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Lucky to Be Scoped

— My screening colonoscopy went really well, but how many people don't get the chance to have one?

Ƶ MedicalToday
A computer rendering of a colonoscope traveling through a cutaway large intestine.
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    Fred Pelzman is an associate professor of medicine at Weill Cornell, and has been a practicing internist for nearly 30 years. He is medical director of Weill Cornell Internal Medicine Associates.

Took a few days off this past week for a little personal wellness.

I was due for my follow-up colonoscopy -- I have been doing one every 5 years because of prior polyps as well as a family history -- and several months ago I realized that it was coming due.

Back in the Spring I'd called my gastroenterologist's office and scheduled it for one day this past week, and put a hold on my schedule to block myself out for a few days. One day for the prep, one day for procedure, and then one more day tagged on at the end in case I wasn't feeling up to going back to work.

When I set my calendar to "out of office" and messaged my coverage team that I was going to be out for a few days for a medical procedure, everyone was very concerned and texted me, "Are you okay? Is your atrial fibrillation back? Are you having another ablation? Please let us know if there's anything we can do." Finally I had to tell them all that I was just having a routine colonoscopy and that I was going to be fine.

The prep went fine (Mmmmm, Miralax and Dulcolax!), as expected, and the day drinking just clear liquids was an interesting one (Mmmmm, chicken broth and seltzer!). The day of the procedure itself went smooth as could be, everyone at my gastroenterologist's office was terrific, and the whole team took great care of me -- overall, an incredibly nice healthcare experience.

As I lay there on the gurney getting ready for my colonoscopy, the anesthesiologist did his timeout with the gastroenterologist and the nurse slipped in the IV (didn't feel a thing), and then said, "Here we go, you'll start to feel this." I felt the propofol kick in, a few seconds of unmooring from the world, and then the next thing I knew I was in the recovery room.

My gastroenterologist stepped in, and told me that my colon looked terrific. Three polyps this time, but they all looked benign; we'll have to wait and see what the pathology shows, but overall good news. I wanted to add in pictures of my transverse colon for this column, which to my eyes looked fantastic (picture-perfect haustra!), but my family vetoed this.

After I finished, and once safely ensconced on the couch at home afterwards, I realized what a blessing it was that I was able to get this all done smoothly and safely, that it was all covered by insurance, that I had really competent people taking great care of me, that the healthcare system had actually worked really well. For how many people would the very concept of taking a day -- or two or three -- off from work be a major problematic event in their lives, forcing them to put off or never do a procedure like this? I have heard many times of patients repeatedly putting off their colonoscopy because they don't have anyone in their life who can commit to take a day off work to come pick them up after the procedure.

As I've said before, doctors often make the worst patients -- not taking care of ourselves, not following our own sage advice, not taking our medicines consistently, not seeing a doctor when we know we should, treating ourselves with medicines and antibiotics and the like, and ignoring things until someone in our life yells at us. But for the most part, we doctors usually have excellent insurance, and we have all the opportunities we need to take really great care of ourselves. For so many, the healthcare system doesn't live up to this standard, and many face a world where what we think should be happening for them just doesn't occur.

Every day as I stop to think about it, it blows my mind that we live in this incredible country with so much, and yet we fail in so many ways to provide everyone with the healthcare they need. Just as we as a society have failed to provide safe housing, clean water and air, good schools and job opportunities, safe neighborhoods, and so many other things that are subject to bias and injustice, the healthcare system is rife with missed opportunities and missteps along the way:

  • That any woman should suffer from lack of reproductive rights
  • That any unborn child growing in their mother should suffer from lack of prenatal care
  • That any child anywhere should lack for routine vaccines and preventative care
  • That anyone should lack for primary or specialty care and go instead to emergency rooms as last resorts
  • That any patient should not have the access to whatever they need to get them to the best place possible for their health

These are among the many injustices we've committed and perpetuated, the wrongs we need to right.

I'm on schedule now to repeat this procedure in another 5 years, so it's already on my calendar for 2027. But how many out there are missing their mammograms, their Pap smears, their vaccines, their ongoing care of chronic medical conditions, or putting things off due to cost, access, fear, and bias? This all needs to change, and we all know it.

Everyone should feel this good.