The state has taken an interest in my bowels
The state has been in touch with me. In many parts of the world that would be ominous. The state has connotations of secret police and the nocturnal disappearances of citizens.
But not here. Here, by and large, the state still serves the people in whose name it exists. The authorities may be cumbersome, wasteful, even wrong, but their heart’s in the right place. They try to do good by us. We are fortunate.
Until now the state and I have had few dealings. I’ve handed it my taxes and enjoyed the roads it’s built with them but I have made little use of the hospitals, the public transport, the social services and so on.
But now it seems that is about to change. The state has begun the process of wrapping its arms about me and caring about my wellbeing. It’s taken an interest in my bowels.
Since I gained a degree of control over them at the age of maybe 2, my bowels have been my concern and mine alone. But now the state is offering to screen them at its own expense.
It would be hard to imagine a more sensible suggestion. Preventive medicine is so much saner and cheaper than treatment after the fact. Catch a polyp, thwart a cancer. And who wants colorectal cancer? Only a fool would decline the state’s kind offer. So why is it that it fills me with disquiet?
It isn’t squeamishness or at least not predominantly. The screening does not require me to attend a hospital or even see a doctor. I have only to take a stool sample and pop it in the post - though since I never previously given or taken a stool sample the word only is doing a lot of work there. But still, that is not enough to explain my disquiet.
Nor yet is the Ministry of Health’s use, in a formal letter to a 64-year-old, of the word “poo”. We are so technologically advanced that we can screen a bowel for polyps but we remain so emotionally retarded that we cannot find a word to describe bodily waste that isn’t drawn directly from either the medical dictionary or the nursery. But again that doesn’t explain my disquiet.
I find myself inventing reasons to turn down the offer of screening. If there is nothing wrong, I obviously don’t need it. And if it turns out that there is something wrong, do I really want to know?
Something’s going to get me in the end. Wouldn’t it be wiser just to cross my fingers and get on with life? That, after all, has been the way of the world for the whole of human history. Ignorance confers a form of happiness.
And could the bowels be just the thin end of the screening wedge? Why shouldn’t the state also screen my heart for weaknesses, my lungs for lumps, my kidneys for pebbles that might become stones? And is it possible that fretting about your innards actually does more harm than good? Could it even induce the ailments it purports to prevent?
And then there’s longevity. We’ve made a fetish of longevity; but we haven’t made an equal fetish of quality of life. My mother suffered a stroke at the age of 92. It effectively killed her. It seared her brain. But modern medicine brought her back from the grave to no purpose.
She lived five further years in demented misery, with nothing to live for but nothing to die of. And there are hundreds of thousands like her. Is that partly the cause of my disquiet? Like everyone I dread cancer, and colo-rectal cancer in particular, but I dread even more outliving my wits.
But perhaps all these arguments are specious, are mere masks for the true source of my disquiet. And that is simply that the state has been in touch. The state knows its statistics. It knows its probabilities. And it knows that a 64-year-old male who prides himself on his autonomy, his self-sufficiency, is going to start going through some things.
What specific things those are and in what order they can’t say but the general effect will be unmistakable. Stuff will start to go wrong. He will gradually need more help. He will become less autonomous.
This offer of screening, though obviously well-intended, feels like the first step in a long slide. Hence the disquiet.