It’s my brother’s fault.
Not quite a year ago, my brother, Kurt, decided to ignore a couple of heart attacks, possibly as many as three.
Perhaps “decided” is not the most accurate term; he had two or three heart attacks, of a less than elephant-sitting-on-the-chest quality, was told by an HMO doc that it was acid reflux resulting from lunches taken nearly every work day at an Iraqi restaurant in southeast Denver, and Kurt did nothing further about it. It made sense to him that five large helpings per week of Timman Ou Keema — the extra-spicy version — might provoke a reaction.
He did nothing, until he experienced major heart failure.
Kurt kept to a family tradition at that point, and decided to do something extreme. In this case, “decided” is appropriate.
When he realized he was in a dire condition, Kurt drove from his workplace to his HMO’s wellness fortress, and was informed by a physician that he was in a shitload of trouble. “Shitload” is a diagnostic term regularly employed in the dollar-hungry world of managed care.
The physician said: “You’re in a shitload of trouble, Kurt. I’m calling an ambulance. We need to get you to the hospital, Stat!
I added “Stat” here because I love it when an actor playing a doctor on TV shouts, “Stat!” I’m certain the docs at Kurt’s HMO rarely employ the alert; they’re too busy calling their brokers and managing their portfolios.
Kurt asks the doc to identify the hospital to which the ambulance will transport him. He does not like what he hears, and tells the physician he wants to go to another hospital.
“That’s out of network,” replies the physician.
“Fuck you, and fuck your network,” says my brother. He staggers from the office, gets in his car, and drives himself across the city to his favored facility — one at which our physician father served for decades as a member of the medical staff.
He stops only once on the way to said hospital — to purchase a chorizo taco at a favorite food truck.
Kurt eats, Kurt drives.
Kurt suffers heart failure.
When he arrives at the hospital, Kurt’s nearly limp frame is dragged into the Cath Lab. When the damage report arrives, the news is less than zippy. He has lost a significant percentage of heart function; he spends several days in the Cardiac ICU, teetering on the ledge. There are no chorizo tacos served in the ICU.
More than the man’s primary muscle is damaged.
Kurt is now saturated with drugs, doesn’t feel particularly energetic during his waking hours, and is on a severe diet. This is a blow to a guy whose adventures as a gourmand are legendary. There’ll be no more soy-brined chicken feet and Sichuan cockscombs, goat papusas, or soup dumplings for Kurt. He now seeks comfort in an array of culinary distortions, and clings to illusions such as “pasta tastes as good cooked in plain water as it does when the water is heavily salted.” I find his necessary fantasies endearing.
He’s lucky to be alive
And so, it appears, am I.
Turns out, I may have overdone it, and it could be time to face the music.
There are a number of people who claim I’ve lived a life of unusual excess, at regular junctures going overboard with regard to what I ingest or indulge — food, drink, drugs, sexual adventures with passive-aggressive antique dealers and frustrated librarians, etc. Most of my critics have known me for decades, and I’ve long believed they have it in for me, their ire prompted by general discontent in many cases, jealousy in others, the byproduct of lives impoverished by restraint.
Some of these folks, holding to their Puritanical line, but better educated than most, call me a Cyrenaic. I prefer to think of myself as an Epicurean who now and then jumps the tracks. It happens, and when it does, I clear the wreckage and move on. That I might have damaged my engine during a crash comes as no surprise.
Wanda, my friend, personal physician, and confidant regarding critical bodily and emotional events, is no Puritan (though, being an ectomorph, she exercises obsessively), but she is keenly aware of my habits and, after I tell her about my brother, she too recognizes the possibility of engine damage, and schedules a cardiac stress test for me at a regional hospital.
It’s Kurt’s fault.
“You’re going, period, no excuses” Wanda tells me, opting in this instance for her stern, rather than her comfy approach. She possesses the full range of doc chops, including requisite hand gestures and facial expressions.
“I have people watching your every move. Do not drink cocktails or wine the morning of the test.”
“Enchiladas ranchero, a three tortilla stack, with extra cheese and a couple fried eggs for breakfast?”
“Not a chance.”
