Memoir, Personal Essays

Asylum, Part 3

Third and final part of my time spent at Brainard Hospital. If you missed the previous posts, be sure to catch up on part one and part two

In time, I began to frequent a room we called the Smoker, and, although not a smoker myself, I adjusted to the languid smoke-filled terrain of our den of inequity. Layer upon layer, the yellow walls were stained nicotine brown. Scraped, scarred and slashed Salvation Army chairs circled eight-foot round rough-hewn tables that were scattered in clusters. A myriad of ashtrays — both on the floor and the tables — were always full of ashes, butts, and spittle. At the head of the Smoker stood two wooden rectangular tables under the naked glare of ceiling lights that cast shadows into the grimy recesses of the large room.

The head tables were for the employees in charge of maintaining decorum in the Smoker. They doled out cigarettes to momentarily abate the incessant cravings of the inmates. One cigarette per customer per 15 minutes 24 hours a day. The line established itself just before the quarter-hour and the dolers regularly shortchanged the clock to avoid being nagged. I supposed it was also a gesture of good will.

The rights to cigarettes were obtained in a variety of ways that included exchanging your disability welfare check for your favorite brand, being a beneficiary of the covert founder of the cigarette endowment, guilting what family and friends still recognized your existence, theft and, above all, mooching. The cigarette cult permeated our society-in-exile and the Smoker was its capital.

I had met a woman in Brainard named Jeanne. Soon she became ‘my woman’ and we had a sort of romance that was born of necessity as much as desire. She and I held intriguing meetings in the Smoker, where we shared butts, kissed and fondled each other in the dingy shadows.

Jeanne liked to deny my fondling both inside and outside of that drab room. With a lean, poised body, darting clear blue eyes, and subtle breasts, she entertained herself by play-acting a fear of being defiled by men. Her mind was seeded with paranoia and she spent most of her free time calling lawyers and begging for their help. She demanded that they comprehend her plight and secure her freedom. In every call, she recanted the sins heaped upon her that were now destroying her brain and infesting her body. A sexy child-woman, over-medicated, frightened and pushy, she was beyond even electro-shock to pull her back from the edge of sanity.

One random morning at two am, all was well in the smoker. John had his head-set radio scattered all over the large round wooden table and was attempting to use black tape to repair its bare guts. For four dollars, he’d just bought at least twenty dollars’ worth of radio from a new incarcerate. Fixing, breaking, re-fixing—his hands flew between waist-attached tape players with head-phone privacy, an army of batteries, double AA, alkaline, triple AAA-used, new, no good at all, and the prized cassette tapes. Barter, borrow, buy and hide away for the needy day. He was hoping to tap into that electronic music sub-culture, an elitist indulgence for the intelligentsia. How utterly sublime to soar through one corridor after another, to sit in the dank Smoker while enveloped in Berlioz’s Symphonie Fantastique! And only he would be able to hear and dance to its rhythms.

Randy, another inmate, postured out of the gloom. His presence was ostensibly to help John, but we all knew he would fail as usual. Randy’s air of monotonous superiority was more boring than offensive, even a bit entertaining at times. John wouldn’t give in to Randy’s attempt to help — or dominate, one could say — and he collected the pieces of his electronic world and left. Randy bantered on, pointing fingers and sermonizing on the need for order and rules. He bragged, as he often did, that his myriad of contacts on the ‘outside’ were waiting for his release. Then he paraded proudly up to the head table and preached at the cigarette dolers. Was it to provoke, ingratiate or simply to relieve his boredom? Maybe all three. But the people in charge were used to his biteless bark and even admired him as they would a strutting peacock.

It was a shame that Randy ran off John. He was the sweetest, brightest and most caring soul I have met in a long time. Like with the radio, he was always tinkering with something, piecing together parts into a whole that never quite came together. I didn’t believe that his Rube Goldberg-style inventions were a sign of what got him institutionalized, but rather the result of 22 years of drugs and institutions. Often he launched into a tirade that lacerated drug psychiatry. “None of this shit works,” he’d say. Because according to John, he “ain’t really sick.”

