“My second cycle of chemo isn’t working,” Molly said.
“So this is good-bye.”
“I’m sorry,” Sunderson said, feeling paralyzed.
“Do you believe in the afterlife?”
“I haven’t figured it out. I guess I’m not very religious.”
“I don’t think anyone has. Someone said, I forgot who, that if nothing happens we won’t know it. I’ll miss flowers, birds, and lemonade.”
The Great Leader (Grove Press, 2011)
. . . . . . . . . .
“Life’s a journey and its always most interesting
when you’re not sure where you’re going.”
. . . . . . . . . .
“Life is hard, and sad, but that’s why we have humor. It’s the best medicine and the best conversation starter. Laughing and crying is almost the same thing at times. And we need a little of both.”
Mary Grace McKeen
Note to her father, 2 July 2015
. . . . . . . . . .
It was time to say farewell to the bag and its foul contents, which had sometimes resembled jellied gravy. Just when I was finally used to it, it was being taken away.
Christian Corwin was ready and so was I — this was my fifth surgery in a year. It was a subdued affair and I was used to the drill: a couple of hours of intravenous fluids, visits from the nurses who would accompany Corwin on his spelunk through my guts, rolling down the hall to the operating room, then an hour of unconsciousness. Then the recovery.
The recovery was easy this time. I was put in another wing in the hospital, this one somewhat quiet and forlorn. I spent a lot of time looking out the window at Weymouth’s Main Street. I was eager to start over, nervous about what came next.
I didn’t have many visitors this time, aside from nurses. Sleep was impossible. I used to think of hospitals as great places for rest. During my cancer surgeries, they’d been torture chambers for the insomniac.
The nurse-navigator from Dana Farber showed up. At first, I’d joked about that job title, calling her the nurse bombardier. But she played an important role for me.
Marian Gilmore was the point person for patients at the Multi-Specialty Clinic. Corwin was remarkably accessible — hell, he gave me his cell number — but when I had a question (Where do I go for this treatment? I’m not sure this medicine is working. My feet hurt), I’d go to Marian and she made sure I got the answer.
She came by my last day in the hospital, as I was waiting for Nicole to pick me up. I was sitting by the window when I turned at the sound of a voice.
“Mr. McKeen? How are you doing?”
“My navigator! Thanks for coming by.”
“I always try to get around to see our patients. I came by once when you were here before, but you were out. I mean out.”
“That was probably a couple of surgeries ago.”
“Probably. You’ve had a lot.”
“Yeah, Buddy. I’m getting to be an old hand at this.”
“Well,” she drawled. “Let’s hope this is the last one.”
I rolled my eyes. “When all of this cancer stuff is over, I still have to have kidney surgery. I’ve been putting it off until I finished with Corwin.”
“If you have to be sick,” she said, “you couldn’t be in a better place.”
“I know,” I said. “The quality of care is phenomenal.”
Of course, she was a large part of it. Everyone at Dana Farber — from the nurses and doctors and navigators and tail-gunners, to the parking-lot attendant, the receptionist and the sandwich lady — gave me the feeling that they cared about me, and all other patients.
In a way, I’d grown to miss the daily visits for radiation and the chemo afternoons. There was a camaraderie in the infusion suite.
Later that morning, Nicole picked me up and after a couple of days at home — with a toilet nearby for those sudden urges — I seemed to be doing okay. I was watching television in the family room once when the need struck and I had to bolt at 50-yard-dash speed to the bathroom at the other side of the house. I made it, but barely.
When Corwin had told me I had to re-train this new rectum — the bionic butthole in JackSpeak — I joked that I’d get it to fetch, roll over and bring me the Boston Globe every morning.
But the hard part was to create a muscle — a sphincter — where there had been no sphincter. All I had now was a sphincter made from something that my body had been using for another purpose. It’s tough to start a new career at 60.
“I’ve never had this done to myself,” Corwin said, “but there’s one thing all my other patients have told me. You ready for this?”
