My GI tract didn’t fully settle after Hazel’s enema. The sensations were difficult or even crazy-sounding to describe, as if my small bowel was distended by gas that never moved because my colon was clamped down around it like the thick shell around an ostrich egg. There was just a shadow of pain, but my abdomen stayed tensed for hours, which was fundamentally exhausting.

Going about my day, getting moving, and trying to ignore it was my usual protocol, and that was the style of day I lined out with Chella in the morning. When I arrived at the barn, Macaroon, my most sensible and forgiving horse, was tacked up for me, ears tracking every word I said.

“Rooney! You know you’re a good boy.”

He leaned his shapely golden head over my shoulder in a horse hug, a pose we maintained for a minute before walking to the outdoor ring. We warmed up and did some pole work, first at a walk and then Macaroon’s relatively smooth, measured trot. The sun climbed enough to feel pleasant, and we pushed open the gate together for a trail ride.

I let him pick the direction and soon we were climbing a gentle rise to an open meadow with a lone oak. A family of deer yanked up their grazing heads and stared; Macaroon continued on, flicking an ear toward their stamping and snorting but spooking at nothing, even when they bounded into the forest.

We picked our way over a downed limb into the wooded dell where the rhododendrons grew; they were long past flowering now and we enjoyed the dappled pine shade as the air warmed. No one else was out. Holding the reins with one hand, I massaged my belly over my riding breeches, hoping something might shift or relax. The massage didn’t feel bad, but nothing inside me relented in any way.

I cued Macaroon into a trot, which I sat instead of posting, letting the jiggling move through me, but even that didn’t loosen the tension and I asked him to walk.

“We tried, buddy.”

I had him on a lax rein and he turned a little to look. I had the feeling he understood what was going on with me, could feel the differences in my seat and read my body language.

Then he huffed a sigh and loosed an avalanche of horse apples onto the trail.

“Showoff. I’m glad that’s working for you.”

Back at the house, Ryan had made a gorgeous plated salad with butter lettuce and peach salsa with roast chicken on the side, but I picked at lunch.

When the plate went back, Ryan found me. “Was it okay? Something I should change?”

I shook my head. “No, no, it was perfect. Like virtually everything you make. It’s me.”

“Tummy again?”

I nodded.

“Oh, no. I’m sorry, honey. Soup for dinner? In the library?”

“You’re the best, Ryan.”

By evening it was good to meld with the sofa velvet under the soft throw blanket, and I must have dozed momentarily because the sounds of Ryan setting my place for dinner woke me.

“Sorry sweetie. I wanted to let you sleep as long as we could.”

I assured him it was fine and watched as he set out a cheerful vase of zinnias and snapdragons with the cutlery and tableware.

The soup was slivers of lean duck breast in a chicken-ginger broth, with thin slices of scallion, chunks of water chestnut, wonton strips, and cilantro; I could see Ryan visibly relax when I started to eat.

“I took the liberty of making you a berry-watermelon-lime smoothie for dessert,” he said. “Just to sip on a little.”

Sometimes I was so grateful for Ryan I could almost cry.

“You’re unbelievable. I bet every other person of means with IBS just wishes they could have you. How did I get so lucky?”

Ryan bowed his head and shaped a heart with his hands.

Not too much later, I took a hot water bottle to bed with me, laying it on my tensed belly as I read myself to sleep. Although I was uncomfortable now and tonight was Benjamin’s practical interview, I didn’t want to text him right away. My intention in every practical was to see how the candidate handled one of my early-morning wakeups, when I most needed the assistance of an enema butler.

2:18. The tension was now pain. For heck’s sake. I drew up my knees and was about to try to return to sleep when I recalled it was Benjamin’s practical night. Yet I was tired and cranky enough that I didn’t want to interact with a relative stranger.

Be an adult, I told myself, and texted Benjamin.

See you in 5, he texted back.

Soon he knocked on the French door, asked to enter and turn on the light. His hair looked flat on one side, an endearing testament to how quickly he came to help.

“Tell me about what’s happened with you,” he said, gloving up. I gave him the rundown, trying not to linger on the crazier sounding parts.

He reached for a stethoscope in his bag. “Mind if I have a listen to your bowel?”

I shook my head and adjusted my pajamas, staying silent as he listened.

“May I examine you? Please tell me if I’m causing you pain.”

He did a full abdominal exam, slowly, raising an eyebrow when my right lower quadrant was tender to palpation. Then he pulled his gloves off, grabbed a chair, and sat at my bedside.

“Sandrine, I’m sorry, but your condition is just too close to appendicitis for me to be comfortable giving you an enema.”

I thought about trying to explain my history, my past medical workups, and how my very-appendicitis-mimicking symptoms never showed as an inflamed appendix on double-contrast CT. And then I thought that even that might not be enough to convince Benjamin.

“I’d accompany you to the hospital and stay as your advocate if you wanted to get evaluated,” he offered.

It was 2:30 AM, and no, I did not. This pattern was just too familiar.

Nor, at 2:30 AM, did I want to debate and educate. Benjamin was young enough not to have seen many people who didn’t fit the algorithm so would be a tough sell.

“I appreciate your offer, your honest assessment and your professional caution. This is, unfortunately, a known pattern for me, so I’m going to decline your offer, despite its generosity. And I won’t ask you to do anything you’re uncomfortable with.”

He nodded in relief, flattened hair bouncing. “I would be uncomfortable and frankly worried I’d cause you harm.”

“I understand. Thank you for your time, Benjamin.”

We shook hands; he told me he hoped I’d feel better soon and let himself out.

Before 3 AM wasn’t the right time to extend a job offer to Mervyn or hit him with an impromptu callback, and by now I needed an enema badly, so I pushed through the fatigue, ran the water warm, and assembled my kit.

Lying on my side in bed on a towel, I inserted the nozzle slowly then pumped warm water in. The faster I could get most of it in, the sooner the pain would end, so I rolled to my back and kept pumping. Water expanding the tensed areas of my bowel felt very good and let me take deeper breaths than moments ago.

I rolled right to let the water reach the most painful parts, something that often felt worse before it felt better. I stopped pumping and massaged my right lower quadrant, breathing through a very hot, sharp pain until something relented and this last part of my large bowel filled. That sensation of agony turning into comfort was choir-of-angels fantastic.

Time to retain to see if I could empty whatever was the source of my distress. I turned onto my back, kicking a pillow down the bed to elevate my legs. I massaged my enema-filled belly, breathing slowly, feeling the contentment of leaving so much pain in the rearview.

I wasn’t moving; nonetheless it seemed my vagina gushed wetness. I touched myself, at first to confirm, and then, discovering I was completely wet and engorged, for pleasure.

The warm enema filling me from within combined perfectly with my rubbing and stroking to slowly build a masterful orgasm that, when it crescendoed, involved every inch of my uterus and made my back arch.

The inevitable expulsion was largely painless and very productive, and by the time my gear was clean and stowed and I was back in bed, I could tell I’d be able to soundly sleep.