I was always fully entertained and pleasantly distracted by John’s lectures on bizarre, erudite articles, published by the psychiatric towers of Babel that preach success through correct labeling within their 280 categories. John had spent most of his 35 years in institutions, and reveled in his theory that he was blowing the hell out of the State’s mental health budget. It was his way of killing them as they’d tried to kill him over the years.

One day, Jeanne simply disappeared. Word was she’d been discharged, though no one had informed any of us, her friends. Thanks to our conversations, I knew the only place she had to go was back to her drunken, abusive father. She was back in a week with fresh tales of mistaken identities, demonic psychiatrists, drug blackouts and a new pair of cowboy boots that accentuate her slender sexiness. Our romance resumed its former function — as a calming background noise that distracted me and allowed her to obsess over the brain damage she sensed was slowly, invisibly enveloping her. She was terrified that the drugs were permanently “fixing” her.

“Can I stay at your house?” she asked me once. “Won’t you take care of me?” Sure I would. Just give me $50,000 a year and a social worker who actually cared. It was clear that our relationship didn’t have much shelf life outside the institution and we both knew it. Jeanne could barely function in the real world and I didn’t have the resources to care for her. She was one of those poor souls doomed to be institutionalized until the monster was slain and a rational treatment for humans with emotional disturbances was invented. For the time being, it was easier to lock her up and drug her: out of sight, out of mind.

Close to my release, someone informed on me and I was caught spitting out my pills. After that I got mouth checks. I could no longer be trusted. I also couldn’t afford to dwell on the fifty years of being sane that I already had under my belt. They did not recognize my credibility in Brainard, and arguing to the contrary would have only set me back further. Like my fellow inmates, I was quite cognizant of the dangers in this prison — after all, we aren’t that crazy.

John had begun to posture — his body became distorted, his arms and hands askew. He took a step and re-postured, another step and again re-postured. With his wicked sense of humor, I first mistook this for a new parody he was creating. But I suddenly realized that it was the tradive dyskinesia of Haldol. Because of the meds, his face became fixed in a grimace to which he added his own sardonic flare. Seasoned by my own suffering, I convinced John to mouth his poison and advised him to be more careful than I was. He needed to use the water fountains to dump the pills and avoid the toilets with their prying eyes.

John had already informed the monster about his previous problems with Haldol (which he did not need in any case), but this is the world of which Kafka wrote. Orders were issued from The Great Oz, who may or may not have read John’s chart, who may have erred but was beyond reproof, and whose capriciousness always wreaked havoc. John mouthed his Haldol, recovered, and the balance was restored again.

Life in Building One went on, with its inhabitants, myself included, trying to piece together our shredded selves into some form of supportive society. All the while, our Keepers fought a stiffly organized resistance against our need to belong. I groped for love, for kindness, for hope — blurred as I was, I was instinctually drawn to this community of comrades.

The time finally came when I became expendable. The system did not need me any longer. It had justified my incarceration, my diagnosis, my druggings, and finally, my disgorgement. Ironically, the admonishment I received upon being vomited from the belly of the beast was, “Don’t come back!” (Almost all do — again and again.) My prognosis was “guarded,” a polite medical term for “hopeless.”

I left my sheltered world, my comrades, and was folded into the darkest cocoon of my mind. By my keepers’ standards, I was cured. Months later, in the sanctuary of my sister’s home, I picked up the trail of my life and hesitantly emerged, clinging to the thought that today was a millimeter better than yesterday. In the face of the monumental incline ahead, it took only minute signs of progress to rally me forward. I had survived in order to live anew — now metamorphosed into yet a deeper understanding of what it is to be human.

The Voice paid a final visit to me during those months of reconstitution when, as a free man, I could finally stop the medications. I was delighted at first, for I had learned to love that mysterious voice in my deaf ear and had feared the drugs had destroyed it. But the Voice told me that it would no longer speak to me. There was no more reason to continue a dialogue it said. And thought I was disappointed, I understood what it meant. It would never truly leave me — it couldn’t. The Voice was me. My inner, most intuitive me. If it were to remain ‘a voice in my head,’ it would always be something separate from me, not part of me. Therefore, it was time to end the dialogue and begin to act on what I had learned. It was time to be what I had become.

Humor Writing, Inventions, Memoir, Personal Essays, short story, zuckerisms

Dining Out

“How are you doing?” Our waitress smilingly greets us with the usual intro. I am ready. I am prepared to strike. I will not tolerate mindless gibberish.

