Thanks for your patience. More words coming soon.

Ed

The scream woke me up. I shuddered, shook my head at the horror of the nightmare and fell back into sleep – and  back into the dream.

The cutting man was still there. Not a gloater, he was nothing like Hollywood Evil. Just a man with a grim task to do. His knife looked like a scalpel, blood ran from my cuts. Why was he doing this? Why didn’t I fight back? If he was the thief the dream insisted he was, why didn’t he just take something and go?

I woke up so quickly at my second scream the sound was still in my room. I was sweating, my heart raced. The cuts burned but I couldn’t see the blood in the dark. My sleep was as deep rooted as the dream inside me and again I fell back into both.

The third time I screamed myself out from under his knife I forced myself out of bed, went to the the bathroom, walked the rooms in my apartment until I was sure I would not again fall prey to the grim shadowy man wielding his scalpel. It took a while to work and there was little sleep left when I finally went back to bed.

Three hours later my alarm went off. I got up, dressed, and headed to the medical center to repeat an ultrasound of my liver I’d had two weeks earlier.

–––

The first ultrasound was routine, a periodic check for tumors in case the cancer that was the cause of my liver transplant had resurfaced. The scenario was unlikely – I’d had many tests before and they showed nothing. Statistically the odds of recurrence were low. I sailed in and out that morning thinking about where to go for breakfast after the tech wiped the goo from my belly.

A few days later the report showed no sign of tumors and hooray for that. But a footnote noted something… what exactly? They weren’t sure. Something to do with the bile duct? My bilirubin (bile levels) had been elevated lately. Was the duct bent? Was it keeping bile from flowing out of the liver? The doc ordered a second ultrasound.

A bit of liver transplant plumbing: When surgeons install a new liver they hook up all the arteries and veins and other connectors on the new organ to the same pipes and fittings the old liver used. If they didn’t, well that would be like installing a new carburetor in an auto engine without hooking it up to the fuel line and manifold. Neither human nor car would go anywhere.

Most of these re-connects are of reasonable size and capable of manipulation, at least by a surgeon. But the bile duct, a small tube that drains the toxins the liver pulls out of blood and dumps them into your intestine for disposal, is a narrow thin-walled straw. Stitching the two halves together is by all accounts one of the harder parts of the surgery. Even well attached the duct remains a weak point. Think of a bent drinking straw straightened out: if a leak occurs it’ll be at the bent point.

A kinked bile duct means a) your liver fills up with bile; b) your body fills up with bile, c) you turn a ghoulish yellow-green, d) you feel really miserable and e) you wind up in surgery, stat.

And that is why I approached ultrasound test 2 with such fear. All I could see was myself back on the icy metal slab in the OR, waiting for then recovering from surgery. Seems I’ve run out of tolerance for that kind of thing.

Truth is, the idea of another body-slicing fills me with night terrors like that anonymous body cutter visiting in the night. I know too much, not just about surgery but myself. I know that if surgery is called for, I’ll probably acquiesce. In for a penny, in for a pound goes the cliché. I spent that pound a long time ago.

Everybody is afraid of surgery. The thought of having someone muck about in our really private parts, the ones even we don’t get to see, having our innards fiddled with by strangers wielding knifes and forceps while we are gassed into oblivion is not something we choose to think about until we have to.

For those who’ve never experienced surgery, it is the ultimate personal definition of the fear of  the unknown. It certainly was for me five years ago.

My experience having my skin cut and my intestines moved about, having parts removed and replaced, followed by the surreal, almost unspeakable strangeness of recovery that follows seems to have ushered me on to a new level of fear: terror of the familiar.

It isn’t pain that frightens. It isn’t another scar. Recovery is weird and wearying but manageable, even revelatory in a sick way. The hospital stay – well, I’ve developed an acute allergic reaction to the enforced confinement; only severe illness or heavy medication keeps me inside my head.

It is the fast rise and slow fade of anesthesia that is true test of endurance and recovery. Anesthesia plagues me more than any physical complication. Compared often – and poorly – to a deep sleep, researchers recently developed a more accurate analogy: to anesthetize is to place the body in an induced coma.

