“The Test” by Sue Granzella

The urologist’s nurse shot me a quizzical look. That should have been my first clue. I guess I looked too happy.

“You know what you’re here for, right?”

“For a baseline on my bladder?”

Months earlier, I’d been shocked by a diagnosis of multiple sclerosis. On my initial visits to the neurologist, cold dread had gripped my insides, squeezing the breath out of me in the waiting room as I moved chairs aside for patients in wheelchairs. I told myself to smile and make eye contact with them. Was I looking at my future self?

With time, I’d adjusted, and that day, I was feeling more upbeat than terrified. Bladder problems are common with MS, and since mine had misbehaved in the past, the neurologist had ordered this exam. I felt strong, though, and eager to receive a glowing report. I’d always excelled on tests. If confidence and determination could influence performance, my bladder might pass.    

The nurse pointed to a portable commode. “First, please empty your bladder. When you’re done, open this door, and I’ll come give the next instructions.” With an encouraging smile, she shut the door.

Why the delay? Were the next directions that complicated? I settled onto the oddly-shaped toilet seat; it was deep, but designed for someone with hips about 18 inches around. Relieving myself in the middle of a room surrounded by furniture made me feel exposed, like in a dream I once had where the toilet was in a school cafeteria.

I voided my bladder, and opened the door. The sweet-faced middle-aged woman silently reappeared.

“Now undress from the waist down. Then sit on the edge of that table, until you almost fall off. Cover yourself with this drape, but don’t put it around you.” As she headed out, she added, “You can leave your socks on, if you like.”

Great! I thought. Then I’ll hardly feel naked! I pulled off the lower garments, keeping my feet sock-clad. Then I perched on the table, covered myself, and waited.

After a bit, I realized that the bed/table was situated so that if a patient were disrobed from the waist down (and this was a urologist’s office), someone opening the door would see, before anything else, a naked rear end. Definitely not good Feng Shui. I decided to lie back, my head inclined, my knees bent, and my feet resting on the floor. I maintained this awkward position until the nurse returned.

“Oh! How uncomfortable! You could have just put your legs in the stirrups!”

I’d seen them, but taking the spread-eagle position voluntarily had seemed wrong. The time for stirrups is only when one is forced to relinquish all pretense of dignity. Alone in the room, I hadn’t been at that point, but it seemed we had reached it now. I scooted forward, and assumed the position.

 

“Now! I’ll insert two catheters. Then I’ll attach electrodes around the area, connect the machine, and see what happens.”

Electrodes? Around my ‘area’? Connected to a machine? Imagined sensations of electrical jolts in a scary region sprang to my mind. Trying to replace these visions with more peaceful ones, I repeated the Zen mantra I’d once heard: I am a stick on the river. I let the current carry me where it will. I am a stick on the river…

Nurse was still talking. “First, I’ll shave you down here. If I don’t…” Following were phrases like “water-proof tape” and “ripping hair out.”

I waved my assent to the razor.

Gripping the blue disposable razor, she added, “Don’t worry — I’ll only shave the one side.”

Because two bald sides would be weird, but one was totally normal? Confused, I lay back. Her soothing voice floated over the white drape that blocked my view of her.

“I’m taking a survey.”

I’m good with small talk at Supercuts, but these circumstances were new for me. Was she just trying to make things less awkward? I waited for a question about a sports team or a book recommendation.

“I’m wondering — would you rather have shaved yourself, or have me do it?”

It was one of those questions to which there is really no good answer. I addressed the paper-towel drape: “I guess it kind of doesn’t matter. It’s just part of the whole uncomfortable process.” I sensed her understanding nod.

“Okay! That’s done! Here’s the first catheter.”

At this, my body rebelled. Nurse’s voice intoned, “Relax. Relax.”

I’d been spread, shaved, electrified, and plunged. Relax? I tried to envision a meadow on a spring day. It worked. We graduated to tape.

“We’ll use lots of tape. With so many electrodes, we don’t want anything to slip out of position.” I was in complete agreement with her. As she finished, there was a tapping at the door. Awesome! A visitor! I adjusted my drape.

“Anna? A minute?” Anna excused herself, leaving me with the breeze blowing where it never had before. A tangle of tubes and wires stuck out all over. I prayed I wouldn’t sneeze.

Anna returned, wearing an ominous look. She spoke from my side of the paper towel. “I’m sorry, but the doctor is stuck in surgery. I’d rather just leave you here, since you’re ready. Is that okay? You’re taped, so you can walk around.”

