After years of suffering, Phillip Comella discovers the cause of his “excessive bathroom breaks” while working on his thesis in biomedical science.
Phillip Comella is pursuing a PhD in Biomedical Sciences at The Icahn School of Medicine at Mount Sinai. His research includes machine learning and genetics in an effort to better diagnosis patients and simulate disease. Phillip has a passion for translating technology and tales from science to the public.
This story originally aired on December 7, 2018 in an episode titled “Science Gets Personal.”
Story Transcript
So about five years ago, I’m sitting in the basement bathroom of my first job with my head in my hands as my boss is shrieking her voice through the crack, “Phil, are you in the bathroom again? We are not paying you to poop.”
As much as I hated her and, trust me, I hated her, I had to admit that the bathroom breaks were getting a little excessive. But I never really thought too much of it. Going to the bathroom is healthy. It just shows I have a fast metabolism. If all of you go to the bathroom once, twice a day, I’m going to the bathroom like eight to twelve times a day. It just shows that I’m eight to twelve times healthier than all of you. And I don't even need to go to the doctor for being too healthy.
But on poop number six before noon on that particular day, there was blood. Not just a little bit of blood, like a lot of blood. So I went to the doctor and I explained that I’m bleeding out when I go to the bathroom.
He says, “Well, do you have a family history of this?”
And I said, “Well, kind of. My grandfather had colon cancer and he actually had very similar symptoms to this all the way up until he died one day after going to the bathroom, so I’m a little concerned.”
He says, “Don’t worry. You're in good hands now. Bend over and take off your pants.”
So he's just going out doing his excavation work, snaps off his glove and says, “Definitely hemorrhoids. Squirt this ointment up your butt for the next two months, you'll be cured. If not, come back.”
So great. The next two months I squirt this ointment up my butt but, to my surprise, I don't get any better at all. I actually get way, way worse. It gets so bad at one point I’m actually buying maxi pads to line the inside of my boxers because I’m bleeding even when I’m not using the bathroom. And let me assure you, maxi pads are not designed for people with testicles. Those winglets stick to everything. Everything.
So I go back to the doctor and I explain to him I’m a 22-year-old man having his period for the first time and it’s not going well.
He agrees and he says, “All right. We’re going to have to do surgery.”
With the surgery I need someone to come pick me up. So I call my girlfriend over and she doesn’t really know all of this. My bloody poops didn’t really come up during pillow talk and so I never really told her because I was honestly kind of ashamed of it. It’s not really a sexy disease. No protagonist in a movie is getting diagnosed with perpetual poop. That would really change the ending of Fault in our Stars. So I never really told anyone about it.
So when I’m telling her, it’s kind of hitting her in waves. And at the end of it I say, “Well, listen. Can you come pick me up at the hospital on Friday?”
She says, “I actually can’t, because I’m seeing someone else.” Which wasn’t really what I was expecting to hear.
So we talked for a little while and she ultimately took all of her stuff out of the apartment leaving it a very cold and vacant place, which is fitting because that’s exactly how it felt.
Then I’m scrolling through my phone and I get an email from my boss, the terrible shrieking woman from before. In the email it’s says, “Dear Phil. Although you have the sick leave to take off, you've not given me an exact detailed message explaining the procedure so I am not granting you the time off.”
And people have their limit to the amount of stress and trauma they can take. Then they go into what’s known as the Fight-or-Flight response. And on that day I said, “Fuck it. Let’s fight.”
So I hit ‘Reply All’, as a few of you have, and I said, “Not only is this a violation of my HIPAA rights, this is a violation of the employee handbook,” I cited the section, “and don’t worry about it because I’m never coming back to work ever again.”
The moment I hit ‘Send’ on that email, a countdown started because, now, I only have until the end of the month for health insurance.
So I called the doctor the next day and said, “Not only don’t I have someone to pick me up on Friday, I also would run out of health insurance for the next two weeks.”
So we have to conjure this plan and it has some sacrifices to it. I don’t have enough time to do the proper pre-op or post-op and the surgeon that we had originally scheduled can’t do it anymore so we had to find a general surgeon who doesn’t specialize in this stuff.
So the primary care physician contacted him and said, “Listen, just cut out anything that’s bloody and necrotic,” and he said, “Sure.”
So we do the procedure and I feel better. But about a month later the blood comes back. So I call the doctor because I can’t afford to physically go see him anymore and he says, “Listen, there's a chance you're just one of the small percentage of people that just has chronic hemorrhoids and there's nothing we can do about that.”
So I just kind of have to accept that as fact. I have to accept that as the new me. I am a chronic hemorrhoid hero. It’s a secret identity. I don't tell anyone. It’s like any other superpower or any other superhero. My only superpower is that I have to shit every hour on the hour so I get pretty good at telling time, which I guess is the only benefit.
But I never really changed my mind on that. It’s just something I have to accept as fact so I changed my whole life to kind of accept this new power. And I don't rethink it for years, until a couple months ago when I take a road trip with a few friends.
