Lying in bed one night, I found a lump on my testicle. This was Spring 2009; I had recently turned thirty. To be certain, I fondled the protuberance with my fingertips, discreetly worrying at it until there was no room for doubt – a small node on the right side not present on the left. My heart sank, my stomach roiled in queasy appreciation. This was it, the moment you think will never happen to you. Certainly not in your twenties but they, it seemed, were long gone. As I lay there, my wife beside me (oblivious to my intestinal turmoil), I made a snap decision – the single most imbecilic, feeble and contemptible of my life. I would ignore it. If I pretended it wasn’t there, maybe it would go away. I said goodnight, turned off the lights, and lay there staring into space.
Why had I reacted like this? I had one of the most supportive people I’ve ever met lying right next to me yet my instinct was not to mention it. Rather than share, which would have allowed me to tap into the unwavering reservoir of support that my wife, Kim, provides, I chose to hide it. Simple: embarrassment. It was too much. Not the embarrassment of becoming ill, (although the idea that my immoderate lifestyle was finally catching up on me, you reap what you sow, the pigeons coming home and all that, did cross my mind as I lay there pretending to sleep), but of having to show a doctor my junk. I was so mortified by the idea that in that instant, I made the fateful decision. It was preferable to slowly die of testicular cancer than to get it checked out. I fell into an uneasy sleep.
This secret, that I had a tumor in my bollix, I lived with for months. I compartmentalized the issue, stored it neatly amongst the bric-a-brac of long-lost friends and childhood clothes at the back of my brain. Nightly I would check and recheck my right testis to see if I could be mistaken, hoping beyond hope that somehow this lump would miraculously disappear, but to no avail. Every time I checked, there it was on my right, there it wasn’t on my left. The old queasiness would roll through me and I would turn over, close my eyes, and hope that when I awoke the next morning, it would have all been a bad dream.
After the first year, I became aware that the growth was living up to its name. Previously, when I first noticed it, it had been more or less the size of a pumpkin seed, whereas now it had doubled to the size of a pea. There was no pain, no tangible decline in my fitness, no erectile dysfunction, no hair loss (which I know is caused by the treatment of cancer rather than the cancer itself but the association is strong). No ill effects to speak of at all. This did not, however, inspire confidence. I may have felt fine, but it was inevitable, the tumor was metastisizing inside me. It was only a matter of time, I was sure, until the ticking bomb in my ball sack went boom.
Still, I kept shtum. The bigger fear, even bigger than dying from a disease slowly but surely forming in my very core, was to have to expose myself to a medic. This is far and away the most pathetic thing about the whole story. I had conditioned myself to think this way. It was hard-wired into me. Years upon years of schoolyard banter, taunts by friends at me or more likely by me at friends, had emotionally stunted me to such an extent that I was paralyzed with fear. Death was preferable to potentially opening myself up to ridicule. A literal case of toxic masculinity if ever there was one. This is all the more embarrassing to admit given that Kim had just given birth to our first child. During this time, as practically all pregnant women do, Kim had undergone any number of smears and scans and prods and probes, yet I couldn’t even bring myself to get checked for cancer? Not just putting my own risk at health, but potentially tearing our newborn family apart just as we were starting a life together.
Another year passed. Still no illness, no pain in the marrow, no thinning hair (I’m aware I’m an idiot, this is the point). We were trying for another child, we wanted a bigger family, and after several months, Kim became pregnant again. We were over the moon. So much so, we decided not to wait until the traditional twelve-week mark to tell people, but instead told friends and family at around week nine. What was the worst that could happen? we reasoned. If there did end up being a problem, surely it would be better for our friends and family to know than have to go through it alone. The theory soon got put to the test. At the next scan, week eleven or so, we were told the pregnancy was ectopic, the foetus was, for want of a more medical term, stuck in one of Kim’s fallopian tubes. We were to lose the child but, with immediate treatment, they may be able to save the tube. A hammer blow, we were devastated, but, thankfully, we didn’t have to go through it alone. Our friends and family swiftly rallied around. Kim subjected herself to more probes and scrapes, pills and poisons, and I did my second-best to support her. I did everything, absolutely everything I could, except, of course, from subject myself to anything remotely similar. God forbid. What if somebody poked fun at me?