“Good for my religion,” I calmly say. The waitress does a double take. She is caught off guard, expecting at most a grunted, “Okay.”

Hesitatingly she asks, “What did you say?”

“Good for my religion,” I repeat.

This time she gets it and it makes her uncomfortable. “Eh, that’s ok, uh…”

I switch to rescue mode. “I used to say good for my age, but that got old.” The heat’s off, the waitress’ posture shifts to relaxed, but her brain is on alert—she is engaged. She laughs. I tell her my response is an original. Next up, when someone asks me how I’m doing, I’ll say, “Good for my creed.”

My wife has to sit through this exchange. It’s not the first time, and I know she views it as waitress harassment. Worse, she is hostile to the repetition she has to bear: she has heard my spiel 1,000 times at least. I tell her once again that the waitress will now give us better service. I have made a stranger’s evening, personalized the server-servee relationship. Often, the truth is the opposite. The waitress, jarred out of her routinized server relationship, gets our orders all screwed up. To me that means ‘contact’ of one mind to another—I am gratified by the interpersonal exchange. To my wife, it means lousy service: pot roast instead of chicken pot pie, forgotten requests for champagne, bloody medium-rare instead of medium-well-done filet mignon. I’m the culprit in her mind, not the waitress.

Later, I pull off another challenge. “I’d like a diet coke with a slice of slime,” I say, emphasizing the slime. Jill, our waitress—we are now on familiar terms—does another double take, but clearly hears the word “slime.” She laughs and tells me she thinks that’s pretty funny.

I correct myself. “I mean lime.” Then I tell her why I said slime. “It’s not a mistake, I’m not dyslexic. In the past whenever I ordered lime, I’d mostly get knee-jerk lemon. When I ask for slime, I always get lime!” My wife gives me her standard derogatory non-verbal dirty look.

It’s hard to be a prophet in your own marriage.

Memoir, Personal Essays

It’s a Bummer

This is the story of my heart attack, and all the worrying, thinking, wondering, and fear that accompanied it. Enjoy!

I couldn’t believe it: I had a heart attack! Well, I had heart damage, and a leaky heart valve to boot. Suddenly, life was moment-to-moment, with yesterday’s indifference becoming a vanishing Eden. I wouldn’t live to my anticipated 85 anymore, instead hoping for 70 with the constant guidance of a cardiologist incubus on my back.

To tell you the truth, life had already become a bore, stuck, redundant. I would even go so far as to say I wished this illness upon myself. I’m a physician, so I know that if you don’t croak right out the minions of cardiology have an ever-proliferating number of drugs, angioplasties, surgeries, diet and exercise mantras to keep the sanguine flow pulsating through your coronary arteries and preserve what’s left of your ticker. Sure you become their patsies, subject to daily assaults by yummies of all shapes, colors, and coatings. You have to be on the lookout for side effects, hair color changes, diarrhea, swelling of the end of your nose. It’s all a royal pain in the ass, a strike against manhood, freedom and wilderness adventure. I felt my life contracting like a prune out to dry. On the other hand, my contracting horizons made my life take on value. I had a sudden desire to grovel, to cling to whatever false bone was thrown before me that might push death’s bite back a bit. Even the thought of being filleted open, having my coronary arteries rerouted, a feared adventure in basic plumbing, seemed desirable. The pain, suffering, the zippered chest scar and possible pump head complications was a price that suddenly seemed worth paying.

My mind reeled forward, reconstructing the new me, the cardiac, with my shrunken life horizon. Yes, I was a 60-year-old, too young to quit my job, though who would want to hire a cardiac cripple? I wouldn’t be able to get a new health insurance policy. Forget life insurance. The angiogram was somewhere in my future and I dreaded it, though both my mother and father went through the procedure without complaining and I had sent innumerable patients to the cath lab without a wink.

As for my colleagues, I was a bit older than most – I would become an incubus they might have to ‘carry.’ Of course, my condition might invoke empathy and human kindness. Maybe I could milk that one. I figured as long as I could stand up they’d have to put up with me. The thought made me feel surprisingly safe.

