As a young person, I was not much interested in medicine and health. The organs in my body which I never saw were simply "body parts", which reminds me of a Halloween prank I pulled off as a teenager. I removed a large sign from a junk yard fence that boldly advertised "Good Used Body Parts" and planted it in front of the local funeral parlor.

As long as my inward parts functioned according to the Creator's plan, I abused them and ignored the occasional murmurings and disputings amongst my innermost beings. I was enjoying life too much to be bothered by such trivialities and considered it none of my business anyway.

It was only after certain inner components decided to go on strike that I was forced to enter into negotiation with them and hope for a quick and satisfactory settlement. For a while this seemed to work.

The farther removed I got from the date of my birth, however, the more frequent such internal uprisings became. Before long I found it necessary to seek third party arbitration in the form of a doctor.

The gradual degeneration of my aging body has caused me to think more intensely about medical issues. I have expanded my knowledge of health and medicine somewhat, but I am still learning at an astonishing rate. I have no other choice.

I have learned about the medical profession, for instance.

Members of this group are categorized and given titles that indicate their importance and usually their income levels.

Orderlies and nurses range near the bottom of the list. As a rule of thumb, a nurse is female and an orderly is male. I have never met a female orderly, but there is a growing number of male nurses. There are registered nurses and apparently unregistered nurses. The orderly seems to be the lowest position in the medical profession, taking orders from both doctors and nurses. If he refuses to take orders, he would supposedly be fired for disorderly conduct.

Next in the medical hierarchy are doctors. These are men or women who have studied medicine and taken the hypocritical oath. At the bottom of this group are the interns who have studied medicine but not practiced much on real live people.

The most knowledgeable and important doctor is the general practitioner, but he or she does not have the same level of prestige or salary as a specialist. This is probably due to the fact that the job of general practitioner is considered entry level for doctors who may later become specialists. A general practitioner is sometimes called the family doctor. The term "general practitioner" is self-explanatory. The doctor generally practices. He or she practices on "patients," who sit patiently in waiting rooms for extended periods of time. Also self-explanatory terminology.

The doctor speaks of "his" or "her" patients and there is no doubt about the validity of the possessive pronoun used here. When you sign in with the registrar, you relinquish all personal and legal rights to both body and soul. If you don't believe me, you haven't read the fine print on those forms! The patient must voluntarily and wholly submit to the doctor, not only for the duration of the visit, but until pronounced healed or dead. Neither condition is good for the health-care profession, so no one is ever completely healed, and dead people are hooked up to tubes and machines to keep their organs functioning as long as the insurance or patient's family agrees to pay for it.

When doctors prescribe medicine for their patients or refer them to specialists, the patient's owner-doctor is always noted on the paperwork. This is important for both the doctor and the pharmaceutical companies, but I will deal with this more in Chapter Two.

Your name is no longer important when you are in the care of doctors and medical institutions. Only Social Security numbers and insurance company names are important. If you are a senior citizen, the Social Security number which you have been instructed to guard with your life lest someone discover and misuse it, becomes your Medicare number. Anyone over 65 must show this to all who request it after which it is photocopied and typed into a computer.

An elevated type of doctor is called a "specialist." Specialists specialize on specific body parts (self-explanatory). Specialists have professional titles which end with "ist." This is true of the lowly dentist and the lofty cardiologist and all those in between. There is a certain hierarchy among specialists which can be recognized in the way they greet or refuse to greet each other, by the cars they drive and the proximity of their private parking spaces to the hospital or clinic.

If you have had open heart surgery, as I have, many specialists worked on you. One is a specialist for valve jobs and another for bypasses. Other specialists do stents, cutting, sewing and simple tasks like putting you under.

