Memoir, Personal Essays

Foreward to My New Book

Dear Readers: I realize that it has been a little while since we last connected. There’s a valid reason for that, I assure you: I’ve been hard at work on getting my latest manuscript ready to be published! I’m happy to say that I’m almost there, and that I will be posting clips from that memoir to this blog over the next few months. In the meantime, I’m posting a Foreward by my former editor that will be included in the memoir. This writing dives into the heart of my story, and posits questions to the reader that I hope you’ll find as engaging as I do. It can sometimes be very flattering to read what others think about you, which is certainly the case with this Foreward. I’m very grateful to Stephanie for her lovely piece of writing, and I think it will make a wonderful addition to my new book. Enjoy!

Forward by Stephanie Ericsson

When I began working with Dr. Stephen Zuckerman in 1998 on his first book, it quickly became apparent that his ideas were multilayered, often built upon one another, even, at times, holographic in their dimensions. These were concepts that pummeled at comfortable paradigms to make way for new ways of thinking. Some were not really so new but rather were more complete, or more compassionate, or more far reaching. In this age of the almighty sound byte and TV’s 7-and-a-half-minute-attention-span, the very art of thinking is in jeopardy of becoming extinct. It is easier to think in clichés or stereotypes, especially with the information overload that we live in.

It is the mark of enduring idea when it continues to bear fruit even after many pluckings. Over the years of working with Dr. Zuckerman and his ideas, I am still discovering layers of meaning within his words and concepts that on first, second or even fiftieth glance had escaped me. Many of these ideas are disguised in such simplicity that it is easy to believe one caught the entire meaning right away. Yet again and again, surprising ah ha’s! have burst upon me from ideas that I thought I’d understood in total. The interconnection of one idea to another, or a larger meaning tucked into a goofy word-play or a concept that suddenly offers a new tool for dealing with some private torment of my own—these experiences have captured me as much as a reader as they have as his editor.

No idea of Zuckerman’s was more challenging than his experience of hearing G-d’s voice. Who, in their right mind, would believe such a thing? Certainly no one who values their credibility! Not other doctors, not psychiatrists, not upstanding businessmen in today’s techno-culture. Certainly, it succeeded in getting him incarcerated in his own Kesey-ian Cuckoo’s Nest. But it also proved to be a brilliant co-conspirator, taskmaster, conscience, mentor and spiritual guru. It succeeded in testing the medical legal system, the patience of his associates, and the odds at the racetrack. It outsmarted doctors, judges, and the DMS-4. It forced him to throw his professional and personal credibility to the dogs and literally got him a prognosis so hopeless that he spent 3 months in the kind of state institution where most inmates never leave. Even so, in taking so much from him, it did not leave him bankrupt.

When Zuckerman first described The Voice and the story of his encounter with G-d, I had a difficult time believing that he was fully sane. But over time, I found that there was nothing about him that supported those doubts. Nothing in his past history, his medical or familial history supported the diagnosis of psychosis. He’d lived a life that was relatively unscathed by misfortune—no physical or emotion abuse from childhood that pointed toward the pathological. Nor was he religiously fanatical—or religiously savvy, for that matter. He’d been raised by his parents as a secular Jew—typical of their generation—who attended synagogue once a year on Yom Kippur, held a Seder at Passover and the rest of the time worked long, hard hours to provide opportunities for their children. He’d never been traumatized like so many men of his generation who’d been drafted into the insanity of Vietnam. And although he was passionate about his work, he wasn’t drive to obsession, but rather led a balanced life most people would have envied for its sanity. He had no history of alcohol or drug abuse and he was physically fit and had been healthy his entire life.

His parents loved him and raised him in relative middle class comfort so he wasn’t tormented by the privation of poverty as so many Jewish families had been during and after World War II. His sense of humor and playful nature seemed to make his long hours as a doctor not only bearable, but thoroughly enjoyable. He had endless patience, was quick to forgive, slow to judge and nearly impossible to rouse to anger. Although he was brilliant, his wasn’t a tormented intelligence, as so many highly gifted people suffer from. In short, there was nothing that pointed to Stephen Zuckerman as a nutcase.

So, I believed him when he told me that he and G-d had conversed over a period of months just after he’d turned 50. His descriptions, both in conversations and in his writing, were always consistent, never indulgent or dramatic, and just quirky enough to be believable.

But when I decided to ‘believe’ his story, I found that I had to do so on more than just a personal level—I had to believe him on a professional level as well. I had to believe him as his editor, otherwise I would find myself either condescending to him as my client, or entirely unable to work with him. Naturally, the process of writing is an intensely interior one, and in order for an editor to be effective, he or she must enter that concentrated interior with the writer, as an observer, as a guide, as a muse and as a critic. Since the nature of the writing is to express what is seen through the eyes of the writer’s soul, the editor must perform all of these roles invisibly and unobtrusively. An editor must coax the writer’s ideas into maturity while being careful not to inject his own ideas into the process or the message of the writer. Often a writer is unaware at first of what he is trying to say—he is merely being pushed along by some deep compulsion to say it. Words themselves are alive and know exactly where they belong so the writer must discover his role as the vehicle of the message by getting out of the way while at the same time surrendering to the forces that are compelling the message. For this to happen, the writer has to disengage from his own ego, while, at the same time, he must so deeply believe in the idea that he will not give up through its arduous birth.

It is the role of the editor to walk beside the writer through this journey. Believing that Dr. Zuckerman had a three month conversation with God was more of a challenge to me personally than professionally. I had to suspend the part of me that was agnostic. I had to challenge the skeptic modernist in me while calling on the Catholic training of my childhood. I read everything I could find that might lead me to the key. I wrote in my own personal journal about it, and even went back to the church. I meditated on my own and secretly hoped that Zuckerman’s God would pay me a visit too. I spoke to mystics and found that things like visions and apparitions were more of a pain than a blessing and anyone with any sense would not wish for one. St. John of the Cross and St. Teresa of Avila had said the same thing, both being infinitely down-to-earth and pragmatic.