I have an even simpler analogy: Anesthesia is artificial death. I feel the disconnect from life each time I’m put under and the slow, confusing reconnect after the sedation is withdrawn. I have experienced death quite enough for one lifetime in other circumstances, right down to the apocryphal walk down the long hall to the light. Twice. Returning to this world after surgery leaves me with a profound loss and something unexpected found, neither of which I want.

–––

That slasher with his scalpel, the dozens of cuts he inflicted that wounded me but did not kill or show, my acquiescence in his brutality… this is one dream I don’t have to pay a psychiatrist to interpret.

I’ve heard this comment from friends and family and even strangers for five years now and it always makes me uncomfortable. Something’s off with it; somehow the sentiment just doesn’t ring true.

Thanks to Thomas Mann’s The Magic Mountain – I’m carrying out my vow to re-read this magnificent and complicated book – I’m learning why the remark causes such unease. I think I understand how the words do not say what they are meant to say.

It’s meant to be a kindness, even a salute. “I don’t know how you do it! I couldn’t,” someone will say to those of us fighting chronic illness or life-or-death health battles. Our treatments, our pain, the unending doctor visits and hospitalizations – they seem unendurable, impossible to someone looking at it all from the healthy “outside”.

How does one respond to such words? What do they even mean? What seems so clear to those healthy others has no clarity at all on this side of the divide. Hearing them, I wonder: Is my life so unique? Am I really doing something so incredible? I  don’t think so. I have only to look outside myself to see others bearing much worse than me.

In reply, I usually mumble bromides about how I’m nothing special, how nobody really knows what they’ll do in a traffic accident much less a health calamity until it actually happens, and that’s true as far as it goes. But what I really want to shout is, “You’ve got it wrong! That’s not the way it is! I’m not doing anything special!” To say that however, I have to bridge that divide between what the healthy person sees and the sick person endures. And to explain it to others, first I have to explain it to myself.

Thanks to Mann’s book I’m beginning to understand that the problem is one of perception.

From The Magic Mountain:

The sympathy that the healthy person felt for someone who was ill, which could intensify to the point of awe, since he was unable to imagine how he could ever bear such suffering himself – such sympathy was utterly exaggerated. The sick person had no right to it. It was based on a misperception…

I have no special coping skills, no extra slice of courage. A bit more than average stubbornness maybe, but just that. I did not summon strength from some inner well to deal with the diagnosis of liver cancer. I was stunned senseless hearing the news, just like most – all? – are. Nor did I meet the challenges of a liver transplant with jutted jaw and iron will. My jaw, like the rest of me, was quivering. Check out my very first post on this blog: you’ll find no heroism, no boldness there.

When I got the news about liver cancer I was still healthy. And Healthy Ed didn’t have cancer. Healthy Ed wasn’t the least bit sick.

… a misperception, a failure of imagination, because the healthy person was attributing his own mode of experience to the sick person, the making of him, so to speak, a healthy person who had to bear the torments of sickness – a totally erroneous idea.

Yes, I understood what the doctor was saying: a tumor had appeared in my liver. It could see me dead in six months. But I was Healthy Ed! I was fine, see? I’d just walked out of a gym when I got that awful call. I’d bicycled 25 miles the weekend before. How could I not be fine? I need a transplant? Need what?

My view of myself – my self-image if you will – was not of someone ill.

Yet bit by bit Healthy Ed morphed into Sick Ed – the one who’s been going through these medical trials, the one taking the risks, the one  enduring the uncertainty and the pain. The one just trying, trying to stay alive. Along the way my perception of myself changed.

The sick person was just that, sick, both by nature and in his mode of experience.

How did the change happen? How did I get from being fine to being sick? As Mann says, the change is rooted in my experience.

When I got over the shock of the diagnosis, I had one single step forward: I was to go to UCSF Medical Center’s liver clinic. After a day or two of numbness, I made the appointment. That was my first step away from Mann’s healthy person to a sick one – the first of many tiny mental shifts in perception that replaced the old Ed with the new one – the one who would put up with all these impossible things.