My girlfriend seemed sympathetic, caring, but I suspected she had some hesitations about how to deal with damaged goods. Was I no longer her corporeal hero? She was a winnowy 5’8”, size 4, with a great ass and long, undulating legs that made men sweat when she wore tight jeans or short skirts. Vigorous sexiness was her dial, regularly giving men the glad eye so they would sweat. Would she be repulsed, see me as a cardiac sex invalid (no rough stuff)? Would my money (and her lack of it) help sustain her climaxes or would fear, disgust, or – worse yet – contagion invert her, dry her womb, zero out her lust and chuck us both into impending greyhood? I always told her marriage would be important to me when I had to bow to the necessity of having someone push my wheelchair. Would I marry her now, not out of desire, but out of desperation? Would she marry me and willingly push my wheelchair? I worried that if she left me I would have to seek out that class of women who are devoted to caring for wounded men, men who are safe bets to stay home, faithful and civil.

Once a patient of mine, an old kraut, broke every bone in his body due to a clumsy arthritic fall from a trellis he was repairing. I asked him if this was a clumsy suicide attempt or a way to prove he was omnipotent. He all but died, and when he didn’t he was treated to two months of rehabilitation in a nursing home. His wife wailed to me, saying that his verbal abuse was worse than ever; he blamed her for his prolonged detention in the land of the living dead. With tears streaming she stated, “All my life he has never let me talk. I have no friends. He wouldn’t let me even go to my parents’ funeral because they hated him.” She felt she couldn’t bear to have him come home if his verbal violence remained at the same intensity. I felt she never wanted him back under any circumstances.

We met, the three of us, in my medically sterile cubicle of an office, and went about changing a 50-year marriage in 15 brisk, brutally direct minutes. I liked the old boy’s stiffness, which made slicing him in half all the more of a thrill. The kraut was emasculated. “You either kiss your wife’s ass or stay locked up in the shitter until damnation rings,” I spouted. He kissed the flesh. Perverse as it was, this event registered as an epiphany, an awakening, in the couple’s journey through their married life. Was I to be the next to do some kissing?

Dr. L, my cardiologist, was a good man: he balanced the business of my heart attack with humor, and a ‘life will go on’ sense of encouragement. He bent wisely to my ‘in denial,’ Cleopatra-like needs. He pushed my diagnoses forward, always supplying me with both the facts and the ambiguities we would likely encounter, and the odds involved in taking action versus sitting on one’s hands. He gave me his home telephone number, which I liked, and didn’t get angry when in a panic I called him at 2 AM, waking and worrying his wife. He was good. Still, as newer diagnostic results revealed or confused my cardiac state, my mind searched for a firm grip and transferred my care to a new bosom friend, a prominent cardiologist who loved me. Years ago I had lived with the Trukese tribesmen who had taught me the magic in the uniting of love and death. I always try to teach this to my patients, and now I was the patient.

But how to share my crisis with my close ones? I’d had a heart attack, but I wasn’t sure where it fell on the scale of seriousness. Was I facing eminent death or was this a minor cardiac event, with me living for many years to come? My girlfriend knew of my evolving concerns. My colleagues were vaguely informed. They all expressed mixed curiosity and apprehension. My work schedule did not change. My compulsive roommate, ten years my junior, was the one who got it right. He demanded all the details. With the ceiling lighting bouncing off his bald head, I felt the heat of his interrogation. He then exclaimed how upset he was. When I asked him why, he blurted out, “I could be next.”

Indeed, three weeks later he landed in the Fairview Southdale Hospital Coronary Care Unit, complaining of chest pain. In the middle of the night he drove himself groggily to the ER, chest pain accelerating with each mile, occupied with impending doom. He only called his soon-to-be frightened out of her wits wife on admission to the coronary care unit.

How vividly I remember the ancient, revered Yiddish cardiologist, Dr. Dressler, admonishing his residents when he was stricken by a heart attack in the far past. At the time I still bore the ignominy of being a medical student at SUNY Downstate Medical Center in Brooklyn. Dr. Dressler’s name was forever attached to the post myocardial infarction syndrome, a cardiac condition he was the first to describe. When told he would be admitted to the newly conceived coronary care unit, of which he was the medical director no less, he declared, “Never! That’s only for the patients.” He croaked two days later, in the wards of Maimonides Hospital, a survivor of Hitler’s attempt to annihilate his people, surrounded by those who had similarly not been annihilated, presumably content with his choice.