He spoke slowly, enunciating each word carefully and emphatically. “Never. Trust. A fart.”
“Dude,” I said. “That word. I hate it.”
“Hate the word or not, do not trust a fart. Because from here on out, it’s never really just a fart.”
He looked at me expectantly and continued. “You’re all new down there. You’ve got to retrain your rectum because right now it has no control. It can’t really hold things down. Or back, I guess I should say.”
I vowed to be careful — when I experienced flatulence.
Post surgery, the angry red nipple on my lower abdomen was gone. In its place was a small hole, not entirely sewn up. Corwin said he wanted this to drain and to essentially heal itself.
I wondered why he hadn’t sutured it himself, but I figured he had a reason. Because I was still draining, he had me uncover the wound a few times a day and to remove some wadded up fabric. Everytime I pulled out the fabric, it tickled the abdominal wall. After a couple of days, I could tell a difference and the healing was proceeding apace. I wrote it off to Corwin’s remarkable sorcery.
I knew i had to return to work. My office is across the hall from the faculty men’s room. That made for an easy sprint. No problem there.
The problem was the commute. I held my breath during the first train ride — 45 minutes to South Station. I’d always find a seat on one of the cars with a bathroom. These were barely larger than bathroom compartments on planes, but they would do.
First couple of days: no accidents, though I had some close calls.
I began to feel cocky. I got this fucker beat, I thought.
At work, I could function as normally as I ever could, though I made frequent bathroom visits. When I felt the urge, I had to act.
Sarah got used to me sprinting through her office on the way to the bathroom. I couldn’t talk about my condition with her — I was too embarrassed — but she seemed to radiate understanding. She didn’t mind me running by her desk, at least.
That Al Pacino line from The Godfather, Part III had become one of the defining sentences of my life.
We watched the Godfather films every year, usually accompanied by the old-country recipe for pasta that Nicole has passed on to the next generation. They boys called it ancestor spaghetti.
I always try to work lines from the films into daily conversation and, unfortunately, I came to the perfect moment in my life to use Al’s great line:
“Just when I thought I was out, they pull me back in.”
Just when I thought I figured out my new life with my bionic butthole, I got pulled back into the miasma of bowel anarchy. It was if my gut was saying to me: “You think you’re in charge? Oh really? Watch this.”
So as it had been with the bag, so would it be with the new wild and free — and untrained — rectum.
And for it to happen on this day, of all days.
I’d been looking forward to this day so much. I planned to spend most of my office time preparing my next two lectures and then slag off mid afternoon to see Rosey, one of my best friends from Florida, who was taking a leaf-peeping vacation in New England with his wife, Peg. This day was their day in Boston and months ago, we hatched a plan to get together to hoist a few.
Rosey was short for Jon Roosenraad (his name is a vowel movement; he’s Dutch), and he was the man who hired me at the University of Florida in 1986. Since moving to Massachusetts, people often asked me what I missed most about Florida. They expected me to say the beach or the warmth or palm trees or something, but it was really just Rosey and Jean and Mike and Margo and Wayne and a few other friends. (And spring training.)
So this day had been circled on my calendar. A chance to catch up with a great old friend.
Things had been going okay down south the last couple of days. I would get sudden urges and rush to the bathroom, expecting a dam burst, only to find another significant round of flatulence. When I did go, it was tough to come by and not nearly as voluminous as in those days of bowel movements past.
SURGEON GENERAL’S WARNING:
Detailed descriptions of excrement are imminent.
It’s going to get gooey right about now.
I came in on the train from Cohasset. I had a short layover at South Station, then would switch to the Worcester train. The second stop — at Fenway Park — was a block and a half from my office. Easy trip.
I felt a gastric tickle during my South Station layover, the kind that usually served as prelude to flatulence. Just to be safe I headed toward the too-small bathroom that never had enough empty stalls. Luckily I claimed a seat just as the tickle turned into a round house punch to the gut.
