unspooling
Explanation
The Joke
A doctor (or medical professional) stands in her white coat, speaking in a philosophical tone: "Every event in the history of the universe has made some small contribution to this moment, right now, where I'm unspooling a tiny camera into an old man's ass." The caption below reads: "It wasn't a mistake to quit philosophy for medicine. It was a mistake to learn philosophy in the first place."
The Humor
The comic takes the grand, awe-inspiring idea of cosmic determinism -- that every event since the Big Bang has led inexorably to this exact moment -- and applies it to the most mundane and undignified medical procedure imaginable: a colonoscopy. The doctor's philosophical training forces her to see profound cosmic significance in something she would probably rather just do without existential reflection. The caption delivers the real punchline: the problem is not that she became a doctor instead of a philosopher, but that studying philosophy at all has cursed her with the inability to stop finding deep meaning in deeply unglamorous situations. It is a sharp joke about how philosophical awareness can make everyday life more absurd rather than more meaningful.