My Cystoscopy

About six months before turning 70, I decide to run the New York City Half Marathon with my brother-in-law. This is not a bucket list item to be checked off. It just seems like a fun thing to do. We are both in agreement that it has nothing to do with our aging.

The day arrives and we run from Brooklyn, over the famed Bridge, up the FDR parkway, through Times Square and into Central Park.

We don’t run for time, just for fun. Running for time would be hard, as I have to stop to pee every couple of miles. Too much pre-race coffee, I tell myself.

For a number of years I’ve been dealing with prostate issues — a frequent need to urinate — which I ignored and rationalized away. But during the race, my brother-in-law’s repeated interjections of: “Again?!”, bring me to a decision.

Within two weeks of the half marathon, I make an appointment with a urologist. He recommends a cystoscopy, an exploratory procedure done under local anesthetic to determine if I am a candidate for surgery that will shrink the prostate and relieve my symptoms.

The procedure involves inserting a thin, lighted scope into the urethra, pushing it through the prostate and into the bladder. I don’t think anything about it.

I show up at the procedure center on the appointed day. A lovely nurse leads me into a long room filled with hospital beds, each surrounded by a privacy curtain. I’m told to disrobe, gown open in the back, of course. I place all of my items in a bag and sit down on the edge of the bed.

The nurse returns, asks me if I’m ready and then enters the curtained corral of my hospital bed. She has me recline on the raised back of the bed. She covers me in a cozy warm blanket. I’m feeling pretty good. Cared for. Welcomed.

She puts on the blood pressure cuff. There is the familiar squeeze on my arm. After two months of extensive training and running thirteen miles, I’m expecting a pretty good number.

“175 over 90,” she announces.

Whoa! What?!

“Try to relax. I’ll be back in a few minutes.” The curtain swishes closed and I’m alone.

175 over 90!!! What the hell?

I take a deep breath and try to calm myself. Another breath and then the words emerge. I felt them more than I heard them.

Here we go again.

From some deep, tight space within my chest, tiny words were escaping like wisps of smoke. Barely noticeable.

How’re we going to get out of this one?

I can hear them more clearly now.

I wish we would just get it over with already.

The words are accompanied by a familiar feeling of fear. Terror even.

“This isn’t then. This is now. This is not that. This is this,” I tell myself.

It doesn’t help. I just want it over with already.

These are phrases from my 7-year-old self. These are the words that started with my first sexual abuse, which continued at the hands of various people for eight years.

The nurse comes back and asks if she can enter. She has me get up and put the warm blanket over my shoulders like a cape. I do not feel like a superhero as she guides me down that long hall of beds to the operating room.

Here we go again. The phrase is now a mantra. I know this is not that. “This is different,” I tell myself again. But my body is sure reacting like this is that.

175 over 90. No wonder.

The operating room is staffed by four women wearing scrubs. One is younger than the rest. She’s a student, there to learn. Do I have any objections? I say no. The objections I feel have nothing to do with her or her age.

The operating table reminds me of something from a Frankenstein movie. Various machines, each one humming and beeping are stacked above the table, crowned by a video monitor. There are two smaller extensions jutting akimbo from its head. These are for my arms. I lay down, the gown is raised. All attention is on my genitals. I feel like they are illuminated by a spotlight. Soothing conversation is attempted. It feels unreal. I’m responding from that deep tight space within.

My genitals are manipulated and prepared for the arrival of the doctor. I am at their mercy. I have no control over their touching me, nor how they touch me.

After a long eon of minutes, the doctor appears. Pleasantries are made all around. The pencil-sized scope is inserted.

It is physically uncomfortable. But the emotional discomfort is familiar. Familiar is not the right word. Familiar as a word brings up warm, friendly images. This is not that.

The doctor tells me to breathe. The doctor tells me to open my eyes. The doctor tells me to relax.

I wiggle my toes.

For decades, I would awaken from a dream with a blinding headache. Terrified. Throwing up everything. Even a glass of water. Blinded by the bright sun. My day would be spent curled on the floor, wiggling my toes. Not eating. Trying not to throw up. Wiggling my toes. Eyes shut against the too bright day. Head pounding. Wiggling my toes. Waiting for the comfort of darkness.

This would happen two to four times a month. Always on a Tuesday.

I knew the molestation had happened. I was aware of it. I was aware of the other episodes that followed as well. I spent most of my life pushing the memories into that storage space under the stairs in the basement.

Acknowledging the molestation meant being a victim. Men aren’t victims. Even seven-year-old men.

