I was working as a journalist in Saint Petersburg when the butt pain started. The doctor’s heavy Russian accent made me believe I had “gemroids,” which sounded like asteroids made of gemstones, which seemed a lot better than what I actually had: hemorrhoids. More than a month later, it had all gotten much, much worse.
I sat across from the doctor. He was very Russian. His English wasn’t excellent. He smiled.
“So, you have problem with the anus, yes?”
He gave my midsection a concerned look. “What?”
“Well,” I told him, “it is excruciating in my — well, my anus. I thought it was just hemorrhoids, but now it is very painful and swollen.” I puffed out my cheeks and made a finger cage with my hands in case he didn’t know what I meant by swollen.
He nodded along with my story, and I could tell the only things he understood were “anus” and “pain.”
He smiled and stood up.
“Let us go to exam room. I will look at your,” he paused, “pain anus.”
We headed into the room next door. It was cold, and a young female nurse stood in the corner. “Take off these,” he said, pointing to my pants. I looked at the nurse, but she didn’t move. I went to the corner and took off my pants. “These, too?” I asked, knowing the answer.
I took off my underpants as well and placed them beside my pants on top of various containers of medical equipment.
“Up,” he said, “like dog.”
I climbed onto the table. He tapped my elbows, and I transitioned into a balled-up Downward Dog pose.
“Good,” I heard him say. He began pressing and prodding.
“Does it hurt here?”
I looked up at the nurse. She was watching like some sadistic, curious, big-eyed cat. She had a surgical mask over her mouth to hide her smile, presumably. Then a finger came into view between us. It was a tremendous yellow-gloved finger, maybe a 10-centimeter circumference, two to three inches long. It wasn’t an artist’s finger.
“I see anus with finger now.”
Ten minutes after the doctor finished playing “I could have sworn I left my keys around here somewhere” inside my anus, we sat across from each other in his office.
“You have trauma anus,” he told me.
“Sorry, one moment. I will get translator.”
He left. When he returned, he was with a kid who looked to be no more than 18. I stared up at him and my first thought was, I can’t shake his hand, I’ve just had a finger in my ass.
Then I realized, No — wait, it wasn’t my finger, so surely it’s fine.
I almost reached out before another thought struck me: But someone in the room has had a finger in the ass of someone else in the room. That doesn’t seem like the most atmospheric time for a handshake.
At that point, I’d been staring at his hand for 30 seconds, so not shaking it would have been awkward. I held out my hand. He took it hesitantly.
“Bet this is the most awkward conversation you’ll have to translate all day, huh?”
He pulled out a chair beside me. “Mhm,” he said.
The doctor went behind the desk and smiled. He began speaking a lot of Russian as the translator nodded along. I couldn’t follow. Eventually, the translator turned.
“He says you have hurt your anus because of trauma. Have you had any trauma?”
I frown. “Butt trauma?”
“No. I just had hemorrhoids, and this pressure started to build.”
He looked to the doctor, said “gemroids,” listened, then translated: “Did you fall or sit down on something?”
I laughed a little and shrugged. “Nope, not that I can remember.”
The translator gave me a funny look; the doctor, too. At that point, I caught on that what I was saying was just the sort of lame-ass lie someone might tell if they didn’t want to admit they’d been playing a game of “who’s hiding what, where?”
“Really!” I said.
The doctor began writing something on his notepad. The translator stood up.
“That is all,” he said, and left. I waved him out.
The doctor continued scribbling and I watched the wall, trying to find the least painful angle for sitting.
Eventually he slid a piece of paper toward me. It was a prescription with a list of things. He pointed.
“Uh — for pain. Two times per day.” He mimed tossing pills in his mouth.
He pointed again. “And this svetcher, hmm, svetcher — hmm, only moment.” He pulled out his phone. He typed something. He turned it to me.
“Candle!” he said.
“Yes! For anus.”
“Oh, it goes right up there, then?”
“Yes.” He laughed. I laughed.
“Okay!” I said, silently praying that some terrible translation error was being made.
He then made a whistling sound and guided his finger through the air, as you might guide a candle through an anus, apparently.
