ERNIE AND ERNESTINA: The Writer, His Wife, and their Afterlife

Book One, Part One, Chapter 69: Radical News

“You don’t know how bad I feel, Ernestina. If I had the courage, I would put a gun to my head.”

Ernie says this so often I’ve become immune to it. I think he’s just being dramatic. But when he doubles over in pain whenever he pisses, and when more blood shows up in his piss, and when his current urologist, whom he switched to six years ago, keeps diagnosing urinary-tract infections, keeps prescribing antibiotics that hurt Ernie’s stomach, keeps telling Ernie to “drink more water”, then puts a Foley catheter in him and tells him it will be a permanent thing, Ernie seeks a second opinion.

Dr. Watkins listens to Ernie’s narrative of his symptoms.

“You have a complicated urological history,” he tells Ernie. “Let’s start from scratch. We’ll schedule a rigid cystoscoping and take it from there.”

Ernie expects to be out of the hospital within hours. While he’s in Recovery, Dr. Watkins meets me in the small waiting room. He takes a seat next to me and slumps over. “I found a tumor at the base of his bladder. I removed as much as I could, but it’s into things.”

I don’t really know what he’s telling me. I go on automatic pilot. “What stage is it?”

“I don’t know. We’ll have to wait on the pathology report.”

“Can we do BCG treatments to boost Ernie’s immune system, the way Dr. Sweitzer did before?”

“That’s only effective in Stage One. This is not Stage One. I’m admitting Ernie into the hospital. We’ll talk more later, after the pathology report comes in.”

Ernie has a double room and makes friends with his roommate, also a patient of Dr. Watkins. The two men talk of bladders and prostates and PSA numbers. Months before, his roommate elected to have his prostate removed. “But I didn’t know I’d never have another erection. I’m like a castrated rooster. I eat more. My stomach’s so big, I can’t even see the damned thing.”

A few days later, Dr. Watkins, in a white jacket and dark trousers, comes in for his talk, taking a seat beyond the foot of Ernie’s bed.

“It’s at least Stage Three. You’ll need an operation.”

“I’ll lose my bladder?” Ernie says.

“Yes.”

“I’ve worked so hard to keep it.”

“Is there any urgency?” I ask.

“I’d do it within the month,” Dr. Watkins says.

“Have you ever lost anyone on the table?” Ernie asks.

“Not on the table. Afterward. Heart attacks. It’s not an easy operation. We remove the bladder, the prostate, and lymph nodes.”

“The prostate, too?” Ernie says.

“The operation is called a radical cystectomy. We might as well remove the prostate. It causes trouble for a lot of men.”

“How long does the operation take?” Ernie asks.

“Six or seven hours.”

“How many do you do?” Ernie asks.

“One or two . . . a year.”

Ernie and I look at each other. One or two a year?