Gutted

Beneath your abdominal wall but before your collection of major organs, there is a network of fatty tissue and blood vessels called the omentum. An anatomist would call it ‘epiploic’, from the Greek for sailing, because of the way it floats across your intestines, navigating the eddies, currents, and occasional storms. Its role is like that of a caretaker. It wraps itself around sites of infection or trauma, providing blood supply and immune responses.

In 2018, mine died.

At first it felt like a stitch. I went out for coffee with my mum, a medical professional, who diagnosed me with man flu. I mostly ignored it, because bodies are constantly dispensing new mysterious aches and pains, and distinguishing between the ones which will kill you and the ones which won’t is very important to avoid going mad. Later I travelled to my then-girlfriend’s house, had dinner, drank several cans of Żubr, and continued the increasingly difficult job of acting like it wasn’t happening. By about 2am I gave up. I rolled out of bed, woke my bleary girlfriend, and told her I needed to go to A&E.

“I’ve got appendicitis,” I told the triage nurse, and she agreed, though with a small flicker of doubt. A rapid onset of sharp pain in my lower abdomen, a growing nausea. The appendix is well known for exploding for no reason. This being A&E in a post-austerity NHS hospital, I then spent approximately 18 hours moving from place to place, staring desperately at the doorway waiting for someone to appear and call my name, averting my gaze from the other sorry Friday night guests, those ashen and shocked into sobriety by their injuries, the elderly and mute, the raging and ranting. The ugly moulded plastic seats, the institutional lino, the harried nurses, time distending and collapsing, the only solid thing the sharp, insistent pain in my gut, the half-remembered sense that an appendix should ideally be removed before it releases its payload of god-knows-what into your abdominal cavity.

Eventually I was deposited on a ward. A bed had been found for me, and I was categorically too sick to go home. I hadn’t eaten or slept for a full day. A whole cycle had almost passed inside the hospital, and without windows to see the daylight it all felt like the same strange endless day to me. My poor exhausted girlfriend went home to get some rest, having been at my side the whole time. A nurse told me that I had missed dinner, but as she felt sorry for me she went and located a cup of sweet tea, some tiny triangle-cut sandwiches of white bread and grated cheese, and a sealed packet of fruit. I cried with gratitude once she left.

The next day the poking and prodding of my abdomen resumed, only with several new participants. The problem was that my appendix didn’t seem to be in the right place. Every fresh surgeon who was invited to palpate me and ask if it hurts here, or here, or here, or here, and so on, would frown slightly at the site of the pain. It was close, but not close enough. I had an ultrasound which didn’t explain anything, but the sonographer suggested I might have an appendix which was the wrong shape. All the better to get the horrible little freak out of me as soon as possible.

A laparoscopy was scheduled. There was no way to know what was going on, so they were going to put a camera in and have a look. If it was appendicitis then the whole procedure would be undertaken without anything more than a small hole for the camera and whatever tools they use to snip it off. I’m hazy on the details, and ultimately they didn’t matter, because when I woke up I had a scar from waist to sternum, ugly metal staples holding it together. I felt a horrible invasive pain in the back of my throat, which was a nasogastric tube. A weight was tugging at my groin — my first catheter. There was also a cannula in my hand, with wires dangling from an IV drip.

On the plus side, my appendix hadn’t ruptured. On the downside, my entire omentum had twisted itself around, cut off its own blood supply, and then died. And then began to rot. This, I am informed, can just happen sometimes. Some minor anatomical abnormality causes the network to snag. They had to unzip me and scoop out all of the bits.

