Left alone in this tomb of glum and silence, my mind was beginning to have sensory overload with all these alien wall decorations.  After about ten minutes, there was a short knock, and the door was thrust open, and a beaming smartly dressed Africa American man entered the room. He was of average height, with close cut, black, wavy hair and a trimmed mustache, while his nose supported thin gold rimmed glasses.  With a smile he held out is hand and introduced him-self.

 
    “Hi, I’m Dr. Foster.  How are you feeling Mr. Gray?”
    “Apprehensive,” I said.   “If I was fine I wouldn’t be here.”  
    “No need to be nervous.  Whatever the problem is I’m confident I can help you,” he said.  He quickly read the notes in my file and looking at me with a smile on his face, he started to ask the same kind of questions that J.B.Q. had asked.  Did I have difficulty urinating? any burning pain? etc. I replied in the negative to all his questions and reiterated to him about my nocturnal visits to the bathroom.

Turning to a smaller simplified diagram of the male reproductive system mounted on a plastic stand on his desk, he pointed to the bladder and continued,

“Below the bladder is the prostate, it’s about the size of a walnut. The urethra links the bladder to the penis and passes through the prostate.  When the prostate is enlarged it often squeezes the wall of the urethra, much like squeezing the end of a hose pipe. It restricts the flow of urine, and you don’t always empty the bladder when you urinate. This could be why you make several trips to the bathroom each night.”

“I see” I said, “But what’s the remedy?”

“It all depends. First do you have a tumor? and if you do, is it benign or cancerous?”

Without warning his left hand appeared wearing a latex glove. I hadn’t even seen him put it on.  He performed the now ritual digital rectal exam.

 “Your prostate is enlarged, and I felt a small lump on one side….. When we couple this with your elevated P.S.A. tests, I recommend that we schedule you for an ultrasound exam and a biopsy to see what we are really dealing with.”

He explained that in the biopsy, he uses an instrument to harvest (the term he used), several samples of the prostate for examination under a microscope to determine whether it contains cancer cells. The procedure, he assured me, was not painful but may be a little uncomfortable.  

He introduced me to Cindy, his nurse.  I had “volunteered”, he told her, to have an Ultrasound test and that if I did not appear he would send out The Prostate Police™  to find me.  The earliest date that could be arranged was 2:30pm March 13th.  I was given two Fleet’s Enemas, three antibiotic tablets, a list of instructions and the hope that I would have a nice day. I left the clinic
feeling less sure of the future than when I went in.

Since the appointment was to be at 2:30pm and it would take an hour or more when all the paper work and waiting was taken into account, I decided that I should have all my pending annual medical needs seen to on the same day.  It had been six months since I had last seen my dentist and a year since I had seen the optician. I phoned both and made the necessary appointments for the morning of the biopsy.

Due to the unusually bad weather for the first two months of the year, my skiing trip with Sarah, and Laura’s busy schedule, we had not been able to arrange our Triple “D” Day until now.  I phoned Captain Mick the following Friday evening. I asked about the weather forecast for the next day.  I was informed that Saturday morning’s forecast looked perfect, and that both of us should report for duty at 0700 hours with best boots and gaiters. I mentally saluted and so informed Laura by phone.

Our pilot emerged to great us.  

At 0659 the next day both of us arrived and parked our cars outside the rental area where Captain Mick stored his balloon. Our pilot emerged from a rather tatty recreational vehicle to great us. My first thoughts when I met Captain Mick were, “So this is what Father Christmas does the rest of the year.”  He has a full head of white hair, long bushy sideburns, and a white beard that reaches down to his chest. With his green checkered trousers and a bright red jacket, he was a fearsome sight.  We introduced ourselves, and we met his wife who would be driving the chase vehicle into which we now entered.

The balloon, we were informed, was stored in a large canvas bag, which was in turn, secured along with the bamboo basket onto the flat bed trailer hitched to the back of the chase vehicle.  As we headed down the eastern back roads of Morgan Hill, we exchanged the kind of information about each other
 

And his wife drove the chase vehicle

that strangers always do on their first meeting.  After about a ten minute drive, we pulled into the school playground of San Martin, a small community just south of Morgan Hill.  Being early Saturday morning, the playground was empty except for a small short haired dog that viewed our presence with great suspicion, judging by his or her vocal anxiety.