Illness battered its victim until they got along with one another: his senses were diminished, there were lapses in consciousness, a merciful self-narcosis set in – all means by which nature allowed the organism to find relief, to adapt mentally and morally to its condition…

Over the next few months the shifts in perception accumulated. The diagnosis was confirmed. I saw for myself the tumor in the scans. I had chemoembolization, a treatment that runs a snake through a vein and drops deadly chemotherapy directly onto the tumor to slow its growth. That was one of my larger shifts of perception: no one gets chemo on a whim. So did being accepted into the transplant program.

One small step followed another small step. Or to be more precise, one tiny shift of perception followed another. And the sum total of these shifts in how I saw myself changed me at my core. I changed from experiencing myself as a healthy person to experiencing myself as sick. Sick Ed replaced Healthy Ed.

…all means by which nature allowed the organism to find relief, to adapt mentally and morally to its condition, and which the healthy person naïvely forgot to take into account.

Healthy people, even the caring or worried healthy, have no clue about this shift in perception. Mann says they “naïvely forgot” to take the change into account. But realistically, how could they know?

Healthy people have not taken the small steps. They haven’t had their view of themselves forcibly changed, haven’t been “battered” by illness into doing what comes next, into seeing the situation as not being something you can agree or not agree to but is instead an insanely speeding ride you’re stuck on, desperately hanging on till it stops.

What is off with the “I could never…” comment, what is so jarring when someone says, “I don’t know how you do it,” is this: the sayer doesn’t realize that the old Ed, “Healthy Ed”, never could have gone through any of these experiences either. But I’m not him any more. I’m not the person I was back when I was “fine”.

Instead, I am this new Ed, the “Sick Ed” in Mann’s parlance, going through these impossible things, having these impossible experiences.

–––

I’ve put the  full quote from The Magic Mountain and  another related quote from later in the book in the comments.

The guy with the gun pulled the trigger in Tucson. But the constant vitriol of hate and demonization by political “leaders” and others helped set the stage.

In 1998, there was a flurry of anti-gay hate speech. Religious groups, sports figures and politicians fell over each other in their eagerness to get in front of a camera and denounce homosexuals, all because President Clinton had appointed James Hormel as ambassador to Luxembourg. Hormel’s sin was being gay.

In June of that year, Trent Lott, then Senate Majority Leader, happily pandered to his base by upping the volume of venom considerably, very publicly comparing gays to alcoholics, sex addicts and kleptomaniacs, characterizing gays as sinners and a “problem to be solved.”

A few months later, while Lott and others continued to spew their bile, Matthew Shepard was targeted, tortured and killed by two men in Wyoming specifically because he was gay.

The connection between Lott’s words and Shepard’s death was noted by many. Playwright Tony Kushner wrote a scathing article titled  Matthew’s Passion, linking the two. Newspapers all over the country decried the vicious talk that had contributed to the hate killing.

Lott and other politicians quickly went into damage control. They had nothing to do with it, they said. Two crazies in Wyoming, they said. They issued condolences to the families and condemnations of the crime. But it didn’t wash. They were forced to tone down the rhetoric, though only a little bit and only for a while.

This is exactly what Speaker John Boehner, Senator Mitch McConnell, and Sarah Palin are doing right now over the Tucson shooting of Representative Gabrielle Giffords and six others. A crazy in Arizona, they’re saying. They had nothing to do with it, they insist. It’s not their fault, they whine.

For two years, Boehner, McConnell, Palin and their toadies Beck, Limbaugh, et. al, have been screaming into cameras and microphone, demonizing anyone who had anything to do with the new health care law. Their vitriol went on for so long and was so successful it resulted turning many people against a law that would only bring them benefit.

Giffords’ sin was to vote for the bill. For that she was placed in crosshairs on Palin’s Tea Party hit-list map during the recent elections, her office was firebombed and her life was threatened. Obviously the threat turned out not to be empty.