As I stated above, there are medical specialists for every part of the body and tasks pertaining to these parts. But there is one notable exception. No specialist is responsible for male sexual organs. Such organs and deficiencies thereof are a frequent topic of vulgar jokes, and profitable business ventures seek to meet the perceived need to enhance and improve the performance of such organs. But, to my knowledge, there are no medical specialists responsible for men's sexual organs. Both women and men may talk freely about ailments pertaining to female sexual organs without anyone raising an eyebrow. There is no need to blush when discussing a hysterectomy or breast cancer in public. You can pray for those with cervical or ovarian cancer in church prayer meetings, but any reference to ailments pertaining to male genital organs is considered improper and even immoral.

Twelve years ago, I started having trouble sitting due to pain in my left t-------. People who noticed would whisper in my ear, "Have you tried Preparation H?" If it was a man, I tried to explain that it was my left t------- that hurt. Most didn't want to know any more and apologized for intruding into personal matters.

You can get a little more personal with a pastor, whose job is counseling and who is bound to protect a person's privacy. I jestingly told our pastor that the only comfortable seat in our home was the toilet seat. He suggested that the Trustees could install a toilet in the sanctuary and put a sign on it, "Ralph's Throne." I replied, "Yeah, the great white throne of judgment!" My dear wife overheard that conversation and while I was at a meeting, she traced our toilet seat onto a piece of cloth and made me a seat cushion. It was fine, but I didn't want to take it to church because she used white canvas material and it actually looked like a toilet seat. She then made me a horse-shoe shaped pillow of blue denim which I could take anywhere. I get some weird looks, but most people think I have back problems or they think, "Preparation H" and politely look away.

I eventually mustered up courage to see a urologist, which is the closest a doctor gets to being a specialist for male genital organs. There are no female urologists. The urologist prefers to be associated with the prostate gland, but my general practitioner discreetly hinted that a urologist might be able to help me.

The receptionist in a doctor's office (always female) normally asks what your problem is, but at the urologist's office, she politely asks you to sign a paper and write the reason for your visit.

Every time you visit a urologist, you are asked for a urine sample because it is good for business. No one is embarrassed because you donate privately in the toilet with no one looking. Once, when I placed the filled cup on the designated shelf, I jested to a nearby nurse, "This was mine, but now its yourine." She didn't think it was funny.

My urologist didn't spend much time checking me out but simply prescribed an ultrasound.

People who take pictures of our insides are also specialists, but they are not honored with an "ist" in their title. They are called technicians. There are catscan technicians and petscan technicians, but to my knowledge, there is no dogscan technician. I've only had dealings with x-ray technicians before, and this was my first visit to an ultrasound technician.

Ultrasound technicians are usually female and they normally do wombs and talk to expectant mothers about the gender of their unborn children. They show them enlarged pictures of the obvious indicator if it is a boy or the absence of the same if it is a girl. When the ultrasound technician makes a mistake, it can cause a traffic jam at the department store exchange desk after the baby is born.

Occasionally, an ultrasound technician must photograph adult male genital organs. Ultrasound technicians obviously hate their jobs when that happens. The lights are dimmed and the monitor is turned so that the patient can't see it. Although the patient is wearing a hospital gown, she covers him with a blanket so she can't see anything except the monitor in her darkened room.

I never saw my ultrasound picture, but the ultrasound technician wrote in her report to the urologist that my left testicle (she actually wrote that word) was swollen. I could have saved her the embarrassment. We both knew that.

The urologist said that a hydrocele (Microsoft Spellcheck does not recognize this word, nor does it recognize the word "spellcheck") operation should solve my problem. By this time, I was desperate enough to try anything that had even a remote chance of giving some relief. An operation was scheduled for May 14, '03 and the urologist became my surgeon (another category of medical personnel). I was sent home immediately following the operation. My s------ swelled to grapefruit size and turned dark purple. It didn't return to near normal for 8 painful weeks.

When the wound was healed and the swelling gone, the pain was still there.

In desperation, I began to search the internet for information on my problem and possible solutions. At first, this was like looking for food in a garbage can. The world-wide-web is full of references to male genitals, most of it pornographic. A few websites had serious medical descriptions of how a person's gender can be operatively changed from male to female. I didn't find any websites about the opposite transformation, which would be conceivably more difficult to accomplish.