The brakes were applied, and the ancient vehicle came to a stop spraying a cloud of dust in its wake.  The four occupants then climbed out of the chase vehicle and started their preparation for the lighter-than-air vehicle’s quest against the laws of gravity.  First, the canvas bag and the basket were removed from the trailer and placed on the ground.  It took all four of us to remove the balloon from its bag. The balloon was placed flat on the ground, and then Captain Mick attached the balloon’s guide wires to the basket.  Laura and I were asked to hold open the underside of the balloon while he pulled the starter on a small gas powered engine that drove a 30” diameter wooden propeller.

Within ten minutes the cold, forced air had filled almost half of the balloon. Then, in a well practiced series of moves, the Captain turned the basket on its side, and lit and aimed the propane burner in the direction of the half inflated balloon. Gradually the balloon started to fill with hot air and began to rise off the ground.  The captain turned the basket upright then slowly climbed inside. He called for Laura and I to follow him. It was at this point in time, that my mind swiftly flew back to, what seemed at the time, redundant college courses, such as thermodynamics, physics and calculus.  Maybe they are important after all?

Now with all three of us in this Jules Verne type vehicle, it slowly became airborne at first by just a few inches. The basket, with its precious cargo aboard, started to drift ominously towards a homeowner’s fence.  Then, within ten yards of a lawsuit, the laws of thermodynamics took over, and we suddenly lifted vertically to five hundred feet.  Old St. Nick, as I began to think of Captain Mick, turned off the gas and the silence was almost deafening, while the views were breathtaking.  It really is hard to describe how quiet it is as you drift slowly in a balloon.  And the small town I had lived in for the past fourteen years looked so different. I had no idea there were so many creeks, streams and swimming pools.

We drifted slowly northward, and from time to time the silence was broken as Old St. Nick ignited the propane burner to increase our altitude.  We had a few rudimentary instruments on board: an altimeter, a pyrometer that measured the temperature inside the balloon, and an air speed indicator.  A check of the altimeter from time to time showed that we drifted vertically from five hundred to a thousand feet.  The three of us talked excitedly about what we were seeing, while Laura and I increased the stock value of Kodak.

After about thirty-five minutes, we started to look around for a landing place. About a mile ahead, we saw an area where another balloon had recently landed.  Their crew had already rolled up their balloon and had left out a large ground sheet.  Our Captain started to pull on his guide wires to spill air out of the balloon, and we slowly drifted downwards towards our target.  As we got within five feet of the ground, the crew from the other balloon rushed over to us and pulled our basket towards the ground sheet. We landed within six feet of our target.  Laura, the Captain, and I got out of our bamboo cocoon and joined the others in dismantling and stowing the balloon and basket. 

After decommissioning, we boarded the horizontal mover once more to be driven back to the school yard from which our lighter-than-air adventure had first begun.  Laura and I then went through an initiation ceremony as first time balloonists.  However, we have been sworn to a code of secrecy not to reveal the exact details about what happens.  I can only say that it involves wet hair and Champagne.  Not once on this epic adventure did I ever think about my prostate or doctors. This was the first time in several weeks.

The day of March 13th arrived. I and my alarm clock awoke at five A.M.  I had tea and toast and read the San Jose Mercury News.  At six A.M., I left my house and drove to the Decathlon Club in Santa Clara. I played five games of squash with my old, but young at heart, friend Sally Bachman, an editorial writer with the San Jose Mercury News.  I am in the unique position of being able to read the editorial column of one of the nation’s largest papers and then argue about its content with one of its writers while she sweats trying to beat me at squash.   Later, we both shaved and showered, (but in different rooms) and after an excellent steam, I got dressed.  My first medical appointment was at 9 A.M. with Dr. Paul Jones, my dentist of many years.

Paul’s receptionist is Tracy.  We have this unwritten rule that I will ask about Paul’s drinking the night before, and she always says that his hands are still shaking (which, for lawsuits and other reasons, they never were).  After a period of reflection, while I view the gold fish in their tank and catch up on the year-old news magazines, Tracy would eventually say it was safe for me to go in.  I’ve had a good relationship with Paul over the years that I have surrendered my teeth and gums to him, and I must say that I have suffered very little pain while he practiced dentistry.

My experience with other people in the dental profession is limited.   However, I am sure that it must be part of their qualifying exams that a dentist should be able to talk to patients while expecting the patient to move their heads only very slightly, or at best, allow a small grunt.  So it was with Paul and I. He is a great San Francisco 49er fan.  He would talk and I would grunt or nod my head, and after about thirty minutes we both knew what each other had said.  It’s a Guy thing after all!  After x-rays on both sides of my jaw, I was pronounced fit and was told that I would be contacted only if my x-rays revealed any problems.  They didn’t.