I gave him a thumbs-up.
“Okay?” he said.
I nodded. “Yeah, okay.”
He smiled, handing me the slip. He shook my hand and waved toward the door. I left. As I walked down the hall to pay, I was able to translate the first sentence of his notes: “Patient Denied Fact of Anal Trauma.”
I found myself back in the clinic two days later, stinking of wax and shame.
“It is not better,” I told the translator, a heavyset woman in glasses who informed my new proctologist in Russian, “It is not better.”
He looked to me, then looked at my waistline. I sat at an angle because the pain in my butt had crawled into my left cheek.
I said, “The other doctor gave me candles, but I don’t think they’re working.”
The translator nodded, translated, and turned to me. “He says you had trauma?”
“There was no trauma.”
The doctor gave me a sad sort of look and spoke.
“Is he sure there was no trauma?” he said in Russian. I glared at him, then at the translator.
“Seriously,” I told her, “it just started hurting.”
She frowned. “You understand Russian?”
The proctologist stood up. He was slimmer than the previous one and balding a bit, with cruel eyes. He pointed to the table pressed against the wall.
“I’ll go,” the translator said, standing up.
The doctor held up his hand. “Where are you going?”
She looked at my butt — I was now standing up — and motioned toward it. He looked at my butt too. I joined them, wondering if I had a fleck of lettuce stuck somewhere on it.
The doctor said, “No, you stay.” He took a changing curtain and pulled it between her chair and the bed, then he patted the table. I tried to hold the wall for support. His fingers were dry and skeletal, with fat knuckles.
Once he finished playing “damn, this ice cream is excellent” inside my anus, he let me stand up and shakily pull on my jeans. I stumbled around the corner to find the translator studying her left knee intently. I couldn’t feel my butt anymore, like when a gun goes off too close to your ear and everything goes quiet. I sat while they spoke. The translator nodded, looked at me, nodded, looked at me.
“You need to have test,” she said.
“Yes — to find anus problem. There is an ultrasound or an MRI.”
I looked at the doctor, “Which is better?”
They spoke, and she looked to me. “An ultrasound is cheaper.”
“Uh-huh, and which one goes in my butt?”
I felt a bit like crying. “I don’t want any more things in my butt, please,” I said. “I’ll get the MRI.”
The doctor, who must have understood some English, began laughing very loud.
At this, the translator, too, laughed with him.
And I, as a prisoner might try to relate to his torturers in the hopes they would develop empathy, laughed with them.
It was a fucking riot.
“But really — schedule me an MRI, please.”
By the time my MRI results were in, I had grown a third butt cheek where there had once been only pain. I theorized it must have been filled with butt spiders because it pulsed against the beat of my own heart. I sweated through the whole taxi ride, sitting entirely on my right hip bone and trying to count raindrops.
I waited in the lobby for 50 minutes, but I couldn’t sit. My legs hurt. A doctor came out and approached me.
“Do you speak Russian?” he asked. This doctor was different, shorter. I watched his hands as he spoke. The fingers were lean and hard and muscular. I shook my head.
“Damn. Translator,” he said in Russian. He went to the receptionist and they spoke for a good while. I waited, realizing there was no way I could make it home alone. The pain was becoming unbearable, as was my cough. I had a constant tickle in my throat, and when I coughed it rang agonizingly through my sack of butt spiders. The doctor returned with the receptionist.
“I translate,” she told me.
I followed them down the hall to an old, dull office. It was dark. They didn’t turn on the lights.
“Sit,” the receptionist told me.
I said, “I can’t.”
“Sit,” she repeated, miming the action and pointing at the chair.
“I can’t,” I said, pointing at my butt spiders and contorting my face. The doctor ignored us and typed at his computer. I rocked back and forth as they spoke. The receptionist typed something into her phone and turned it to me.
“AB — SKEE — SUH,” she said.
I took her phone and looked at the translation: ABSCESS.
She typed again while I waited. She turned the phone to me: SURGERY.
“Great.” I gave her a thumbs-up. She frowned.
“When?” I asked.
