In Abeyance of a Colonic Resection

By: Patrick Johnston

At some point, nearing the advent of his 56th year, Atticus Johnson became aware of a small god that inhabited a cave in the back of his mind. Although he had not been previously aware of the small god’s existence, it nevertheless seemed to him that the small god must always have been there, for the cave was ancient and seemed to have been inhabited for a long time.

When Atticus Johnson became aware that the small god was dwelling in a cave somewhere at the back left of his mind, he also had the sense that the cave was situated slightly to the left, which he found slightly odd, since whilst it seemed obvious to refer to parts of his brain in such simple spatial terms, it had never previously occurred to him that his mind might share a similar geography.

Another slight oddity that accompanied Atticus Johnson’s discovery of the small god in his hidden cave, at the back left of his mind, was that it never occurred to him to wonder whether the small god had a name, or indeed to give him one. He simply contented himself with thinking of the small god as “the small god.” Rather, he was almost solely concerned with the question of what the small god’s purpose was, and sometimes gave some small thought to the matter of how the small god came to be there in the first instance.

His thoughts on this second matter generally led him to the conclusion that the question was futile, since all evidence pointed to the likelihood that the small god had always been there and must have taken up residence in the earliest stages of development of his brain, or mind, or whatever substrate gods require to make a home. He spent much more of his time pondering what the small god’s purpose was. Because for almost infinite periods of time, the small god simply did nothing but sit and look at his fire.

It was following the elective but entirely necessary surgery, when they cut out a stretch of my lower bowel measuring approximately thirty centimeters in length, including the S-bend known as the sigmoid colon, that I first became aware of the presence of the small god. Before the surgery I had no inkling that he was there, but after the surgery his thereness has been a constant part of my knowing.

The surgery was required since I had been suffering from repeated episodes of diverticulitis, a condition which was extremely painful and which held a risk for perforation of the bowel, which itself could prove fatal. The lower part of my colon was in tatters and was prone to repeated infection, and so the medical advice was to have it removed.

On the first occasion that I suffered from diverticulitis I ended up in the Emergency Department of a hospital, so great and debilitating was the pain. I had already been diagnosed by my General Practitioner, who had contacted the hospital. When I saw a doctor in the Emergency Department, more or less the first thing he said to me after establishing my identity and that I did not suffer from any allergies was, “Would you like me to give you some morphine?”

I replied, “You and I, sir, are going to get along just fine.”

On the second occasion that I ended up at the Emergency Department, suffering again from the same condition, the doctor in attendance told me he would give me some fentanyl. My initial reaction was one of mild annoyance that he wasn’t going to give me morphine. I later discovered that fentanyl is, in fact, a much stronger opioid than morphine. On neither occasion did I offer any account of my previous experiences with opiates.

Repeated episodes of diverticulitis led me to eventually take the advice of my doctor to go under the knife so as to have the offending section of colon resected, which is to say, cut out and disposed of. This would involve having to go under general anesthetic, for which I had no real appetite, but accepted the necessity.

In the earliest post-operative stages of my recovery from surgery, when I initially became aware of the small god’s presence, I had little control over my observation of his activities. I could not make the conscious decision to check up with him as I now can, and do, as an intentional act. I would be simply there in the cave observing him, or I wouldn’t. Or I would simply be looking at the cave mouth from the outside, watching the tendrils of smoke that escaped its mouth or the chimney crevice of the cliff above, aware of the goat turds and the movements of the dried clumps of grass in the dry warm breeze. Or I wouldn’t. And these states would have the quality of seeming to be endless. And simultaneously to be excruciating in their mind-numbing monotony, but at the same time strangely reassuringly comforting in their constancy.

Of course, all of this went on after consciousness returned to me following the odd jagged discontinuity of its absence that I had experienced three times before.

On this occasion I had been aware of having a conversation with the anesthetist who had come to speak to me whilst I was lying in a hospital bed, waiting in the holding area to be taken into the operating theatre. I remembered that the anesthetist had a kind face and pale grey eyes, and that when I had said to him, “So… you are the person that is going to keep me alive?” he had replied that yes, he was that person, and I remembered that I had suddenly felt a profound sense of gratitude to him that had moved me almost to tears, since I had immediately believed him — that it was true — that he would keep me alive.

I remember him giving me an injection of something that would help me relax. I remember being wheeled into the operating theatre. I remember greeting the surgeon, who was known to me and whom I liked. I remember them placing warm blankets on me, which felt good. I remember them telling me, “Now we are going to put you under…”

…then I remember a nurse telling me something. I think I said, “What?” I think she said, “It’s all over.” I think she said, “You are in Recovery.” I think she said, “Everything went well.” I think she said, “You are ok. Everything is ok.” I think I might have said “Yes.” I think that when I spoke, my voice felt and sounded strange, as though it was someone else. I think I fell asleep.

I think that was when I first noticed the small god. It seemed like he was in his cave. It seemed as though he was sat on his stool staring at his fire. It seemed as though the whole scene was taking place in the back of my mind. Slightly to the left. And I just watched him forever, whilst he just looked at his fire.

When I next awakened, I simply attributed this experience to being some form of post-operative delirium, or perhaps some residual effects of the various drugs that they had given me, altering my brain chemistry and thereby playing tricks on my mind.

For perhaps the next twelve or so hours I drifted in and out of sleep. People woke me to take my blood pressure and temperature and to measure my blood oxygen saturation. People woke me to move me to a ward. People woke me to give me medication. People woke me to ask me if I was in pain. Yes. I was in pain. People asked me to confirm my name and date of birth. People gave me strong opioid drugs. People woke me to take my blood pressure and temperature and to measure my blood oxygen saturation. The surgeon woke me to tell me that the operation was a success. She told me some other things about some minor complications, which I immediately forgot about.

In between being awakened I dreamed dreams. I dreamed all manner of dreams. But I also spent a lot of time looking at the small god. Sometimes I was inside the cave. Sometimes I was outside the cave. When I was outside the cave, I knew exactly which cave it was and who was inside. Sometimes I had my own thoughts whilst I watched the small god; other times I just saw him, with my mind otherwise and forever bereft of content. Again, upon waking, or sometimes even whilst watching, I had the thought that this kind of experience was probably the kind of thing that is fairly normal in the immediate period following surgery.

Over the days that followed, I began to spend more time awake and more time in a space of coherence and logic. I was still in substantial pain when the opioids wore off. They had given me a button that I could press to self-administer small doses of fentanyl. Once I had pressed the button, its light went out, and no amount of pressing the darkened button could induce it to relinquish more of its life-giving elixir until a further five minutes had elapsed, and it again showed its light.

I was reduced to the status of a laboratory rat, endlessly watching for a signal and responding to that signal in order to receive my reward. I imagined myself trapped in a cage with my white fur and whiskers and pink eyes — Sprague-Dawley, the behavioral scientist’s best friend — whilst they gleefully watched how easily my behavior was shaped by their manipulations. To what end, I thought? Why do they need me to endlessly press their goddamn button?

Of course, I knew in reality it was my button, and my pain, and my fentanyl. And when I was asleep, sometimes I was with the small god. And when I was half-asleep, sometimes I was with the small god. And sometimes when I was awake, I thought I knew the small god was there too. But at that point I still imagined that he would most likely go away soon.

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