My next bout with the medical profession on this fine day was with Dr. Crowe, my optician for the past five or six years.  His secretary has no sense of humor whatsoever, even irony falls on stony ground, so I let my natural talents rest.   Antiseptically, I handed her my medical forms.  A smile was neither given nor received.  Eventually, I was summoned to the man himself.  After the normal “How are you?”, and “The weather’s fine” conversation, this large imposing machine was thrust in front of my eyes.  After preferring many lenses in front of my eyes and asking the question, “Which seems clearer? This or---- this?”  I responded accordingly. 

Eventually, he said my eyes have not changed since last year, and I did not have cataracts or glaucoma.  In fact, I have quite young eyes for a fifty-five year old. I thanked him and said I would see him again next year. 

By now, it was close to noon, so I went home to be greeted by my two dogs and three cats.  After a thorough licking and a light lunch, I read the instructions given to me by Cindy, Doctor Foster’s nurse.  I self administered the  Fleets enema and took the antibiotic tablet. Next, it said to drink two eight ounce glasses of water half an hour prior to the exam. “The bladder must be partly full to perform the exam.” I didn’t know it at the time, but I was setting myself up for future torture.

I arrived at the clinic, and by this time the staff knew me by sight and the sound of my English voice.  The inevitable labels were produced, and it was at this point in my travels through the medical bureaucracy, that I realized the importance of labels.  Nothing it seems can be initiated without the production of labels. From this I concluded that labels are the key to good medical science. This knowledge was going to be my key to better surgery (more on this in a later chapter).  Diana (she with a boyfriend called Howard Also) gave me my labels and told me to report to the lab. for a blood test.

This particular legalized vampire turned out to be an ample sized African American lady with a marvelous sense of humor.  After some verbal gymnastics between the two of us, she took my arm in hers and swiftly withdrew two vials of my blood.  I was then given the now familiar round plastic container and requested to leave a urine sample in the confessional.
 
Clutching my remaining label, I followed the signs to the basement and the home of the X-ray department. I presented the all important label to the 

 A door marked Ultrasound

receptionist.  She gave it a quick glance and asked me to be seated. Finding a seat against the wall, I looked around at my fellow travelers.  They all had one thing in common, no one was smiling.  On the table next to my chair, the choice of magazines was one, a three month old “Field and Stream.”  The subscriber’s name having been removed, I concluded from this, that he did not want to have animal rights activists showing up at his front door.  Now, this is not a magazine I
would normally read, but when the choice is this or nothing, well you know what I mean.  I flipped through the pages, and found there were articles on the best
scopes for hunting bears, the cost of hunting licenses for various rare animals, and how to find a good taxidermist. It seemed to me that essays on the various methods of terminating life were inappropriate in this supposed haven of healing. 

Eventually, a very nice young nurse called out my name and asked me to walk this way.  I tried my best, but there was no way I could walk the way she walked.  We left the reception area and walked a short distance to a door marked ULTRASOUND.  As the reader might have gathered by now, I take things rather literally.                                              

I asked, “Is this the room were you test all the latest audio systems?”
“No,” she said smiling.  She opened the door, and we both entered.  The room was quite small, and the lighting was subdued.  My companion of 43 seconds then asked me to remove all my clothes below my waist (I resisted the desire to say, “I will, if you will”). Now, I consider myself as some what experienced, as I have lived in three countries and visited many more. But this was the quickest time I have been requested to do this by a woman I have just met. It must be my after shave lotion, I concluded. I went behind the screen and did as I was told and pulled on the back-to-front gown that I was given. Then this unnamed lady held my hand and guided me to an examination table, where I was told to lie down.  She then covered me with a blanket, and we both waited for the arrival of the radiologist. 

But before she arrived, three more young ladies entered my sanctum. There was quiet conversation among the now four ladies, and I could hear equipment being moved.  A few minutes later, I heard the sound of the door opening and the radiologist entering the room.  She introduced herself.  In her early thirties with short blond hair, she started to explain the procedure she was about to perform.  It consisted of inserting about a one inch diameter by twelve inch long plastic probe into the rectum.  The other end of the probe was connected by cable to the ultrasound generator. The probe would be moved in and out and twisted in several directions to obtain a good overall view of the prostate. The output was a series of video images that could be selected one frame at a time for examination by the doctor.  The time for pleasantries had past.  I was asked to roll onto my side.

