Streams of consciousness

When my doctor sliced a hole deep inside me, a lot more changed than just my sex life.

Published August 28, 2006 11:30AM (EDT)

Except that it costs me my whole deductible, I enjoy my hysterectomy. I find hospitals stimulating. I like the funk of anesthesia, and I'm amused by the bright blue nun, like on the wine bottle label, who stops by at pre-op to pray. I'm proud of the tumor they get out of me, and I love that my friends bring me lavender oil and that my sons serve me dinner when I come home to heal. Though I'm a reader and a writer, I prefer CNN, the way my dull, pelvic pain and the world's sharper sufferings coalesce in a haze of morphine and pills. We'll cancel each other out, I imagine. If I'm hurting inside, then what's happening outside will distract me. And when bad things happen outside, then what's happening inside will protect me. At 4 o'clock every day, I'll walk the dog around the block, gauging my agility along the uneven sidewalks. I'll cook my healthful meals and write my weird, peculiar stories and pick the kids up after school, keeping things neat and appealing, functional. If, as the doctor orders, I lift no sack of groceries and vacuum no floor, I'll be back at the YMCA in no time, doing my crazed aerobics, my skinny-legged jumping jacks.

But then ... then ... the strangest thing.
I remember giving birth, my water breaking on a hospital waiting room chair.
Rather, my body remembers.
Really, no, the couch remembers. The battered loveseat with its mattress-ticking cover, remembers.
Water breaks in it.
My body awash, as if floating there, coolly regarding the too-white ceiling.
I pay no heed to the burgeoning war on television, no heed to the loveseat, no heed to the fog rising out of the cushions.
It won't happen again.
"You won't pee your pants again," Wolf Blitzer instructs.
"No," agrees Christiane Amanpour, "she won't."
I do.

Two days later, I haven't yet told my boyfriend I'm peeing my pants, and even when my boys are at their dad's, I don't ask him over. Alone I lay a towel across the mattress, and in the middle of the night, I spread a dry towel next to the soaked-through one. Come morning, I scoop a third towel between my legs to catch the deluge of pee on my rush to the toilet.

There's no sense rushing, no sense in toilets at all. There's only this upended pitcher that I struggle to maintain is ordinary -- a woman driving to the mall on a folded towel, intent on buying a new winter coat to share space with the doctor on the credit card bills. See her marching through the mall, wearing her cowboy boots with the quilted lining. She makes her way to Wilson's Leather, drops her purse at the mirror. The coats are like animal skins, this season. She likes the inside-out sheep, the outside-in lamb. But her corduroy pants with their knuckly crotch provide inadequate camouflage. There's a drenching of urine, the very heat of it weighing the pants far down. Maybe her frantic exchanging of hangers, the way she tugs at the toggles, flings off the skins, rounds up another five -- maybe this is camouflage.

The girls at the counter wrinkle their noses, stifle their horror. I imagine them making their casual way to a bathroom, relieving themselves. I imagine them wiping, drying themselves. Every woman I see, I think of this.

Women in developing countries suffer far more vesicovaginal fistulas than in developed ones, usually a result of childbearing rather than hysterectomy, and if they don't find the aid available to them (visit if you're able to help) they are rarely as lucky as I would be. Many are flung away by family and society, outcasts forever, suffering constant infection and dripping urine, or feces, wherever they roam. Here, repairs are easy to come by, though because of the tenderness of the damaged flesh, you need to wait some time to be successfully stitched back up again. In my case, five months would pass between the day my shamefaced doctor, wearing one of his Disney bandannas -- Dumbo for surgery, Daffy for making hospital rounds -- finally owned up to having scraped a hole between my bladder and vagina, and the day Chuck drove me 300 miles to the Mayo Clinic for repair.

I don't actually need to tell Chuck I'm peeing my pants; instead I sit beside him on his new leather couch in his carpeted TV room. Chuck is the sanest person I know, and laid-back enough that my weeklong avoidance of spending the night raises no alarms. I don't jump up when I flood his couch, and when the leathery runnels make their way to Chuck's half, forming bleak, steamy ponds that drip onto the carpet, he doesn't jump up, either. He simply meets my eyes. Clearly, he suspected. Maybe he's smelled it on me, has seen my agitation, my furtive changing of clothes.

"I'd say it's time to buy diapers," he gently advises.

"But what if there's nothing they can do about it?" I ask, flapping my hands at my jeans and bursting into tears for the very first time. "What if I'm like this forever?"