Echocardiography is elegant simplicity – sound waves bounce off the heart and are reported as a cinema of cardiac motion. Good hearts move rhythmically and with courageous strokes. Damaged hearts hesitate, flap about, move discordantly. As I watched my heart’s performance in real time, with narration provided by the eager seasoned tech, I was treated to the viewing of a small area of ‘hypokinesia,’ at the inferior margin of my heart. There was also a jet of red, in a sea of blue. “Back flow through a leaky mitral valve,” the tech told me. His matter of fact detailing of my echocardiogram, portraying damage, was not encouraging. I was now truly the patient, the damaged, the sufferer. The tech attempted to sooth me. “I have seen it before,” he said. But no words would make it better. I was the health care deliverer, now on the other side of the fence. As much as I tried to climb back over the fence, the faulty performance of my heart on that video haunted me.

How would my kids deal with a wounded dad, no longer their fearless, faultless defender? The thought crushed me. I needed a good work out. I went home that day, grey with information. I had had a heart attack, a small one, which in itself could be a minor event. The echocardiogram strongly suggested my other heart vessels were okay but my mitral valve structures may have been damaged causing the valve to leak, possibly enough to complicate life for years to come.

The next night, my daughter Gabrielle and I had our usual two week dinner hour at her favorite Sushi Restaurant. She was 28-years-old, her tall, stately body molded more by the menarche suppressing effects of her childhood ballerina training than by parental genetics. She’d had many relations over the years, but she’d avoided marriage, avoided an occupation. Gaby had never avoided life experiences though, and I loved her dearly.

That night, I told her of my heart attack. I cried, she cried. She relieved me of my burden. She wasn’t crushed; my daughter was already sufficiently rooted in herself. The evening went well, and I started to realize that my mortality, my death was okay.

My new cardiologist was a prince of his profession – a philosopher, scientist and discoverer. I brought him the ‘echo,’ the most damaging evidence of heart damage so that he could evaluate for himself its message. Echo interpretation is in the eye of the beholder, art and opinion. In the university expert’s opinion, the video’s quality was suspect, my heart’s performance was even more suspect than previously thought to be. I was chilled. I never hesitated (half ignorance was hell), but the issue now was to directly visualize my coronary arterial system and to end the anxiety ridden ambiguity. ECG’s, echo’s and blood tests are all safe but never definitive – only the invading coronary angiogram settles the issue. It was scheduled for four days hence.

I blocked out the date, tried to stop time, closed my eyes, and let it happen to me. Once again, I had a front row, real-time seat to the main event. Fifteen years before, I had shared the fluoroscopy screen with Dr. Sewell Gordon as he squeezed barium gingerly about my small bowel looking for the devil that had caused me so much pain. We both observed the sentinel marker of incurable cancer at the same moment – in a rush I felt disbelief and belief at the same time. I saw my death and simultaneously exiled my mind from the bedeviled image in the fluoroscope. In the end I survived. But now another moment of fluoroscopic truth awaited me, soon to be self-evident in three to five second segments of a video. This time I was emotionally seasoned and forewarned. One moment I was preparing for a filet job, coronary bypass surgery, the next a much more benign assault on my status quo – angioplasty, weight loss, medications. The angiogram would tell me which life would soon be the real one. I had both scenarios ready to be rolled out, and I found myself shifting between the two, like an uprooted plant waiting to be put back into the ground.

But first came the awkward hospital gown, the shaved right groin accomplished by amateur barbers, a cold slab table, gowned and masked performers, cameras and meters everywhere and three needle pricks in my bared-groin, ready for launch. The placement of the catheter in my femoral artery was accomplished with only a sense of pressure. My view of the 18-inch fluoroscopic screen, eight feet away and up to the left, was unobstructed. A clear view of my destiny.

How many wounds has my mind, my body incorporated into me? Jacob became Israel in his night-long tussle with the angel and limped ever after. Virginhood, the Garden of Eden, both unacceptable to human kin­­d, were only starting points. I could feel the universe, gravity pulling me forward into the light, and fully embracing revelation (or perhaps it was all the sedative?).

