Special Delivery for the Back Door Man

The problem shows up nine years ago when my longtime friend, Dr. McDigit, decides there’s something wrong with part of my plumbing — a part found in a corner of the cellar, far from the light of day.


“I feel things that concern me,” he says, whipping off his latex glove after finishing a less-than-pretty part of his work. “I have reason to suspect something is wrong.”


I, too, suspect there is something wrong: Doc McDigit seems to enjoy the exam. He giggles as he inserts a fat finger up my ass; he smiles as he mops up (more a smirk than a smile), then refers me to a specialist. Before he leaves the examining room, we decide to partner on a case of Vieux Telégraph and a case of Pigeoulet de Provence. It will be expensive. It will be worth it. Rectal exam and wine, both in a matter of fifteen minutes. A perfect day.


McDigit schedules a blood test and an appointment with a specialist.


“The PSA is high, and I feel things that concern me,” says the urologist a week later, as he, too, peels off a latex glove. He has an earnest expression on his face; I imagine he practices in front of a mirror, refining what he learned in Facial Expressions 101 at med school. I can’t imagine the guy wants to split a case of expensive French wine.


“I was briefly in the radio business, doc. What on earth could a high Public Service Announcement mean in terms of my health? I don’t get it.”


Oh, but I was going to get it.

My PSA joke flies over the guy’s head, and he says, “We need to schedule a biopsy, to determine exactly what’s going on here.”


“Here,” is my prostate gland. It has been unpleasant having that little nugget prodded to this juncture but, if I remember correctly, a biopsy involves extracting a core sample. So, obviously, things can be more unpleasant yet.


I wonder how the doc will go about doing a biopsy on a prostate gland. Wouldn’t that involve hauling equipment the wrong way up what is, for many of us, a one-way route — the guy gland being located in a spot most easily accessed via one’s rear entry? I don’t need to draw a map; it would not be the kind of map I’d frame and hang on the wall of the rumpus room.


I am about to receive a delivery via that back door.


First, however, there is a pre-biopsy procedure that is not at all attractive. It’s not quite the massive cleanout you undergo prior to a colonoscopy, but it is similar. A warm-up act for the headliner, as it were.


At 10 p.m. the night before the procedure, I’m on my knees on the bathroom floor, head down, elbows on the bathmat, reading a two-year-old issue of Art Forum, the tip of an enema bottle crammed up my ass. I’m there for a while, until the bottle process produces results — pay dirt, if you will. I stay on the alert, watching for Kathy and her cell phone camera; I don’t want an image to make its way to Facebook or Instagram.


I am back in the same place at 5 a.m. the next morning, in the same position, taking on more water, then draining, tidying up, and making the hour-long drive to the urologist’s office. While in the bathroom, I grow weary of being on my knees, reading about the failure of the neo-expressionist movement in the ’80s. Come to think of it, I was weary of the neo-expressionist movement when it was taking place. As Robert Hughes notes: few of the vaunted art clowns of that era could draw worth a damn.


The idea of the biopsy prompts anxiety, and my trepidation is compounded by the fact I encounter complications in nearly everything I experience: unforeseen occurrences invariably amplify proceedings beyond what is comfortable. It is a tradition, and this interlude will be no exception.


“Karl,” says the nurse as she wedges her head through the open door to the waiting room, “we’re ready for you now.” I bid Kathy farewell, and I waddle down the hall. Kathy is reading a four year-old issue of National Geographic; she waves, without looking up. Such is the allure of a feature about the endangered Sumatran tiger.


“Here’s what I want you to do, Karl,” the nurse says as we enter the procedure dungeon: “Disrobe from the waist down, and take a seat over there on the exam bench. Put this paper blanket across your lap, for privacy.”


As if there’s something interesting to see.


I look across the room to a bank of instruments; it seems a high-tech Inquisitioner labors here. I do as I’m told, casting an occasional glance at the tools, knowing they are destined for a trip up … me.


The nurse returns to the room. Complications.


“Oh, incidentally,” she says, smiling too broadly, “we’re training some new assistants. We were wondering if you would mind if they observe the procedure?”