The rest of my stay in hospital was long and tedious. I remember several moments as flashes in a sea of boredom. The couple of days I made it home after Christmas, before a complication sent me hurtling straight back in. The sympathetic nurse asked me at midnight on New Year’s Eve whether she should pause in the insertion of a new catheter so I could look at the fireworks. The handsome, partially toothless old man on the neighbouring bed who ate soup in furious silence and begged his visiting family to let him fucking leave. The obese Forest fan on the other side who did nothing but watch a TV show about Vikings on his phone on full volume, well into sleeping hours, who I spent a lot of time fantasising about smothering. My best friend visiting and feeling so bizarrely out of place on the hospital ward that she panicked and claimed to be my sister, and therefore had to cover my exposed nipple out of familial modesty. The slightly pained look on the consultant’s face he explained to me that if I didn’t submit to a second, more dangerous operation, the only other option was something he called “managed decline”.

Otherwise I was just on Twitter.

I transmitted morning, noon and night. I alternated between scary updates on my condition (the scariness slightly overstated — I liked the attention) and talking about the same shit I did before, sniping about politics, football, internecine disputes between this person or that. I watched Netflix on my tablet, propped up on the little table they have over the bed, and I scrolled on my phone, permanently attached to a charger on the wall. In moments of particularly heavy-handed metaphor the cables would sometimes get tangled up with my IV drip.

Every day my girlfriend would visit and spend some time with me, try to get hold of updates on what was going on. I was often on a lot of morphine (they let me control it with a little button, I learned to count down the seconds until it would let me push it again) and not especially communicative. So too with my parents or friends, who I would chat to for a bit and then wait for them to leave. Hospital visits often have the same character. Awkwardness at being in such an ugly space, around the sick and the miserable. A kind of enforced jollity, a pretence that you don’t look ghastly. There’s nothing to do and small talk runs dry. I felt the awkwardness of my own presence and wanted to spare them from it. If this seems ungrateful, it is. And perhaps another person might have felt more lonely, more isolated, more desperate to have their loved ones around them.

Not me, though. Because I was on Twitter.

Mostly I would tweet from bed, but sometimes I would be encouraged to get up and walk around, conduct some laps of the ward so that my legs didn’t atrophy. So I would take my wheeled IV drip on an expedition to go and tweet in a slightly different location, for long enough to satisfy the nurses that I wasn’t going to get bed sores.

I later learned that my girlfriend, upon returning home with no clear sense of how I was doing or what was happening, was forced to read my Twitter. To wade through all of the embarrassing, tossed-away bullshit, just in case I said something illuminating about myself or my treatment. Sometimes I did. On one occasion I posted that I thought I might be in for 6 weeks, as one potential outcome of this complication or that. This would have been enormous, scary, disruptive news. She didn’t find it out from me, though, and neither did I rush to tell her straight after. I posted it on Twitter, and then I went back to watching Netflix.

I wasn’t even aware I was behaving so shamefully until we talked about it some time later. It hadn’t occurred to me that her worry was so amplified by my disinterest in talking and engaging, alongside this frenzied, no-boundaries online posting to thousands of people. Thinking back to it there is a particular, extra shame, not so much for the behaviour itself but that in her worry she was forced to see the kind of thing I was posting. Whatever pompous, trivial, gratingly ironic thing popped into my head and was disgorged without blinking, another thought exorcised and then forgotten about. The shame of not just being an awful boyfriend, but of a side of me to be so exposed, and one that I didn’t like at all.

This was six years ago. I would be lying if I said much had changed.

*

I’ve been on Twitter across two different accounts for 14 years. I joined during my first year of university, because I read somewhere that it might be of use for academic work because it taught one to articulate thoughts with brevity. The first ever thing I posted was a joke about James Corden being fat. At some point during the next three years, it became an addiction.

I wasn’t consciously aware of it happening. I just know that into my second and third years, I would spend more and more time alone in pubs, because I wasn’t alone — I had taken my phone with me. Or that I would get into raging arguments with people late at night, a bottle of Frosty Jacks with Ribena top next to the desk in my student accommodation, so invested in whatever was going on that I was having furious, teeth-gritted thoughts about it.