Ultimately, it was a matter of letting go of my blocks to believe and having the courage to simply listen to the message. Did it make sense? Did it sound real? Did it speak to me?

These are the questions that anyone who has picked up this book will have to answer for themselves. Some of what Zuckerman describes is supported in scripture, tradition and history and some will be debatable.

And so, Gentle Reader, in the end, it will be as it always has been—a matter of faith.

 

Humor Writing, New Cliches for the 21st Century, zuckerisms

Positive Feedback

My books have been up on Amazon for a while now, but we’re doing some new promotions for Medical Humor at its Best . It’s now available in paperback AND as an audiobook. Plus the Kindle version is only $.99!

zuckerman-new-cover

For less than a dollar, you can get hundreds of witticisms, insights, and life advice that’s only a little tongue-in-cheek. The book is getting a lot of 4 & 5 star reviews these days, so it’s definitely worth the low price. Here’s what some other people are saying:

Andrei: “Creatively written and mind-stimulating, this book challenges readers to go deep into their thoughts and analyze each word, saying, quotes, and thoughts the the writer has presented in this book. Creative writing is at its finest, the poetic approach of this book is just beyond amazing.”

Wylie A.: “A few years ago I began jotting down phrases that people said and the context in which they used them. It amazes me how many cliches and idioms we use daily without really thinking about where they originated, or in some cases, what the expressions actually mean. I was certainly not disappointed. So much work and research went into this book that it is difficult to even fathom. I would highly recommend this book to anyone interested in the development of our language and the many ways that we sprinkle our speech with metaphors.”

Bryan: “I wasn’t exactly sure what to expect with this one, but I’m very glad I took the leap of faith. This book made me laugh, it made me think, it gave me inspiration, and it entertained me from beginning to end. There was never a dull moment from the moment I started reading.”

Aleksa: “I had fun reading this book… I think that we need books like one in order to lighten up when the burdens of the world seem to be heavier everyday. There were so many pages that actually made me laugh.”

Get your copy now!

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.

Memoir, Personal Essays

Asylum, Part 2

Here’s a continuation of my 3-part story, Asylum. To read part 1, click here. And check back on the blog next week for the final installment of my time spent in the Brainard State Hospital.

Asylum, Part 2

Before the first court hearing, most of my time at the University Psych ward was filled with these conversations with The Voice. I began to see a pattern in our talks, a purpose in all the seeming strangeness, not only in regard to my own little world, but to the world at large. Step by block, my spiritual house was taken apart and analyzed down to its foundation — its fundamental intuitive self. I began to see that I was being re-made through the drama of these dialogues with what appeared to be an all-knowing, purposeful mountebank.

But The Voice in my ear was not content simply with dialogue alone. Before being locked up, it had challenged me to drop my social decorum and call people on their dishonesty. At a board meeting where I was a member, The Voice asked if it could ‘take over’ and give hell to a member whose smugness had always irritated me. Hesitantly, I agreed to allow what I, myself, would never have contemplated doing on my own. WHAM! The Voice took off on a diatribe fit for my father’s Manhattan schmatah business. On four or five more occasions, The Voice led outbursts that caused serious concern among my colleagues. But what really got me into trouble with the Mind Police was when The Voice told me I was God.

Initially, I objected vehemently — I was absolutely NOT God! No way, no how. I was just one of the 6 billion schmucks on earth with no special talents or successes. However, The Voice persisted. Being a good human, not superhuman, was all that was necessary to be God. Any human could be God too, The Voice helped me realize, each with a unique ability to express godliness. This line of reasoning impressed me and I began preaching it whenever I felt there was a reason to do so. To talk of God is, of course, anti-psychiatry, which is a religion of its own, built on atheism. Fundamental to psychiatry is the belief that hearing voices (known as auditory hallucinations) is the most dire symptom of psychosis — not a spiritual intervention.

During the time I was entranced in dialogues with The Voice, I tried, as a scientifically trained professional, to figure out what it actually was. Could it be a telepathic alien who’d come to infect me as a means of establishing itself on planet Earth? Or could it really be The Voice of God in my ear?

I wasn’t much of a believer in God but I wasn’t an atheist, either. I considered myself to be more of an a-religious Jew. It was difficult to buy that The Voice, who at times cursed and threatened me in a very un-God-like manner, was really a spiritual voice in my ear. Maybe it was an alien being reaching out from another world? Or just my own mind playing tricks on me? But try as I might, I could not reconcile The Voice’s brilliant explanations and insights with those of my own. It constantly enlightened me on new ways of seeing the world, and possessed information that I could not have known on my own. After a while, I was convinced that The Voice had to be a superior intelligence that had somehow, for whatever reason, slipped into my mind and was speaking through my deaf ear. Or else, I really was cuckoo.

Regardless, The Voice was certainly trying to be useful. It promised to bail me out of my commitment hearing, and as we were filing out of the courtroom it suddenly told me: “Tell the judge you have a brain tumor.”

So I did. But I had no idea that my ‘off-the-record’ comment would create a major dilemma for the judge. If I was acting strangely due to a ‘real’ medical disorder, then incarceration and the use of neuroleptics were actually dangerous. If a tumor was my problem, the court couldn’t permit the university to force anything on me. The judge was compelled to grant the University only the right to incarcerate me, but denied them the right to force neuroleptic medications on me until they had proven that I did not have a brain tumor.

I had won an advantage: unless I allowed them to examine me, the University could never prove that I didn’t have a brain tumor. At that point, I became psychiatry’s Catch-22.

For two months and two stalemated trials, I remained incarcerated at the University’s psyche ward. Then, early one morning, I was shanghaied to Brainard State Hospital.

That fateful morning, I was awakened violently by two sheriff’s deputies who ambushed me with handcuffs and threatened to get rough if I resisted. I’ll never forget the helplessness I felt as those two hostile officers threw my possessions in a bag and dragged me to their police van, where they locked me in a steel-mesh cabin.

Ten years earlier, I’d been a medical consultant at the very hospital they were transferring me to. I remembered the vast, isolated and desolate campus of archaic institutional buildings. To be locked up at Brainard State meant you were beyond hope. Now, it was my turn to be on the inside of this somber hell.

