In his early 20s, the author William Fiennes had an operation that left him with a spout of open intestine. For the next two years, he marvelled at the strangeness of his own body

The pain began when I was 18: cramps like a torsion in the bowels, shock splashes of blood in the toilet bowl, the weakness after a dozen bouts of diarrhoea. I would feel porous, ghostly, like cirrus, as if solid things could pass straight through me. When I was a child, I thought illness was just an interval, at worst a few days in bed, my mother stirring glucose powder into fresh orange juice, using a kettle to fill the bedroom with steam, the world waiting outside until you were ready to step back into it. But this was a new region of experience and language: my abdomen inflating like a balloon as doctors pumped air in via sigmoidoscopes, plastic tubes threaded down my nose and throat into the stomach and ileum, litres of heavy barium milk betraying the sausagey coils of my intestines to x-rays, the “sharp scratch” mantra of phlebotomists after fixing the tourniquet and pressing a latex finger to the vein, the companionship of drip-stands, the quick taste of metal before you went under; canulas and endoscopes; the splenic flexure and the Houston valve; ulcer, granuloma, Crohn’s disease.

There are things we only think about when they go wrong: the fanbelt, the combi boiler, the bowel. Before illness I must have imagined a gummy muddle behind my navel, but now gastroenterologists drew me a tube stretching 20ft from mouth to anus, air and light at each end, an ingenious pipework that incorporated oesophagus, stomach, small intestine, ileum, colon and rectum, and contained 100m nerve cells or neurons, more than in the spinal cord, as well as 95% of the body’s serotonin. I began to feel, specifically, the topography of the colon or large bowel sitting across my abdomen – the ascending, sigmoid and descending colon, the bends at spleen and liver known as the splenic and hepatic flexures – which, when healthy, is a brilliant gourd absorbing 10 litres of liquid a day (water, saliva, gastric acids, biliary secretions, pancreatic juice), but which in my case had become the messy red bioscape of ulcers, inflammation and scar tissue I saw in photographs from colonoscopies, a tiny mobile eye with its miner’s headlamp probing the dark, curving tunnels.

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