For just one moment… forget about what Jesus would do.

Today was a good day at work.

I cried.

The last time I recollect crying at work was at least 6 or more years ago when a patient of mine – a young black male, who was his mother’s only son – had been murdered, and as I looked into her bloodshot, tired, hollow, intently peering and watery eyes, volumes were communicated though we neither said a word.

I couldn’t bear her gaze, and after what seemed ages, I averted my eyes, and departed behind a nearby curtain in the Trauma ICU to cry. There, my tears flowed like twin rivers, swollen by a storm, albeit an emotional one, which was joined by the two smaller tributaries of my nostrils. Gazing over the city from atop the 11th story of the teaching hospital through tear-drenched eyes, I wondered… was this what dear Mother Mary felt like when she gazed upon her only son as he hung from that cross?

Today, I wept for a young white woman.

We always weep for the living. We never cry for the dead. We either cry for our own sense of loss, or for those who have lost.

But we never cry for the dead.

Never.

While I am not ashamed of my tears, after my involvement in her case was concluded, I departed to the dressing room. Because I could not bear the thought of showing my tears to others, I sought refuge in a toilet stall, where toilet tissue was of little comfort to me as I prayed.

We had performed a preparatory and exploratory colonoscopy upon a young woman in her late 30’s, who, according to one of the two residents present, was scheduled to have major surgery within a few weeks, in which her bladder, urethra, ovaries, fallopian tubes, uterus, cervix, rectum, anus, labia and vaginal vault would all be removed. As well, she would be given another parting “gift”… a permanent colostomy. That entire radical procedure is called a “pelvic exenteration,” or “pelvic exoneration.” Both terms are equally understood, and correct.

Colonoscopy is a procedure in which a patient may be, though not always, anesthetized, often with propofol – which is an excellent medication, because it is quick-acting and wears off equally quickly – in which a flexible tube with a camera and light upon the end, is inserted into the anus, and threaded up into and through the large intestine (which is also called the colon, hence the term “colonoscopy”), and the internal walls of the colon are visualized to detect the presence of disease, or that which often may become diseased.

Thus, in the process of facilitating that procedure, a patients’ perineum and genitals are exposed. Every effort is made to provide dignity to the patient throughout the procedure, by covering as much of their bodies as practicable. Because of the anatomic structure of the female, it is often difficult, if not impossible to completely cover the genitals during the procedure, but only slightly more so than the male.

And so, it was in the course of my work today, when I glanced down at the patient for whom I was caring, observing the physician’s hands and the scope, I happened to notice what appeared to be a rather large, unusual-appearing growth that seemed to be emerging from upon the patient’s labia. It was a condyloma – a very large genital wart, or collection of warts. Genital warts are caused by HPV, Human Papillomavirus.

She had first been diagnosed 15 years ago.

I was dumbstruck as it occurred to me what that woman very well might endure.

Fifteen years ago.

Fifteen years of HPV had done its damage.

That’s fifteen years of unfettered HPV growth.

Now, in order to save her life, her body will be permanently disfigured.

I do not know if she was married. Nor do I know if she had children. I do know her life will forever be changed.

My mind raced as I imagined what she might endure.

After recovery from the surgery, I sincerely wonder if she will never recover emotionally. I could be wrong, and hope that I am. But imagine this: no more sexuality. Her very identity as a woman will be removed. There’s a very great likelihood she will likely not have a partner the remainder of her life, and quite possibly could very likely become depressed – perhaps even deeply so, and for an extended period of time – must pass feces into a bag which requires daily change, similarly urinate in a bag which also requires daily change, and purchase ostomy materials until the day she goes to her eternal reward. And that, is just a good start.

Quite frankly, I would imagine the quality of her life will be very low. But, odds are, she can survive.

Now, we have an inoculation that has demonstrated effectiveness against HPV – Gardasil and Cervarix – which protect against the two types of HPV (HPV-16 and HPV-18) that cause 70% of cervical cancers, 80% of anal cancers, 60% of vaginal cancers, and 40% of vulvar cancers, and most HPV induced oral cancers. Gardasil also protects against the two types of HPV (HPV-6 and HPV-11) that cause 90% of genital warts.

Many may not know how common HPV is.

HPV is the most common sexually transmitted infection in adults, and by age 50, over 80% of all American women will have contracted at least one strain of HPV.

When news of the vaccine was announced, it was received with great joy in the medical community, but received a lukewarm welcome – if not outright rejection – by the fundamentalist religious Christian community.

Typically, the line of thinking on sexual behavior in the fundamentalist Christian community goes like this: People shouldn’t be having sexual relations outside of marriage – either before marriage, or during marriage – so “keeping your pants on” is the best way to prevent sexually transmitted disease.

Why, of course it is! There’s absolutely no denying that fact. And, it is a fact. However, not everyone can, nor will every unmarried soul remain celibate. Some may become celibate later in life. Some may be lifelong celibates. However, few are. And in fact, many practice “serial monogamy,” which is defined as being sexually faithful to one partner, while in relationship with that partner. However, for one reason, or another, people change partners either by choice, or default.

However, here’s what has been so blatantly avoided in discussion… fifteen years of unfettered HPV growth, and the gross disfiguring that accompanies such radical surgeries sometimes required to treat or (hopefully) eliminate the disease.

Several adages come to mind.
“You can pay me now, or you can pay me later.”
“An ounce of prevention is worth a pound of cure.”
“Do not put off tomorrow what you can do today.”

Yes, you can pay me now, or you can suffer later.

I simply cannot imagine that someone – anyone – would knowingly relegate a person to a life of suffering if they could have prevented that suffering. If they could have prevented that decline in health. If they could have prevented that unnecessary cost of hospitalization, and more.

To do so is purely cruel. It is definitely anti-Christian.

Rarely am I ever at a loss of words, and rarely am I ever at a loss of how to express myself in writing. Yet this is one moment in which I find myself somewhat stymied in that regard.

Think of what it might be like if this were your spouse, your daughter, your sister, your relative or loved one.

For just one moment… forget about what Jesus would do.

What would you do?