It all began in Africa with a pain in my backside. My wife, Val, jokingly called it payback time since I’d been a pain in her backside for 37 years. The pain was just an annoyance at first, but it persisted and each new episode grew in duration and intensity. My doctor, probably suspecting colon cancer, recommended a colonoscopy. The scope vindicated my colon, but revealed a troublesome bulge pressing against my rectum from the abdomen. A follow-up MRI uncovered a 9.5cm tumor of unknown origin. My Namibian surgeon urged me to return to the States for diagnosis and treatment.
Instead of chemotherapy, I prescribed baseball therapy for myself. I took my pill in the morning and went to Colorado Rockies baseball games in the afternoons and evenings while waiting for Gleevec to do its job. My nightmare became a dream come true. Since my son-in-law works for the Rockies, my therapy was free.Two weeks later (May 2009), a biopsy in Denver returned a GIST diagnosis. Up until then, the word ‘gist’ meant ‘the essential part of a matter;’ but now the essential part of my GIST became a tiny orange bullet – Gleevec. I had braced myself for the horrors of chemotherapy and the oncologist replaced my imagined nightmare with a once-a-day pill that amazingly came with almost no side-effects.
Oh No, Anything But That
The only problem on my medical horizon was the specter of a permanent colostomy. My family physician assured me a colostomy would be the certain aftermath of any surgery to remove Gollum (more on that later). The required surgical margins would severely compromise the surrounding sphincter muscles, thereby requiring that my closest friend be an unmentionable bag.
My daughter decided my tumor needed a name and what better name than Gollum, the gray and slimy, mysterious creature who kept popping up unwanted in the Lord of the Rings trilogy. Gleevec quickly shrunk Gollum to 6.5 cm, but no more. My surgeon assured me that the only way to avoid a colostomy would be for Gleevec to reduce Gollum to three centimeters or less. It wasn’t happening, but my surgeon wanted to cut anyway.
In the meantime, I’d heard about doctors using DaVinci robotics to perform rectal surgery in a way that preserved sphincter abilities, thus avoiding the permanent installation of the nasty bag. I mentioned it to my surgeon and he frowned. He grudgingly referred me to both a colo-rectal surgeon and the only surgeon in their surgical group who performed robotic surgery. The colo-rectal surgeon assured me that it was impossible to avoid a permanent colostomy and openly mocked the idea of robotic surgery and he surprisingly mocked his own colleague who had embraced this new technology. I left his office totally discouraged, but convinced I would never let such a man touch my body with a scalpel.
R2D2 to the Rescue
The DaVinci robot…or R2D2?
My next and last surgical consultation was with Dr. Warren Kortz whose office suite adjoined Porter Adventist Hospital in Denver. He was as optimistic as the prior surgeons had been discouraging. So on February 26, 2010, they carted me into the sterile operating room where the scary looking robot waited patiently in the corner. For the next 11 hours, without ever touching my body with his own hands, Dr. Kortz painstakingly and meticulously excised Gollum while sitting at a computer console on the opposite side of the room. The DaVinci robot has three surgical arms and one camera arm that move around your body with a minimum of disruption. The camera shows the surgeon a view of the surgical site that he could never see with his own eyes alone.
Just a few hours after waking up, I spent most of the day out of bed, sitting in the guest chair in my room. I was walking the ward the next day. And only three days after surgery, I walked out of the hospital under my own power. I love robots and I’m absolutely in awe of Dr. Kortz’s care, compassion and capability as a surgeon.
My Worst Friend – P.T.
That’s the good news. Moderating that good news only slightly is the fact that my GIST was attached to my rectum for its entire length of 6.5 cm. With that amount of surgical disruption, Dr. Kortz felt it necessary give me a temporary diverting ileostomy in order to let the rectum heal for three months before further use. He had warned me before surgery that a lengthy tumor-to-rectum connection would necessitate this procedure. In keeping with the family naming tradition, I named my bag P.T. (an abbreviated form of “Poop Tank”).
True to his assurance, three months later in June 2010, Dr. Kortz was ready to reverse the ‘ostomy. Before that procedure, he performed a proctoscopy to make sure the surgical site was completely healed. I thought the hospital receptionist would split a gut laughing the morning I walked up to her desk and said, “Hi, I’m here to play a starring role in your ‘bend-over’ movies.” That was the last fun I had that morning. When I asked Dr. Kortz if I would be under anesthesia for the procedure, he laughed and said, “No; instead you’ll get to watch the whole thing on live TV.” So for an hour he took me on a guided tour of a part of my body I’d never seen before and hope to never see again; down where the sun don’t shine, but the camera lights do. Immediately following my movie debut, I had the privilege of enduring a barium enema. Oh boy! I passed both tests with flying colors and believe me, with the enema there were a lot of flying colors. Next stop – ileostomy reversal.
So I celebrated my 60th birthday on the operating table, while Dr. Kortz ripped me a new you know what. Later his surgical assistant told me that while he was stuffing my intestines back into my body, he sang, “Back in the bus, Guts” to the tune of Paul Simon’s “50 Ways to Leave your Lover.” A few days later he came into my room and said, “I’m releasing you, but before you go, I want you to roll on your side and wink at me.” So I obediently rolled away from him and “winked” in a way I’d never winked at anyone before, all through the breezy side of my hospital gown. He was sufficiently satisfied that I could squeeze the right muscles. Dr. Kortz is an excellent surgeon and a really funny guy. His father was a surgeon; his brother is also a surgeon. When the rest of the neighborhood kids were playing doctor, he and his brother were operating on the cat.
Back to Work
Two months later I was back in Namibia continuing my missionary duties. It took a full year for my plumbing to return to pre-operative effectiveness, but I’m now completely back to normal. I remain cancer-free and I’m living each day to its fullest with joy in my heart for another day to make a difference in someone else’s life.
Life is beautiful, even in a life raft. Carpe Diem.Our team just completed building a community training center in a very poor squatter’s camp.