Gulp: Adventures on the Alimentary Canal

A few minutes pass before Elaine appears on the stairs. She crosses the living room with a crooked gait, the combined aftermath of a car crash and a fall from a ladder. “Sorry, I was in the bathroom,” she says. “I’m sure y’all can understand”—y’all meaning the freaks down in the living room talking about bowel health.

Elaine sits down on her dad’s mobility scooter. She shows me where the pins stuck out of her ankle as it healed. Then she pulls down the shoulder of her shirt. I expect more medical hardware, but it’s a tattoo. “Do you like monkeys?” I almost say, but then I get it: There’s a monkey on her back. Oxycontin, fentanyl, drugs for chronic pain. On top of everything else, she has fibromyalgia.

“. . . and bipolar,” her dad chimes in.

She makes a face at him. “No, you are.”

I ask permission to try on the hamburger ring. “Go ahead,” Nichopoulos says. “We’ve got finger cutters.” It’s a fabulous object. I love the mix of diamonds and hamburger, glamour and trash. I feel like Elizabeth Taylor and Larry Fortensky at the same time.

ELVIS PRESLEY’S COLON is not on display in a glass case, but you can get a good sense of what it looked like by reading the autopsy section of The Death of Elvis. “As Florendo cut, he found that this megacolon was jam-packed from the base of the descending colon all the way up and halfway across the transverse colon. . . . The impaction had the consistency of clay and seemed to defy Florendo’s efforts with the scissors to cut it out.”

Nichopoulos was at the autopsy and remembers the moment. The clayey material, he says, was barium, administered to prep Presley for a set of X-rays—taken four months earlier. “That barium was . . .” He gestures toward the fireplace. “Just like a rock.” He says the impaction obstructed at least 50 to 60 percent of the diameter of Presley’s colon.

In the 1600s, the venerable English physician Thomas Sydenham advocated horseback riding as a remedy for an impacted bowel. I mention this to Nichopoulos, noting that Presley had liked riding well enough to have had a stable built at Graceland.

“That’s interesting,” he says. “It would certainly loosen it up.” Elaine turns the scooter and drives away.

Thomas Sydenham was an uncommonly gentle practitioner. Another of his treatments for intestinal obstruction featured mint water and lemon juice, as if all that were needed to make a man right was a refreshing summertime beverage. “I order, too,” he continued, “that meanwhile a live kitten be kept continually lying on the naked belly.” The kitten was to remain in place for two to three days, whereupon a dram of something unrecognizable but presumably stronger was prescribed. “The kitten is not to be taken off before the patient begins with the pills.”

Sydenham did not explain himself. I was left wondering whether this was an early form of animal-assisted therapy and the kitten’s role was simply to help the patient relax while nature took its course. Impactions often resolve on their own. Sydenham once treated an overburdened London businessman by sending him to Edinburgh to visit a specialist who didn’t exist. The patient returned from his weeklong rail journey vexed but rested and cured.

It’s also possible, though unlikely, that the kneading of the kitten’s paws was viewed as a kind of therapeutic massage. Around the turn of the last century, massage—or medical gymnastics, as it was also then called—was not uncommonly applied to the obstructed bowel. Here is Anders Gustaf Wide, in the HandBook of Medical and Orthopedic Gymnastics, discussing the technique of “colon-stroking”: “One can at least feel the lower part of the larger intestine and often the hard feces in it and even feel, how, in stroking, these are carried forward in the direction they should go.”

Mary Roach's books