a man’s gotta do what a man’s gotta do

It starts with my pal Big Al; “what’s your pain threshold like?”  He knows someone who had to stop the procedure halfway through because it was just too much.  Then another friend, Grace, chips in; “it can’t be worse than childbirth.  Just remember to breathe in for 4 and out for 8”.  Whoever first said, “it is better to give than to receive” had not thought this through when it comes to advice.

The hospital sends a helpful leaflet explaining that a cystoscopy is a ‘relatively painless process’.  Like dysfunctional family weddings, it’s the ‘relative’ bit that always causes trouble.

Al comes over all philosophical.  Like John Wayne in Stagecoach, and with a tear in his eye (I can’t decide if from shared experience or laughter) he says, “a man’s gotta do what a man’s gotta do.”   Or something along those lines.  I’m still grappling with the idea of John Wayne as an existentialist[1] when it’s time to go.  He’s right of course and with Annie prodding me in the back with a pointy stick, I square my shoulders and stride manfully into the hospital, reserving my best smile for the camera.

 “We meet again”.  While I sign the consent form he explains the procedure; “we’ll do this quickly – it’s probably overkill, but I just want to make sure”.   As I follow him into the cystoscopy suite I can’t help wondering how doctors choose their specialism.  I can see the appeal of the more glamorous – or rather, what are considered more challenging fields – like brain surgery.  Indeed, we often use ‘brain surgeon’ as a metaphor for superior intellect.  But who would choose to become an urologist?  Why?  What was going through their mind when they ticked that particular box at med school?

I lay on the bed dressed in the ubiquitous hospital gown – and as a concession to the cold floor – I’m advised to keep my socks on.  The shame of it.  The world is divided into two sorts of men – those who wear socks with shorts and those who don’t.  I’m a no-sock man, so imagine my discomfort at this particular combination.

I am extremely nervous, Big Al’s words hanging heavy on my mind.  Two nurses hover round the bed.  One distracts me with innocuous comments about the weather while the other suddenly whips the bottom of the gown away.  Are there no humiliations left?  Cold gel is applied to my nether regions and it begins.   He is incredibly quick – and it’s not as painful as I imagined.  But it is very uncomfortable.   And then it’s over.  He utters the magic words; “your bladder is fine – I don’t need to see you again”.  I don’t know if I really believed that I might have cancer of the bladder; my head is just a mess of different conditions and diagnoses at the moment.  I’ll have a good Spring clean sometime.     

I hobble back to the car – now it hurts.  OMG; this is really something else.  I guess anyone who’s passed a stone or had cystitis will know the feeling.  I haven’t – so this is new one on me.  Forget all those ‘100 things to do before you die’ lists.  I’m going to start a new one; ‘100 procedures to have before you die’.   Cystoscopy – tick.

It’s been a week now, but I think it fair to say that the voice procedure has not worked.  Or rather – has not worked to the extent that I could appear on a talent show confident of walking away with the prize for best Ethel Merman impression.  Or any competition for that matter, that requires speaking out loud.  There may be a slight improvement but I can’t detect it.  Annie hears “no discernable difference”. Others might though.  Particularly those who want to.

A piece on the BBC news today about optimism; the brain filters out bad news and keeps us optimistic.  I don’t particularly see myself as an optimist – and I’m not alone in that.  Researchers report that “80% of people were optimists, even if they would not label themselves as such”.  I’ll buy that.  It’s the only way I can explain my behaviour over the past 5 years.  There are days when I could land the part of the Black Knight in Monty Python and the Holy Grail“it’s only a flesh wound”[2].

We keep going in the face of all sorts of adversity because the brain lulls us into a false sense of security.  I see evidence of this each day that I cycle to work.  I wrote previously (The wind is our mountains, June 24th 2011.) about a bridge I have to cross and how difficult it becomes on the way home, in the face of the prevailing Westerly.  From my office window I see the trees bowed and humbled by the wind.  The evidence is there before my eyes.  And yet, as I set off – I always image that as I approach the bridge, the wind will have miraculously changed direction.  It never does – and I never stop imagining that it might.

There must be some evolutionary benefit to this behaviour, but it has a downside – we tend to underestimate risk.  The researchers also suggest that ‘smoking kills’ messages don’t work because people think their own chances of getting cancer are low.

And likewise, I continue to think that eventually my voice will be sorted out.  I’ve seen evidence that shows, for a lot of people with vocal palsy, these procedures simply don’t work.  But like the smokers – I assume it doesn’t apply in my case.  Is it optimism or naïveté?  I guess it doesn’t matter – my brain is telling me it will be so.

The new procedure was the not the pain-free option I first assumed it to be.  The effects of sticking a needle in my throat became apparent after about three days.  But the spirit of the Black Knight (who just happened to bump into Oliver Twist) prevails.  I put my hand out; “Please Sir, I want some more.”  A man really does have to do what a man has to do – the brain says so.

[1] No doubt my educated friends will want to correct me, but if “a man’s gotta do ….” isn’t a perfect encapsulation of the human spirit and the essence of human existence then I don’t know what is.  Besides which, I’ve been trying to get ‘existential’ into a sentence since the 1960s when I was trying to impress a girl studying philosophy.
[2] For those who don’t know – the Black Knight has lost every limb in a sword fight and now simply consists of a head.  And still he calls his opponent back to continue the fight.
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3 Responses to a man’s gotta do what a man’s gotta do

  1. Grace says:

    Congratulations, Mr Spratley, it’s a beautiful baby boy …. !

