You are enchanted with Farrah Fawcett. You watch Charlie’s Angels, sitting on the floor close to the TV. You appreciate the plucky, shiny-haired Kate Jackson and the icier Jaclyn Smith, but it is Farrah. You have the trio of barbie-like dolls with their different colored jumpsuits and neck scarves. Your Mom helps you feather your hair in homage. Extremities scares you to your core. You watch Dr. T and The Women many times over both for the wonderful, circuitous strangeness of Robert Altman and for the small role where Farrah plays a woman breaking from reality. She is, of course, a human woman, but always seems to glow with an otherworldliness. A not-like-us-ness.
It is a sunny day when you are sitting on your bed in your second studio apartment on Capitol Hill in Seattle. You have sold your big house in the country along with nearly everything in it and have started a new life. You moved to this apartment on the top floor after having a heavy-footed upstairs neighbor who played Dummy by Portishead on repeat in your first little postage stamp of a dwelling. The roof has not yet started to leak, but it will, and because it is a small studio, the leak will occur right in the middle of your bed, requiring another move. On this day you are reading People Magazine and have gotten to the back section where they include short blurbs about this and that. You see her name, Farrah Fawcett, and read the short paragraph indicating she has confirmed that she is being treated for anal cancer. You are horrified on a couple of fronts. First, you don’t know such a cancer exists and feel offended that it does. Both of your grandfathers died of colon cancer. You have already had gallbladder disease and Crohn’s disease and you are not yet 40. You know you are at high risk of colon cancer, and you fear the colostomy that your paternal grandfather endured. But anal cancer? C’mon. Really? Your empathic spirit cringes at the invasion of privacy Farrah is enduring along with this awful sounding cancer.
It is in this same apartment where you learn of Farrah's passing. It is in this same apartment that your butt starts to hurt. Yes, a sharp nerve pain that over time does not resolve. It is in this same apartment that you are standing at the end of the bed feeling (and apparently looking) stricken, and your partner asks you what’s wrong and you crumple, let out a sob and say, “I think I have the Farrah Fawcett cancer”. You know there is something wrong. Not in our head, in your soul. A cursory glance at the internet confirms common symptoms and risk factors, most of which you check off. You send your gastroenterologist an email titled “Farting is ruining my life and the Farrah Fawcett cancer”. When you see him, aside from the farting discussion, he wants to know why you think you have anal cancer. You tell him and he explains that it is unlikely. You are too young. You tell him where the issue is. It is at 4 o’clock. You will give this location several more times. It is your way of saying that you can feel what hurts. It is an area that is slightly on the outside and slightly on the inside of your anus and is at 4 o’clock if you use the clock face and your anus as circular references. Even though you have clearly told him where the issue is, he examines you be sticking his entire arm up your butt and swirling it around. He proclaims that he feels nothing, there is no mass. You’re too you and you don’t have a mass. You will hear this again when you discuss the issue with the gastroenterologist who conducts your colonoscopy. Again, they are not looking in the right place. He brushes you off in a similar fashion and you apparently look dubious, or pissed, or some combination of the two because he says “I can see you’re not satisfied. I can send you to a surgeon if you would like”. You tell him yes, you would like.
When you present for the appointment with the surgeon, she asks you what brings you in. You say, “I think I have anal cancer”. She asks you why you think that, and you run through the short list. To be clear, you have a pain in your ass, it’s not going away, you have, or rather had, anal sex with your partner and smoked off and on for twenty years. Anal sex is not something that you desire with any regularity and given your druthers would prefer to pass. However, you know somewhere inside that if you that if you decline, you will fall out of favor with him. You fear being a disappointment so deeply that you go along with the pain, risk of infection and scariness, telling yourself that the orgasms make it worth it. You will use this rationalization with yourself for many years to come. That if you achieve at least one orgasm, if not several, whatever else happens is okay. It is a lie told by self-hate in response to your fear of not being enough. This is what self-hate does. It hangs out in-between your idealized image and your fear and hammers you with lies about what you must be to be accepted. And it typically scolds you for being fearful. There is no compassion here. Compassion is the enemy of self-hate. Self-hate tends to be the more formidable opponent leaving compassion to languish.
You get on your knees on the special table that then goes up in the air and positions you ass-over-teakettle and direct them, again, to 4 o’clock. The surgeon has a resident working with her that day and asks the resident what she sees. The resident sees a fissure. The surgeon asks what would have happened if they scoped you and the resident responds they would tear you further. You had been scoped and examined by the two previous gastroenterologists such that it exacerbated the fissure. And a fissure being a small tear, when stretched out flat, disappears and can’t be seen. You are diagnosed with a fissure and sent home with nitroglycerine ointment that you can only use if you lay down, because it lowers your already low blood pressure and there is a risk that you will pass out and fall and crack your head open and told to take sitz baths for 30 minutes three times a day. These are impractical solutions and even when tried do not help.