“He look. You wait.” She led me back to the lobby and pointed to a couch.
“Sit,” she said.
I shuffled away to get water. I stood and drank and sweated and tried not to cough for the next hour while I fought to stay standing. The doctor returned and spoke to the receptionist before they approached me.
“You stay tonight. Surgery tomorrow. They will anesthesia, you sleep. Much pain after. Stay four days.”
She held up a slip of paper that said 100,000 RUB, which was about $1,500 in U.S. dollars.
“I don’t have that,” I told her.
“Price,” she repeated.
The doctor pointed to the slip of paper and said, “Price.”
“What if I don’t stay?” I asked. “If I just come back tomorrow for surgery and then leave for home?”
The receptionist frowned, pointed at the paper, and said, “Price.”
I held up my hands helplessly and repeated, “I cannot afford that. Please, I can barely stand, never mind walk home.”
The doctor said something to the receptionist, so she typed it into her phone and turned it to me: SEPSIS.
“Death,” she said.
“Got it,” I said.
She held up the slip of paper again. “Price.”
I thought about strangling her. Instead, I told them to wait, and I called my girlfriend, Julia.
“It isn’t butt spiders,” I told her, biting back tears. “It’s an abscess. They say if I don’t get surgery, I could die, and they want me to stay here for like four days, and they are saying it’s 100,000 Rubles and shit, and I don’t have that money, I don’t know what to do.”
Julia told me to wait. She would call her parents, who were doctors, and ask them what to do.
With a capable woman with a healthy butt on the case, I told the doctors I needed to think about it. They left, and I waddled in circles until Julia called to say she had found another doctor, a specialist. He would see me the following morning at 10 o’clock to perform the surgery. “And I’m coming to get you,” she said.
When she arrived, she spoke to the doctor and told him I couldn’t afford it. The doctor shrugged and said okay. He said he’d like to have a look at me before I left. Julia and I followed him through the halls.
“Is he going to stick his finger in my ass?” I asked her, trying not to cry.
Julia said, “I don’t know.”
“Two of them have already been up there, you know. And they did an MRI. What could his finger tell anyone?”
“I know. I don’t know.”
We stepped into the office. He turned on the light this time and pointed to the table. I turned to Julia and said, “He is, isn’t he?”
She looked at me the way a police officer does when he bends down to tell a fresh orphan about their parents’ car accident. She nodded.
I looked at the doctor, and he gave Julia a confused look.
“He is scared,” Julia told him.
The doctor smiled without teeth and said something.
“He said he understands. But get on the table.”
“Will he be gentle?”
“He knows you’re scared.”
I took down my pants and laid on the table. “I’m not scared, I just don’t understand why they did an MRI… they did an MRI…”
I couldn’t walk home. I tried. I made it halfway, but I couldn’t. A taxi picked us up.
The next morning, I stood outside the gates of a military base. By stood, I mean I held both of my knees and tried not to vomit as Julia led me through a line of armed guards. I had a backpack with my laptop, a book, a few packs of cigarettes, and a phone charger.
“The best doctors are military doctors. He will perform the surgery, and you might have to stay a couple of days,” she’d told me the night before. We hadn’t slept. I was in too much pain.
We passed big army jeeps and pairs of marching officers as Julia led me down a path to an antique building. A doctor in a lab coat made from rent-by-the-hour motel sheets stood outside, smoking a cigarette.
We shuffled past. The stairs were dirt-trodden and there was no receptionist. A Soviet poster from the ’80s told me: IN CASE OF FIRE, DEATH.
I couldn’t speak, couldn’t do anything but stand and watch this poster of people on fire while Julia called the doctor over and over. An hour later, he arrived. He spoke no English. His fingers were huge.
“Did you do this to him?” he asked Julia in Russian.
She laughed, and he laughed. I watched the burning stick figures in the poster run toward a torn-off corner of the hospital map. The doctor led us through a set of chipped white doors, down a hill, and up an elevator that stank of cigarettes and had one button taped over.
“Don’t speak English,” Julia whispered as we passed a desk of old Russian women who made us put blue bags on our feet.
“You’re not supposed to be here.”