I eventually discovered that there are actually a number of serious medical websites where you can find helpful information on any facet of the medical profession, provided you understand the terminology. Even those organs which are distinctly male are covered. I learned, for example, that removal of a t------- is called an orchiechtomy (also unknown to MS Spellcheck). There were detailed explanations on how the orchiechtomy is performed and the limited effect it has on sexual activity. Two websites even took pains to explain how NOT to perform the operation. The surgeon is to cut along the "bikini line" (that puzzled me since this operation is only performed on men) to remove the t------- and not attempt to operate through the s------ wall. That should have been fair warning, but I falsely assumed that a urologist would know how to do an orchiechtomy.

When the pain in my t------- became unbearable, I returned to the urologist and asked him to perform an orchiechtomy on the offending organ. He agreed and set a date for the operation.

I should have known that it was going to be a bad day when I had to show the anesthetist that there was a kink in the tube he had inserted in my arm. He looked and said, "Oh, no wonder it's not working!" The operation was soon over and I was sent home. You probably guessed it; the urologist/surgeon removed the t------- the way those websites said it should NOT be done! He probably couldn't find my bikini line.

The swelling was worse than after the hydrocele and pain was intense. When it hadn't subsided after two weeks, I returned to the urologist seeking relief. He decided to siphon out some of the blood that had built up, which was causing me the pain. He tried with progressively larger needles and finally gave up. He said the blood was coagulated and too thick to enter the largest syringe he could find. It took 8 long weeks for the purple color to dissipate and the swelling to recede.

The pain which I had been experiencing for the past ten years was still there and even intensified, so I decided to get a second opinion. A friend who worked in a Delaware hospital recommended me to the "best urologist on the east coast." I got an appointment and he said that another operation would probably not alleviate my problem. There was little that he could do about the aggravated blood vessels, scar tissue and damaged nerves. He advised me to live with the problem as long as it is tolerable. That was the best advice a doctor ever gave me. I have developed what my wife calls "an elevated pain threshold." The diagnosis of the best neurologist on the East Coast has become my favorite expression. Whenever I hear someone complain, I say, "Live with it!" Unlike members of the medical profession, I don't charge for my advice.

I find it much easier to live with discomfort than with people who notice it and ask questions. It's impossible to hide my condition from others, and friends often want to help. It is especially embarrassing at church. Normally, if you tell one person about a health issue, the whole church knows within hours. In some churches, this is called the "prayer chain." But nobody wants to spread news about an orchiechtomy. So, over and over, you tell your story and it goes something like this:

"Would you be willing to help with...?"
"I'm sorry, but I won't be available."
"Where are you going?"
"I have an operation coming up."
"Oh? What kind of an operation; hopefully nothing serious."
"No, it is just same-day surgery."
"What is it called?"
"An orchiechtomy."
"What is that? I never heard of that before."
"It is sort of like a male hysterectomy."
"But only women have those!"
"Let me just say that, afterward, I will be half the man I used to be."
"I don't understand..."
"With animals, it is called a castration."

The questioner then pales and almost faints. I used a bad word -- in church!

How different it was in Bible times. Eunuchs were highly esteemed and honored after sacrificing their family jewels for the good of the nation. King Ahasveros placed Esther in the care of his trusted eunuch and the Ethiopian eunuch was trusted with the national treasury. Babies were circumcised with family members and friends looking on and celebrating.

Throughout the history of the Christian church and into the middle ages, little effort was made to hide evidences of sexuality. Numerous paintings depicted the blessed virgin nursing the Christ child. Masculinity seems to have been especially important. In the Sistine Chapel, where Popes are made, Michelangelo covered the walls and ceiling with naked or almost naked bodies, and not all of them are cherubim. Religious paintings dating back to the middle ages show men dressed in pants which exaggerate the proportions of their sexual organs, similar to women's garments today.