Of course, whenever anything went sour in my life, the victim feeling came back. The car broke. I got a parking ticket. A relationship ended. I was late for work. I experienced much of life through a window of victimization.

As I entered my 30s I was able to drop much of that. I stopped using drugs and alcohol. I got married. My wife’s love and care were welcomed, and at times hard to accept.

Having children in my 40s invited more healing. Loving them. Caring for them. Playing with them. Listening to them. Being the parent I never had. As my children laughed the headaches went away. But relief from the headaches granted me the fiction that I was done with the molestation. I could stack more boxes of memories in front of that storage room door in the basement.

What remained was anger and sadness. A sadness that threatened to drown the world. An uncontrollable anger that punched through the smallest slights.

Tying these feelings to events that were decades old seemed ridiculous.

It wasn’t until my 60’s that I decided to actually deal with it. Not just admit the serial molestation. But process it. It took that long to overcome my denial. It took that long to understand that something that occurred so long ago could still affect me today.

Anger and shame brought me to therapy just as I retired. I guess I have the time now. Now that I’m not working 70 hours a week.

Most men who have experienced childhood sexual abuse tend not to confront it until they are in their 50s and 60s. Best estimates are that one in six men in the U.S. were sexually abused as children.

As my follow-up appointment with the urologist approaches, I wonder if he knows of other men that might have reacted as I did. Should I divulge my childhood sexual abuse to him?

Synonyms for “divulge” include the words disclose, tell and betray. Disclosing, or sharing my most intimate secret means telling on and betraying. Strong feelings of telling on and betraying applies to both my abusers and myself.

The prospect of divulging to my doctor, becoming public, means facing social condemnation. My socialization taught me that real men don’t show pain, are not victims, and never admit weakness.

Diminutivization is not a word. It should be. That’s what I did with my abuse. I made it smaller and smaller. I didn’t diminish it. Diminishing implies the eventual “poof” of nonexistence.

I couldn’t make it disappear. I struggled to make it smaller. It wasn’t that bad. Get over it!

As a society we don’t like to recognize childhood sexual abuse. We don’t want to talk about it. It is a diminutive problem. All too often, it is easier to side with the abuser, to not believe the child. “Children lie. Children make things up. Children forget.” The problem is diminutive, just like the child. In fact, false reports of child sex abuse occur in only some five percent of cases — usually fabricated by a parent in divorce proceedings. 

Yet ”fight the victim” is the strategy used by wealthy perpetrators and institutions when defending themselves against abuse allegations and lawsuits. This is true for religious groups large and small, it’s true for schools and universities, it’s true for youth-serving organizations, it’s true for celebrities, and it’s true for politicians and their cohorts.

In choosing to divulge I must overcome my own internal denial of the abuse. That means considering the social reaction I might face from friends, family, acquaintances and, if public enough, complete strangers. It’s no wonder why more men don’t disclose their childhood sexual abuse.

At my post-cystoscopy follow-up visit with the urologist, I divulge my past abuse to him. I tell him how deeply the cystoscopy affected me. Have other patients shared similar experiences?

“Never,” he replies. I am the first. He’s been doing this for over 40 years.

Whenever I go to the doctor, any doctor, I’m required to fill out a long questionnaire detailing a history of operations, as well as drug use both current and past, prescribed and illegal.

When I give blood I’m required to answer some very prying questions: Have you ever used street drugs? Are you an intravenous drug user? Have you ever had sex with an intravenous drug user? Have you ever paid for sex? Have you had sex with another man? Have you ever been in prison? (Another way of asking about homosexual sex.)

Never once have I been asked if I was sexually abused as a child. Since most men don’t come to terms with their abuse until they hit their 60s, about the same age they start seeing a urologist, wouldn’t it make sense for doctors to ask about childhood sexual abuse in the history questionnaire?

The problem I had as a survivor of sexual abuse was first admitting to myself that it had happened. Then realizing that admitting it wasn’t the solution. Sexual abuse has long-term effects— physical, mental and emotional. I also needed professional and peer-to-peer support.

As more men — including athletes and celebrities — divulge their past abuse, hopefully that will empower each one of millions of survivors to realize he is not alone.

Medical intake is the simplest and most direct way for men to disclose and access healing for this most taboo of subjects. After all, how many men have denied themselves life-saving medical procedures because of the shame of childhood sexual abuse? The medical establishment seldom connects the dots between trauma and physical ailments. Until that changes, too many men will just have to keep rubbing dirt on their emotional wounds and just get over it.

Bert Atkinson was raised in Chicago and is a resident of Los Angeles. He is a filmmaker and Emmy-Award-winning camera operator.