked. Just bring in the rabbi right now because I am over, I am so over.

I can see that Olivia is very upset, really falling apart, so I call out to the nurse, "Can we have a tranquilizer for my wife? She really needs something."

And here is why she's so upset: what the resident has told her (but she has withheld from me) is that my chance of surviving this surgery is fifty percent.

On my way to the OR, a nurse approaches me with a form on a clipboard. It appears to be another release.

She explains: "Since this is a teaching hospital, medical students sometimes watch surgery in progress. This release gives them permission to watch your surgery — which would be really helpful, since your operation is so unusual."

This is not exactly what I wanted to hear at this particular juncture. What I want to hear is something more along the lines of, "We knock out twenty or thirty of these jobs a day — like falling off a log, bitch!" But no, my surgery is "so unusual." I want to grab her by her white coat and say, has this ever been attempted before?

But I don't. Instead, I sign the release. I understand.

I'm wheeled into the OR. As the surgical staff prepares the room for emergency surgery, the atmosphere is jarringly festive. A sound system is playing: Marvin Gaye is singing, "Let's Get It On."

And I think to myself: Well, let's.

***

Three hours later, I magically wake up. I'm fucking alive! And the first person I see is Dr. Wu.

He explains what they've done to me: they've sewn up the leak in my colon and wrapped it up so that it is absolutely airtight. But they don't want to take any chances this time, so they're going to give the colon a few months to heal, and in order to do that, they have diverted my digestive tract "somewhere else." And I'm like, um, what does that mean?

Here's what it means:

They have taken a part of my small intestine and pulled it outside of my body and it is now emptying into something called an ileostomy, which is a fancy medical name for "plastic bag of shit." That's what's there, right now, hanging from the outside of my belly. Dr. Wu has literally torn me a new asshole and it's in the front, where assholes do not belong. So I'm getting this bad news, this fucking terrible, terrible news, and he tweets to me, "Only three months."

He explains that at the end of three months when the colon has completely healed, they'll do a reversal surgery and put my small intestine back inside of me and I'll be as good as new. But I can't focus on any of this. I'm still rocked by the horrible news: how the hell am I going to live with this?

Within minutes, I have my answer — sort of. A nurse appears and starts talking to me about the care and feeding of my latest accessory. It soon becomes clear that her sole job at the hospital is to spread pro-ileostomy propaganda. She has copies of a publication called The Phoenix, a glossy magazine devoted to the ileostomy lifestyle. (Who knew?) You flip through The Phoenix and it's like GQ—there are all these sexy people, and they're at the beach and they're at a barbeque and they're playing tennis and they're dancing. But the one unspoken thing they all have in common is that under their clothing, there's a fucking bag of shit.

***

We go home. Olivia and I have three months to live with this thing. And here's the thing that they don't tell you in the glossy pages of The Phoenix: when compared to other innovations in medical technology, the ileostomy bag belongs in the same epoch as the leech. It fills up quickly; it leaks; and when your body wants to fart, as it does when it has been furnished with an actual asshole, where does all of that gas go? Into the bag, which promptly blows up like a balloon. Unlike the volleyball-playing, barbeque-attending shit-baggers in The Phoenix, I am under virtual house arrest for weeks. And so begins my Netflix Period.

Olivia is doing an amazing job as my nurse, cooking for me, keeping my spirits up, and helping me with the highly disgusting task of changing the bag. Dr. Wu says it's important to my recovery that I walk, so she takes me for regular strolls in Central Park, walking me around a small oval of pine trees called the Pinetum. I can't go more than a few yards without getting exhausted. And I can't help feeling that I've done a total bait-and-switch on this poor girl. Nine months ago when we got married I was healthy and robust, and now I'm totally broken down. I feel tired and old. Back at our apartment, I look at myself in the mirror: I've lost 25 pounds, I look like a scarecrow, and I've got this — there's no other way to say it — bag of shit hanging from my stomach.

And now, here comes the gross part.

I look at that bag of shit and I notice something weird. I take a closer look and see that the little piece of intestine that they pulled out of my body — it's called a stoma — is protruding from my abdomen further than before. Seen the movie Alien? Rather like that. So it's back to the hospital, back to Dr. Wu, who gives us the first good news since this whole ordeal began.

"Prolapsed stoma," he says.

What Dr. Wu means is that my intestine is coming out of me and will keep coming out of me unless something is done about it. So he moves up my reversal surgery by a month. That means that a month earlier than planned, I'm going to return to the land of the people who have their assholes where they're supposed to be.

My final operation (the third, if you're counting): I'm lying on the operating table, about to be anesthetized. Dr. Wu comes in, looks me in the eye, and says the single longest sentence he's said to me since this nightmare began:

"Look, I know you've had a lot of complications with these first two surgeries, so I'm going to be extra careful this time."

And I'm thinking: Yes! The learning curve. No more boozing it up in the operating room. This time we're going to focus!

***

Dr. Wu is a man of his word. He must have been extra careful that time, because I made it.

I awake from my surgery in a lot of pain and wrapped in an adult diaper, just like the kind spurned astronauts wear when they drive across country to stalk someone. It turns out that one possible post-op complication of the reversal surgery — one that receives scant coverage in The Phoenix, I hasten to add — is incontinence. (Fortunately, the diaper turns out to be unnecessary. Here I go bragging again, but to this day I'm entirely continent.)

There's no hospital room ready for me, so I'm wheeled into this weird barracks-like infirmary in the basement. I feel like I'm in a scene from Atonement. And as I lie in my bed, juicing myself with as much pain medication as my bedside pump will allow, I see a familiar face: the nurse who, several weeks earlier, shared with me her pro-ileostomy propaganda. (I recognize her by the stack of Phoenix magazines she has under her arm.) She sees me and comes over to my bed. I tell her that I just had the reversal surgery.

"How did the bag work out?" she asks. But before I can answer, she leans closer to me and whispers conspiratorially, "It leaked a lot, didn't it?"

***

Three days later, Olivia and I walk out of the hospital, hoping never to return. But twelve months later we're back. This time, though, it's for a happier reason: Olivia is giving birth to our daughter Madeline. There are no complications; everything goes as planned, just as you might expect from one of the ten best hospitals in America. When I contrast Olivia's experience with mine, I can only conclude that the hospital just didn't like me.

One night not so long ago, as we looked at Madeline fast asleep in her crib, I said softly to Olivia: "If I hadn't made it alive, there wouldn't be a Madeline."

She said: "There wouldn't be an us."

Which leads me to the part of this story when I tell you the life lessons my colon has taught me. Someday I'm going to write down all of those life lessons in a book called Tuesdays with my Colon, but until then, here's the main thing:

I was always the kind of guy who went through life saying, "Life is precious, so you have to make the most of every minute." But you don't really believe that or know it or feel it until your life is almost taken away from you. So now, every morning when I wake up, I do two things: I look out the window at the city, the beautiful city, the sun rising over it. And then I look at my beautiful wife sleeping next to me. And I realize at that moment that I've got today, and I have everything.