With all the explicit sex being promoted on TV and in Hollywood, and especially considering the exploitation of female sexuality, it is difficult to explain the modern aversion to any public reference to male genitals.


You should always see a general practitioner at the slightest sign that something is wrong with your body. You should never attempt to see a specialist first. The specialist would ask who sent you to him and why you think you know what is wrong. Specialists don't meddle in each others domains, but they do cooperate. For one thing, they make certain that colleagues in other specialties get a fair share of the business. For example, if the cardiologist discovers you have mouth odor originating from a bad tooth, he refers you to a dentist. If you have a heart attack sitting in the dentist chair, the dentist will likewise refer you to a cardiologist. Referrals, like prescribing medicines, are profitable sidelines in the medical profession. That is why all advertisements for medicine include the words, "Ask your doctor..." If you are not sure that something may be wrong with you, then you are not watching TV or perhaps you have a Tivo that allows you to skip the commercials. At the very least, you have aches and pains or can't sleep. If you are male, you probably have ED and if female, you likely have RLS. The first thing you do when you see your doctor is ask if that stuff you saw on TV is right for you.

It is.

If we avoid seeing a doctor voluntarily, our bodies are constructed so that we must be carried into their presence. And more often than not, one malady leads to another. If you put off going to the dentist, you get an infection that requires you to see your general practitioner who prescribes medicine and when that doesn't work, he or she refers you to a specialist.

In the summer of 2005, I was a perfect specimen of health except for the nagging pain in my groin. I was getting plenty of exercise including a daily 45-minute walk. My wife cooks healthy meals, bakes whole grain bread and makes fantastic granola. I avoid fast food, tobacco, alcohol and anything that contains saturated fat.

While mowing the lawn on a hot August day, I had shortness of breath and a strange feeling in my chest. I took a brief pause before finishing the job. The next day, while my wife and I were taking our daily walk, the same feelings came over me and I stopped to catch my breath. After a minute, we continued but only for a few steps before it returned. This time, I told Verna that she could take the walk by herself. I was going home to rest. She went with me and called our family doctor.

He ordered me to the Emergency Room immediately!

I spent the next three hours getting my blood pressure checked, blood tests, a chest x-ray and an electrocardiogram. Everything checked out just fine, so they sent me home. As a precautionary measure, I was to return in three days for a stress test.

I had never had a stress test before and I flunked it big time! The doctor injected nuclear fuel in my arm and put me on a treadmill. After a minute, he increased the incline and speed a little and asked how I felt. I said I felt fine, but he suddenly shut down the treadmill and made me sit in a chair. An attending nurse placed a glycerin tablet under my tongue. That is when I felt the same sensation I had when mowing the grass and taking a walk. The cardiologist said that I had a mild heart attack and would not be going home soon. He actually saw it happen on his computer monitor! I got an ambulance ride to Cooper Hospital for heart catheterization.

I can remember the days when ambulances and hearses were luxurious, smooth-riding Cadillacs that only differed in color. The hearse is still the same, but ambulances are now rough-riding box trucks. The opposite should be true. The sick or injured person is subjected to every bump in the road, but a dead person feels nothing.

When I woke up after the catheterization, a cardiologist told me that I needed quadruple bypass surgery.

All my life, we Harvey boys (there were six of us) considered ourselves to be indestructible. I survived riding 60 mph on a homemade go-cart with no brakes and I survived the spanking I got for wearing out my new brake shoes. By the time I was married, I had built 38 cars from junkyard parts and although they looked and sounded like accidents on their way to happen, the only ones I wrecked were destroyed on purpose. A neighboring farmer had a gravel pit where I practiced roll-overs with a '35 Ford coupe. I wore neither helmet nor seat belt but I did weld a roll bar in the car to make it last longer. Now this doctor dude in a white coat was telling me I could be killed by something as tiny as a clot!