“Edibles? Fifty-fifty THC-to-CBD, an anti-inflammatory precaution?”
“Oh, for god’s sake. Take and eat nothing, and do what they tell you. Don’t cause trouble or upset anyone. They’ll send me the results as soon as they’re available. Are we clear on this? Focus! Do you understand me?”
I comply with Wanda’s orders since I’m angling for a series of Ketamine treatments to forestall seasonal writer-cum-painter’s block, and the depression that accompanies it. She adamantly refuses to provide and administer the Big K, but I hold to the hope I can pry a referral out of her.
The cardiac test is set for 10 a.m. Kathy makes the 60-mile drive with me, and drops me off at the hospital.
“I’m going downtown to find a djembe,” she says. “I’ve always wanted a djembe, and I hear there’s a used one for sale at the music store. Then, I’m heading to Bed Bath and Beyond to buy festive cloth napkins just in case we ever host a holiday brunch, and from there to Home Depot to check out kitchen remodel packages we can’t afford, what with you being a writer and painter. Since you refuse to own a cell phone, I’ll come for you whenever I’m done. If you get out before I return, wait on the bench outside the front entrance. If you get cold, it’s because you’re an idiot, and refused to bring a coat.”
I arrive at the hospital at 9:40 a.m. in order to answer the ridiculous questions administrators ask during the admissions phase of the game. Questions like: “Do you have insurance?” and “Can you prove it?”
Dixie sits across the desk from me. She sports armor comprising far too many pieces of clunky jewelry, signaling she is emotionally and/or physically timid. Her heavy sweater has a collar that extends up to her chin — an indication of a frail foundation and probable troublesome incidents experienced at school dances during her adolescence. I watch her gnaw on her lower lip as she makes her way through the process, and I can’t help but wonder how long it’s been since she’s had an orgasm in the company of another human being, if ever. Peekapoos don’t count.
There are framed posters hung on the walls of Dixie’s little room. The posters feature sunsets, mountain vistas, newborn chicks and kittens. The posters are emblazoned with uplifting sayings: “Make every day count…with love,” “Each new day brings the promise of health, and happiness.”
The hospital is affiliated with the Catholic Church, so one of Dixie’s posters urges a reader to “Rest easy in the hands of the Lord.”
What does Dixie say during confession? Best case scenario, she blurts out the details of her sordid thoughts about Earl, the shoe rental guy at the bowling alley.
Most likely scenario: it has something to do with chocolate chip cookies.
I see Dixie in my mind’s eye, lurching down the aisle to the front of the church for communion, safely enveloped in her bulky sweater, jewelry clanging, closing her eyes and trembling noticeably as wafer meets tongue.
She savors a tidbit of Jesus.
I’d say chances are good she’s never eaten anyone else, at least not when she was fully conscious.
As I watch Dixie’s chubby, be-ringed fingers dance across the keyboard, I wonder if a zealot is excused from further communions if she consumes enough wafers to equal a complete Jesus.
Who knows? I’m not a Christian, and I’m in the dark when it comes to the finer points of cannibalistic ritual.
I am finally admitted, and I read an entire issue of Martha Stewart’s Living as I wait for the call to proceed to the testing bunker. Martha has a peasant’s hands, the husky paws of a Polish serf who claws at frozen soil in search of root vegetables as the Wehrmacht nears her village. I picture those hands caressing a cellmate during Martha’s brief tenure at the Federal Prison Camp in Alderson, W. Va.
I hear someone call my name.
“Karl, I’m ready for you.”
It’s Sandy, The Nuke Tube Jockey.
How to best describe Sandy’s appearance? Her demeanor?
As Sandy hustles me down the aisle to her domain, I imagine her in Colorado City, Arizona, one in a gaggle of women, all wearing pioneer dresses, the browbeaten gals and twenty or so kids following their patriarch as the family leaves the walled compound to shuffle to services.
