I was ten years old and supposed to be in some sort of program at church that Mama was in charge of because she was the leader of the Baptist Women’s Circle.  But I was sick – sick as a dog. So nauseated I could hardly hold my head up, my mouth full of that sickly, salty taste that floods in right before you throw up – only I wasn’t throwing up. I just wished I would. I told Mama I didn’t feel good. She looked doubtful and reminded me that I “had a part in the program.”  Great. Now I felt nauseated AND guilty. Thanks, Mama.  She went into the bathroom and started putting on her lipstick.  I followed her and sat on the edge of the tub.  “Mama, I really don’t feel good” I said again and wished mightily that I would throw up that very minute so she would know that I was completely serious. She said I should go lie down which I interpreted as being dismissive and irritated.  It didn’t occur to me that she was just in a hurry and distracted which I can see clearly now as an adult. The trouble was that I really did feel guilty about not “doing my part” – it was just in my DNA, that guilt thing.  I don’t remember now whatever it was I was supposed to say or do but you can bet your bottom dollar that I had rehearsed it to the hilt and was prepared to do my best.  I just couldn’t do it the way I was feeling and I knew it right down to my toenails.  I continued to feel guilty but I felt much worse physically than I did mentally and so I made my way back to my bedroom where I crawled into bed hoping I would die so that my mama would feel guilty. 

My grandmother from Virginia that I called Bobo was visiting so she stayed with me that evening.  I suppose that Daddy and my little brother went to church, too, but I really don’t remember.  I was too sick.  By the time they returned from church I barely remember Mama calling my name. Daddy carried me to the car and took me to the doctor.  The only memory I have of that visit was Dr. Stallings pressing my abdomen and the pain I felt. It was excruciating and made me throw up.  Mama said I screamed but I don’t remember.  Dr. Stallings sent us directly to Rex Hospital in Raleigh where I met his surgeon friend who explained to me that my appendix was inflamed and needed to be removed.  I had no idea what an appendix was but if that’s what was making me feel so bad I was all for whatever it was he was planning to do.  My mama must have asked more specifically about the surgery because I recall him proudly announcing that the surgery had been perfected and I would only have a tiny “bikini” scar on my right lower abdomen. I was too sick at the moment to care. The next thing I knew I was being wheeled into the Operating Room where my big feat was to count backward from one hundred. I think I said, “One hundred, ninety-nine…”

The next time I opened my eyes I heard someone yelling, “Nurse! Nurse! Give me something for the pain!” – just like an actor on television. Maybe it was a program on television? And then I realized that someone was me. What? Why? Oh, yeah. I was really in pain – like nothing I’d ever felt before. I couldn’t figure out where I was hurting or why I was hurting. And I had no idea where I was. I wasn’t at home. An unfamiliar face appeared before me – a woman with a nurse’s cap on. She said something to me but I couldn’t say what and soon everything was swirling and I was falling down into a black hole of sleep. 

The next time I opened my eyes the sun was shining through a big window and I was swaddled in white and lying in a hospital bed with rails on either side of me.  A nurse was saying “good morning” as cheerfully as if I’d just arrived at Sunday School.  There were other beds in the room with lumps in them but I couldn’t tell much else about my roommates.  What I wanted was my mama and I could feel myself wanting to cry.  The nurse told me she was going to adjust my bed so that I could sit up.  And when I tried sitting up as I usually did I realized why she was helping me. Ugh.  Once I was upright she pulled a tray over to me with breakfast food – I couldn’t say now but it was likely eggs and toast but it didn’t matter.  I knew I couldn’t get any food past the lump in my throat. I didn’t want this cheerful nurse nor any of the food she claimed would be delicious. I wanted my mama.  I was struggling not to burst into tears when I saw Mama’s face at the door.  The sight of her was so wonderful that something tipped over and the tears spilled out. No angel could have been more welcome.  When she put her arms around me I began to sob and apologize for not “doing my part”.  I was surprised by her laughter as she caressed my face and said that nothing mattered except that I was alright.  And so I learned that the program had gone on without me. My absence hadn’t ruined a thing.  I must say that I was both relieved and surprised.  And then I wondered if anyone had missed me at all.  Mama laughed and said “of course”. 

In retrospect I learned quite a lot from that experience. Mostly I learned how good it makes you feel to have people take good care of you and to have people let you know that they are thinking of you. I got flowers and cards and visitors. I was fussed over by my parents and other relatives. My little brother was especially sweet. The surgeon told my parents that I had arrived at the hospital in the nick of time as my appendix was on the verge of rupture and that would have been a life threatening condition that would have made recovery more difficult. I also learned what an appendix really is and a bit of its medical history.

The appendix is small pouch like structure that hangs from the side of the colon.  It actually looks a bit like a worm and is attached to the first part of the large intestine. It was discovered by anatomists in the 1500s but they had no idea of its function although they knew that it could be inflamed and cause serious illness. The first appendectomy was performed around the mid 1700’s but there was no general anesthesia until the mid 1800’s.  Can you imagine?  And, yes, they really performed the surgery without it – which required a lot of folks holding the patient down. Lord have mercy! I cannot even imagine. You’d be scarred for life – physically and emotionally.  Once general anesthesia came into being surgery became almost the gold standard treatment for appendicitis. Nowadays laparoscopic surgery has mostly replaced open surgery and a laparoscopic appendectomy is considered one of the safest, lowest-complication surgical procedures.  That said, the appendix remains a mystery. The cause of appendicitis has yet to be identified and no one understands why the appendix will rupture in some patients but recover in others.  As recent as 2007 research showed that this tiny body part appears to play a role in both the digestive and the immune system as it stores beneficial bacteria that can be used when the GI tract loses its gut flora. More recently, professionals are wondering whether antibiotics would be just as effective as surgery – noting that men on submarines that could not surface for six months during the Cold War received antibiotics instead of an appendectomy and recovered relatively well. I understand there is an ongoing study in California attempting to verify whether or not antibiotics would be just as good as surgery – certainly it would be less invasive.

Appendicitis is most common in children and young adults between the ages of 10 and 30. In the United States, appendicitis is one of the most common causes of sudden abdominal pain requiring surgery. Each year more than 300,000 people have their appendix surgically removed.  Left untreated the appendix can rupture and the death rate for a perforated appendix may be as high as 50% according to The Science Direct.

What I have NEVER learned, however, is how to NOT feel guilty – and I feel guilty a lot – sometimes about stupid stuff.  A doctor I used to work with told me once that he could probably make me feel guilty for WWII if he put his mind to it. See what I mean?  Too bad that surgeon couldn’t remove the “guilt gene” while he was removing my appendix.  Sigh…….