The university psychiatrists had made a final appeal to the Attorney General and won. His signature erased my human rights. When I arrived at Brainard State Hospital, I was held down by six aids, injected with a sedative and forced through a CAT scan to prove that my brain tumor was a hoax, which, of course, it was. I wondered how many of those aids would have denied their actions under penalty of perjury if I had taken them to court. But for now, like all prisoners, I was forced to accept that the system held all the cards.

Throughout my tribulations, I always felt that I was in control of the seemingly out-of-control me. Even though I went on to try and outsmart the system, to this day I believe that my loss of freedom and nearly all hope were my destiny—one I desired on some level and brought on myself.

After the CAT scan found no tumor, I was put on a multi-drug neuroleptic cocktail that was in vogue at the time. Even though the drugs severely impaired my thinking, I still had the wherewithal to know I would die unless my medications were changed or stopped. I wasn’t wrong. Not long after they started the medications, I was rushed to the area medical hospital with a toxic reaction.

My medications were adjusted, but the manic pacing continued. I still knew I had to persuade the rarely visible wizard of our Oz, Dr. Walker, into changing my drugs or I would crash again. I’d wait in ambush for him, obsequiously badgering his nurses on his whereabouts within the hospital. Was he even here yet? Was he in a meeting? Would he be here by 3 P.M.? Why was he delayed? I worked them over daily, but it only seemed to fuel their disdain for me as some annoying and disenfranchised creature.

I tempered my own anger until it became a white glow in the middle of my brain. I knew that the day would come when I would ensnare them all — Dr. Walker and this infernal, inhuman monster-machine of psychiatric incarceration. One day, I would try to destroy it. But for now, guerrilla warfare was my only available tactic. If I bit the monster directly on the neck, it would label me untreatable. Then it could crush me with more drugs, solitary confinement, shock therapy and lock-up forever.

I finally succeeded in cornering Dr. Walker, who listened to my pleadings for all of 30 seconds and later changed my medications. But to what? The new mix, of course, was none of my business, according to the nurses — after all, I was incapable of any rational comprehension.

Four times a day, the announcement blared out: “Medication time!” All of us inmates lined up dutifully for drugs at the tellers’ windows. Only then would we know our medication had been changed as the pills and liquids changed colors and shapes and turbidity.

I balked at being forced to swallow them and crossed an invisible line by asking questions. The drug teller tersely rattled off the names of a half dozen drugs. When I objected, she threatened to call the guards, who would gladly force my medication on me.

How I dreaded swallowing those multi-colored toxins that had caused me all forms of psychological and physiological aberrations! Once downed, the side effects were unavoidable. In truth, they weren’t side effects at all, but effects of poisons. I adapted, somewhat, to the debilitating effects of the drug regime, but I braced myself for new horrors. After a while, Walker put me on another concoction, and this time the results were less devastating. The anxiety, the pacing and the showers all stopped.

With my medication stabilized, I searched for a way out. Day after day, I beseeched my social worker, Tom Littlehawk, to clarify my status. He was a busy man—which meant, in his limited vocabulary, that a mere stroke of his pen could cause me either great harm or great good.

In the end, Tom Littlehawk turned out to be one of ‘us.’ He’d returned to the system to milk it for dough and power. He now had the best of all worlds, considering the blows life had dealt him as a Chippewa Indian who’d been alcoholic and ‘crazy’ to boot. He knew the system inside and out. He had the power to torment us or help us. He did both. But I found that he generally kept his word when he gave it.

I begged Tom for a transfer to Sector B, and got it.

My new room faced north. The summer sun no longer inflamed my bed. Best of all my new roommates were old-timers who’d calmly settled into the horror, with savvy and without guilt. My new compadres.

These new roommates taught me the art of mouthing pills so I could spit them out later. They taught me about radios and tape players and how to hustle our keepers to get batteries. They showed me the secrets of getting smokes day or night, how to protect your coffee stash, who to share it with, how to tap hot water from a myriad of out-of-bound faucets and—most vitally—how one should act if one is caught. In short, they taught me how to retain my humanity while trapped in the belly of the monster.

Memoir, Personal Essays, short story

Asylum

This is the first of a three-part essay about my time spent in Brainard State Hospital.  

Asylum: Part 1

How can it be,” asked the spider of his brother,

“that the fly ensnared only one of us?”

Good fortune,” lied his brother.

 

For five days I had suffered an overwhelming drug-induced anxiety that didn’t allow me a moment’s respite. I fed my body in five-minute forced spurts, afraid of starving, but unable to alight for a second longer. I hobbled about my prison corridors in a daze, sleep alluding me. I lay down a thousand times, but only tossed and turned in agony.

At some point I hit critical mass and my sweat-drenched body frantically righted itself — fatigued beyond fatigue — pulled on its clothes, shoes and socks to, once again, thrust itself into the openness of those shadowy corridors. The incessant anxiety drove me to pace my confinement: down Corridor A, the suicide protection unit, then through the blue fumes of the Smokers’ Inferno where bleary-eyed lobotomized puffers hid in its smoky recesses. On to Corridor B, rank with the piss- stench of communal toilets. Past the stark 4-bed dormers strewn with other prisoners. Creeping by the cloudy surveillance mirror, I barely recognized my reflection, seemingly headed in an opposite direction. Lastly, I’d reach the padded lock-up room that marked the end of my pilgrimage and the beginning of my next revolution. The only relief from my jangling nervous fits were the 15 or 20 cold showers I took daily, dutifully charted in my dossier by the nursing wardens.

And so it went again and again.

I existed. Period. My mind was full of mandatory medication and involuntary exhaustion. My bedroom was filled with stifling August heat and three menacing strangers who were also newly imprisoned and besieged by ominous tomorrows.

Like me, my cellmate, Nervous Cat, performed his own yo-yo-like ritual. He’d fling himself violently onto his cot, thrash about amidst his sheets, kick his locker and then curse himself into a frenzy, only to finally bolt upright and disappear down Corridor A, dressed only to the waist, to vent his rage in the Smoker.