The exam room was eight by ten. I doubted I would feel the urge to exercise.

“That’s okay, I don’t think I’ll be walking around.”

“Oh, I meant just in this room. I wouldn’t expect you to walk out in the waiting room.”

I glanced down toward my naked-but-for-socks lower half. Did I look like someone who’d wander around with her southern landmass exposed?

“I’ll get magazines. If you need to relieve yourself…” She again indicated the commode.

I was startled. “That’s okay? Even with wires, and the machine?” Moving seemed dangerous. Could I possibly electrocute myself with my own urine?

Anna reaffirmed that movement was safe. Then she left, and I read about celebrities and their rock-hard abs.

 

After forty-three minutes, I tested Anna’s assertion that standing wouldn’t kill me. I tip-toed to the commode and began the evacuation process. Just then, the door swung open. “Wait!” I yelped. Clutching my paper-towel drape, I hobbled back to the table.

It was Anna. “The doctor’s back! Since we’re not quite ready, he’s with another patient. Let’s get you finished!” She pushed in the second catheter, the more uncomfortable of the two. A suspicious look crossed her face. “Did you empty your bladder?”

What’s the right answer? Had I done wrong? I said, “Well — I tried. I don’t know if I emptied it. I was startled in the middle.”

“Oh — that’s okay. I’ll empty it for you. There…oops! I got your sock.”

Clearly, leaving the socks on had been a bad move.

Next she verified electrode placement, helped me down, and guided me toward the commode. As I settled onto the skinny-child-sized seat, she handed me another drape, about the size of a party napkin. I spread it over my legs, but she hiked it up until it was a mini-skirt covering two inches of thigh.

“I’m sorry — we need to see the tubes.”

I continued arranging myself, as if the perfect placement of paper could restore my dignity. When I stopped fidgeting, I asked, “Now do I just go to the bathroom?”

“Silly child!” said her face. But her voice answered, “No, remember? We emptied your bladder.”

Oh, yeah, the sock. I was confounded. “Then what will you measure?”

Anna’s eyes bored into me. “We’ll fill your bladder, then see how much you get rid of.”

Fill it? How? There were no cups of juice. Then I followed Anna’s gaze above my head, and saw two enormous plastic bags of clear liquid hanging on a pole. Each was the size of a small watermelon. Through the cloudy plastic, I could see the wall behind, sporting a poster entitled The Urinary Tract. The life-sized bladder on that poster was one-fifth the size of one of the plastic bags. Oh, God, no. I’m a stick on the river, I’m a stick on the river…

“You’ll fill me from the other direction, and see how much comes back out?”

Anna nodded sadly. “That’s when the real fun begins.” I felt betrayed, like a kid who has just learned that Santa was really her dad.

She vanished.

Within seconds, the door was flung open, and the horn-rimmed-glasses-topped doctor strode in, apologizing profusely. He did not shake my hand; my hand was clutching the paper-towel skirt. He perched on his doctor stool and I on my commode, each surveying the other.

When I accidentally walk in on a stranger in an unlocked bathroom, I scream. I can’t help it; it horrifies me to interrupt a person in such a private moment. But this doctor always encounters people seated upon that most intimate of chairs, and never by accident. Thankfully, he did not scream. In fact, he did not in any way acknowledge the power imbalance demonstrated by our respective seats. Suddenly my rear end felt even more naked.

Then he slapped his file onto the desk. “Well, let’s get to the bottom of this!”

I narrowed my eyes. Really? The bottom?

He wasted no time. “Okay, I’ll start filling you up. Tell me when you feel something.” He pressed a pedal, the machine hummed, and Bag #1 began to empty. The doctor focused on the computer screen, Anna focused on my southern region, and I focused on a spot on the wall. We all waited for a message from my bladder.

“There! I feel something!” I couldn’t help sounding triumphant.

“Now tell me when you feel like you’d like to urinate, but you’re not really uncomfortable.”

The machine hummed. We waited. We waited. I sensed them watching me. Should I have said something already? Was I failing the test? I was tempted to look at the bag, but quickly vetoed that idea. If I saw that there was already one watermelon inside me, I’d freak out and something in that room would explode. It was time.

“I’d like to go to the bathroom!” They both appeared pleased with my pronouncement, and Anna even exclaimed, “That’s great!” Proudly, I sat up straighter in my commode.