Boehner et al may not have pulled the trigger in Tucson Saturday. But when those who have easy access to the public pulpit, when those in authority publicly and repeatedly demonize those who disagree with them, when public discourse has deteriorated so much that politicians show videos of themselves shooting at laws they don’t like and calling for “second amendment solutions” to people and laws don’t like, they become accessories to the crime.

There is always someone out there willing to pull a trigger. All they need is to be pointed at a target.

Boehner and McConnell, Beck and Limbaugh, and particularly you, Palin – all of you have the blood of Tucson on your hands.

___

[The title of this post is a quote from a New Yorker article, apparently a literal translation from the Chinese about reluctance to speak publicly of problems. However, the moment I read it I was reminded of the Tucson shootings and the outpouring of political denial now under way.]

So I’m celebrating, right? Well… yes and no. Its not just downward-facing-dog poses, attentive doctors and luck that’s improved things. I made a choice – one of those choices where, to gain one thing you must sacrifice another. I’m doing it solo because no doctor would ever agree.

I’ve been around a lot of sick people and one of the most stubborn rules of thumb I’ve observed is this:as drugs are added one on top of another, as doses are maximized for effect, as new drugs are added for new problems or to counteract miseries caused by those already taken, the body reaches a point when the number and toxicity of the meds ingested becomes unmanageable and the consequences of what amounts to a giant chemistry experiment becomes unknowable. Unknowable that is until the meds go to war with each other and start killing their host.

This drug war is something I’ve been dreading. In the last year I’ve gotten perilously close to a full scale, multi-front battle.

I take meds for HIV and for HCV. I take more to suppress my immune system to prevent rejection of my transplanted liver. I take yet more to keep away infections like pneumonia or fungals that prey on intentionally weakened immune systems. And there are meds for a stomach eaten away by so many meds.

Then last year I scored some sort of dubious achievement by concocting not one but two autoimmune diseases, something supposedly impossible when you have an intentionally suppressed immune system.  And of course there are meds for these new AIs too.

It turns out that one of the meds crucial to keeping my stomach in line is essentially a blood pressure type med. As anyone who’s taken blood pressure meds knows, they s l o w    y o u    d o w w w w n. Problem is, that’s the exact opposite of what the meds the for autoimmune problems are doing: boosting (speeding up) circulation. I asked one of the autoimmune docs  if this was in fact the case. I deduced this clash myself, and though I sometimes pretend otherwise, I really don’t have a medical degree. He said yes. I asked what to do about it. He shrugged.

The important phrase in the last paragraph is “one of the autoimmune docs.” because I see multiple AI docs. And they are different docs from the multiple transplant/liver specialists who look after that part of my body. And both are different from the GI docs, who are different from… you get the idea.

Ask any one of them to do about their area of expertise and you get specific answers and instructions and an admonition to take prescribed meds EXACTLY. Ask any of them about conflicts with the meds prescribed by other docs, and they give that shrug and tell you to go see them. When you see and ask them what to do they tell you to take their meds EXACTLY. Conflicts? See the previous docs.

Not one of doctor, ever, not even your GP, will deal with the the totality of the situation that is you. Not one will acknowledge that what they see as a multiplicity of chronic problems is in fact just one: how you can stay alive; how you can live your life.

So if you need or want to make a choice, to treat one chronic condition over another, you must do the choosing yourself.

For me the decision was a no-brainer. Nothing I’ve experienced has been as bad as the autoimmune problems. Nothing. A liver transplant, where you are almost literally drawn and quartered? That’s a mere finger cut in comparison.  Same with pneumonia, decaying stomach, aches and pains. For me, nothing was worse than my body rejecting its very existence, which is essentially what AI diseases are.

So I stopped the med that relieves the pressure on the veins in my stomach that led to internal bleeding in favor of the meds that control keep the autoimmune conditions under some small control.