My other two roommates were barely visible. We communicated to one another in grunts and gestures — each of us recently trapped, caged and helpless. Our four bare cots were each adorned with black striped mattresses of 2” thickness, a coarse pillow, a sheet that no one bothered using, and a thin cotton blanket. Each cot had matching rickety, green metal lockers, battered by previous inmates as their only legacy — perhaps in hopes someone would remember them. We each had a crude, waist-high dresser with four sticky drawers and no mirror. The two large windows, sans drapes, welcomed in the summer swelter, with only smaller-than-human-girth transoms to prevent suffocation. This was my ‘personal’ space in captivity.

Brainard State Hospital was my fall from grace. At 50-years-old, I’d gone stark raving mad (so some said), to the horror and intrigue of my family, business associates and friends, who had never expected this emotional rock to crumble.

Personally, I sensed why, but how it came about had shocked everyone, including myself. Spiritually, I’d been pregnant for some time with an overwhelming need to change my life. Now this pent up force had taken over. Frightened, but willing (did I have a choice?), I plunged forward.

Those around me, many of whom were in the medical field — psychiatrists included, assumed that I was in the throes of an attack of mania. Not unexpectedly, four months into my evolution, I was arrested by a psychiatrist at the behest of a good doctor friend and my brother, both of whom assumed I was mad. I was locked up in the rather gentile psychiatric ward at the University of Minnesota. My prevailing impulse was to resist any and all treatment offered by my jailers — a common reaction among those like myself who are involuntarily detained.

The psychiatrists’ protocol was to threaten resistors with a court commitment hearing, which almost always resulted in being committed for six months. I was told that if I voluntarily committed myself, I would be treated less harshly. But I firmly believed in myself, my sanity and my purpose for changing. I refused to volunteer.

The ensuing series of unfathomable, legal maneuvers first allowed a doctor to lock me up for 72 hours (actually 120 hours because weekends don’t count), and then be brought before a county mental health judge for a “dual-commitment hearing.” It all seemed like a mad comedy of errors to me, but evidently, it was standard operation for the University Psychiatric Department. In this hearing, the judge would decide not only if I should be locked up for a prolonged period, but also whether or not the psychiatrists could use their frightening neuroleptic drug arsenal on me.

The day of the hearing, my lawyers told me that my chances of avoiding commitment were one in a hundred. But I had done my own research. I hired my own psychiatrist to examine me and testify in my defense. I never allowed the psychiatrists from the University or the county psychiatrist to interview me. In spite of this, both of them testified at the hearing that I was seriously ill and needed commitment as well as neuroleptic medication.

My own shrink came to my defense. He testified that I could easily be treated as an outpatient and expressed his doubts that neuroleptics were necessary. Out of the three expert opinions, none suggested that I was, in any way, a threat to others or suicidal, only that my behavior had become bizarre and was “disrupting” my societal status. A few other witnesses: my brother, my ex-girlfriend, and a close friend gave ragtag testimonies under oath, which, considering their own character twitches, made the hearing more of a Gilbert & Sullivan operetta than a serious decision about my destiny. Not that their testimonies mattered. Apparently, standard procedure dictated that only the doctored-evidence gathered while I was imprisoned at the University and the arresting psychiatrists’ statements would actually be considered by the judge.

Just as we were leaving the courtroom, I was suddenly inspired to tell the judge I had a brain tumor — shooting an arrow into the Achilles heel of psychiatry. The inspiration for mentioning a “brain tumor” is another story.

One evening, months before my commitment, I heard a voice in my deaf ear. Although it terrified me, I was also intrigued by this sudden presence. Over the next four months, an on-going dialogue with The Voice took place and ransacked every nook and cranny of my belief system.

These were not benign conversations. Initially, they were full of The Voice’s threats, accusations and seeming attempts to degrade me. But I soon recognized that The Voice was unearthing all my secret pockets of shame and inadequacies.

The first issue that The Voice had made me tackle was the question of whether or not I was a good person. I insisted that I was. But The Voice responded with a single haunting word: “Evil.” I defended myself with a litany of good deeds, but again, The Voice only said, “Evil.” Again and again, I protested, but the answer I got was the single word: “Evil.” Finally, I succumbed. Maybe I was evil? All the times I had acted selfishly, ignored others in need, lied, came flooding in. But after an agonizing moral inventory, I realized I wasn’t evil. Just human. Full of human frailties. I was not exceptionally good or exceptionally bad — merely perfectly imperfect.

I came to the conclusion that there was no such thing as “Evil” or the “Devil” but rather that everything was about love and God. What we call “evil” I concluded was really the inability to express love. Once I understood this, I felt no further need to focus on my unworthiness. I also felt a contentment that I had not felt before in my life.

Following this, I developed a repartee with The Voice that was filled with humor, delight — even wonder. Each conversation was like an advanced yeshiva on the Big Picture: What is our purpose as human beings on this planet? Did the future already exist? How did spiritual forces give form to the material universe? And always, these were integrated with intimate dissections of my own relationships. I examined the nature of my personal loneliness, which in turn, gave me insight into the loneliness of others.

Check back on the blog next week for Asylum, Part 2!

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

The Horse Race

This essay is the write-up of an event that happened to me several years ago. Check the photo for proof!-20743251542B1DD264

Freud once said, “Love and work, work and love – that’s all there is.”

Well, I was in the midst of losing both: I had been feeling powerless about the changes going on inside of me, but I also felt euphoric about them. Ten years ago, I had had a glimpse of my future and now it was here. The tectonic plates of my existence were once again in motion and I was on the verge of the biggest roller-coaster ride of my life.

That particular Saturday in the spring of ‘91, I was scratching my head in my kitchen, contemplating how to get encrusted food off the abandoned dishes that were knee-deep.

Out of nowhere, a loose thought broke into my pitiful train of housekeeping acumen. Lightning Dancer will win a pick six race today at the Canterbury Downs. The tickle in my brain said that the name would be close to Lightning Dancer. Since there were no live races at Canterbury Downs in February, it would have to be a simulcast race from some tract that ran live races in the winter.