Another year passed. The lump had, at least, remained pea-sized throughout. This did little to encourage me though. I was sure this could only mean the tumor was boring inwards, its ever-metastasizing carcinogens seeping deep into my dick, my other ball, my spine. By now, I knew, I could be riddled, and there would be nothing I could do about it. Through a mixture of embarrassment and prudishness, I had let myself die. I’d destroyed our family. Finally, one night, after more than three years of procrastinating, I mentioned it to Kim.
You need to get that checked, she said without hesitation. No drama, no molly-coddling, just straight. She was right, I agreed, there was no time to lose.
Two weeks later, a helpful porter escorted me into a room in St Vincent’s Hospital in Dublin, asked me to take a seat on the trolley and wait. The Ultrasound Doctor would be along shortly. A minute later, in walks a young, female doctor, extremely attractive, who asks me to lie back on the gurney and pull down my pants. This was it. The moment I had been dreading for so long, that I had put my health at risk for. What if, God forbid, she laughed at me or, even worse, I had an erection. Dublin is a small place; this woman could easily know people I know. With no small sense of horror and shame, I did as I was told. The doctor was in no mood to hang about. Without the faintest amusement, repulsion, or admiration for that matter, she slopped a dollop of KY on my ball sack and began nudging my nuts with a sonographic probe.
The experience was neither pleasant nor in any way, shape or form, arousing. It was perfunctory and sterile, and the doctor, like every other medic in the country, was actually there to help, not to laugh at or tease me like an immature child.
You’ve a cyst, she said matter-of-factly.
Is that, like... cancer?
Oh no, an epididymal cyst. They’re quite common, really.
Oh. Ok, I said, my fears evaporating like the mists of a new dawn. So, what do I do about it?
Nothing. Just ignore it. It’s not dangerous. If it gets too big, come back in and see us.
How big is too big?
The size of a fist.
At this, I almost choked on my own relief. The notion of having something the size of a fist tucked neatly betwixt my balls was abhorrent.
Whenever it gets to bothering you, she reassured. Here, she said, handing me a ream of blue tissue paper, clean yourself up. That’s it for today.
I went home to Kim. Everything was going to be okay.
Part 2
A decade passes. A second daughter is born, then a third. We have the family we have always dreamed of. My cyst is not yet, thankfully, the size of a fist. It is, however, the same size as the other two spheroids in my sack. This was considerably disconcerting, especially when playing football. I took one to the balls a couple of times that year and the pain was the usual agony but exacerbated by a crippling fear. The cyst might burst, I thought, leading to who knows what kind of a mess down there. There was only one solution. My third ball, the superfluous bollock, had to go.
I told my doctor the situation and we booked in for another scan. This was the diagnosis.
Below is your ultrasound report. There are several things that can go amiss in one's sack and you have more than your fair share. Good news is none of them will harm you unless they get too big and even then are only an annoyance to be removed. Your visit to the urology clinic in June will be infinitely more valuable with this done in advance and ideally they will offer you the chance to have some of these extraneous items removedThere is a 4.2 by 4 cm cyst in the head of the right epididymis, this has increased considerably in size since examination of 02/11/2012.There are small bilateral varicocoeles, larger on the right. There is a small left hydrocoele. No other focal abnormality in either testis is demonstrated. Conclusion: Interval increase in size of right epididymal head cyst. Small bilateral varicocoeles, larger on the right.
4.2 by 4cm cyst. Slightly larger than your standard ping pong ball. Two months later, having fasted for eight hours, I arrived at Loughlinstown Hospital for surgery. I met the consultant leading the operation, he made some crass joke about me being lucky to have three balls (obviously went to an all-boys school too), and I was escorted to wait in a ward. A few minutes later, I was in a cloud of blues and whites, six medics surrounding me. The mask went on and the lights went out.