I’m a big fan of science, so I go along. “Well, the more the merrier. If we’re going to party, let’s have a crowd in the room, perhaps a DJ as well.”


The trainees enter, and huddle in the corner; each looks to be 14 years old, eyes wide, a fawn caught in the headlights of a speeding truck. This is obviously their first excursion to the underworld.


The doc arrives. He explains to everyone present what is going to happen after I recline and turn on my side, to a “comfortable position.” In brief, the procedure involves a scope (think hood ornament) crammed up the poop chute, toting a camera and a device armed with a hypodermic needle that delivers a “numbing agent” to my prostate. The scope then makes a second journey with an array of biopsy needles, to be thrust with force into my precious, walnut-shaped gland. Six times.


Note: the term “numbing agent” is used carelessly. I think the title was slapped on a relatively ineffective product by overzealous drug company salespersons to stimulate sales to naïve physicians. These shills have, after all, successfully pimped a great many high-priced, questionably effective medicines over the years — concoctions that cause hair loss, the growth of vestigial tails, paralysis, drivers to fall asleep at the wheel of heavy machinery.


The first thing I hear after the rubber hits the road: “This might be just a bit uncomfortable.” (Doctor Talk for, “Grab the handles and hold on for dear life.”)


I hear a collective intake of breath by the novices clustered in the corner of the room.


“You might feel a bit of pressure as I move the camera around.”


“Pressure,” you say?


The nurse keeps up a constant play-by-play for the rookies, who are now holding hands. I take strange pleasure in my objectification. She describes my asshole as, “the entry portal.”


“OK, now you might feel a little something as I insert the needle.”


Yep, you’re right, doc. I’m not sure how “little” that something is, but I definitely feel it. I begin to wonder if there is a “numbing agent,” or whether the urologist injected my prostate with tonic water. You know doctors and their love of placebos.


Thump. Thump. Thump.


“OK, Karl, I’m finished with the right side, Now, I’ll move over to the left side and do it.”


There are sides to this thing?


Thump. Thump. Thump.


Then, more complications, something I don’t want to hear when I am in a “comfortable position,” my stern exposed to kids dressed in Junior Doctor costumes. The trainees are lucky: they get to hear it, too. During their first ride on the Back Door Express.


“Hmmm, this doesn’t look good. You know, Karl, we try our best to procure the highest quality equipment, but they’ve been outsourcing production of these darned needles and, sorry to tell you, this particular needle array isn’t working the way it should. We need to get a new package, and do this again.”


So, here I am, my large white ass hanging out for a gaggle of community college grads to inspect. I have been invaded by technology of formidable girth, and the sharp parts have failed. I am feeling considerably less than “comfortable,” and I am about to be subjected to another round of fun.


What to do at a moment like this? Shout out a famous line from Conrad’s “Heart of Darkness?” Try to remember my lawyer’s phone number? Call out for mommy?


The doc clears his throat and muscles his way in.


I feel the “pressure” of the instrument as it moves around inside me. I prepare for the blast of another needle, and here is what I think: “I wonder what I can eat when I get out of here. I’m pretty damned hungry.”


Yep, there’s a clown with a big ass plopped in the center ring of the Biopsy Circus, and he thinks about food.


The needle nonsense begins anew.


Procedure complete, the rookies get a lesson in post-procedure cleanup, complete with a short demonstration of wet wipe techniques, as the doc and I chat. He alerts me to a number of possible reactions to the biopsy. Believe it or not, they tend to be negative. He reminds me to take the last in a series of antibiotic tabs at a certain time of the evening. He sets a date for a return visit. The guy is a consummate pro. He’s done thousands of these things, and he hasn’t put a red dot in the loss column to date. He’s not responsible for inept, preteen biopsy needle factory workers in Chengdu. I have complete faith in him.


Especially when I hear his final words to me.


“After you tidy up, you need to go have a good breakfast.”


Cudos to the faculty at whatever medical school he attended.


“Anything I should avoid?”


“Nope. Do your best.”