I stood very still and wondered: where did THAT come from?

This thought didn’t feel like it was purely imaginary, like some random burp of an idea floating up from my bored mind, a daydream everyone has while doing mindless tasks. It was solid. A Fact with a capital F. As real as, the sky is blue. I’d been so thoroughly consumed by coming up with various ways to clean dried spaghetti off dishes with the least amount of sweat that there hadn’t been the opportunity for anything else to creep in. Actually, it didn’t even feel like it had been my idea, like it had sprung up from nowhere. But it was so compelling. I immediately considered heading out to the track even though I already had other plans for the day.

What if it was real? This could be the tip of a lifetime! A dead certainty. What other reason is the future revealed?

Like the hardwired gambler that I am, I convinced myself to go in a split second. I dropped the scouring pad, shut off the water in the sink and rifled through the morning paper until I found the sports section. My hands began shaking as I scanned the pages for that day’s racing entries at Golden Gate Fields in California, where winter racing was in full force.

4th Race? No. 5th Race? No. 6th? 7th? 8th? 9th? Nada. Not a single pony with a name that was even close to Lightning Dancer.

I was confused. The message had been so clear: it had to be right. Instead of logically considering the idea a fluke, I started to come up with other possibilities.

Maybe the horse was a late entry. Maybe the paper was wrong. Maybe the dates were screwed up.

Then, it hit me: on weekdays, the Pick-6 always started in the 4th race. But on the weekends, it traditionally starts in the 3rd. I checked the new column.

And there it was: Lyphing Dancer, so close to Lightning Dancer. The number three horse in Race 3. The morning odds on her were 4:1. It would be a pretty sweet return if this was, in fact, a ‘sure thing.’ I decided to put $200 on this dark horse to win.

I dipped into my cookie jar and pulled out enough cash for the bet, left the kitchen to the cleaning fairies and drove out to the track. I had plenty of time to make the 3rd race.

Maybe I’ll run into my friend Val, I thought. He always wanted to quit his job in sewer management at the county to go back to school and become an artist. If I won big, I could give him the money, turn him away from being a drunk…the daydreams kept coming as I started to imagine all the ways I could spend the money I was surely about to win.

When I was twenty, I worked nights as a cashier and ticket-seller at Monticello Raceway – Upstate New York’s harness track. It was a rapid-fire summer of new experiences for me, there in the Catskills of the ‘60s. By day, I was a lifeguard at Pollock’s Hotel in the hills above the swanky Swan Lake. Pollack’s was a bedraggled resort that had seen better days. Most of the guests were Jewish and had traveled from their tenement apartments in Brooklyn for their annual one-week in paradise. To them, a swimming pool was an anathema – something dangerous you didn’t go near and made damned sure your kids didn’t either. “Stay away from the edge! You’ll fall in and drown!” the Jewish mothers yelled at their kids daily. In fact, during that entire summer, I only saw one person who actually knew how to swim.

Pollock’s also had a ramshackle old dinner theater that seated maybe fifty guests and every night they’d dress up to watch itinerant comedians, many sharpening their acts on their way to stardom, schlepping the rounds of the Borscht Belt circuit. The noise in the room, even during performances, was a cacophony of distracting schmoozes, staccato snores and table pounding over schlock one-liners.

Within the first week, I conceived an escape plan from those nights at Pollock’s and took a job at Singer’s Delicatessen, Bar & Chinese Restaurant in Liberty, NY as a sandwich maker/bartender. I was in heaven. My first love affair was with the meat slicer – one slice of pastrami for the customers, one slice for me. But I quickly discovered that the bar really put out: one maraschino cherry for the customer, one for me. One shot of Jim Beam apiece for the party at table three in the corner, one for me. I topped off my orgasmic gastric bombardment at closing, with unkosher pork-fried rice leftovers before I headed over to sleep with my fiancé at her parent’s house in Jeffersonville, seventeen miles west of Liberty. This visit necessitated a round-trip in socks, tiptoeing up – and then down – three flights of stairs. By the end of my first week, I was six pounds heavier, well-fellated and a lush. I knew this love affair was headed for doom so I quit Singer’s and found a job as a ticket-seller at Monticello Raceway, thanks to my Phi Sig fraternity brother and former fiancé of my fiance, Lonnie Sachs, who lived in Liberty. Thus began the corruption of my soul through racetrack betting.

My summer soon found a rhythm. Every day by 8:00 am, I crawled back from Jeffersonville to Pollock’s Hotel, unlocked the pool, threw forty chlorine tablets willy-nilly into the water, perched myself securely in the tall lifeguard chair and donned my sunglasses, which allowed me to catch up on my beauty sleep while appearing ready to rescue the next victim from drowning if anyone dared to venture into the menacing pool. By the afternoon, I was off to the races at Monticello, topping the day off at 11:00 p.m. with the usual romance in Jeffersonville.

By the time I got back to New York City to start my fall semester, I had acquired a limited skill for betting on harness racing as well as a not-so-limited appetite for it. I made it a point to take my dad out to Roosevelt Raceway on Long Island once a week to play the trotters. One night, before our weekly sojourn, I dreamed about a horse named Symphony Rhythm who won three races in a row. Normally, I didn’t remember my dreams, but this one I did.

At Roosevelt raceway the next day, I scanned the program for my dream horse and, to my surprise, there was a filly named Symphony Starlight who’d won three races in a row.

“That’s our punt,” I told my dad, so we pooled our funds and put eight bucks on her to win. We walked out $56 richer that day. I must have been too young to appreciate this amazing incident, because I’d forgotten all about it until the day I drove out to Canterbury Downs, ready to bet on Lyphing Dancer.

Once I got into the Downs, I looked for my buddy, Val. Normally, he was a fixture out there, and just as normally, a loser despite being a studious horseman. But he was nowhere in sight. Instead, my attention was drawn to a lone middle-aged African American man contemplating his tip sheet. It was fifteen minutes to post in Race 3. I asked how his luck had been and he said, “Lousy, not even close so far.”

“Who are you going to bet on in the 3rd race?” I asked.

“I don’t know. They’re all a bunch of nags. Anyone could win.”