Over the course of the next year or so, you live with your painful, bleeding anus, move to a new apartment to escape the aforementioned leak, and decide that you might like to try to get pregnant. As per usual you are concerned about your weight. Even on your weighed and measured food plan, you have normal fluctuations and fear weight gain. You decide that because you might get pregnant that you should join a gym and maybe get a trainer. You hate the gym. You hate going. You hate what the trainer has you do. You hate being measured and metrics assigned to your body. You do these things that you hate out of fear that your body will become something you hate. It is the insidious cycle of self-hatred. Like the devil, self-hatred has a way of running roughshod over you whilst convincing you it does not actually exist. But you go and one day while running on the treadmill, which you hate, you get a sharp, shooting pain in your ass. When you get home, you feel for the familiar spot where the fissure is and now there is a small protrusion. You email the surgeon and return to see her.
After examining you on the same teakettle table, she explains to you that while she can cut out a fissure, she doesn’t. She doesn’t because it is extremely hard to heal. It can’t be sutured due to the anatomy of the anus and its need to expand and contract. Each time you poop, it will tear again. She tells you that you will have to be on narcotics, will not be able to work, will not be able to sit down for several weeks, and that due to all the nerve endings in that area, it will be very painful. Before she leaves the room so you can think about what you’d like to do she tops if off with, “It brings grown men to their knees and makes them cry”. When she returns to the room you simply say, “I want you to cut it out”.
You schedule for January of 2011. On the day of surgery, you arrive with your hair done and a full face of make-up. This privilege will be revoked on subsequent surgery days, but today it is allowed. The nurse throws back the curtain and says, “You look like a model, what are you doing here!?!” You drolly reply, “Hemorrhoidectomy. Not very modelesque”, to a round of chuckles. You opt for a spinal block and have the experience of your brain feeling your legs stretched out straight but your eyes seeing them in stirrups as if they belong to another. In recovery, they leave you too long and the pain meds begin to wear off giving you a taste of what is to come. It is painful and you express your irritation when they say they must keep you longer to give you more pain meds. No, you will go home, but you are hurting, and there won’t be any getting in front of the pain. The pain is already in front.
The next day a nurse calls to check on you. All seems according to plan. You are propped up on pillows with a heating pad and alternately on your side. Using the bathroom is terrible and is nothing compared to what is to come. But you don’t know that yet. On the following Monday, four days post procedure, your surgeon calls you. In the split second before she begins speaking, you think it’s odd that she’s calling given that you’ve already been checked on by the nurse. And then she begins. “I’m so sorry. Five pathologists looked at it because no one could believe what they were seeing. You have fully developed invasive cancer. There is a treatment protocol that includes chemotherapy and radiation. I’m sending a referral…” her words trail off as your heart pounds and the blood rushes to your ears. You tell her you know it’s a stupid question, but based on the pathology report, is she sure that this is the tissue she cut out of you. You break and begin to cry and say that you don’t want to tell your mom unless, she’s sure. She responds, “you need to tell your mom.”
You text your partner to ensure he is planning to come over so you can tell him in person. He senses something is wrong, calls and is scared so you tell him on the phone. You hang up and gather up your beloved little Minpin Esme and take the familiar walk down Bellevue Avenue as a light dusting of snow falls and the air feels crisp and clean. You are glad it is dark outside. You are glad you look normal on the outside. You are already beginning to hide in the appearance of normalcy. You acknowledge to yourself the end of something. It feels like the end of something. It is the end of something.
When your partner arrives visibly upset, he has consulted the internet and says, “I feel like I gave this to you”. You hurriedly brush that away to take care of him and his feelings. In fact, many years later, you will feel the same. You will believe he gave this to you. Except you will also see your part, or more precisely, the part that self-hate and self-denial have played. Had you centered yourself, been true to yourself, protected yourself and loved yourself, you would have avoided the repeated stress to that area caused by anal sex. And the sly, invisible, percolating HPV would perhaps not have joined forces with the fissure to create this cancer. This type of conjecture is a black hole of nothing that only breeds suffering, but you don’t understand that yet. So, you blame HPV and the lack of vaccine for people your age. It is easier than blaming him and blaming yourself. Blame is a funny thing. If feels useful, but it isn’t. It is inherently hateful and poisonous. When you blame someone or something for what has befallen you, you are cultivating self-hate. Self-hate repeatedly steps in and tells you that things should be other than what they are and that you are a victim of this scarcity of what you truly deserve.
There is no acceptance in blame. No compassion. No love.