Choke

Chapter 37

URSULA STOPS TO CATCH HER BREATH and looks up at me. She shakes the fingers of her one hand and squeezes the wrist with her other hand and says, "If you were a churn, we'd have butter a half hour ago."

I go, sorry.

She spits in her hand and makes a fist around my dog and says, "This sure isn't like you."

Anymore, I won't even pretend to know what I'm like.

For sure this is just another slow day in 1734, so we're flopped in a pile of hay in the stable. Me with my arms crossed behind my head, Ursula is curled up against me. We don't move very much or the dry hay pokes us through our clothes. We both look up into the rafters, the wood beams and woven underside of the thatched roof. Spiders dangle down on their strands of web.

Ursula starts yanking and says, "You see Denny on television?"

When?

"Last night."

What for?

Ursula shakes her head, "Building something. People are complaining. People think it's some kind of church, and he won't say what kind."

It's pathetic how we can't live with the things we can't understand. How we need everything labeled and explained and deconstructed. Even if it's for sure unexplainable. Even God.

"Defused" isn't the right word, but it's the first word that comes to mind.

It's not a church, I say. I throw my cravat back over one shoulder and pull the front of my shirt out of my pants.

And Ursula says, "They think it's a church on TV."

With the fingertips of one hand, I press around my navel, the umbilicus, but digital palpation is inconclusive. I tap and listen for changes in sound that might indicate a solid mass, but pre-cussing is inconclusive.

The big trapdoor muscle that keeps the shit inside you, doctors call that the rectal shelf, and after you shove something above that shelf, no way is it coming out without a lot of help. In hospital emergency rooms, they call this kind of help colorectal foreign bodies management.

To Ursula, I say, could she put her ear against my bare stomach and tell me if she hears anything.

"Denny never was very together," she says, and leans in to press her warm ear against my belly button. Navel. Umbilicus, doctors would call it.

A typical patient presenting colorectal foreign bodies is a male in his forties or fifties. The foreign body is almost always what the doctors call self-administered.

And Ursula says, "What am I listening for?"

Positive bowel sounds.

"Gurgles, squeaks, rumbles, anything," I say. Anything that indicates I'll have a bowel movement someday, and the stool isn't just packing up behind some obstruction.

As a clinical entity, the occurrence of colorectal foreign bodies rises dramatically every year. There are reports of foreign bodies that stayed in place for years without perforating the bowel or causing significant health complications. Even if Ursula hears something, it won't be conclusive. Really this would take an abdominal roentgenogram and proctosigmoidoscopy.

Picture yourself on the examining table with your knees pulled to your chest in what they call the jackknife position. Your buttocks would be separated and held apart with adhesive tape. Somebody would apply periabdominal pressure while somebody else would insert two tissue forceps and attempt to transanally manipulate and extract the foreign body. Of course, this is all done with regional anesthesia. Of course, nobody is giggling and taking pictures, but still.

Still. This is me I'm talking about.

Picture the sigmoidoscope view on a television screen, a bright light pushing along a clenched tunnel of mucosal tissue, wet and pink, pushing into the puckered darkness until it's there on TV for everybody to see: the dead hamster.

See also: The Barbie doll head.

See also: The red rubber butt ball.

Ursulas hand has stopped its up-and-down jumping, and she says, "I can hear your heart beat." She says, "You sound pretty scared."

No. No way, I tell her, I'm having a swell time.

''You don't feel like it," she says, her breath hot on my periabdominal region. She says, "I'm getting carpal tunnels."

"You mean carpal tunnel syndrome," I say. "And you can't because it won't be invented until the Industrial Revolution."

To keep the foreign body from moving higher into the colon, you can provide traction by using a Foley catheter and inserting a balloon into the colon above the body. Then inflate the balloon. More common is a vacuum above the foreign body; this is usually the case with self-administered wine or beer bottles.

Her ear still against my belly, Ursula says, "Do you know whose it is?"

And I say, that's not funny.

With bottles self-administered open end first, you have to insert a Robinson catheter around the bottle and allow air to flow past it and break the vacuum. With bottles self- administered closed end first, insert a retractor into the open end of the bottle, then fill the bottle with plaster. After the plaster sets around the retractor, pull it to remove the bottle.

Using enemas is another method, but less reliable.

Here with Ursula in the stables, you can hear it start to rain outside. The rain patter- ing on the thatch, the water running in the street. The light in the windows is dimmer, dark gray, and there's the quick repeating splash of somebody running for cover. The deformed black-and-white chickens squeeze in through a broken board in the walls and fluff their feathers to shake off the water.

And I say, "What else does the TV say about Denny?"

Denny and Beth.

I say, "Do you think Jesus automatically knew he was Jesus from the start, or did his mom or somebody tell him and he grew into it?"

A soft rumble comes up from my lap, but not from inside me.

Ursula breathes out, then snores again. Her hand goes limp around me. Limp me. Her hair spills across my legs. Her warm soft ear is sunk into my stomach.

The hay itches up through the back of my shirt.

The chickens scratch in the dust and hay. The spiders spin.