I hesitated on giving him the tip on Lyphing Dancer – it’d be awkward if the horse lost, but I took the chance anyway.

“Bet number 3. A sure thing.”

He looked it over and thanked me.

With ten minutes to post time, I headed toward the betting windows to place my wager. The line was twenty deep. Not a problem, I thought. There’s plenty of time. Suddenly, I saw Val, so I gave up my place in line to rush over to his table. He was sitting with three guys I didn’t recognize and I suddenly felt hesitant. As I looked down at him sitting right in front of me, I couldn’t convince myself it was him. He was almost Val, but some quality, possibly softer features, stopped me from speaking to him. I tried not to appear to be observing him until I had to accept it wasn’t Val at all, but just someone who looked like him.

I ran to the betting lines in a panic. It was five minutes to post and I was 30th in line. After all that, I was about to get shut out.

The line advanced at a torturously slow rate, but my heart rate was over the top. I kept talking myself in and out of the bet, wondering if I’d invented the whole thing in my head.

Finally, it was my turn, with only minutes to spare. “$50 on Lyphing Dancer, I mean #3, in the 3rd race at Golden Gate Fields,” I sputtered to the cashier.

I had punked out.

I walked away from the ticket window, totally confused. I wasn’t certain about anything, including my own reality. Like seeing almost-Val, the whole day felt like a dream.

I bunched myself with other hopefuls in front of the large TV screen that would beam us our destiny from sunny northern California.

Lyphing Dancer broke out of the gate smartly and my heart started to pound. Effortlessly, she powered to the lead as if it were her place. I was elated by her confidence and I could feel her fire gaining strength within her.

She’s really going to do it, I thought, scanning the track behind her. None of the other horses were pacing with her. No one was even challenging her. Heading into the far turn, none of the other horses had closed the gap.

My head began to swim. My chest was pounding harder and harder as the finish line approached. Joy of joys for a horseman, knowing that your horse is going to prove you a genius, a courageous gambler, omnipotent, a winner in an orgiastic ten seconds to the finish line.

Lyphing flew into the last stretch almost as if she didn’t need to touch the ground. Two hundred yards to go and she was still 4 lengths ahead. Damn, she was gorgeous. I drooled.

Just about then, two other horses began closing ground on her. Abruptly, the finish line seemed farther away than it had just a split second before.

“No! No! It can’t happen!” I shrieked. Suddenly, time became elastic and those last one hundred yards seemed to take forever.

“Hold on…hold on…hold on, you bitch!” I screamed, as the other two nags relentlessly nosed into the gap between themselves and Lyphing.

Then, at that last possible moment, a lightning flick of the whip from her jockey launched Lyphing Dancer forward, and it was all over. She slipped past the finish line with distance to spare.

“She did it! She had it in her all the time!” I screamed at the glum betters standing near me. “How could you bet anyone but Lyphing Dancer? Don’t you guys have brains?!”

As I stood in line to collect my winnings, which would have been significantly more if I had not chickened out at the last minute, I considered this remarkable experience I’d just been given. I wondered: what good is knowing the future if I don’t believe 100% in it? From now I on I would take these premonitions as G-ds truth.

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, short story

Tyranny

“You’re fired,” not by Donald Trump, but by Dr. Kurt, a middle management medical administrator at Allina Health Care System. For 23 years, from age 51 to age 73, I was a PCP, a primary care physician extraordinaire at East Lake Street Clinic in Minneapolis. East Lake served an ever-changing inner city population. The euphemism, ‘Hennepin County Hospital South,’ gave East Lake Street Status relative to the county hospital. We were figuratively and literally one stop up from ‘the bottom.’

To work at ELS you need to be dedicated to the less privileged, less educated, less motivated, less compliant, less healthy, less skilled, more drug and alcohol addicted, more criminalized, more mentally and physically ill, more jobless, more poor, more on welfare, more diabetic, more diseased, more obese, more prone to violence, without being patronizing, without being judgmental, with an open heart and head. Otherwise you’re toast, you are going to fail and you might as well move to the suburbs!

As a student at the old Kings County Hospital in East Flatbush, Brooklyn, I already had experience with a place like ELS. How well I remembered the dingy, poorly lit 10 bed wards filled with groans of suffering patients. A famous saying around Brooklyn was “if I get shot, take me to Kings County” – and many in the neighborhood did get shot.

Next it was on to Michael Reese in Chicago’s south side, followed by Mt. Zion Hospital in the Fillmore in San Francisco during the height of the Haight and LSD. I routinely got high on second-hand marijuana smoke on daily rounds through Mt. Zion’s wards – it was all very Cheech and Chong.

After earning my medical license, my first work was found in Central MN, with its post-glacial lakes and rocky soil, its poverty, its tacky fishing resort and its tar-paper shacks.

Then my odyssey took me to Truk Islands in Micronesia, driven by my love of the sea and a romantic vision of escaping to the South Pacific ala Paul Gauguin. The Trukese didn’t consider themselves poor if they had a breadfruit and a pandanus tree, land with brackish soil to grow taro, a piece of the barrier reef to fish on and most of all, a multi island extended family to rely on.

In ELS, my patient population included African Americans, Native Americans, Somalis, white blue-collar workers, newly minted immigrants of all races, drug addicts of all races. All of these were my ‘extended family.’ I gave to them and they gave to me. I studied their varied lingo, their mannerisms and made them my own. I ‘stole’ their pearls of wisdom and made them my own. I became, over time, intimate with my patients, redefining the definition of ‘medical boundaries’ and making our relationship the meeting of souls: naked, open, always with as much humor as could be injected into often catastrophic circumstances. I became my mentor, Gabriel Kirshenbaum, the Don of Williamsburg, Brooklyn.

At age two and a half, Kirshenbaum charged head-long into my life and instantaneously inspired me to go into medicine. A huge bear of a man, gruff, alert, always moving forward and always out to make you better, to protect you even from yourself, even if he had to sacrifice himself to do it. And who, in all of Williamsburg, no matter white, black, Jewish or Christian, didn’t love the irrepressible force that was Kirshenbaum. G-ds tool, an avatar, a Kabbalah Tzadek, a Jewish Saint.

