The crudest approach to breaking the dam was simply to toss the patient over a hospital attendant’s shoulder.* The intestines do not take a fixed position in the human interior, and simple inversion can, in some cases, bring a measure of relief. A Dr. William Lewitt, of Rush Medical College, in 1864 related the case of a man with a tumor in his abdomen the size of “a child’s head at term,” which was putting the squeeze on his digestive works. “On visiting the patient, we found him suffering intense agony from pain in the abdomen, with frequent desire to expel flatus from the rectum, which could only be accomplished by standing upon his head and hands, in a perpendicular position.” Dr. Lewitt gave his title as Demonstrator of Anatomy, and I imagine it took all the restraint he had not to pack the man up and bring him down to the lecture hall for a demonstration.
The treatment of last resort was surgery. If a blockage could not be shaken, stroked, hosed, or zapped into submission, it was likely to be excised. Surgery in the pre-handwashing, pre-glove-donning era bore a sobering risk of infection. Surgery on the bacteria-laden colon, all the more so. Horrifyingly, colectomy was being performed not just for life-threatening impactions, but as a treatment for constipation and its spurious consequence: autointoxication. What better way to speed digesta through the body than by shortening the chute? Scottish surgeon Sir Arbuthnot Lane, the operation’s inventor and vociferous champion, began with “short circuits,” removing a span of a couple feet. Soon he moved on to total colectomy, removing basically healthy colons and stitching the end of the small intestine directly to the rectum. If diarrhea can be considered a cure for constipation, he may have done his job, but in the process he put his patients at risk of nutritional deficiencies. As we learned from the coprophagic rodents of chapter 15, the colon—via the metabolic labors of its bacteria—produces not just feculant putridity, but valuable fatty acids and vitamins.
Lane was a raging coprophobe. The normal variances of skin color that you or I would attribute to race or time spent in the sun, Lane perceived as staining from fecally poisoned blood. One patient’s “yellowish-brown complexion” disappeared, he noted with pride, a month after her surgery. “She has lost almost all her brown colour,” he wrote of another woman. Lane went so far as to deem the colon a useless structure and a “serious defect in our anatomy.”
It takes a sizable sum of arrogance and ignorance to second-guess human anatomy and the evolutionary fine-tuning that produced it. The colon that Lane would so cavalierly lop from his patients’ interiors is more than a simple waste-storage facility. The bacteria feared and despised by the likes of Lane and Tyrrell and Kellogg—the germs that live and thrive and ply their trade within our waste—are not only harmless, they are critical to good health.
* * *
* This was less exciting than it sounds because Dhody keeps the “creepy-tastic” stuff out on display. For example, the necklace of dried hemorrhoids, and the jar of skin (dropped off by the roommate of a compulsive picker, in a Trader Joe’s strawberry preserves jar with a note attached: “Please recycle,” presumably referring to the jar).
* Oddly, the exhibit chosen for billboarding on the building’s exterior was “Young Women Basketball Players.”
* It’s amber. Because there are more cancers than colors, awareness ribbons are like paint chips now: Stomach cancer is periwinkle, ovarian is teal. Colon and rectal cancer are plain blue. They used to be brown (just as the color for bladder cancer awareness is yellow), but some patients objected. A mistake, I say. They could have had brown all to themselves; blue they have to share with Epstein-Barr, osteogenesis imperfecta, victims of hurricane Katrina, drunk driving, acute respiratory distress syndrome, child abuse, baldness, and secondhand smoke.
* He wrote a book on the topic, called Why Can’t I Go?, which features dozens of defecography stills and close-ups of colon surgery graphic enough that the back cover has a warning. Can I Go Now?
* Vigorous debate followed, under the italicized heading “Size of the Hand.” A hand more than nine inches around is, declares Dr. Charles Kelsey, “unfit for the purpose.” Dawson counters that the size of the pelvis must be taken into consideration. “A broad hipped man or woman would admit a ten inch hand readily,” and to fix the limits lower would have the effect of “deterring and embarrassing the practitioner who happens to have a large hand.” Or four. Dawson also relates the story of a Dr. Cloquet who, “in quest of a glass tumbler,” inserted fourteen fingers into a rectum: six of his own, and four belonging to each of two colleagues. The patient’s sphincter, if not his dignity, recovered intact.
* In related matters: Is it possible to literally knock the shit out of someone? Depends on the shit and who’s knocking it. “I had a high school football coach who was an offensive tackle for the Washington Redskins,” says gastroenterologist Mike Jones. “He swore to me that Mean Joe Greene hit him so hard he had to go change his pants.” Jones added that his coach had had “a bit of the squirts” at the time, and that it would be tough to hit someone hard enough to “knock a solid turd out of him” and not simultaneously kill him.
Bristol Stool Chart
17
The Ick Factor
WE CAN CURE YOU, BUT THERE’S JUST ONE THING