I awoke back in the ward, groggy and weak. The surgery had been a success, I was told. I had pain along the centre line of my scrotum where the incision had taken place, but apart from that, all was well. The cyst had been removed; my balls were back to normal. Kim kindly picked me up, three relieved daughters in the back seats, and we went home. Despite having been under for two hours, or perhaps because of this, I was still exhausted by the time we got home. I shuffled into the living room, lay down on the couch, and promptly fell fast asleep for another hour. Then, at about eight p.m., I made my way upstairs, brushed my teeth, and crawled into bed to sleep the whole thing off.
Part 3
Break the fucking lights. This is what I asked – no, correction – begged of Kim as she pulled up behind a couple of cars at the junction of Ailesbury and Merrion road. Run the fucking lights, I screeched in hysterics, another wave of pain crashing over me. Run the fucking lights!
It was astronomical, the pain, like nothing I had felt before. I was teetering, on the verge of passing out. I needed to be in the Emergency Department fifteen minutes ago, when the pain was only threatening to pull me apart. Not now, too late, when it already felt like I’d been shot. The lights turned green, Kim raced through, pulling up in an ambulance bay where a kindly porter fetched a wheelchair and helped me into triage whilst Kim parked the car.
I’ve always fancied myself to have a reasonable tolerance for pain. I’ve played rugby with twisted ankles, broken fingers, a broken thumb. Every tackle sent a white-hot jolt up my arm as my thumb inevitably banged off the opposing player’s hip, but I played on, then strapped it up the following week and togged out again. This was different. For one thing, the pain was bigger, much, much bigger. It felt as if somebody had affixed a clamp to my gut and was slowly but surely jacking it apart. Like a hole was ripping inside me and it was only a matter of time until my guts spilled out on the floor. Then there was the fear. Despite not being localized there, the pain could only be emanating from my most delicate point. Something had gone wrong with the surgery and now there really was a problem down there. The pain was excruciating. I sat in my wheelchair in the E.D. waiting room and whimpered inconsolably.
Eventually, after an interminable half hour, I see an administrator. He asks me some details. My brain is too scrambled to communicate effectively but thankfully Kim is by my side, (in sickness and in health) and relays the pertinent points. How I had had an operation, what time the surgery, what time the pain kicked in, etc, etc.
Did you do any strenuous activity when you got home?
Not a thing. Slept on the couch for an hour, then went upstairs and went to bed.
You walked up the stairs? he asks incredulously, as if I had broken the cardinal rule of cyst excision. This stair-shaming did little to alleviate the pain. Yes, I mewled desperately, mea culpa. I had walked upstairs.
At this point, or some indeterminate length of time thereafter – time had ceased to move forward but was instead caught in an eddy, slowly but surely dragging me down with it – I was shown through to the ward and assisted onto a trolley. Kim was not able to follow me through so reluctantly turned away and, without any concrete understanding of what was going on inside her husband, headed home. My trolley and I were wheeled into the middle of a busy E.D. and deposited there to wait our turn. I can talk (even if only to groan), I can breathe, I am not bleeding. I am demonstrating no immediate risk to life. Ergo, my problems can wait. At least a full five agonizing hours later, a cannula is finally inserted into my vein, I am administered a shot of morphine and slump into an exhausted heap. The opioid hits me like a cold blast. The pain, the incessant, interminable pain, is finally gone. I sleep.
Part 4
Briefly. I am awoken by a drunk woman who is shouting outside my door (unbeknownst to me, I have been wheeled into one of seven rooms which stem off the central station), threatening to fight the entire staff on duty. No particular reason, as far as I could make out, but she was well up for a scrap. I look down at my stomach. There, where the pain still resides despite the lingering effects of the drug, is a dark purple bruising. Two inches wide, slightly below and to the right of my naval. The penny drops. Internal bleeding. The scab on my right epididymis where the surgeon cauterized the wound must have come off and I’ve been bleeding into my abdomen. This is a relief. Yes, the pain is still monstrous but at least I now know what’s going on. I lie back down and listen to the soothing sounds of an Emergency Department in full flow and soon fall back to sleep.
