Scholarly Musings

 Kelly's Body

*excerpted from my anthropology honors thesis entitled: Pain in the Butt: Chronicity, Identity, Trauma, Burnout and Inflammatory Bowel Disease*

Kelly’s body walks into the doctor’s office, follows the nurse around the meandering halls of the clinic and into the sterile exam room. Kelly’s mind is still in her car overthinking and overanalyzing everything about this upcoming appointment, her recent symptoms, her long to-do list at home. The loudest and most pounding thought in Kelly’s mind is the flashbacks of when she was molested by one of her physicians. 

This doctor doesn’t even work here. Dr. Harris doesn’t even know him. She doesn’t even know what happened to me. Very few people know what happened to me. What if she wants me to take off my clothes and put on a gown? What will I say? How will I tell her I just can’t do it? Gosh, why can’t I just be an “easy” patient? Why can’t he get out of my head?!

Kelly takes center stage in the exam room, right on top of the hospital standard light brown, faux-leather exam table that eerily creaks if you move around too quickly. The painfully familiar crinkle of the paper covering the table makes Kelly grimace as she fights with her own mind to stay present. She spots a neatly folded hospital gown peeking out from the drawer across from her and her heart starts to race, sweat begins to fall down her face, her stomach starts to churn, and just like that, there are three short knocks on the door, and Dr. Harris, Kelly’s gastroenterologist enters. Just as quickly as those knocks on the door, Kelly now has to shove down her anxiety, her flashbacks, her trauma and focus on the business that is managing her Crohn’s disease. You only get 20, maybe 30 minutes if you’re lucky with these specialists every few months so every second of these conversations is valuable. 

“How’ve you been feeling?” Dr. Harris asks while her body is still in the doorway.

“I’ve been doing okay. I think the Stelara is working, but I still have days where my symptoms flare. I’ve been struggling to eat and drink enough.”

“Okay, well it’s nearly time for your colonoscopy. We’ll know a lot more after that.”

I really need to tell her about my anal fissures flaring up and causing a lot of pain. I know she’ll want to take a look though. There’s no way I can let Dr. Harris look up my butt. Maybe I’ll just keep quiet. 

“Anything else going on Kelly?” 

“Um, I’m having a lot of pain and burning when I go to the bathroom.”

Oh sh*t. Why did I just tell her that? I should have just ignored it like I’ve been doing for months. I hate this disease…

“Okay, let’s have you change into a gown so I can do a rectal exam and take a look. It’s likely an anal fissure, and since you’re on Stelara it may not heal on its own.”

Oh sh*t! No, no, no, no, no! What did I do?! How do I get myself out of this? How do I tell her I can’t be touched like that, not after… 

The tears start falling as Kelly’s breathing picks up and becomes more shallow. She looks down at the floor. 

“I can’t,” Kelly whispers.

“You can’t, what?” Dr. Harris asks.

“I can’t let you examine me like that. Something happened and I just can’t…”

Dr. Harris sits down and wheels her stool closer to Kelly. 

“I’ll take a look during your colonoscopy. I’ll see if we can get you in this week. Sounds good?”

“Thank you,” Kelly looks up at Dr. Harris with her tear-filled eyes and nods.

“You don’t have to tell me what happened, but I want to make sure you’re as comfortable as possible when you come see me. If it’s easier to write down some of your concerns and fears and email them to me ahead of time, let’s do that. Okay?”

“Yeah that would actually help a lot, thank you.”

“Anything I can do, let me know. Can I give you a hug?”

Kelly, shocked and almost numb by Dr. Harris’ kindness and humanism, just nods and leans into Dr. Harris’ embrace.

“We got this girl, we’ll make these visits and the Crohn’s stuff less triggering for you, I promise.”

Later that day Kelly logs onto Zoom for the bi-weekly inflammatory bowel disease support group that her clinic organizes. Kelly, being one of the youngest amongst the group, still enjoys participating in each meeting. This group is a place for Kelly to learn from other patients with the same condition and for them to exchange tips, tricks, support, and encouragement. It is also a place to share stories. From what went down at an appointment to a funny story about having an accident in your car to sharing fears about an upcoming surgery or even worries about the future, this group is a safe place to do that.

“Hey Kelly, how was your appointment with Dr. Harris today?” the group facilitator asked.

Kelly had had a rough morning. She felt trapped in her head, her thoughts and fears felt as though they were running in a hamster wheel. After her appointment, she cried in her car for 40 minutes before she could even think about driving home. However, something about being virtually surrounded by “her people”, a group of people also living with IBD who will always very intimately understand, made Kelly feel better.

“It was rough, I’m not going to lie. We are doing a colonoscopy at the end of the week. I’m having a lot of rectal pain and she’s worried it’s a severe fissure. I wanted her to take a look at it while I was under anesthesia so that’s why we are doing the colonoscopy so soon.”

Somehow, what was nearly impossible to articulate to Dr. Harris, almost flew off Kelly’s tongue to the group. 

“Oh girl, anal fissures are the worst! I hope Dr. Harris can assess the damage and even fix it up during your procedure,” says one of the women.

“Oh definitely. I, too, always have Dr. Harris do her rectal exams while I’m under anesthesia. Why go through the awkwardness?” giggles another woman.

Suddenly, Kelly could crack a smile and almost a laugh for the first time in days. What seemed like a major embarrassing issue in her head, was just another bonding moment for Kelly and the group. 

The lived experiences of people with IBD are embodied very differently in the exam room versus within areas of community and support with fellow patients and that is one of the themes I will address in the upcoming chapter. In addition, the trauma Kelly has experienced as a patient that she has to re-endure consistently has an effect that transcends the traditional contexts of trauma and overlaps with notions of chronicity that I too will explore in greater depth throughout this chapter.