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Daniel Dunlap, MS3

A young surveyor makes his way toward his final job of the day. He’s been tasked with inspecting a cave in a remote area for structural integrity. The cave is located at the center of a densely-wooded 80 acre plot of land owned by a disgruntled 45 year old man, Mr. Reynolds. The surveyor weaves his way up the final quarter mile of the dirt road leading to Mr. Reynolds’ cottage, and steps out of his car.
He rudely begins opening the front door almost at the same moment he has knocked, seemingly not concerned with whether or not the man on the other side actually wishes to grant him entry. He introduces himself, and quickly informs Mr. Reynolds that he has come to perform an inspection of the cave on his property. This inspection, the surveryor explains, has been recommended by the American Spelunking Society due to their belief that the cave actually spans the entirety of Mr. Reynolds’ 80 acres, therefore potentially posing a serious risk for him were there any structural faults.

“I’ve been living here 45 years and haven’t had a problem yet!” Mr. Reynolds bellows indignantly after the surveyor finishes his dissertation.

We at the A.S.S. have reviewed the county records and are fully aware that there haven’t been any issues for you yet, sir, but the cave is the only part of your land that hasn’t been directly examined since you’ve been here. Plus, living here longer actually increases the risk for several common structural issues we’re concerned about with caves, and catching these things earlier also increases the chances that any issue we might find could be repaired or at least prevented from getting worse.

“Well what’na hell kinda issues is your department lookin’ for, anyway? It’s just a cave, and it seems to me it ain’t no different than any other cave out there. I don’t know why you’re so worried about this one here!”

He pauses, then continues, “Like I said, I’ve been livin’ here my whole life, so why isn’t just askin’ me if there’s a problem with the cave enough to satisfy your department?”

Well, I want to make it clear that the choice of whether or not to proceed with the inspection is ultimately your decision, but the A.S.S. recommends regular yearly checks for those in your
circumstances. There are a number of things we look for during an inspection. We want to check to make sure there hasn’t been any abnormal growth or thickening of the walls at the far end of the passage, and we also check for abnormal cave formations or substances that we shouldn’t see in…

The agitated man cuts the young surveyor off. “Oh, alright, inspect the damn cave. But make it quick, and I’m coming with you to make sure there’s no snoopin’ around while you’re down there.”

They march silently down a hill to the mouth of the cave, but the surveyor stops. He looks around the exterior of the opening for a few moments thoughtfully.

You’re gonna need to wait right here…I can’t take you in there with me.

“I was afraid you might say that,” Mr. Reynolds murmurs nervously. “Listen, you get out of there as soon as you’ve seen what you need to see. And watch your step and don’t touch anything you don’t have to.”

Alright, Mr. Reynolds, I understand your concerns. I’ll be careful. Would you mind turning around? I know this inspection is something you’re not entirely comfortable with, so I think it’s best if you don’t watch.

Mr. Reynolds nods solemnly, and looks away as the surveyor begins to put on his spelunking gear. Had Mr. Reynolds been looking, he may have noticed a change in the young surveyor’s demeanor. His hands are now cold and a little sweaty, and he struggles to get his gloves on. He mouths a few words as though coaching himself onward. He hadn’t disclosed to Mr. Reynolds that he had only been working as a surveyor for about 2 years, and most of that period was spent in an office pushing papers, rather than doing field work. Even worse, he figured his boss was probably on the way to repeat the inspection since he wasn’t yet fully certified. He should have probably told Mr. Reynolds this up front, but his boss told him not to because it would decrease the odds of him being allowed to perform the initial investigation. Perhaps 20 seconds passed, but it felt like hours for Mr. Reynolds.

OK, Mr. Reynolds, I’m going to begin the inspection.

Both men take a deep breath. The surveyor steps sure-footedly into the darkness, seemingly having regained his confidence. At least that’s what he projects.

Only a few steps into the cave, the light from the mouth of the cave no longer illuminates the surveyor’s path. He pauses in hopes of allowing the tension of the situation to abate a little. Still a little unnerved by his unfamiliar surroundings, the surveyor convinces himself that it’s time to push forward, and he marches deliberately toward the posterior end of the passage. He tells himself that despite not really being able to see anything, he knows where he’s going, and that he has a pretty good idea what he should find there. He’s been in a few caves before, but always with his supervisor’s guidance. He finally arrives at the first location he wishes to inspect, and everything seems to be fine. I’m almost positive everything is fine here. It’s all structurally the same as what he’s seen in the prior caves, which he has been told repeatedly is normal cave architecture. Alright, everything is fine here. He turns around and begins retracing his steps. This time, he pays a little more attention to his surroundings. He does a quick sweep of the walls on both sides, and doesn’t notice any abnormal or concerning formations. Alright, nothing to worry about, almost finished here. As he reaches the mouth of the cave, he takes out a plastic vial and collects a sample of cave material from his glove for lab analysis.

A long time had passed before the surveyor reappeared before Mr. Reynolds. Or was it a short time? Neither man was really certain.

“Are we done here?” Mr. Reynolds asks. A pause. “Hey, I said are we through here?”

The surveyor doesn’t answer initially, appearing dazed. Oh, yes Mr. Reynolds, I apologize, I just… Another pause. The surveyor’s vision goes cloudy. He looks down at his feet, but finds a pair of black leather dress shoes where his muddy boots should have been. He looks up – gone is the cave and the cottage amidst the trees – he’s standing in a brightly lit exam room. A man sitting on the table leans forward with an inpatient stare.

“You look like you’re daydreamin’, Doc. Anyway, what’s the verdict?”

Your rectal exam was completely normal, Mr. Reynolds. Your prostate is within the normal size range, and I didn’t detect any nodules or irregularities during the course of the exam. I also didn’t notice any visible blood in your stool, but I’ve collected a sample of fecal material for the lab to be certain. We’ll get you those results as soon as we can.

“Alright, good to hear, Doc. That wasn’t as bad as I thought it would be…I mean I’m not sayin’ it was fun…but I’m still here, right?”

Well, I’m glad to hear you feel that way. I know it’s not a pleasant process, but I hope you trust that we wouldn’t perform the exam if it wasn’t an effective means of making sure you’re healthy. If it’s alright with you, I’ll go get Dr. J. and share these findings with him, and we will both return in a few moments to speak with you. There’s a chance he may want to repeat some portions of the physical exam, as I’m still in the course of completing my medical training. Before I go, though, do you have any questions for me?

“Ohh…uhhh….naw, son. You’re fine. Just go find Dr. J. for me.”