As I have written about earlier in this blog, in 1980 while serving as a Peace Corps volunteer in Mali, West Africa, I suffered a blow to my rear end during a motorcycle accident. This wound abscessed, then developed into a fistula-in-anal* which threatened my life. For the next two years I underwent six surgeries to correct the tunnel that formed from anal canal to exterior skin on my rear end. The operations ultimately closed the passage (for the most part) but extensive internal scarring made child-bearing less of an option of me. And externally I was left with an unsightly, sometimes painful, scarred skin fold located several inches from anus which medical personnel now find unfathomable.
Recently a newly immigrated Nigerian proctologist made a blatantly foolish diagnosis. According to him the scarring on my rear end was a hemorrhoid. Apparently he was oblivious to the facts that a hemorrhoid is defined as a swollen vein or group of veins located in the rectum or anus, and my scarred skin fold was several inches from the rectum or anus. All subsequent doctors have concurred with his assessment, even though none of them have visually examined me. My current primary care physician actually argued, debated with me about this scarred skin fold on my rear end. He insisted that it was a hemorrhoid even after I had become silent and refused to speak further. He said, "See, it says right in your medical record, hemorrhoid." He suggested that he could examine my "hemorrhoid" if I agreed to pay extra for a more extensive exam than Humana/Medicare would pay for. I declined. I will never speak of that sometimes painful, scarred skin fold on my rear end again. I want put the indignity, the infuriation of it out of my mind.
And why have doctors not just routinely examined all of me since I schedule an annual exam each year? The reason is that Humana/Medicare has a policy of "No Touch Examination" for senior citizens which sounds nice until you realize this new type of annual exam does not include undressing so that the doctor can examine your skin (the largest organ in the body with many nooks and crannies that only a doctor could see to ascertain whether or not there are problems lurking there). Nor will the doctor examine your feet hidden within your shoes. Doctors do not even look in your mouth, in your ears, or up your nose. And if you want them to look at your nether regions you will have to self-pay extra for that. By this point I am so angry with doctors who are in cahoots with insurance companies to give me skimpy medical care that is not beneficial to me, that I refuse to pay extra for medical care that will probably not benefit me anyway. (When I was a young woman up until middle aged, even when I went in to see the doctor for a head cold or the flu, doctors had me put naked into a paper gown and they performed extremely complete physical exams. I complied because I thought that was the way everyone was being examined, although I did wonder about a rectal exam for a head cold.)
The facts that this Nigerian proctologist was so fresh from Africa that he could not understand me when I spoke English and vice versa, and he had the disgusting quirk of requiring his patients to wear their underwear during examinations so that he could finger their underwear aside to examine their private parts, did not detract from his credibility in other doctor's estimation. Perhaps they did not know of his deviant ways, but isn't it their job to know? I refused to participate in his perversion and removed mine as standard procedure before he examined me. He said nothing but was foot-stomping furious.
Laugh if you will, I certainly have a few times over the years. This tale is a farce, true but farcical. Too bad it had cost me so much.
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* "Anal fistula is a chronic abnormal communication between the epithelialised surface of the anal canal and usually the perianal skin. An anal fistula can be described as a narrow tunnel with its internal opening in the anal canal and its external opening in the skin near the anus. Anal fistulae commonly occur in people with a history of anal abscesses. They can form when anal abscesses do not heal properly." Source: https://en.wikipedia.org/wiki/Anal_fistula
Caption: Debating A Farcical Hemorrhoid
by Annmarie Throckmorton 2019