by Tim Parks
‘Signor Pax, could you just tell us whether you actually need to pass water or not?’
I was on my back, squeezed under the X-ray machine again, but this time without my underwear. On my stomach I had what the Italians wonderfully call a pappagallo. Ordinarily, the word means parrot, but in this case it referred to a small white plastic urinal. ‘Slip your penis, Signore, into the opening,’ one of the nurses instructed me, ‘then hold the parrot still with your left hand, but without blocking the photograph.’
‘No, like this.’
She smiled as she reorganised my hands and genitals.
Once that was sorted, all I had to do was lie dead still and . . . pee. At that point the grey apparatus looming above me would take a snap of the contrast medium seeping its radioactive way through my iffy plumbing.
‘Siamo pronti?’
The staff retreated.
‘Just shout when you feel the urine coming, Signor Pax.’
At last. I had been waiting ninety minutes for this release. I had been praying for it. I pushed to pee.
Nothing.
Relax, push gently.
Nothing.
The minutes passed. Eventually a door opened and the radiologist’s young assistant hurried over.
‘Signor Pax, you can pass water now. Just shout when you’re starting.’
He repeated the instruction, speaking more clearly. I could have killed him.
He retreated. Through the glass wall all eyes were on me. Evidently the star of the show, I tried to relax and pee. Nothing. The needing-to-pee pain remained exactly as it was, a boiling swamp in the bladder. But nothing budged.
The young doctor came back.
‘Signor Pax, could you just tell us whether you actually need to pass water or not. We are behind with our schedule.’
‘I beg your pardon?’
‘We are behind schedule and—’
‘No.’
He looked at me. There were a couple of days of dark beard on his cheeks.
‘No, I can’t tell you whether I need to pee.’
He looked perplexed.
‘I don’t know,’ I repeated.
‘Signor Pax, perhaps—’
‘Do you actually realise why I’m here?’ I asked. ‘I presume they told you what my symptoms are.’
‘Signor Pax—’
‘If you had read the referral papers you’d understand that most of the time I have no idea at all whether I “need” to pass water or not, OK? Nor whether, needing to, I can. If I knew those things, I wouldn’t be here. I’d be happy, perfectly happy.’
Even as I was indulging in this shameful sarcasm, I was acutely aware that the real object of my anger was my body.
The older radiologist came over and explained that we are all taught from earliest age not to urinate while lying down on our backs. ‘It’s just a psychological block,’ he said. He would turn a tap on. The sound of running water would help.
If ever there’s a myth, it’s that the sound of running water helps you to pee. I now felt a complete invalid, and criminally crotchety to boot. My tackle, I’m sad to say, looked pathetic, lolling limp and wrinkled on the rim of the white plastic urinal.
Not that anyone was interested.
‘Just give me time,’ I said.
We tried again. The doctors ran off behind their screen, I concentrated and pushed and waited and pushed and tried to relax and waited and pushed and . . . at the first hot feel of pee arriving, yelled, ‘Viene!’ Coming.
As if we were making love.
Exactly as the X-ray machined buzzed, the pee stopped. We had wasted an expensive photographic plate.
The rigmarole began again.
‘As many times as it takes,’ the radiologist reassured me.
And again.
The pee wouldn’t come.
The radiologist shook his head. ‘We’ll have to try standing up, Signor Pax.’
As I swung my legs off the table, I heard one of the nurses explaining to another that I was a personal friend of one of the doctors in urology.
They stood me up against a white plastic curtain and started setting up a machine to photograph me front on. Meantime, I was supposed to drink glass after glass of water to ‘keep things moving’. After a few minutes it occurred to one of the nurses to bring me a towel to cover myself. She smiled. I smiled back. Then at last something eased, something opened. I peed – oh not spectacularly, nothing to be proud of, but I produced the goods, they got their photo.
‘All’s well that ends well,’ the radiologist laughed.
‘All’s well that ends,’ I replied.
No sooner was I out of the X-ray room than I stopped at the first bathroom and peed at least as much again.
At ten past two I met my designated surgeon, a lean, dark, earnest man with disquietingly prominent veins on wrists and neck. Together we went to the radiography viewing room where he introduced me to the head of radiography, a Romanian in his late forties.
‘Stefan, this is Tim,’ my surgeon said, ‘Carlo’s friend.’ As if this relationship explained everything. To me in a low voice, the doctor muttered: ‘This man is brilliant, probably the finest radiologist in Europe.’
Despite being anxious to know the worst, I couldn’t help but be amused by how Italian all this was. The surgeon was the best surgeon in Italy, the radiologist the best radiologist in Europe. And by purest chance we were all the best of friends.
Let’s hope it was true.
The big grey X-ray plates were slid up onto the illuminated viewing panels. It was rather eerie. My body had been reduced to the two-dimensional black-and-white of the biology-book illustration. I could study myself as a separate phenomenon.