  2. JJ says:

    Hi ian
    Glad to hear all is OK “down below” as they like to say.

    If you want existential thoughts can i recommend Irvin Yalom a US psychologist an writer….”Love’s executioner”, “When Nietszche Wept”..

    A few years ago I did a counseling course and wrote a bit about this last book.

    “When Nietzsche Wept”, Irvin D. Yalom, 2005, HarperCollins, USA
    Josef Breuer, a doctor and Freud’s friend and mentor, agrees to treat Friedrich Nietzsche with his “talking cure” without him being fully aware of this undertaking. Breuer asks Nietzsche to help him with his own demons, thinking that he can switch roles with the philosopher and ultimately end up taking the therapist’s role to help Nietzsche with his problems. However Breuer finds he needs and receives Nietszche’s help….. and in his own cure can then best help Nietzsche.

    B lists his problems to N, and N replies. (2005:167)
    “You’ve talked a great deal about the second item on our list; ‘besieged by alien thoughts’. Perhaps we have today exhausted that category, for I now have an appreciation of how these unworthy thoughts invade and possess your mind. Yet they are nonetheless your thoughts, and it is your mind. I wonder what benefit there is to you in permitting this to occur – in making it occur”
    “……….It feels like it happens to me……” B

    To me this passage is about taking personal responsibility for one’s thoughts.
    Also, it is interesting to consider why B is thinking these thoughts. What he might think of if his mind was not taken up with these particular thoughts. What do they aid him in avoiding him from thinking about.

    B and N discuss B’s fear of death and oblivion. B asks N how he bears the horrors of death. (2005:247)
    “I do not teach, Josef, that one should ‘bear’ death, or ‘come to terms’ with it. That way lies life-betrayal! Here is my lesson to you: Die at the right time!”….”Live when you live! Death loses its terror if one dies when one has consummated one’s life! If one does not live in the right time, then one can never die at the right time”….”have you lived your life? Or been lived by it? Chosen it? Or did it choose you? Loved it? Or regretted it?”….

    …“No I’ve not chosen! ..I’ve lived the life assigned to me. I- the real I – have been encased in my life”…”What does claiming my freedom mean to my everyday situation? How can I be free? …I have a family, employees, patients… It’s far too late…”
    “My friend I cannot tell you how to live differently because, if I did, then you would still be living another’s design. But I can give you a gift, the gift of my mightiest thought…. What if were some demon to say to you that this life- as you now live it and have lived it in the past – you will have to live once more, and innumerable times more; and there will be nothing new in it, but every pain and every joy and everything unutterably small or great in your life will return to you………imagine the eternal hourglass of existence turned upside down again and again……. Consider the implications of eternal reoccurrence of your life…..it means that every time you choose an action you must be willing to choose it for all eternity. And it is the same for every action not made,…every choice avoided….Do you hate the idea? Or do you love it?”
    “I hate it! Breuer almost shouted. ”To live forever with the sense that I have not lived, have not tasted freedom – the idea fills me with horror”
    “Then”, N exhorted, “live in such a way that you love the idea!”

    B gets Freud to hypnotise him and he imagines giving up his wife, family, practice and leaving to see Bertha and Eva, (as in his dream). When he wakes up he says the following.. (2005:274)
    “What have I learned? Perhaps to live now so that at 50 I won’t look back upon my 40’s with regret….
    (B speaks with his wife)
    “It is a strange day but an important one – I’ve decided to marry you”
    “I thought you decided to marry me 14 years ago”
    “What’s important is that I choose to do it today Mathilde. And every day”

    (I have heard of the phrase “Die at the right time”, and am wondering if it was in an Elizabeth Kubler-Ross book??)

    The second part about living life as if you had to live it eternally reminds me of the phrase “life isn’t a dress rehearsal”.
    NOT that everything is “your fault”, but to be aware that you do have some choices. Both try to say that one should live ones life now, not worry about the future as it is as yet undecided, nor the past as that is done.
    The demon with the eternal hourglass is only a notion to make one focus on how it might feel IF this were true, with the aim of teaching you to ACT AS IF IT WERE TRUE… even though life isn’t a dress rehearsal and we don’t get to live it over and over with some chance to perfect it next time.
    Live it as you really mean to and to be aware of, and take responsibility for, the choices that you make.
    Sometimes we don’t have choices, but sometimes we don’t realise just how many choices we do make without an awareness of doing so…. Rather like Breuer’s choice to be married to his wife. Beyond the sentiment is a powerful thought. You have more control over your life than you might ordinarily believe.
    Life isn’t like teapot that comes with a guarantee and someone to complain to if things go wrong, yet that’s how I think sometimes.
    Note to self…… life isn’t a teapot, …life isn’t a teapot……..

    What did you choose to do today?

  3. Bob says:

    I wish to call your attention to the speech Steve Jobs gave to the graduates at Stanford Univ. in, I think, 2005. They played it over and over again in honor of his death last week. I am sure you could find it on the web somewhere. Please check it out. Very powerful, I thought.

    Best Wishes,

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