But I soon calm down. There's a story I remember, about some people who hired a cook and asked her to serve the honeydew melons, a fruit she'd neither seen nor eaten before. When 15 minutes went by, she emerged from the kitchen bearing a deep bowl of pulp and seeds, and a silvery ladle. Chuck understands that because I'm a writer, I might align myself with that bowl of juices, sweet but wasted, the seeds floating in goo, and that the image might make me feel better. I'm not a woman pissing through her vagina when I remember that bowl. Instead I'm a sodden, spongy fruit, a dropped peach with torn skin. I almost find her funny and beautiful then -- the woman buying diapers at Kmart next day, shyly proclaiming to the checkout line that the diapers are for grandma. "If there's nothing they can do about it, we'll live with it, Hon," Chuck answers. Then he draws me a bath, brings me thick towels, puts my jeans in his laundry, and fetches me a T-shirt that reaches my knees.

Back in June we arranged for a trip to Jamaica, but by the time winter comes, our romantic getaway is far different than we expected. At departure, it's me they single out for a random search of my carry-on, which holds a week's worth of ladies petite diapers that pile up on the table in view of the other passengers. Aside from mealtimes I've little intention of wearing them, for I regard this trip as a chance to leak, unnoticed, into the salty atmosphere. I long to feel air around me again. Swimming, aware of the ocean seeping into my body through the extra incision it has been granted, I'm like a gladdened jellyfish slopping around. The bladder infections that accompany the fistula are quickly soothed, and though I leave a trail behind me wherever I go, it might as well be seawater soaking my droopy sarong.

As for our sex life, suffice it to say that penetration is forbidden for a whole half year, that I don't blame Chuck for not exactly hungering to go down on me, and that I feel just sore enough that I don't much want him to. I want only to cuddle skin to skin in that long lazy hour between beach and supper, padding barefoot now and then to the chairs outside our room. Every time I sit on one of those chairs, pee gushes through the slats with the flat noise of sheet rain striking the tiles, but Chuck goes on peaceably nursing his cigarette, holding my hand, asking if I mind him turning up the volume inside on TV so we can hear the ski races and admire the ocean at the same time. Between slaloms we turn to CNN, where the war grows ever nastier. Against the spectacle of such athleticism and then, such cruel barbarity, I understood I am at least appropriately bestial, dripping and stinking, wounded, open, filled with scary, raw emotion. I weep at the carnage, and I am frightened of my Mayo Clinic repair, scheduled for March. No matter how I long to be normal again, to be all at once healed will be like a song ending too soon on a radio. You want it to last you the whole way home. You don't want it to end before you know what it takes to feel like part of the human race again.

Because one diaper never lasts a whole night, my doctor on and off suggests that I try to get by with a catheter, instead. It's a "walking" catheter, which means you carry the bag on the end of the tube like a shoulder-strap pocketbook, only lower than your bladder lest the urine slide back where it came from. The first tube is too wide -- it burns so much I need to be rushed to the hospital -- and the smaller tube leaks. What I like about those catheters is that you clean them with vinegar. You use the plain white vinegar from the gallon jug with the picture of cabbage and onions on it. First thing in the morning, you empty the urine out of the catheter into the toilet, and then you fit a dented, aluminum funnel to the end of the tube, and then you fill the bladder and the tube with vinegar before letting them steep a while before clothespinning them up in the shower to dry. Pretty soon the house reeks of vinegar. In a way I hate the smell, but in a way I get a thrill from that humble funnel, and from how basic and inexpensive the vinegar is and for how many centuries it's been around, and you wonder what her name was and how she did up her hair and how many people she was feeding for supper and how she lived and how she died -- that first farm wife who dressed that first cucumber with fermented wine -- and how on earth they got from there to disinfecting catheters.

After the Mayo Clinic repair, I need to be catheterized again for three days, but instead of the tube running through the urethra, it snakes in through my lower abdomen like a confused umbilicus. When it's time to remove it, I unclamp the balloon, wait until it deflates, and give a slow, steady pull until the tube slides free and there is left amid my pubic hair a small, clenched mouth that will soon disappear. I sterilize the catheter twice with vinegar, and coil it up in a shoeboxful of doctor toys to be saved for the grandchildren, whenever they arrive. There's a roll of bandaging, a handful of swabs, the aluminum funnel, those funny hospital socks, and a graduated cylinder.

Eventually I'll move with my boys into a house with Chuck and his old dad, and sell my house to a lady who likes everything about it except for the color I had that too-white ceiling painted back in November. Ripe persimmons are a deep, rich, nectary, puckery orange, and when I and my sons lie tangled beneath it on the striped, ruined loveseat once I am healed (they wouldn't snuggle up with me when I was in diapers) most often we turn on the news, but sometimes we don't, and sometimes we talk about how we are feeling, but often we don't. It's OK to not know everything that's happening to everyone all of the time, I figure, as long as we know that whatever it is, we are porous in the face of it. For we are made of tiny openings, of freshly rended passageways. Sometimes they're painful, and often they're messy, and now and then they make you fall completely apart, and that's what they're for.

This essay is the basis for a longer essay to be published in a yet untitled Seal Press anthology in December 2007.

By Abby Frucht

Abby Frucht is the author of five novels, including "Life Before Death" and "Are You Mine?"

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