Or I would have been able to, if they had given me time enough to understand what I was looking at. No sooner had he put up one plate than Stefan was taking it down again with barely a glance. The surgeon wasn’t even looking, but reading through the radiologist’s typed report. I wondered how much detail the brilliant Stefan could be seeing. One image followed another. Filled with contrast medium, the kidneys floated up like white lilies in a weedy underwater of muscle and bone.
‘These next ones are where you’re passing water,’ the surgeon said.
Now he was paying attention. The two men gazed at length at five small plates, arranged one beside another; Stefan took a pen to follow the line of the urethra in each.
‘Marked restriction at the sphincter,’ the surgeon observed, ‘and narrow through the prostate.’
The radiology man didn’t reply. He took a magnifying glass to examine one of the images.
Neither of them invited me to look at the points in question.
Stefan shrugged. ‘Nothing dramatic.’
‘Since we’re only getting two dimensions,’ I suggested, ‘couldn’t it be that the urethra is pinched along the plane we’re looking at, but not in the other dimension, if you get me?’
Nobody replied.
‘Calcification in the prostate,’ the surgeon remarked.
Stefan smiled and took down the plates, shaking his head. ‘Nothing,’ he announced. ‘Niente di niente di niente.’ He had a strong accent. ‘If Signor Tim had no symptoms, I would say from these X-rays he was perfectly fine.’
A Tussle in the Mind
LANGUAGE SPLITS THE world up into thousands of discrete units, then puts them back together again in unexpected ways. In a hotel in Agra, Uttar Pradesh, I was thinking about the word psychosomatic.
I had come to India for ten days to talk at a conference in Delhi on storytelling and translation. By the time I appreciated that my approach to the subject was not welcome it was too late. For more than a century now, I said from the podium, writers had been suspicious of the values encoded in their languages and in the kind of stories people told each other. They altered the stories to expose convention, they forced words into surprising combinations to challenge the unthinking conformity of their languages. That was the modern novel. But the trans
lator’s culture was constituted with different stories, his language was a different straitjacket. How could you translate Lawrence’s description of Gudrun’s mental state after lovemaking – ‘She was destroyed into perfect consciousness’ – in a language where consciousness did not have the strong positive connotations it had developed in the West. The provocation would be lost. How can you convey the strangeness of ‘destroyed into’, if in your culture nothing is ever truly destroyed, but only transformed?
As the public began to ask perplexed and indignant questions, I realised that in India people were wonderfully excited by translation, by becoming part of a globalised world where everyone reads everyone else’s books and imagines they’re getting the real thing. They didn’t want to hear my cavils. Perhaps they weren’t obsessed, as I was, by the problem of being inside or outside a particular story. The one about the operating table, for example. Talking to one of the organisers after the presentation, I found myself asking if she could direct me to a respectable ayurvedic doctor.
‘They are all respectable, as far as I know,’ she said and gave me the phone number of a friend who used such a doctor.
India was decidedly cooler than I had expected. I hadn’t realised that Delhi had a winter. Incongruously wearing a sweater beneath a linen jacket, I sat in an auto-rickshaw as it fought its way across town. Finding a goat or a cow in the road is normal here, I realised. Here, you would have to slip rather different spanners into the works to bounce people out of their mental routines. What was I doing, consulting an ayurvedic doctor, if not trying to bounce myself out of my medical dilemma? I had never given any credence whatsoever to alternative medicines. I prided myself on being rational, sceptical, modern and Western. I believed in evidence-based medicine. I had always made fun of homeopathy, aromatherapy, crystal healing and the like. It would never have occurred to me, I realised, to consult someone like this, if I weren’t, by the merest chance, in India, if there wasn’t the excuse of the travel-writer’s curiosity. I hesitated for some time before pressing Dr Hazan’s bell.
It took me a while to tell the whole story. The doctor wore a shirt and tie and listened attentively; his wife and secretary (thus he introduced her) was sitting beside him.
‘So, the urologist still wants to operate on me, but having heard the radiologist’s comment on the urogram I’m not convinced. There’s no evidence that there’s anything wrong with the prostate at all. On the other hand, the symptoms are getting worse. The only test still to do is the exploration of the bladder. For cancer.’
The wife nodded, making notes. She was modest, attractive, wearing Western clothes. Dr Hazan waited some moments before responding. Had I seen him in the street, I would have imagined he was a young executive in one of Delhi’s booming software companies.
‘Well, for immediate relief, we could address the symptoms,’ he eventually began. ‘For that I would prescribe an enema of sesame oil and various herbs to be held in the colon for as long as you can manage, certainly not less than forty minutes.’
I was silent.
‘On the other hand . . .’ He sat back and looked me in the eyes. His face was frank. ‘This is a problem you will never get over, Mr Parks, until you confront the profound contradiction in your character.’
I can’t recall being more surprised by a single remark in all my life.
‘Ah,’ I said at last.
‘There is a tussle in your mind.’
I sat still. I had wanted a different story, to challenge the ‘official medical version’. I was getting it.
‘What actually causes all this pain?’ I asked.
‘It is blocked vata.’
