I was lying face down on an operating table with the top of my butt exposed to the three ladies in the room.
A blood pressure monitor was attached to one arm and to the other, an IV that dripped a “conscious sedation” cocktail solution into my grateful bloodstream.
The effects of the Versed to relax me, combined with the opioid narcotic to remove pain from the equation took me to a place I was in no hurry to leave, but my curiosity yanked me back to reality.
“That’s ‘what’? Are we done already?”
“Yep, we sure are!
“I must have fallen asleep” I declared. “It feels like I’ve only been here for five minutes.”
Cheery Nurse responded, “That’s all you’ve been here, five minutes. That’s all the longer it takes!”
I was confused, as this was my second attempt at having marrow withdrawn from my hip bone, and the first (unsuccessful) attempt took significantly longer. It felt different, too-much different. This one was quick and absolutely painless. The other, well…
A big part of prescribing a cancer treatment protocol is “staging” it; that means finding out how effectively it’s invaded your body.
The way to find out about the first was to stick a big-ass needle into my hip bone, drill down to the marrow and suck some out. Then the pathologists could examine it and determine if any of the little cancer-bastards had taken up residence in my bone marrow.
When Dr. Robertson informed me of the necessity of this procedure I simply said, “Let’s go. Right now; let’s get this done.” I was semi-bluffing of course. There was no way that the Simon Cancer Center at Indiana University hospital was going to have a qualified bone marrow sucker just hanging around like a firefighter waiting for an alarm to go off-but they did.
Moments later I found myself dropping my drawers in front of Dr. R’s “Fellow,”…
…an advanced medical student working closely with him to get advanced training in oncology.
“So Brad, who’s gonna do this procedure?” I asked.
“I am,” he replied.
IU Health is a “teaching hospital.” That means that inexperienced medical-professionals-to-be are allowed to hone their skills on patients. And we all know that “hone their skills” means “get good at it by screwing it up a few times”; this at the patient’s expense, oftentimes.
I assumed my position atop the operating table that would serve has my personal torture chamber, oblivious to the waterboarding I was about to receive but happy I’d donned clean, colorful boxers (now you know) this morning.
From what I can tell, the bone marrow biopsy protocol goes something like this:
• Find a suitable place on the posterior iliac (hip bone) to withdraw the marrow.
• Numb the area where the withdrawal needle will penetrate muscle tissue to reach the bone.
• Pierce the surface of the bone and withdraw marrow.
Dr. R mentioned earlier that this should take about five minutes.
Then he began sticking me with needles in order to dull the pain he apparently knew he was about to inflict on me.Then he did it some more. And some more. For about fifteen or twenty minutes, not five.
He hit nerves that reacted to his assault on them by shooting piercing electrical pains all the way down my leg that crashed heavily into my foot. Not once or twice, but more like five or six times. I jerked, sometimes violently. I yelled and moaned. I feared I was going to pee in my clean, colorful boxers.
I did my best to be a big, brave man but these were involuntary reactions-
I had no choice in the matter. Just when I thought I was going to jump off the table, grab the nearest surgical scalpel and demand they bring me my wife and my get-away vehicle, Brad asked his nurse to go find Dr. R.
He approached from behind and as he squeezed my rear end every muscle in my body tensed; I felt a trickle of sweat run down my chest. I was determined to “take it like a man” but that became unnecessary. Dr. R knew immediately that I’d become shell shocked and called off the procedure.
“Let’s re-schedule this for next week with a sedative and pain blocker,” he instructed his staff.
“And a different doc,” I mumbled.
I’ve been around long enough to realize that in order to get good at something you have to be willing to screw it up a few times-that’s how we learn. I respect and understand the necessity for teaching hospitals. And I don’t mind being a crash-test dummy for a dedicated medical student-to a point.
Here’s my new policy when anyone new and different comes at me with a sharp object or other implement that might cause me unnecessary discomfort.
• “Have you done this procedure before? How many times?”
• “I respect that you need to learn and I’m willing to participate in you education. However…”
• “You get to hurt me once, maybe twice depending on the pain. But when I say ‘Enough’, you have to go and get someone who will not hurt me. My insurance company will get billed the same either way and I prefer the painless alternative.”
Brad and I both learned something today. Now he’s a better doc and I’m a better patient.