Shortly after, I would guesstimate at about four in the morning, I feel the need to pee. With an abundance of care, I ease my legs off the trolley and, wincing, take to my feet. I stick my head out the door. All is quiet now, relatively speaking. The mad woman has been sedated, there are few shouts or cries. I tread my way to the toilet, lock the door behind me, stand in front of the bowl, and pull out my penis. Still groggy, but having done this literally thousands and thousands of times, I take aim, close my eyes, and let it flow. Disaster. My urine is not just slightly off target, it has flicked to full garden-sprinkler mode. The spray is everywhere, all directions all at once. I look down to see what is going on and that’s when I see it – the horror. My dick is not something I recognise. Instead, I appear to be holding a dark purple mess in my hands. It’s an organ of some description, that I can tell, but if I had to guess, a barbecued kidney would be my best bet. I turn off the hose and, mortified, stuff my malformed sex back in my pants and wipe the piss off the walls and floor.
I now have a moment of confusion. In this bathroom there is also a shower, it’s a wet room of sorts. I wonder if this shower has been provided for people in my exact predicament – that of not being able to control the trajectory of flow. I wonder in all seriousness whether I am meant to piss up against the wall and then wash it down. Eventually I realize this can in no way be hygienic and is probably the last thing I am meant to do, but nor do I think if I sit down on the toilet will I be able to hit the pan beneath. I’m torn, and still in dire need of the toilet. So, for once, I do something sensible. I go and ask a nurse.
Of course, as luck would have it, the nurse at the station is unbelievably good-looking. Let’s have a look, shall we? she says, leading me back into the bathroom where I am obliged to show her my mutilated genitalia. No problem, she says, disappearing for a moment before coming back with a cardboard jug. Here you go, she says, handing it to me. Pour it down the toilet after and then stick it in the bin.
I do as I’m told. The jug, a one-liter not dissimilar to the type of juice bottle that has a handle fitted into its side, has an over-sized mouth for this very reason. Relief. My dick may be presenting as an aubergine emoji, but exhaustion takes precedence. I limp back to my room, lie down in the bed, and snatch a couple more hours’ sleep.
Part 5
I spent four days in hospital that week. The streak of bruising along my midriff extended from one side to the other, three inches deep, fifteen wide. A belt of blood, purple and green; a bike tire track across my gut. My balls and dick matured in color from mauve to a dark wine. Guts of a pint had spilled into my nether region, one nurse estimated. The elasticity of the ball sack ideal for soakage. Like a sponge, he explained loudly. I thanked him for his candor.
There were three other men in the urology ward with me. To my right, Kieran, a short, wealthy (as he liked to allude), tonsured man in his early seventies. Kieran was of a nervous disposition, and understandably so. He was being monitored to see if he could qualify for a new kidney. Opposite him was Gerard, a younger man, mid-fifties I would say, with rich, thick, dark, peppered gray hair and pitch-black eyebrows. He reminded me of one of those guys in a Just For Men advert. His was a good news story. He had found blood in his urine, flagged it with his doctor straight away, and now here he was, a couple of months later, happily recuperating as somebody else’s kidney filtered the waste from his body. Time would tell but the surgery, it seemed, had been a success. Then finally, opposite me was Patrick, the eldest of the group. He was in his eighties. I wasn’t sure what he was in for, general waterworks presumably. Tall and thin with a sharp nose and sprouting eyebrows that gave him the air of an elderly emu, he was a warm, friendly, chatty man, but ever-so-softly spoken. On the first day we exchanged pleasantries but neither of us could clearly hear the other given our debilitated states. The important thing was, though, we both understood and recognised that the man opposite us meant well. There was an immediate rapport.
There were curtains between each of the beds which any of us could draw around ourselves should we need our privacy. Plastic piss jugs sat on the night stands beside each bed (Patrick had several scattered around his enclosure), and a television was on mute in the corner. That is to say, your typical man’s urology ward. Whitewashed walls and linoleum floor. There was also a large bathroom into which we could totter to use or empty our piss jugs or to give them a rinse.