‘That is an energy that flows in the body,’ his wife explained. ‘One of the five elements. It balances others and needs to be balanced by them. When the balance goes wrong, then the vata is blocked and causes pain.’
‘It is this mental tussle that blocks the vata,’ the doctor said.
I reflected. ‘So, what is the tussle about?’
‘Good question!’ The doctor smiled.
‘A tussle like this is not really about anything,’ his wife explained. ‘It is part of the prakruti.’
They began to explain what prakruti was: the amalgamation of inherited and acquired traits coming together to form the personality. If those traits were at odds and the two couldn’t mix, you’d be in trouble.
‘In that case a person may get the impression that his life is a series of dilemmas. He may think: If only I could resolve this or that dilemma, I will have resolved my problems. But each dilemma is a only a manifestation of the deeper conflict.’
It was an elaborate theory.
‘Let’s assume that you are right,’ I said. ‘How would one go about, er, sorting out something like that?’
I sensed as I spoke that ‘go about’ and ‘sorting out’ were the wrong terms. Somebody who knew ayurvedic medicine would not have used them.
Dr Hazan was weighing me up. ‘There is no prescribed cure, as such. It is hard to treat the prakruti. But a good way to start would be with a birth chart.’
I had noticed some publications on astrology in the waiting room. The doctor could see my scepticism.
‘You don’t believe in our connections with the stars, Mr Parks?’
I shook my head.
‘It is a shame. I have been able to help many people in that way.’
He began to explain that one of his specialities was helping businessmen with dilemmas: perhaps a man has been trained in one field but is offered an interesting job in another. He doesn’t know what to do.
‘That sounds more like a question of convenience and good sense.’
‘To you, perhaps, yes. But he doesn’t experience his dilemma like that. For him it goes deep. It threatens his health.’
There was a silence. Astrology was a bridge too far for me. I was eager for new stories, but they had to be stories I could believe in, or at least such that I could suspend disbelief.
‘Let’s go back to the physical side.’ But I stopped myself: ‘Or are you telling me it’s entirely psychosomatic?’
A slow smile spread across the doctor’s face. ‘That’s not a word we have much use for, Mr Parks.’
I looked at him.
‘You only say psychosomatic,’ his wife explained, ‘if you think that body and mind are ever separate.’
It was a fair point. ‘Diet then,’ I said. ‘Could it have to do with diet?’
The doctor laughed openly now. But when I told him what I was eating he grew more reflective.
‘It is difficult without getting to know you better,’ he said. ‘I mean without understanding the balance of the various elements in your body. But looking at you, listening to you, I would say you should eat less raw food, less salad, more cooked vegetables. And, in general, you should eat more.’
‘The last thing I need is to get fat.’
‘I have the impression that at present you are starving yourself.’
‘Not at all. My weight is more or less what’s recommended for my height and age.’
‘We have that impression,’ the wife confirmed.
I wondered if they always shared the same view of their patients. They seemed very sure of themselves. I couldn’t imagine my own wife and I reaching the same opinion about anyone, never mind a person we had only known for half an hour.
‘Masturbation can be an important factor with these kinds of pains,’ the doctor said.
Again I was surprised. It was the ease with which he introduced the subject. The Harley Street doctor, years ago, had warmly recommended the habit while carefully avoiding the word. Hazan’s wife seemed relaxed.
‘Tell me.’
The doctor began to say that recently he had treated another man with similar problems. A man much younger than myself. In his late twenties.
‘He had all kinds of worries. About his life and his job. His prakruti was very troubled. He had split up with his girlfriend, he wasn’t seeing a woman;
when I questioned him, he admitted he was masturbating very frequently.’
I waited.
‘When I suggested to him he should get over that, he found it helpful.’
I asked, ‘As you see it, Doctor, how often is very frequently?’
‘As often as twice a week,’ the doctor said.
Now it was my turn to laugh. ‘I’m sorry,’ I shook my head, ‘but for a man in his twenties, without a girlfriend, even twice a day would hardly be considered excessive, in the West. A Western urologist would have told him he wasn’t masturbating enough.’
The doctor wasn’t put out. ‘Perhaps our worlds are so different in their assumptions that it is difficult for me to advise you. But . . .’ he reflected, ‘what matters is not really how often someone masturbates, but in what spirit.’
I listened.
‘When a boy or young man is naturally moved to masturbation from excess of vitality, this is normal and healthy. His physical energies must find a release. But if a man constantly works himself up, neurotically as it were, because he is unhappy, because something is missing, then his masturbation will upset the balance of elements in his body and his vata may become blocked.’
Here it seemed to me that Delhi was making more sense than Harley Street.
The doctor now spoke to his wife in Hindi. She stood up, went to a cabinet full of small drawers and began to make up two small polythene bags of pills. The doctor was writing a prescription. ‘These herbs may be a help for the pain you have,’ he explained. ‘I have written down dosage and instructions. In case you wish to pursue a serious treatment, I shall give you my card with our email address. We can send birth chart, advice and medicines to Italy with no problem. We supply many people in Europe.’