I argued with him, saying that I didn't want the operation. He looked startled and said, "You what?!" I explained that I was one of those rare Christians who didn't mind going to heaven. He said that he too was a Christian and gave me a little sermon that got me converted. He said that heart attacks are more likely to paralyze than kill. Did I want my wife to spoon feed me and change my diapers for the rest of my life? I didn't; he operated, and here I am writing about it. Heaven has to wait!

My bypass operation went without a hitch. When I recovered consciousness, my lovely wife was at my side and I was attached to many tubes and wires. I was to remain in the hospital for recovery and observation, so I told my wife she should leave and get some sleep. She was hosting a stamping party the next day and we both would need rest, so she agreed not to visit. I called later and asked how the party went. It went fine, but when she told me what she had given guests as door prizes she made me laugh. You are not supposed to laugh cough or sneeze after heart surgery! We had a bumper crop of tomatoes that year and Verna gave everyone a small basket full.

Except for catching a live cockroach and giving it to the head nurse, my hospital stay was without incident. When they told me I could get dressed to go home, I was elated. I called Verna to pick me up, packed my things and was headed for the elevator when the head nurse saw me and went into shock - again. No one told me that an orderly had to take me to the car in a wheelchair.

I had blood work done prior to the operation and every six months since. All my vital statistics would make most people green with envy. My family doctor told me so. Many people have bad good cholesterol, but even my bad cholesterol is good. When I asked why I was a heart patient, my cardiologist said it probably runs in the family. All my predeceased relatives had heart failures, but they died of other causes. Now, when anyone in my family is asked by a doctor if someone in their family has had heart issues, they have to answer "yes" - all because of me!

I determined to get to the bottom of this mystery because cardiologists are only concerned with operations and prescriptions. Using that wonderful invention called the Internet, I Googled a perfectly plausible explanation. It is called "inflammation." The more I read, the clearer it became that I should have had a C-Reactive Protein (CRP) test. People who have arthritis and other maladies which cause frequent or constant pain, are prime candidates for heart disease even though all other indicators are negative. You only know about the presence of inflammation if they do a CRP test.

I am still in perfect health, but have constant pain, so I take fish oil and beta blockers to keep from being diapered and spoon-fed by my dear wife. The cardiologist told me to take Lipitor, but I quit without permission after reading what it can do to my liver. Several months later, I had bloodwork done. My cardiologist said he was happy with the results and asked if I was getting plenty of exercise. I told him that I took two 45-minute walks a day, and that I had shoveled and spread four tons of topsoil the day before. That made him happy, but when he discovered that I was no longer taking Lipitor, he winced. That would cost him vacation time!

When I returned to the cardiologist for a check-up the following year, he looked at my papers and asked, "Did you shovel four tons of dirt yesterday?" I replied, "No, but I poured five yards of concrete; does that count?" He again said that I should be taking Lipitor, even though my cholesterol numbers were fine.

There are things the cardiologist doesn't tell patients. It was my therapist who told me I should no longer shovel snow. More people are killed by snow storms than hurricanes and tornados. They have heart attacks shoveling the fluffy white stuff. Because I don't want my wife to become a widow or have to spoon-feed me and change my diapers, I bought a good used snow blower for $150. When I told my cardiologist, he said, "hopefully not a pull-start." I replied that I had a pull-start lawnmower, pull-start weed whacker and pull-start chainsaw; why not a pull-start snow blower? He said that snow blowers have larger motors. I bought an electric-start snow blower and tried to sell the other one. It didn't snow all winter. Everyone was trying to sell their snow blowers to pay off Christmas debts. I finally sold mine for a $50 loss. I actually considered buying a generator with electric start, but how does that work in a power outage?


In 1996, I got a pimple on my left forehead that didn't go away and it started to bleed, so I went to my general practitioner. The good doctor sent me to a specialist for skin conditions, called a dermatologist, who took a biopsy and sent me home. About two weeks later, his secretary called to say I needed to come back. I had skin cancer.