As much as I proclaimed, as a young man, that I had to make a choice between theatre and medicine, there really was only medicine. I had stage fright; I feared forgetting my lines on opening night and never recovering from the trauma. Yet theatre was always on my mind.

This why the examining room became my stage, ad-lib my style, my patients my co-thespians. With each new patient I expanded my repertoire. I kept thinking of my exam room as my medical ‘house of illusions,’ where reality played out.

“Did the cardiologists tell you how long you have to live?” I asked a patient once.

“Well, they said I was late stage and I guess that means not too long.” He had hypertrophic cardiomyopathy, a condition of an ever-enlarging heart that finally cannot pump blood – he was ‘end stage,’ having maybe 1-3 years to live. The condition was inherited: his daughter has it, his uncle died from it. The ‘cure’ is cardiac transplant, but he was being denied a transplant because he was positive for Hepatitis C. At 55, overweight, living on SS disability checks, he was depressed and had given up trying.

My job was to provide a ray of hope, not only for him, but through him to his daughter. The University of MN was less rigid in its transplant criteria. If his Hepatitis C could be cured, if he stopped smoking, he could be a transplant candidate. “I don’t know if I can do all that, go to the University and start all over,” he said to me.

“What about your daughter?” I asked.

“She won’t go to a doctor. She’s 16 and won’t listen to me, but she knows she has it.”

“If you die, she’s next.”

“I suppose so.”

“What if you somehow make it, somehow get the transplant and live?”

I met with him every month or more often. He went to the university. “They say they have transplanted other patients who got their Hepatitis C cured,” he told me.

It took time, but he gradually stopped smoking with the help of E-Cigs. The treatment of Hepatitis C was undergoing a revolution. “I really feel fortunate, the G.I. people at the University said they could pretty much guarantee they could cure my Hep C.”

Now his original doctors say they can transplant him too if he gets cured of his Hep C. “I know my daughter is watching what I’m going through. It seems to be helping her deal with it.”

The dance goes on. Will he make it to transplant and will it be successful? Hope, encouragement, that’s my role.

“Oh, I am so afraid to die.” Doris Redhorse shudderingly informed me.

“Why?” I asked, “Are you afraid to go to Hell?”

“No, no, I just don’t want to die like my older sister did. She had diabetes too, but didn’t take care of herself. I want to take care of myself, but you know I had to move out of my house and had all my medicine stolen. I didn’t even have money to buy my insulin or syringes.” Doris was 60 years old, modestly overweight, and all but homeless. Her type II diabetes had been out of control for years. Her fear of death was all but paralytic. She stopped drinking alcohol 5 or 6 years before but still smoked. She was ready to change, fear was driving her, but she has no road to travel on.

Doris and I hit it off. Through it all she still loved to laugh. “You know when we were kids we would hide my grandfather’s shoes. His memory wasn’t too good, so he would get blamed for misplacing them and then get all angry. We’d sneak ‘em back right under his chair. Boy, did that confuse him even more!”

“How about the Barking Walleye,” I said, not fully understanding the Native American reference. But just mentioning it makes Doris laugh.

“You know Jewish people believe animals are made to talk to tell G-ds truth. A carp in a barrel in a Jewish market in the Lower East Side in Manhattan told a Latino worker that the ‘End of the world was near,’ scaring the dickens out of him even though he didn’t understand English. He ran to get the Jewish owner of the shop and when the carp told him the same thing the frightened owner killed the carp!! Whose world did end?”

We both laughed.

Doris Redhorse slowly gave up cigarettes, she lost a few pounds and went faithfully to see the diabetes educator. She takes her insulin regularly, now. She sees me monthly to share jokes. Her last hemoglobin A.C. was 7.6 – down from 12. “I can’t believe it, this is the first time in years my diabetes is normal!” And her anxiety is, well, better too.

Sometimes it’s not so easy.

“Please call Dick Young at the Hennepin county coroner’s office regarding Evelyn Chace.” Evelyn was 65, has chronic arthritic pain and was on a modest dose of oxycodone, which she got when she saw me monthly. She was a model opiate-taking patient, clean urines, never a day early for her prescription refills, never asking for medication increases.

“Hello, this is Dr. Zuckerman, is Mr. Young in?”

“Yes, he is, hold on.”

“Hi, this is Dick Young, is this Dr. Zuckerman?”

“Yes it is, how can I help you?”

“Is Evelyn Chace your patient?” I don’t want to answer yes; I know what’s coming.

“Yes.”

“Ms. Chance was found dead in her apartment two days ago. There were a number of bottles of medication in her possession with your name on them.” I must be hyperventilating, because my lips and fingers are numb and I feel like fainting.

“Did she O.D.? Were there signs of trauma?”

“There were no signs of trauma but we haven’t finished the autopsy or the drug analysis yet. Was she ill with any chronic disease that could have killed her?”

“No.”

“Well, I will get back to you in 3-4 days with our results.”

“What pills were found in her apartment, any opiates?” I asked.

“Yes, a bottle of 5 mg oxycodone prescribed by you ten days ago.”

“How many are left in the bottle?”

“About 45.”

Some relief, I had written the prescription for only 90. I figured if Evelyn wanted to O.D. on oxycodone she would have taken them all.

“Thanks, Doc,” the coroner concludes.

I try not thinking about Evelyn – it doesn’t work. If she O.D.ed on oxycodone, well – I have been down this road before. Ten years ago a patient went into withdrawal when she couldn’t get “enough” dilaudid from me. She had been shooting the medication instead of taking it by mouth. I never noticed the needle tracts. The Board of Medical examiners raked me over the coals even though the patient lived, even though I monitored her and had no previous problem with opiate prescribing. It was two years of hell.

After hearing about Evelyn, I didn’t sleep the next three nights.

“Hello, is this Dr. Zuckerman?”

“Yes.”

“This is Dick Young from the coroner’s office. The autopsy on Evelyn Chase is finished.” Here it comes. Heads or tails I think to myself. My stomach anticipates the worst.

