I sat in the waiting area of my doctor, waiting for my turn to be seen for my yearly physical. I was soon whisked away into the exam room, took off my shoes and opened my shirt as the medical assistant took my vitals. Weight, height, BP and pulse were done in a few minutes and the assistant was off to their next patient.

About ten minutes later, my doctor walked in and we exchanged the usual pleasantries. He got into the usual exam, changes in family history and reviewed my lab results. He was happy I dropped a few pounds and hoped I can continue to keep going. He then mentioned I had a birthday coming up and wished me an early 53rd birthday.

I knew what was coming next. "Richard," he said, “three years ago, you had your colonoscopy. They did find two polyps and that usually means you need another one very soon". My heart sank. I know screening is important but I didn't want to go through that torture again. I asked if we could postpone it for a while and he asked why.

I told him what happened when I had my first one at 50. The seemingly endless day before with the horrible prep and fasting. The sedation that made me sick to my stomach and the mean nurse (recurring theme througout my life) that stuck me so many times and placed the IV in a place in my arm that kept me in constant pain making me practically beg for the sedatives that I knew would make me heave afterwards. When I mentioned to her that the phlebotomist complemented me and my "beautiful veins" in the crook of my left arm and when she drew blood, I hardly felt it. As the nurse kept skewering me with the IV and I was doubled over in pain, she told me to grow up and she is in charge and knows where the veins are and doesn't care what the "blood drawer" said.

I also mentioned that I could not afford the co-pays right now and would be in a better position to pay them once my bills were paid off. He saw through all of my reasons to procrastinate and reached inside his desk. He took out a business card and handed it to me. He recognized my concerns and while he said he would like to see me have the colonoscopy done within his practice and hospital, he is a very good doctor and places my well being above his income. He mentioned the doctor is in an area with many people who can't afford the level of care his practice provides but her methods are traditional and sound. I placed the doctor's card in my pocket, thanked the doctor again and showed myself out of his office. I studied the card on my bus ride home, getting up the nerve to call.....