Unfortunately, as i began this urgent bowel movement — much more forceful than anything I’d had since my reconnection — I found I had no control of my new man-made rectum. I was like a faucet unable to stop. I tried to hold it in, but I had no strength down there and I ended up staining my boxers.
I finished, tidied up, and did the best job I could cleaning a couple of stains in my pants. It wasn’t an All-Tempa Cheer level job, but I thought it was something I could live with.
They called the Worcester train. Having washed throrougly — as if scrubbing in for surgery — I stepped into CVS, grabbed a bag of peanut-butter-filled pretzel nuggets, and ambled toward the train.
“You shouldn’t have!”
It was Wally, one of my favorite conductors. Friendly dude. I offered him the bag.
“Naw, I was just kiddin’,” he said.
“I don’t think I want them after all,” I said. “Eyes bigger than the stomach.”
He waved his hand toward the bag. “Naw, I’m full, but thanks.”
And then, a few yards past Wally on my way to the car for the people getting off at Yawkey Station, it hit.
And by it, of course, I mean it.
I grimaced and tried to hold it in. No amount of tightening or flexing helped. I immediately turned back to the station.
Wally was startled to see me about face, and he could tell from my pained expression that something was wrong.
….”“Just … a … health … issue
It was all I could get out, though I thought about saying, “As a matter of fact, I am in the process of shitting my pants.”
“Do you need me to call someone?” he asked.
“No,” I managed to gasp, waving my hand, still trying to hold it in.
Now I knew what it was like to guard the door at Walmart on Black Friday; there was no way to hold it back.
“Changing! Travel! Plans!”
I figured running would make it worse and I still tried — largely in vain — to flex the sphincter muscle and hold everything in.
If something can go wrong, it will. Cliches, God damn them. They become such because they are true.
When I returned to the entrance of South Station’s barely adequate men’s room, Satan had posted a sign on an easel blocking my entry: “Restrooms temporary closed. Please use the bathroom on the mezzanine level about the food court.”
To add insult to injury, I had already passed the mezzanine.
So now, still dealing with a loosening in the gut, I had to walk through the food court to the cloistered upstairs bathroom. The main bathroom was inadequate. This one — with just one urinal and one toilet — was a joke. Luckily. I was able to claim the seat.
Despite the constantly changing personnel outside my stall — and there must have been two dozen urinators during my time in my porcelain sanctuary — I stayed on the toilet for fifteen minutes.
I wasn’t stalling in the stall. It was just that I had a fecal apocalypse to deal with.
That made me very unpopular with the mass of urinators standing asshole-to-bellybutton in front of the one trough in the men’s room. Everyone is in a hurry in South Station. For an unruly mob to have to share one urinal was outrageous.
Who’s that asshole in the stall? The fuck’s up with him?
First of all, it was different. It was a looser texture and more orange in color. A significant amount now rested in the seat of my JC Penney boxers — an extremely comfortable pair that I now knew were now beyond salvation.
With the shuffle of feet and steady rumble of resentment that some asshole was hogging the stall, I disrobed from the waist down. It was as if an army of rodents and mythical beasts had escaped my colon and slid down my leg.
. . . . . . . . . .
[Two young parents discuss their infant’s excretions.]
’Did our little angel have a bowel movement this afternoon?’
‘Still hard? Like oatmeal, or more like a banana?’
‘Well, less like thick cream soup than yesterday.
More like scrambled eggs. Only brown.’
‘No, caramel colored, rather than chocolate.’
‘Did she have to strain?’
‘Some. But not like yesterday.’
‘Sounds pretty good,’ says he, afcionado of feces.
Kinflicks (Knopf, 1975)
. . . . . . . . . .
Fortunately, toilet paper was in good supply in my stall. I set my underwear aside, folding it up to contain the mass of waste. Then I did my best with the toilet paper to make my blue jeans presentable. Though it was November, I was sweating. I had to remove my sport coat and I stood there in the stall, naked from the waist down, using massive amounts of toilet paper, trying to clean out the mess inside my jeans. (Thank God, nothing had leaked through.)