“No, not that side,” a gentle voice said.

I was turned back through 180°, now with my buttocks facing the five ladies. A hand was placed on my hip and I felt the probe being inserted.  The pushing and turning lasted maybe eight minutes, but it seemed like an eternity.  It was not as painful as it sounds.   The real problem was that the procedure put so much pressure on my now partially filled bladder with those two 8 oz glasses of water. It made me want to urinate so badly that sweat was forming on my brow.  I squeezed as much as I could but the pressure was beyond my capacity to hold it back.  I could feel the dribbles flowing.

At last, the torture was over.  The radiologist put her hand into mine and applied a slight pressure.  No words were spoken, yet so much was said. I felt her compassion and squeezed back, ever so grateful for her understanding. This small gesture I thought was the true mark of a healer.  I didn’t know it at the time, but I was to meet at least several more magical people like this before my medical journey would end.

I lay on the examining table for a brief period of time to get my composure and breath back, and then I excused myself to go to the washroom.  When I returned, the radiologist had left, leaving the four nurses.  I climbed back onto the table and covered myself with the blanket.

When a person goes to a clinic or a hospital for any kind of procedure that they have never experienced before, they are understandably apprehensive.  Their mind is normally focused on themselves and the prospects for the very near future, and they tend to tune out any external stimuli, it is like short term hibernation. So it was with me at this particular moment. I could hear the four nurses talking, but it was just white noise to me. My mind was thinking about Lionel and the harvesting he would soon be doing with his high tech. cultivator.  Then suddenly out of the white fog, I heard one young lady say the following five words that set my curiosity antenna into high gear:
 

My brother has two Sisters

 “My brother has two sisters.”

What is the relationship of this speaker to the brother and the other sister was my first thought?  I had to find out who this verbal contortionist was.
I propped myself up on one elbow and looked at my four companions and asked,
“who said that?” 

          “It was me,” said a voice I recognized as Michelle Castillo, one of Dr. Foster’s nurses.
           “What did you mean by that?” I said.

           “Yes… I suppose that does sound strange” she said
 
She went on to explain that she and her brother are very close in age and temperament, and that their sister was quite a bit older than both of them.  Since she was closer to her brother than her sister, they both tended to bond together,  which in her mind left her and her brother with two (totally different) sisters. Hence the statement “My brother has two sisters.” It made sense to Michelle, and that’s the most important thing I suppose.

Lionel Foster entered the room shortly after this stimulating verbal exchange. His smile was as broad as mine was narrow. He went over to the screen to look at the illuminated images of my prostrate.  He examined each picture individually.  I was to learn later that this gland we call a prostate is medically mapped just like mother earth. Each area has a specific name in Latin so that doctors can communicate their specific findings and recommendations to others in the medical profession. I suspect that they say something like “There’s a cloud cover over New Hampshire”. This means “bombard it with radiation, if that doesn’t work cut the sucker out.” I may be wrong. But I don’t think so.

Farmer Foster, without a straw in his mouth, came over to me. He assured again me that the procedure that I was about to endure would not be painful. The ultrasound probe that was used

earlier would have a spring mechanism gun attached to it which, 

when fired, would allow Lionel to obtain a needle biopsy of the                Lionel with his Hi-Tech.

prostate.  I would hear what sounds like the clicking of the finger                     Cultivator

and thumb when the samples were taken, and he would be harvesting

at least six, maybe more, samples. “These might be samples to you              (Prostate Gothic)

mate,” I thought. “A medical bureaucrat answerable only to the

Hippocratic Oath and the insurance company.

But this was my DNA. Unique in the universe, known only to me, and it should be handled with the deference such rare occurrences deserve.”  I lay on my side and let the sport begin. The clicking went on not six but seven times. Again, the procedure was not in itself painful, but it put a great deal of pressure on the bladder. When it was over, I was told I could get dressed, and that I might experience the passing of blood in my urine when I went to the washroom.

After getting dressed and thanking all the ladies and the doctor who were a witness to my examinations, I went to the washroom.  My motivation was not so much the urge to test his theory, but the urge to go!  However, the sight of dark red blood exiting my penis, even though I was told to expect it, was quite dramatic.  It made me feel slightly light headed. Eventually, I got over this and was able to drive myself home.