I am ready; I reviewed my options as I was being punctured. I hustle into the waiting room with a target in mind. Kathy has finished with the tigers and now has a concerned look on her face, her brow knit tight, head tilted at a slight angle. She radiates empathy. She, too, has been practicing in front of a mirror.


“How did it go? Is everything all right? How do you feel? What did the doctor say? Are you supposed…”


“Enough chitchat. Let’s go eat.”




“Food, I need food. In fact, I need a massive breakfast burrito, smothered with green chile.”


“Aren’t you supposed to hurry home, go to bed, and rest?”


“Not a chance. I need food. We need to find a restaurant, stat! I might leak a bit, but its inconsequential. I’ll stuff a wad of Kleenex in my underwear, and I’ll deal with the discharge.”


We find a restaurant, and I order a breakfast burrito: scrambled eggs, green chiles, sausage, a few beans, all rolled in a fresh, warm flour tortilla, the swollen tube smothered in New Mexican chile verde and cheese, accompanied by sides of salsa fresca, sour cream, and guacamole. And, there, next to the good-morning monster is something I usually avoid: hash browns.


I don’t often order hash browns because they are rarely made well. These, however, are perfect. I can’t believe my luck as I shift on the booth seat from one side of my ass to the other, a wet spot developing at 6 o’clock. The slab of hash browns is crispy on the exterior, the potatoes creamy within the slab. The seasoning is minimal, slightly salty, an edge of black pepper. Nothing else.


The fry cook knows her stuff. She cares. She must be an undocumented worker.


The breakfast rush is over, and we are two of four customers left in the restaurant. I do what I often do: ask the manager if I can go to the kitchen, and meet the cook. Most often, the answer is “no.” But, when I shine the situation, brag about being a noted food writer (though the note is not specified), and hint that a great write-up is in the offing, I am led to kitchen and cook.


Adelita is delighted, Kathy translates, and we talk hash browns, with a side trip to a discussion of which peppers, roasted, peeled, chopped, and sauteed, make the best addition to the standard chile mix


Technique confirmed*, I intend to whip up a batch of the potatoes the next time I decide to put some effort into cooking breakfast.


I’ll eat the hash browns with eggs (runny yolks), chile, sausage, toast, tortillas, whatever. Just eat them and enjoy them. Get lost in the experience, because, with a corrupt prostate, it’s likely there are interesting times ahead.


Hopefully, without Chinese needles and an audience.



Biopsy Hash Browns


The secret to great hash browns? First, avoid packaged potatoes. Use russet potatoes, and prepare them just before they are cooked. Peel the russets and grate them by hand on a box grater. Put the grated potatoes in a bowl of cold water as each batch is finished.


When the grating process is complete, drain the spuds and squeeze as much moisture from them as possible. Dry them on a towel; if they’re not dry, they won’t brown.


Heat a combination of extra virgin olive oil and butter in a cast iron skillet, over medium-high heat. The skillet choice is crucial: the pan must be heavy, providing even heat on its surface. Do not season the spuds prior to cooking; this is a fried food, best salted when done, and still hot. Same with pepper. Pepper burns, so use it at the end of the line. A teeny bit of finely sliced white onion can be added to the potato mixture, if desired. Could burn, though.


Apply a layer of potato to the surface of the pan, about a half to three-quarters of an inch thick. Smush it down into a uniform layer that covers the entire surface of the pan, then leave it. Don’t mess with it; don’t move it around, don’t mix it up. Let the bottom surface of the layer brown. These are hash “browns,” after all. The starch in the spuds will knit them together. When the bottom surface of the slab is crispy brown good, put the plate on top of the potatoes, invert the skillet and catch the potato cake on the plate. Carefully slide the cake back into the pan, raw surface to the heat (it might be necessary to add a bit of oil and butter, before the cake meets pan).


When the second side of the spuds is golden-brown, slide the cake onto a plate, and season with kosher salt and freshly ground black pepper.



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One Response to Special Delivery for the Back Door Man

  1. wm musson says:

    good story…..thought for sure you were going to have a fudge recipe for the ending……hash browns are good….jake works for Medtronic….maybe your doctor should try some of their equipment if you need to return……good, sharp needles…

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