But Sandy, dour as she is, is slightly out of sync with the prototype: she sports a Marie Osmond, circa 1980 hairdo. The juxtaposition of Sandy’s flat-line, repressed personality and the “I’d do cocaine at the club if I weren’t Mormon” hairstyle provokes an empathetic response in me. I imagine Sandy going solo to a local CW bar on Saturday nights, line dancing with sweating strangers for several hours without cracking a smile, drinking nothing stronger than Sprite, suddenly bursting into tears as she drives back to her studio apartment in her 10 year-old Acura. The one with duct tape on the headrests.
My empathy is short-lived as Sandy brusquely orders me to recline on the sliding bed of a machine that waits to devour me.
I make a train and tunnel joke.
Sandy is impervious to juvenile Freudian humor.
I make an “Open the pod bay door, Hal” joke.
Sandy is no fan of Kubrick.
She inserts an IV in my vein and injects a radioactive isotope.
“Put your arms behind your head” she commands. “Don’t bring them down in front of you or I’ll have to start over. This takes half an hour, and I’m ready for my lunch break.”
As I slide into the tunnel, I recall a piece I wrote some time back in which I speculated that line dancing was created as recreation for concentration camp guards.
It seems some guards favor odd, outdated hairstyles.
The machine swallows me, makes noises, things rotate for 30 minutes, and I emerge isotoped, but unharmed.
Departing Sandy’s realm, I transfer to a room across the hall and Jamie prepares me for a pharmacological stress test. She shaves two spots on my chest, revealing the soft and alluring curve of my swelling man tits, slaps patchlike gizmos on those flesh bombs, and hooks the gizmos to wires.
I perk up when Jamie informs me the test will not involve strenuous exercise. She will inject me with a potent chembrew, she says, then put me on a treadmill set at one mile per hour.
“For how long?,” I inquire.
“Four minutes, to help the drug circulate through your system,” replies Jamie. “Make sure you read the poster in front of you in order to determine the severity of any problem.”
There is a colorful poster hung at eye level in front of the treadmill. At the top is written: “What level of stress do you feel now that you are walking on this treadmill?”
Below that is an illustration of an elderly woman walking on a treadmill, and next to her is written in bold, red letters: “The level of stress you experience when tying your shoes? This is Level 1 stress.”
Below that is a graphic of an elderly male on a treadmill, next to which is written: “The level of stress you experience when you walk through the grocery store? This is Level 2 stress.”
A third illustration of a feeb on a treadmill is at the bottom of the poster, and next to it is written: “The level of stress you experience when you change the sheets on your bed? This is Level 3 stress.”
“I can probably manage this,” I say. “I rarely change the sheets, but if I experience discomfort you’ll be the first to know.”
As I amble, Jamie tells me what the drug does, and notes the possible side effects.
“This drug dilates all the veins and arteries in your body, as if you’d run a 10K race,” she says. “I’ll take an EKG, resting and standing, then I’ll send you back to Sandy for a second set of pictures with your vessels open. You might get a headache, feel dizzy, and if you have arthritis you could experience joint pain for a couple hours. Are you feeling anything unusual?
“Unusual is the order of the day for me, Jamie, but let me get this straight: my veins and arteries are wide open, and blood flow is at the max, right?
“This is a purely scientific question, Jamie, so take as much time as you need before answering: What if a hypothetical patient had prostate cancer surgery and, following the removal of the polluted gland, he experiences a degree of … what is it …oh yeah… erectile dysfunction? Is there any chance that hypothetical patient, veins and arteries wide open, will experience an unexpected erection if he’s fixated on a Marie Osmond, circa 1980 hairdo? And, if he does, is there a quiet, private space with a mirror available nearby?”
Jamie remains silent, avoids eye contact, finishes her task, and delivers me back to Sandy, who has just polished off a tuna salad on white, half a bag of Ranch-flavored chips, and a Sprite. There is a small clot of Miracle Whip at the corner of her mouth; the boost in her blood sugar level does nothing to improve her mood.
I recline, put my arms over my head, and think pure thoughts as I am transported again into the belly of the beast.
I become mildly hypothermic as I wait on the bench outside the hospital entrance.
Wanda comes to the house two days later. She has her laptop with her. I whip up a triple vodka tonic, fasten my seat belt, and prepare for the news. Wanda shows me charts that make no sense, and some notes my ADD and vodka prevent me from reading.