That first day I remember very little of, other than being visited twice by troops of trainee doctors requesting a look at my butchered meat. Two separate occasions, two separate cliques. I lay on my back, pulled down my tracksuit bottoms, and thought of Christmas. Twice. The ignominy. If my teenage self could see me now. Here you go, folks, here’s the road kill. Feast your eyes.
The second day passed much like the first. More trainee doctors, some nurses, a consultant, all swung by for a gander. Down went the pants and up went the smile as I grinned and beared it. At least something good might come out of this, I thought. At least by exposing myself to all these future healers I may help prevent some other poor unfortunate three-balled bastard from experiencing likewise. A learning experience all around. Also, Gerard had had more good news. His latest test results were positive. He might be allowed leave tomorrow, all things being equal. The same couldn’t be said for Kieran though. His bloods, or whatever it was they were monitoring, weren’t where they needed to be. There was zero progress being made, no evidence his body would accept a new kidney and therefore no point risking one. He put on a brave face but we could feel his anxiety heighten, but what could we do? Patrick, opposite me, had a quiet day that second day. He sat up on the side of the bed when the nurses and doctors came to examine him. He’d shoot me a conspiratorial smile, the occasional wink before the curtains were drawn, but other than that there was little engagement. Rest was the order of the day. No family came to see him, nor me, for that matter. I had agreed with Kim it would be too much hassle with the kids and sure wouldn't I be home soon enough.
On day three, Patrick slept even more than the day before. There were no smiles, no craning of the neck over a nurses’ shoulder to give me a wink. The man was clearly exhausted. But overall, day three was a good day. We said goodby to Gerard. At least, myself and Kieran did, Patrick kept his curtain closed. Gerard’s levels had sustained, they were happy for him to check out; he could take his new kidney home to meet the rest of the family. Hands were clasped and, when Gerard’s daughter came to collect him, celebratory sweets passed around. We were both genuinely happy for him. He was a nice guy and now he’d go on being a nice guy out there in the real world. If Kieran was jealous, it didn’t show. Gerard’s bed, a totem to modern-day medicine, remained unoccupied for the rest of my stay. Patrick’s, however, was still occupied and still he lay asleep. At intervals I would get a peak in at him, resting there, surrounded by quarter-filled jugs of wan piss, which the nurses would either empty for him or not, depending on how diligent they were feeling. Whatever plumbing issues he had, fatigue was a major side-effect.
I, on the other hand, could feel my strength coming back. More nurses and doctors came to visit me, to peer at the medical anomaly between my legs, and I even managed the occasional joke. Not literally, but things were looking up. I’d be home the following day, where I could lie on the couch and not have people come to visit me and the most mangled member in Dublin. Kieran said he was glad for me. I almost believed him, too.
The next day, day four, the day I was to be discharged, I woke to a commotion. Patrick had died in the night. Nobody, other than medics, that is, had come to visit him during the four days I had been there. Nobody, confirmed Kieran, during the two days prior to my arrival. Just me, Kieran, and Gerard, the last three people on earth he had spoken to who weren’t discussing his blood pressure, piss or pills. The wink he had given me the day before was the last interaction with a human outside of the medical profession he ever had.
Kieran and I shook hands when it was time for me to go home. I wished him well with the kidney, even though I had heard the consultant earlier that morning telling him the bad news. They would wait one more day but if there wasn’t a significant change there would be nothing they could do for him. He wished me well with my recovery. I thanked him and we parted. Him, climbing back into the bed. Me, by chance, walking out the front door.
A few weeks passed (it would be a few months yet until I was back at the 5-a-side football); I had some old school friends around to watch a match. A barbecued kidney, I insisted, much to their disbelief. I’m serious, I said, slipping out the phone. (On day three, prior to a shower, I had taken a snap in the mirror. A quadrangle of black circles described my torso, the gluey residue of monitor suckers. My penis engorged and hideous). I flashed the screen at them.
Look, I insisted. Look!
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