A pattern formed. Twitter became like a parallel life, one which my real life friends would treat with suspicion, an eye-roll, occasional worry, but generally nothing to do with them. Many would briefly follow only to discover how immensely annoying I was, and then unfollow, to preserve our perfectly happy and normal relationship in person. I would lean into this. People I met in real life wouldn’t hear about it — I’d actively deny being on it, pretending not to have heard of a particular meme or character.

The voice I developed on it began to diverge from my own. It was angrier, more overwrought, more politically engaged. More mentally unwell. This wasn’t totally dishonest. Twitter seemed to provide a faceless way to sublimate the real frustrations I had without having to deal with much in the way of consequences. Displacement anger for the conflict-averse. Sometimes, eager to justify what was obviously a destructive activity, I would insist that being annoying on Twitter was in fact the point — it discharged all of the natural buildup of being annoying which would otherwise trouble those around me.

With the benefit of wisdom we know this not to be the case. The way we act online is self-reinforcing. There is no finite pool of shameful behaviour. We can always be worse. The best way to win the game is not to play.

Not playing isn’t entirely satisfactory either, though.

I’ve made more enduring friendships through Twitter than I can count. Many of the most exceptional people I know happen to pass through my corner of the internet, and my life is better for knowing them. I do my best to convert these into friendships which happen in person, but the world is a big place, and you can never meet everyone. The fact is that without some kind of central, unifying network, many of these friendships will fall away. Some already have.

Nobody has yet produced a successful alternative to Twitter because the things that people like about it are so hard to extricate from the things they don’t. The thrill of Twitter is the thrill of scale. It’s good because of its vastness and its multiplicity, because it is the “town square of the internet”, because in its billions of intersecting circles there are produced perfect little crystalline moments of comedy and outrage.

This is what so many post-mortems of Twitter fail to capture, treating it as a kind of totalising institution that people must grudgingly participate in. But it’s also fun. There are some days when it is more fizzing and alive than almost any online community. Can I honestly say there isn’t a certain giddy thrill to seeing the whole timeline converge on an issue like seagulls going after a chip?

As of the time of writing, there is a mass exodus from X (formerly Twitter). It remains to be seen if it will be any more effective than the last few. The only way any alternative will produce the peculiar attraction of Twitter is enough people from Twitter go there, enough to give it some kind of momentum. And with enough people, the same bad habits will follow.

Bluesky, the most likely destination for immigrants at the moment, currently has a worthy, humourless air to it. A place which defines itself by what it isn’t — the nasty, bloated, scabrous older brother. It doesn’t seem to me like somewhere that anything funny will happen, but I’ve been wrong before. Some football clubs and media outlets have officially made the jump. I can’t blame anyone for wanting to be on a network with fewer fascists.

If I have become better at identifying the bad habits and bad outcomes it isn’t because my relationship to the website has fundamentally changed. I’ve just got older, and better at emotional regulation. Some days I sign out and do something worthwhile with my time, like write an essay. Some days I sign in and the day is lost to a sort of sick, itchy dissatisfaction, an aimless anger. Some days it’s a lot of fun, the special kind of freewheeling, vertiginous fun that you only get in a crowd. In that respect it’s not so different from the rest of my life.

*

Some time after waking up from my first operation, after the general anaesthetic had worn off and the dull ache in my gut had graduated into something much more sharp and urgent, I had a conversation with a doctor who took me through what had happened. Explained what an omentum was, and why it had to be removed. How the operation had gone, and that I had needed several transfusions. The potential consequences of the surgery, some of which came to pass.

All of this I absorbed fairly calmly. The truth was that even at my most ragged and fearful, I never felt in any doubt that the doctors would fix me. I had total, implicit faith. In fact the whole experience was almost certainly more traumatic for the people around me, who could only visit me in my shrunken, stapled-shut haze. I did have one worry, though, as I learned about this new organ which had been snatched away from me without ever having time to appreciate it.

“Do I not…need it?” I asked. “What will happen when it’s gone?”

“Probably nothing,” the doctor said, giving my shoulder a squeeze. “You’ll be fine.”