Doctor spoke again. “This time, wait until you’re extremely uncomfortable. Like if you’re at your favorite movie, and you need to go so bad you have to run out of the theater.” The machine kicked up a notch and I dug my heels in.

Soon, I was listing to the left, my right hand curled into a fist. I coached myself: Be strong…you can take a lot more… I was right. Time passed, and again, I resisted peeking at the watermelons. I entered a zone, like a long-distance runner after the endorphins kick in. I was unstoppable.

A voice broke my concentration: “Don’t you have to go yet?” Doctor didn’t sound impressed. He sounded as if he thought I were a freak.

“It’s pretty uncomfortable, but I’m not running screaming out of the theater yet.”

“Oh! Stop then! We don’t want agony. You did great.” He clicked the computer keyboard, and Anna did a tube-check. I thought: My work here is done.

But then the doctor stepped back from the computer, and Anna’s eyes locked on mine. Apparently whatever was next was big. What we had been building toward all along.

It had come down to this.

The doctor spoke. “Okay, now – go to the bathroom.”

They faced me, lips pressed tightly together. Though his order was clear, I was confused. Physiologically, was it even possible? Didn’t the tubes running the watermelons in counteract any outward flow?

“Can I? You mean – now?”

“Sure! Absolutely! Right now!” His manner was breezy, but his expression belied his cheeriness. So I knew – this question was 95% of my grade. All eyes including mine stared at the tubes exiting my body. I can do this, I can do this. I focused all my strength to counteract anesthetic, wires, electrocution fear, humiliation. I strained with the effort.

His voice split the silence. “Is that how you usually go?”

At this, my mind erupted. What’s wrong with how I go? Why isn’t my way good enough? Is this one of those experiments where they torture you to see how much you will accept? Oh man, I let it go way too far. But the loudest voice in my head hollered: IS THIS HOW I USUALLY GO? Tubes, watermelons, electricity, an AUDIENCE?!

“Ummmm…I’m not sure what you mean.”

“You’re pressing on your abdomen. Do you usually?”

Did he truly not realize? “Well, it feels weird…all these things going in and out…”

Their faces relaxed, and Anna puffed a sigh of relief. “Oh! Would you feel more comfortable if we stepped outside?”

WHAT DO YOU THINK?!

But all I said was: “Probably.”

They hurried toward the door, as if my privacy and dignity were suddenly all that mattered. Aren’t we a little past that? I wondered, but still, I was grateful. In a touching gesture of thoughtfulness, Anna turned the faucet on her way out, averting her eyes. I felt like a guy in a fertility clinic, when the nurse hands him a magazine with his little cup.

The door closed, and the faucet streamed.

It was effective. I passed with flying colors. Upon her return, Anna declared that I had produced more fluid than they’d pumped into me. Given that I had begun with a theoretically empty bladder (the sock), it was unclear where the extra had come from. I didn’t argue; I just stood up to get the hell out of there.

But Anna touched my arm. “I think he’s done with you, but I’m not positive. He’s with a patient, but it’s your call. Do you want to wait?”

With spectacular understatement, I said, “Well… I’d rather not come back, so…” I sighed, settling back onto the commode.

Anna’s eyebrows curved in compassion. “I’ll ask him.”

In a flash, she was back. “You’re done! I’ll unhook you, and you can get dressed!” She whisked away all the paraphernalia, and was gone.

I jumped up and grabbed my jeans. Just then, the door swung open.

Although I had been half-naked for two hours, modesty kicked in. Like a panicked matador, I flapped my pants in front of the opening door. I heard, “She’s not ready? Where’s the next patient?”

“No! I’m ready! I’m ready!” Desperately, I hopped on one leg while jamming the other into my jeans. The doctor popped in, we said our business-like good-byes, and parted ways.

 

On my way out, I stopped at the bathroom, my urge more mental than physical. Like a dog on a walk, I craved autonomy, the freedom to sprinkle where I wished.

The prospect that MS might someday force me to relinquish much control was a frightening one, especially in those early months. But somehow, the unpredictability of the day’s experience planted in me the seed of an idea: maybe I couldn’t know how I’d respond if my body one day failed me. During the test, I’d struggled with “Performance Peeing” and “Understanding of Electrocution,” and something about the ridiculousness of it all reminded me: the future is unknowable. Maybe I could endure more than I knew.

I walked out into the sunshine with my bladder a little lighter, my sock a little wetter, and my head a little higher. I decided that I’d earned an “A.”

 

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