From the volume of grumbling, i figured the urinators were ready to riot and breach the stall.
What kind of filthy animal monopolizes the head?
When I finished my work, I slipped on the jeans and considered what would happen if I had another accident while going commando. I did my best to slip out of the stall without making eye contact with the pissed-off horde.
I held my befouled boxers against my side, behind my haversack. After a cursory hand wash, I sidestepped the vengeance of the urinators, and slipped from the room alive, dumping my boxers in a food-court trash can (please forgive me, custodial employee) and took off for the CVS Pharmacy in the station.
Alas, the store did not sell underwear. I did, however, buy a travel-pak of baby wipes, stuck them in my haversack, and set off toward Boston Common. Macy’s was on the way.
But here’s how deranged I am: I am in crisis, having just had a horrifying bowel experience, fearing that another explosion might be imminent. I quickly find the men’s department at Macy’s but don’t buy the boxer shorts because of the price. Really — $39 for one pair of shorts? Good Lord!
After a quick stop in the Macy’s men’s room to check things and see if I need further cleaning, I head back to the outside world, walking toward Boston Common.
Down a side street I see a Marshall’s, the Taj Mahal of the cheapskate. Three Calvin Klein boxers for $19 — now that’s more like it. (Still, wish there was a Penneys or a Target downtown.)
I check out and make it to the visitor center at the Common, where there is a restroom. The workers at the tourist center don’t give the stinkeye to drop-in bathroom users, knowing how hard it is to find a place to pee downtown. I quickly rip into the underwear package and put on two pair of boxers. I can’t be too careful.
I grab the subway at the Park Street Station on the Common and the whole ride to Boston University, there’s a mantra in my head: I think I can I think I can.
I make it to my office, quickly breeze past Sarah and close my door — something I never do.
I sit down on my couch to catch my breath. I had texted Rosey that I had to cancel our beer date because of ‘medical issues.’ Now I texted back. Turns out I could make it after all. Were he and Peg stll free? Sure thing, he said, and we set a meeting time.
I sat in my office, thoroughly demoralized and disgusted with myself. I’d made it there, having lost some clothes and bought some others, and at some point I’d have to make the commute home. I felt like a prisoner and i feared what would happen — if I’d have another accident and embarrass myself in the office.
Sarah was out there at her desk, on the other side of the wall. Did she sense what horrible things had happened to me?
I had about an hour until I was to meet Jon and Peg, so I tried to do some work. But I kept thinking about what I’d done that morning and how ashamed I was.
I opened the door and addressed Sarah. “This is a wasted day. I’m going to drink beer with an old friend.”
“I thought you said this was a wasted day,” she said. “It does not sound that way to me.”
I met Jon and Peg down at the Pour House, across from the convention center. My stomach was calmed and the beer was cold. We had a lot of catching up to do. I’d spent 24 years of home football Saturdays with these two. Rosey and I had worked together all that time. We’d gone to a few concerts together — tailgating for the Rolling Stones and getting front-row seats for Bob Dylan and Santana. (I remember driving back from that show at 2 in the morning and looking to the back seat, where Rosey sat like a big, slumbering rabbit.)
We talked children, grandchildren (in their case) and the joys of retirement and traveling the world with the person you’d lived with for three-quarters of your life.
Rosey still taught part-time in retirement, which meant he had all of the pleasure and none of the drudgery of academic life.
But one thing I learned that day: other people had been through what I’d gone through. Jon and Peg knew all about it and just to know that other people understood gave me great comfort on that day — that day I’d looked forward to for so long. They were compassionate. They understood. Rosey didn’t even joke with me about it.
Maybe I would not just be seen as an object of revulsion and disgust.
We spent a couple of hours at the bar, then said goodbye. I made it from the bar to the train station, then on the train, then home.
God was with me. I made it home. Further intestinal agonies awaited and horrifying thngs occurred that night. But I was home.
I had to face this as an alcoholic would — one day at a time.