Didn’t your mother warn you to never, ever, ever take a photograph of your private parts and give it or send it to anyone, let alone a complete stranger who asks for it? But this is exactly what happened when Donn Edwards, an old school friend of mine, submitted a claim for specialised wound care from Discovery Health. Discovery wants a picture of his butt. Donn has given me express permission to explore the ridiculousness of this situation.

I know Donn Edwards as a passionate man, relatively easily incensed by affronts to his dignity, a trait that we “friends” used to our own enjoyment in the brutal environment of an all-boys boarding school in the late 1970’s. Donn, now a programmer, has developed his own sense of worth and morality as a campaigner for personal privacy in the digital age, and has been a real pain in the anus to big corporations who transgress these boundaries.

So in an act of cosmic karma, Discovery Health unwittingly refused his request for specialised wound care when he developed a memorable condition, ranking alongside childbirth and renal colic, known as a perianal abscess. For those interested in the details, Donn tells the full story here. In a nutshell, he has been left with a festering crater in his ringpiece, which needs specialised dressings to heal. And for which Discovery will not pay until they have a detailed and explicit photograph in their sweaty palms.

Donn (@donnedwards) is not a man to take this sitting down, both literally and figuratively, and DM’ed me his concerns. I (@martinyoung) asked the Destroyer-in-Chief of Discovery Health, Dr Jonny Broomberg (@jonnybroomberg) for an opinion. Donn, with the resigned air of a man whose bum was about to go public, then outed himself with an entertaining train of tweets, now detailed in his blog, to us both. The stalemate, however, remains. Discovery stands its ground and still wants a photo of his butt.

Let’s explore the ridiculousness of this all for a bit. Lagging only momentarily behind the porn industry, doctors have been taking photographs of bottoms and other bits for as long as there has been photography, primarily to use the images as clinical records and teaching aids for textbooks. In every modern case, however, the patient must be unidentifiable and needs to give permission beforehand. To do so because the medical funder demands it is a new invasion of privacy with which many doctors, as I do, feel uncomfortable.

Tempting as it may be, a brief sojourn sitting on the office colour photocopier is no substitute for a medical photograph. Medical photography itself is an art, requiring special lenses and light sources, with many academic hospitals having their own photographers who see all the legal requirements fulfilled and make sure the image has some academic value and practical purpose. It is not an easy process, unless there is some new filter on Instagram or Snapchat that I don’t know about.

The “anatomical position” for an anus is with the body lying in the prone position, and the vast majority of photos taken to document anal pathology do this with the subject in lithotomy poles or stirrups. Now, I don’t have a set of lithotomy poles at home and I don’t believe many normal people do. The kind of friend who does probably does not represent the kind of friendship one wants to encourage. So one is left having to lie in one’s bedroom, assumedly, with less than perfect lighting and exposure. The buttocks will have to be gently retracted in this instance to reveal the focus of attention, and the guy bits will have to be elevated by hand, unless one resorts to using duct tape, and this involves three hands, with no spare hand to take the photograph. Not even your new selfie stick will do.

So, the indignity of it all not being enough, another person has to take the photograph. Who should this be? Second cousin Sidney who did your wedding photographs? Your best drinking buddy? Your mom? Your wife? Some marriages are on shaky ground already and may not survive this incident.

Make sure your images do not download instantly onto Instagram, for this may cost you old friends and gain you new ones of the wrong sort. Likewise, remove the image from your phone, lest you show it inadvertently to the girl you’re trying to impress with photos of your skydiving trip.

Assuming you do get a decent enough photograph, how do you prove the bum in the image is yours unless your face is in the picture, and this is not a stranger’s bum taken off the internet? (Yes there are images there and no, I am not inserting a link.) Or should you at least make sure your ID book is open and stuck to one buttock as proof of your identity?

A perianal abscess wound is a deep three-dimensional cavity, and a two-dimensional image may well understate the severity of the condition. Photographs nowadays, as EVERYONE except Discovery appears to know, can be photoshopped to make things look bigger, smaller, redder, pussier, or even include a maggot or two.

Assuming you overcome all of these obstacles and have a glossy, colour-contrasted HD image of your bum and identifying features to submit. Then what? Discovery wants you to email it to them. Not, as you would hope, to their resident proctologist at [email protected], who is a connoisseur of gaping anal wounds and past shocking, but instead to the general claims department!

Donn, having been annoying to many big corporations in the past and an expert on privacy, knows that his image could easily be intercepted by the FBI, Mossad and M15, or anyone else with a vested interest in him. Who at Discovery gets to look at this image? What qualifications does that person have? What security is there over their database? Could it not be your vindictive ex sister-in-law, who used to be a midwife but was fired for being too fond of the Entonox in the labour ward, and who now works as a Discovery case manager, who gets the image in her mailbox? You have absolutely no idea and no control whatsoever over your public humiliation!

This is all blatantly ridiculous, and some members might think that the financial pay-out is worth a bit of indignity. But the very worst thing about this is that Discovery, and many other medical aids, no longer believe the word, or opinion, or recommendation of the doctor looking after Donn, or you, or me. This is where we are at the moment, what this ridiculous policy means. Big Brother, the earner of fat profits from healthcare, is firmly in control of your health, not the doctors who trained so hard and work so hard to keep you well. This is the real shocker!

In my opinion, the only butt picture Discovery deserves is a group photo of all the doctors like me and likeminded consumers who oppose their tactics, showing them in unison exactly where the sun doesn’t shine.

And what’s more, not only can they have a picture of my healthy butt. They can kiss it, too.

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Martin Young

Martin Young is an ENT surgeon living an idyllic life in Knysna. He is a firm believer that "the unexamined life is not worth living", writes for a hobby and is happy to speak truth to power www.drmartinyoung.com...

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