On this road trip, we’re going down the East Coast. We’re coming back. It’s like a 20-hour straight driving at the end of it. And we get to the Lincoln Tunnel and I’m awoken in severe pain. I was like, “Shit. We’re so close.”
It’s twenty hours of driving. We’re like this close to getting home. I can deal with it. I can rule it. But the Lincoln Tunnel and traffic, which is New York’s most terrifying villains, have a different plan in mind.
So we get to the bottom of the Lincoln Tunnel and I’m not doing well at all. So I kind of whisper to my friends who don’t know about this secret identity, I say, “Listen, I’m not doing too well.”
They said, “Well, we’re driving as fast as we can. We’ll get there soon enough.”
That’s when I start shaking. That’s when I start sweating. That’s when my stomach starts cramping. So by the time we get to the end of the Lincoln Tunnel, we hit that first red light and my brain shuts down. I go back in this Fight-or-Flight response. This time I chose flight and just kicked open the door and started sprinting.
So it’s nine in the morning, I’m sprinting down the street and I’m running up to these restaurants. I’m hammering on the door and I’m saying, “Please, let me use your bathroom. Please, let me use your bathroom.”
They're like, “No bathroom, no bathroom.”
I go to the other place. I’m hammering on the door and they say, "No baño, no baño. Port authority.”
I’m like, “Okay.”
So I’m sprinting down the street. I’m pushing over grandmas, I’m hurdling taxis, I’m running as fast as I possibly can. I see the door. It’s held open by a rock. I fling it open, I run down the hallway, I see the elevator. I’m mashing the button but nothing is happening.
So I’m starting to look at other options here and that’s when I see the bowling shoes, and the bowling balls behind this long desk. I’m not in the port authority. I’m in the bowling alley next to the port authority and they're not open yet. I don't know why the door is held open by a rock.
So my brain just starts working in overdrive, like how much time do you have left? How much pain are you in? How much sweat have you lost? And at that point it flashes in front of me. “You're out of time. Jump the desk.”
So I jump over the desk, I kick over the phone and the pens, find a trashcan, drop my pants…
I don't know how many of you have ever broken into a bowling alley at nine in the morning to shit in a trashcan but it’s a very coming-to-Jesus sort of moment. It really allows you to rethink just about everything about yourself. And it’s in that moment where I thought, “Maybe this isn’t hemorrhoids. Maybe this is something different.”
So at that time in my life, a few years have passed. I’m a graduate student and I’m preparing for my thesis proposal. That’s just a formal way of telling the school what I plan to do for the next eight years of my life, which is terrible. But my plan is to basically create this machine learning tool that can read genetics and then spit out a diagnosis.
My boss kind of tells me, “What do you want to use that for?”
And I said, “Listen, I don't really care what we use it for because I just need a lot of data to do the first try.”
He says, “All right. We have a really good data set in ulcerative colitis. Just go for it.”
So I write it up. I get it finalized and formalized and it’s accepted, so it becomes my thesis and I have my first meeting with the ulcerative colitis group.
They say, “Well, what do you know about ulcerative colitis?”
“Well, I actually don’t know a whole lot because I spend my whole time trying to figure out the technical sides of this.”
They said, “Okay. Ulcerative colitis is a chronic autoimmune disease.”
Most people are familiar that the immune system is there to protect you against viruses and bacteria and other things that make you sick but, on occasion, it will go rogue and will act as a double agent. In the case of ulcerative colitis, it will start attacking your intestines.
So after hearing that I’m like, “Wow, that sounds terrible. What can you tell me about the patients?”
So they’re describing the dataset and they said, “Listen, we have a lot of people between their mid-20s to mid-30s. They have a range of intestinal complications and they often go misdiagnosed for years.”
And I kind of get this out-of-body experience, like someone is talking about me to me. She could have said, “Listen, ulcerative colitis patients are like this tall, have dark hair and their girlfriends often break up with them during a flare-up.” And I’m like, “That sounds familiar.
So I call a new doctor once I get out of the meeting and I tell him, “I have ulcerative colitis.”
He's like, “Listen, just because WebMD says…”
I’m like, “No. I’m well past that. We’re well past WebMD. I want a colonoscopy, I want a histology, biopsies. If it’s an –ology, I want them looking at this.”
So we do all these procedures. He pulls me into his office when the results are done and he says, “Phillip, I’m sorry to tell you but you are not the chronic hemorrhoid hero. You are the ulcerative colitis champ.”
I'd never been more relieved to have a chronic autoimmune disease because I spent years wearing this misdiagnosis that just didn’t fit me. I would like to take credit for discovering this myself but that’s not really what happened. This transformation was more just being flexible to new information as it came to me.
So after some medications that I'll probably have to take for the rest of my life and some pretty heavy diet changes, I, for the first time in five years, am pooping once a day. That’s a superpower I will gladly bear. Thank you.