I had heard a lot about cancer and watched a few people die of that dreaded disease. I love to sail and had only recently read a newspaper article that said sailors are especially vulnerable to skin cancer. The article also said skin cancer was the worst kind of cancer and if you get it, you can be dead within six months. The author was of course writing about the dreaded melanoma, but I didn't have a clue that there are different kinds of skin cancer. Only the melanoma is deadly. If you have the basil cell carcinoma or squamus cell variety, you don't die. At least not all at once. The dermatologist kills you one piece at a time. I have had scores of operations for skin cancer and expect to go through many more, but I probably won't die of skin cancer.

If you are ignorant about how people get skin cancer, please allow me to explain. If you live in a place like Austria, that has long winters and short summers and then expose too much skin in summer, you are a prime candidate for skin cancer. And I discovered that you should not lay on a beach for even an hour if a Russian atomic reactor has exploded within a thousand miles of you.

On April 26, 1986, a reactor in the Ukraine blew its stack and spewed out deadly plumes of radioactive fallout. Everyone has heard of the Chernobyl reactor incident by now, but it took the Russians a week to tell the rest of the world and even then, they played it down. My wife flew to America to attend our son's graduation from college on May 2, leaving me to keep the house and fulfill my obligation to the church. Sunday, May 4, was a lovely spring day. I preached in the morning service, grabbed a bite to eat and headed for nearby Attersee Lake to bask in the sun. Meanwhile, nuclear physicists who worked at the International Atomic Energy Agency in Vienna, thought it would be a good idea to check Austria's air quality. To their horror, they discovered that the highest readings in Europe were registered in Austria -- at Attersee! I heard the news on our car radio while driving home.

Most Austrian crops were condemned and we had to change the sand in the sandbox. The sandbox was not for us, but for children of married students in our Bible Institute. When I asked where the new sand came from, the truck driver said it was from a pile located behind the building supply. Apparently the radiation missed that spot.

In 1995, my dermatologist said that the incidence of skin cancer in Austria had increased 10 times since 1986.


I could go on and on about my experiences with medical institutions and personnel, but this will be the final chapter. I hope.

I have already described the main actors of the medical profession, but I think I should explain what one specialist does in more detail. There are specialists who work on you from the outside and others who work on your insides. Of those who work on your innards, some work by remote control, using tubes, lasers, catheters etc., while other specialists actually open you up and get bloody. My bypass surgery involved all the above.

The generic term for a medical invasion of the human body is called an "operation" or "surgery." The simplest form of surgery is called a "procedure" or "same day surgery." Then comes "general surgery" and finally, "major surgery." The ranking is just the opposite of military protocol. "Major" surgery" is more important than "general surgery" and military "procedure" takes precedent over both. The military is also about operations and invasions, but I'm not sure if a "surge" has anything to do with surgery.

Many procedures hardly qualify as operations or surgery, but they still involve a full or local anesthesia. The colonoscopy is one such procedure. Doctors prescribe colonoscopies for anyone over 50 but my wife and I somehow managed to escape until we were well over 60. Because a person is unconscious during the colonoscopy, the procedure itself is no big deal for the patient. The preparation is something else. You are told to drink a gallon of lousy tasting stuff that really cleans you out. On the evening before a colonoscopy, you never stray more than three feet from a toilet.

The doctor who was to perform the colonoscopy ordered us into his office a week before the procedure to give us "pre-op instructions." Since we were both having the same procedure, we asked him to share the instructions with both of us at the same time. This would have saved him and us ten minutes, but he refused to oblige. When we saw what he charged our insurance provider, we could understand. For $250 each, he told us what could have been recorded onto a cassette tape for all his customers.

Fortunately for us and unfortunately for some other specialist, we didn't need an operation. The procedure cost our insurance provider about $2000. The nurses had an unflattering name for the doctor, who reportedly does ten colonoscopies a day. The hospital and attending nurses get a share in the take, but "Dr. Poop" can easily afford his BMW.

By this time you must be very thankful that I have written the final chapter. It surprises me that you read this far!

Ralph V. Harvey, March, 2007