“I’m near death, aren’t I?,” I ask. “Do I need to drink that 2006 Pahlmeyer, and polish off my remaining bottles of Pigeoulet en Provence and Sang des Cailloux in the next couple of days? Tell me the truth, I can take it. As an Epicurean, I’m reconciled to the inevitable scattering of my indestructible atoms into infinite space.”
“Oh, spare me. Is this the first cocktail you’ve had this afternoon, or have you been at it since this morning?”
Wanda informs me there are irregularities in the EKGs, and that a cardiologist who deciphered the thermonuclear myocardial perfusion test mumbo-jumbo noted a possible problem with circulation to the left ventricle.
The fucking Widow Maker!
As Wanda tells me this, I realize I had no idea I have a left ventricle, much less a right one, that I do not know what “perfusion” means, and that I detest cardiologists. They’re of an arrogant breed. They wear snappy white coats, with their names embroidered above the pockets, like pompous executive chefs at high-end restaurants.
“So, as I said: I’m near death.”
“We’re all near death. But you might have had at least one small, silent attack some time in the past.”
“Probably that night forty years ago when I snorfed five grams of primo Peruvian flake and fired up a load of Steamy Bliss in a misguided attempt to impress a deaf stripper at the Tipsy Tiger. Her name was Lavonne. There was a speaker mounted beneath the floor of the stage, and she felt the beat with her feet. Delightful person. If I remember correctly, my heart stopped. My business associate and friend, Jim, had to pound on my chest with an empty Cuervo bottle to get me going again.”
Wanda remains a paragon of control. “You’ll probably live long enough to see a cardiologist in order to determine what, if anything, needs to be done.”
“Is there any chance you can ask them to skip the prelims and go straight to the stents?,” I ask. “That way, after the procedure, I can stop at Brenda’s Old West Café in Bayfield and pound down a chicken-fried steak before I roll home. I can order it with green chile in the cream gravy. The proprietors roast and chop their own Hatch every fall. They care about product. That’s unusual, and commendable, in a small town eatery.”
“You make me so very thankful my other patients are stable and cooperative,” says Wanda. “Your appointment will be with Dr. David Choi.”
“Choi? Of Korean heritage, by any chance?”
“I think so. Why does that matter?”
“If so, he no doubt has info concerning the alleged curative powers of gojuchang. Ancient cultural traditions, worldwide, involve the withholding of miraculous folk cures from outsiders — those of other tribes, races and religions. For example, substances obtained from the gallbladder of the feared Bushmaster by members of the Maku tribe; the Sami’s reliance on compounds from the reindeer’s tarsal scent gland; sheep tail fat and the Mongols; and, of course, the many uses of the dried placenta of the now endangered St. Aignan’s Trumpet-eared bat by inhabitants of the D’Entrecasteaux Islands. I had an acquaintance in Manhattan in 1967 who ingested less than a gram of bat placenta. It cured his arthritis and a vicious heroin habit, and gave him the confidence needed to apply for work as a motorman on the MTA. I left the city shortly after, but friends who remained tell me he married the owner of a Hmong restaurant in Queens, has three kids, seven grandchildren, employs a smidge of placenta on occasion as a restorative, and plays pickleball three times a week.”
Wanda rubs her forehead with the palm of her hand, as I continue.
“I’ll ignite the diplomacy afterburner and massage the secret out of Cho. I have ways of removing bricks from a wall of exaggerated self-confidence. There’s a source in Los Angeles for past-the-sale-date, ten-pound tubs of gojuchang —old gojuchang being far more potent than newly manufactured stuff. If Choi lets the cat out of the bag, there’ll be no cardiac co-pays for me. Care for a cocktail?”
“I’m outta here; I have a four o’clock at the office with a thyroid problem, and a couple kids with strep to see before I go home.”
“Gojuchang. Add a tablespoon to whatever’s for dinner, dissolve a glob in fruit juice or a glass of Tang, drink it before bed…problem solved, without an expensive trip to the pharmacy.
“Oh, and about that Ketamine…”
It’s so quiet I think I hear my heart beating.