“What did you find?”

“The patient had a lethal level of Methadone in her serum. She died of a Methadone overdose.”

My prescription hadn’t killed her. I vow to never give any patients opiates again. But I will.

“I have to be on disability, I have been working for thirty years for peanuts, with no man to help me. Can’t you get me disabled?” Caroline, my 60-year-old patient asked, demanded.

“Physically you ain’t there, mentally you might make it,” I say. “I’ll take it, I know I’m crazy.”

And Caroline did make it. I referred her to psychiatry where she got certified. Caroline carried her work ethic into her disability retirement years, taking her medication compulsively, exercising, coming to her appointments. She manages her SS payments and thanks me for “making her crazy,” and for the most part she is.

My Ethiopian patient returns from a trip home with a gift for me, a carved wooden bowl inlaid with pieces of porcupine quills. I now know porcupines live in Ethiopia. Another patient proudly presents me with two lbs of canoe-harvested wild rice, another with warm pastries baked by her husband that I waste no time heating up and eating. Others send me cards, “Thank you for being our doctor all these years,” or “You saved my life,” or “I can talk to you,” or “My husband, may he rest in peace, loved coming to you,” or “You are the funniest and best doc I ever had, don’t retire, my husband and I need you!”

My health is good, my brain still facile, I can do computers, eMR, well enough I feel. I am ‘booked solid’ a month in advance. I feel at the top of my career, the most accomplished as a human being. And then suddenly it is over, I am fired, at a time when I feel the most capable of being a PCP. The corporate megalith, Allina, that has bought our doctor-run group has other criteria than patient allegiance, patient satisfaction. I am at first bewildered by the computerized score sheets that claim to quantify the quality of my care and my patients’ satisfaction (patient experience is the new title). I am told I am unprofessional (for first time in my 60 year work career) and overly negative, buck authority and “have few friends in administration.” It feels like its character assassination – why? Well, a little, but well informed bird says I communicated about a pet concern of someone in power, in a manner that was inappropriate, out of “chain of command.”

I protest, East Lake Street is not the suburbs. I write a poem extolling East Lake Street (Ode to East Lake Street Clinic) that echoes Emma LaZarus. “The new Colossus,” I reproduce “letters to the staff at Allina,” from Ken Paulus, CEO, Rod Christianson, Medical Director, and others, requesting “feedback” from the rank and file – to no avail. The request for feedback is a ruse. I come to realize the doctors in administrative roles have truly gone over to “the Dark Side.”

Dr. Kurt is no longer my colleague, I cannot deal with him as such. If he spouts intellectual dishonesties, that is what corporate talk demands and he will obey. The corporate computer generates gobbledygook reports based on inscrutable alchemist’s formulas.

Socrates’ choice, to be ostracized, or sentenced to death by the cup of Hemlock. I chose “retirement,” at least from Allina.

I am angered by being cornered into giving up my practice, my patients. “Stephen Zuckerman, they are not your patients, they belong to Allina,” I’m told. My patients rail against my being fired, vote me savior, likeable and funny – all to no avail. I hate Dr. Kurt for his cold bloodiness. His indifference to all but his concocted reality ignores my relations with my patients – yet I thank him. He has freed me from the tyranny imposed by my vision of my needy patients. I could never abandon them until I was invalided or the grave opened up to suck me in.

Since the Allina buy-out, my work days have been tainted with the angst caused by the badgering of the likes of Dr. Kurt. I bite my nails and cuticles, I eat knosh food (caramel corn, tortillas chips, dried fruit for constipation, jelly beans, roasted, unsalted cashews) incessantly and avoid lunch to lower the daily caloric count. I really don’t want this type of practice anymore!

As for the Allinas and their Dr. Kurts, I feel they are building a square wheel, which will give them a lot of bad headaches and, worse yet, screw up their “bottom line.” New schemes will be invented, the same culprits will scramble to stay in power, but that’s no longer my concern, I suppose.

Memoir, Personal Essays, short story

Amoeba

I like to think of the amoeba as the building block of the animal world. Enough amoeba, enough blocks, and you have a human or a building. As far as life goes you’re supposed to be able to reproduce yourself and keep evolving. As such, amoeba are probably in the middle of life forms, somewhere between…say prions and top dog humans.

The nice thing about amoeba: the more you know about them the more “human” they seem. Prions, virus, algae, aren’t easy to feel kinship with, but amoeba, that’s a different kettle of fish. Amoeba do what we do – eat, defecate, avoid bright lights, know gravity can kill, prefer neutral ph, have sex (I would call it monosexual sex, not homosexual sex, as there aren’t two amoeba sexes) and best of all have well-meaning leaders, called head amoebas, who help organize the regular fellows into complex social orders (slime molds). Heck, about all amoebas can’t do, assumedly, is procrastinate since it is assumed they are of one mind (one cell).

I know, I know, any thinking person has to come to the conclusion that a minuscule amoeba, with no obvious brain, can’t have enough space to store all the things it knows. Then how the heck does it know what to do? I guess you would have to analogize with modern computer technology. The amoeba must have a non-stop connection to the big know-it-all in the sky, G—D, the universe’s cloud of knowledge. Heck, that fits right in with the Garden of Eden Story. One bite of the Tree of Knowledge fruit and bang, Adam and Eve got it all (although the first and only thing the bible mentions that they learned was that they were naked), all the knowledge G-d had. Some call that know-it-all, “intuitive know-it-all.”

Now, if this amoeba, like us, knows it all, what does the amoeba want out of this life? Must be the same thing we want. In fact, maybe this amoeba dreamed of becoming us to get what it wants and that is to know and fill the universe (or populate the universe).

Genesis, in the Old Testament, gives humans dominion over all that’s on Earth, but its G-d’s universe and ours too. Behind all that conquering of the universe has to be the belief that we, and the amoebas, will discover creation and figure out how G-d became the universe. Now-a-days it would be to figure out how G-d, the spiritual all, big banged himself, herself, itself into becoming all those stars and galaxies, full of gravity, mass, time and all that JAZZ.

amoeba17