BARIUM FOLLOW THROUGH | Patricia Wentzel
My ten-year-old son lay still on the x-ray table, a little limp. It was after 9 pm. The long day of waiting had been followed by the unpleasant but tolerable strawberry-flavored barium shake. They had asked him what flavor, had choices besides the licorice offered by the other hospital last year. He hadn’t liked licorice before that ordeal. Now the smell of it made him gag.
The technician chatted with my son as he set up the machinery, explained a little about what to expect. I listened as he told my son a story about doing a barium swallow with a grouchy, uncooperative grown-up. He told him how the patient resisted the technician’s instructions, how his exam had taken a long time and would have to be repeated because of it. The technician and my son agreed he might have been in pain. Perhaps that explained it. They laughed together as my son agreed he would not be like the grouchy grown-up, that he wasn’t in pain today, and he would follow directions.
My heart pinched at my son’s report he wasn’t in pain today. The technician had let me stay in the room, wearing a heavy lead apron to match his. The few moments we had spent in conversation had been reassuring and his offer to let me stay surprising. His story about the grouchy patient eased my worries that this would be another painful, scary experience in a long, unending line of such experiences.
As the procedure began, he coached my son in a quiet voice as he turned him this way and that. The screen overhead showed the progress of the barium through my son’s gut. The glow of the light cast by the barium on the screen lit the darkened room up, left no doubt about what was important, what was trivial there in that room, in that one young life. The silence except for the murmur of the technician felt profound. The barium curled and twisted through his small intestines like a plump earthworm. If the circumstances had been different, I might have called the pictures intriguing, evocative. Instead of thinking of the images as beautiful or grotesque artwork, I was focused on the power of that glowing worm to confirm or deny a diagnosis.
But I could not miss the reverent art of the technician’s movements, the way he carefully tipped the young body before him forward, backwards, his eyes on the screen. The bright light on the screen outlined his guiding hands on my son’s back, hips and knees.
I held my breath for a little bit then let it out, realizing the quickness of my breath, the withholding of it in suspense, could not make things go faster. It would not insure the hoped-for outcome. The digestive dance would go at its own pace urged on by gravity and the technician’s skill.
“Almost there,” the technician coached my son. Their patience, each with the other, was a gift. “Ah,” the technician sighed. There on the screen the line slowed to a crawl. The barium puddled at one end of a narrowing that shrunk to the diameter of a pencil and corkscrewed before our eyes for several inches before the barium reached the end, emerged and puddled again. He shook his head, no word to me, no word needed as I stared at the image, at the mark of Crohn’s on my son’s body.
There were no other strictures. The barium flowed smoothly to the end and the technician let my son’s body come to rest flat on the table again. As my son sat up and then rose from the table, the feeling that this had been, for a time, a sacred space passed, and we were once again just two adults and a child. The technician congratulated my son on being a better patient than the grouchy grownup. My son smiled with pleasure, said “It was easy. It didn’t hurt at all.”
The technician turned to me, accepted the lead apron into his waiting arms and looked me in the eyes. “The radiologist will get a report to the doctor tomorrow,” he told me. “I’m sorry,” he said. His face looked older than it had before but perhaps that was the lateness of the hour. I nodded, thanked him with a gratitude I struggled to express. I tried to hide the tide of rage that had erupted in me at the sight of that stricture. I had had to fight to get this test done despite signs my son’s Crohn’s was not in remission. My instincts, my expert caregiver knowledge of my child, had been dismissed as irrelevant. Now I would have the ammunition I needed to get a different doctor, a different team.
But that was for tomorrow. For now, I would rest in the knowledge that this one test had probably not added to the burden of medical trauma my son would carry. As I took his hand and we headed for the elevator, he told me, “That wasn’t hard.” and I sniffed back my tears.
Patricia Wentzel has several decades under her belt as an expert caregiver and expert patient. She has raised children with severe Osteogenesis Imperfecta, Crohn's, Traumatic Brain Injury, Attention Deficit Disorder, Cholesteatoma and hearing loss, Asthma, one now adult child with bipolar disorder and anxiety compounded by substance use disorder, and two other now adult children who live with depression and anxiety as well as learning disabilities. Her own health has been impacted by breast cancer at 32, post-mastectomy lymphedema, bipolar disorder, arthritis requiring total knee replacement of both knees and severe restless legs syndrome. She writes poetry and the occasional prose piece. Her work has been published in the Journal of the American Medical Association, Right Hand Pointing and other journals.