The black catheter slipped rapidly through the gray space of my body. Suddenly its tip began to beat rhythmically, then a gush of squid-like ink discovered the mouth of a mighty river. The catheter snaked into the river, the left coronary artery, the major arterial system bringing oxygen and sugar to my ever hungry beating heart. The next second a large gush of black shot out of the catheter and outlined the major river, lighting up all its myriad tributaries. I was enthralled by the river’s marvelously smooth branching esthetics – a clear left coronary! The big one down, one still to go. The catheter snaked into the right coronary artery. Again, a rapid black gush revealed a pulsating river, again what a wonderful branching, pulsating vessel. The chief of the masked men pointed out a blocked distal channel, the culprit revealed. The decision was to open this clogged channel so that in the future it might succor other nearby vessels, if they ever became clogged. The balloon catheter entered the involved area and opened the blocked channel. It caused an aching pain in my chest while it did its duty, and then black ink swarmed freely through the previously blocked channel – a stent was placed and all was back to normal. The ventriculogram – accompanied by a swarm of tasty dye induced heat that traversed through my whole body – confirmed a near normal ventricle. The only blemish was a small limp area caused by the occluded vessel. Forever the limp, but life goes on. My cardiologist said it all: “Now at least you know you are normal.”

In the past, there were times I was deemed insane, depressed, inconsiderate, isolated, insensitive, loved, unloved, cursed, willing to die, fearless, fearful, incapable of controlling my bowels, etc. Now, I welcomed them and all other descriptions I would be called in years to come.

Bring on the rest of my life, I am ready.

Humor Writing, Memoir, Personal Essays

Universal Recognition Symbol

A year ago, I wrote about the Universal Recognition Symbol – something I learned when I was staying in the Truk Islands. It’s an easy and instant way for people to say: “I see you, I recognize you, I acknowledge you.”

To see exactly what I’m talking about, here’s a video of my family doing the Universal Recognition Symbol:

Memoir, Personal Essays

5 Seconds Worth, Please

Forty one years later, the anguish over what could have been still remains as horrifying, if not worse. Disaster did not happen – there was only a five second period in which life and death hung in the balance – yet that five seconds is indelible and undiminished in its intensity. How different these past forty one years would have been had the balance tipped toward death.

My two-year-old son, Josh, and I were home alone playing on the living room floor of our rented house in South Minneapolis. As a young doctor I had wandered from the normal path. I had not established an office practice, rather, full of indecision, I developed an itinerant internal medicine practice in rural MN, three days a week. I had lots of time to spend with my family, my wife Kathleen, four-year-old Gabrielle, and Joshua. Both children were happy and healthy. Aside from my indecisiveness, family life was good.

One of my joys was to wildly tickle my children. I had become a master tickler, knowing all Josh and Gaby’s’ “weak” spots. As Josh lay on his back, I rapidly countered his every move to cover his armpits, his belly, his knee caps, his neck, the soles of his feet. He writhed in joyous laughter.

Suddenly, a look of bewilderment mixed with fear came over Joshua’s face. His breathing stopped. Faced with sudden immediate death they say your whole life flashes before you in an instant. Josh was lying in my arms. A riot of thoughts pushed through my brain. Contact! I plunged my right index finger into Joshua’s mouth following the inside of his left cheek into the back of his throat. There blocking his bronchus was a hard object. I dislodged it. Josh gasped once or twice and then his breathing returned to normal.

Five seconds, no more, had elapsed.

Yes, Josh admitted he had been playing with a nickel in his mouth when I took up tickling him.

Had Josh died at age two we would have never lived in Truk Lagoon, where I taught him to swim amongst the coral gardens and tropical fish, and to appreciate and not fear the ever so graceful reef sharks. There never would have been those fishing trips to the Florida Keys to catch Tarpon, snapper, trout and red fish. No Bar Mitzvah at the University of Minnesota Hillel, no tennis matches or high school acting career, no Children’s Theater School, no living and growing into manhood in Barcelona, no wife named Lisa, no granddaughters, Ruby and Ava, no talking about the meaning of life.

Years later, my cell phone rings: “Hi, Josh. Would you like to come to Minneapolis for a few days and help the old man rehab from hip surgery? Can you get away from Lisa and the kids for a short stay?”

“Sure, Dad, I love you. See you soon.”