“Mhm,” I said.
We followed further, deeper down musty pink-painted hallways. Half the lights in the ceiling didn’t work, and a man with no face walked by, spinning a set of keys on the two remaining fingers of his right hand. As we turned a corner, we heard a scream come from a room as a man with no foot crutched past saying “fuck, fuck, fuck” in Russian.
The doctor told us to wait in front of the scream room. He walked away. I set down my bag and held on to a windowsill for support and looked out the window at the dead trees and garbage scattered throughout the courtyard. There were bars on the window. A minute later, they rolled an old man out of the scream room; his left arm was a bloody, bandaged stump.
My doctor returned, masked and white-hatted. He pointed into the scream room and I went. Inside, there was a bed to the left where an old man lay on his side, groaning. There was a curtain in the middle, hiding the man from the empty bed on the right. There were almost a dozen people in the room. Many of them were young. They looked like students. He pointed to my pants and then to the bed, miming a sleepy time pose. I de-pantsed in front of the crowd. They gathered.
I assumed he was going to examine me. I assumed he was going to take my blood. I assumed he was going to do tests. Then I assumed he would bring me to a private room where I assumed he would put me to sleep. I assumed I would wake up hours later, healed, healthy, and ready to spend two days in a hospital comfortably reading and picking my nose. You know what they say about assumptions and asses.
They laid a medical sheet over me. Two young nurses came and held my legs, two more held my midsection. Then he said something to the crowd, they leaned in. I watched the cracked cabinets across from my bed.
Up he went.
When he finished his game of “hold on, I’ve got exact change for that” he wiped his finger on the cloth covering my leg. He stood. He walked around into my field of vision, holding a gigantic needle in his left hand. In his right, he held a box covered in Russian letters.
“Allergy?” he asked.
I looked at the needle, then the box. I could barely think in English, never mind read Russian, so I said, “Uhhhh?”
He nodded and returned to his post. The nurses holding me down tightened their grips. I could feel all the air in the room lighten as the medical students took a collective breath.
The doctor sliced and began to squeeze.
If an orgasm lets you see God, I was looking up Satan’s nose. I writhed and tried to scream but my voice was empty and dry. The nurse held me tighter.
“Little-little,” she said in Russian. Every time he squeezed, she said, “Little-little.”
And that’s how it went on. Little-little by little-little.
When the pain stopped, I was shaking. As the bandage was placed on, I could hear the crowd muttering to themselves the way onlookers talk about a woman who just slapped their child, full of helpless empathy.
The little-little nurse was the last to go. The doctor held my underwear over my head, and I reached up and grabbed it. I put them on and stood up. The doctor squeezed my shoulder and held up a finger. It was such a fat finger. He wagged it around to ask whether I was dizzy. I shook my head and he helped me stand. I re-pantsed and walked out of the room to where Julia sat. They spoke for a bit before she turned and said, “It will be 40,000 rubles.”
I reached into my bag and pulled out a trembling stack of cash. The doctor put it into his pocket and spoke Russian to Julia while I stood and bled down my leg.
“He says you would have died if it had gone longer,” she told me. “He took 80 milliliters of puss out of you. Gross.”
Then she took notes about what we needed to do for my recovery. Finally, she said, “We have to come back for a follow-up because there is a 50% chance you could have this problem again.”
I looked at the doctor, then back at her, waiting for laughter. It never came.
“Is there anything I can do?”
They spoke, and he said something and pointed upward.
“It is up to God,” she translated.
“But I don’t believe in God,” I said.
I looked at the doctor, trying to write horror and concern onto my face with the time I had.
He shrugged. There was a sound of the door closing down the hall. The doctor turned. The man we’d seen on crutches stood there. The doctor yelled something after him in Russian. “Fuck, fuck, fuck,” the man said as he crutched away. The doctor held out his hand. I took it.
“Good luck,” he said, then trotted off after the man on crutches.
While this experience was harrowing, I am glad it happened in Russia and not in America. I did not have any recurring health issues and I was not buried in crippling medical bills. While Russia might not be the most sensitive place for butt surgery, they do know their shit.