I know this is a temporary choice. I know I will probably have to resume the lapsed med if bleeding occurs in my stomach again. I can tell when things start to go wrong there (don’t ask) and the docs will tell me when things get out of hand. But it won’t be them making the decision, it’ll be me. And though they’d no doubt tsk-tsk in disapproval, I’m convinced they are in fact relieved that I insist on making the decision.

From Hollywood to Oprah, seems like is taking a swipe at Mark Zuckerberg and his thrown-together monster, Facebook. I got burned by the two-faced beast too…

Every geek, techie and IT pro I know has exactly the same opinion of Facebook: Don’t. Go. There. Ever. Facebook is a giant con, they all say, a tentacled medusa crafted to steal personal information, parse it into marketable chunks for sale to the highest bidder. Privacy, as we have been informed by Zuckie, is dead.

I adhere – or did – to the no-Facebook ethic. It wasn’t hard: 25 years ago with a single PC and a database program now known only to aging geeks I extracted personal info from tiny, innocuous client lists that made my conscience burn. I know well what can be – is being – done with the terabytes of personal info that everyone is shoveling onto the ‘net.

That’s not the only thing about Facebook that makes me queasy. A virtual social network? Posting life’s little conceits and embarrassments on some public wall? Friending as a verb? Unfriending? How very high school. Ugh. My dislike is not unique: “I hate the very idea of it,” is a critique I’ve heard and read many times.

But two people whose work I value store their efforts inside Zuckie’s fortress, so I did what we all do when we want to bend a personal rule and do something we usually won’t: I rationalized. I’m a Google fan, I reminded myself, a company some consider more egregious than Facebook (though Google hasn’t unfriended anybody except maybe China). And I do know a number of reasonable, post-pubescent folks who use Facebook without stooping to posting drinking party and  butt-crack pics on it. So I gave it a try.

It took FB only a few hours to dump me into social hell.

As soon as I entered an eMail address Facebook presented me with a list of people who “were ready to be my friends”. Surprise on me! The list wasn’t random. Some were friends, others I’d worked with or knew from my years in the theatre. A few were vaguely familiar but the how and where had long disappeared. How in hell did Facebook know I had connections to these people?

Later I checked my eMail. A message from someone I keep in occasional contact had come in. “I’d love to see your pictures,” she wrote, “but I don’t have a facebook account. Any other way to do it?” (Yes, she’s an IT pro.) Huh? I hadn’t sent her an invite to “see my pictures.” I didn’t post any pictures on FB; I didn’t post anything there. Heck, I never even found my “wall.”

My eMail box fast-filled with Facebook spam. “So and so has friended you!” “Still haven’t heard from so and so, but your request to friend them is still out there!” And more people asked “see my pictures”. It all felt  somehow prurient, like I’d clicked on one of those fake browser links that triggers bad porn and Nigerian check scam eMails.

How this was all happening really bothered me. Did Zuckie scan my eMail? Did other people list me as friends to watch out for – i.e., was I already in FB databases even though I’d never signed up? My work with databases and computers tell me that is more than possible.

I finally hit angry when a non-techie friend whose computers I keep running called to ask why I’d sent him an invitation to join Facebook. This guy barely manages AOL and I would never encourage him to sign up for anything if only because I’d bear the task of keeping it working.

Pissed off and embarrassed – I’m the one who regularly mounts a soapbox and lectures everybody in earshot about computer hygiene after all – I set about eradicating my presence from the Social Kingdom.

Logging in I found the list of potential friends had grown, and every one now had a checked “friend me!” box next to it. I unchecked them all, hunted and deleted the info I’d entered during signup, changed what couldn’t be deleted, and replaced the eMail address with a fake. Then I spent almost an hour wading through the infamous Facebook “privacy” settings”. Then I deleted my entire account. Or tried to.

So hideous is Facebook, so like a cancer snaking its tendrils into your innards so it cannot be extracted, you can’t even quit the damn thing. Instead you are put on a mandatory 14 days’ probation in hopes you’ll change your mind. Check the status of your quitting and Facebook takes it as a change of mind and resets the clock.

I don’t know if the real Zuckerberg posted nasty stuff about his girlfriend at college as the movie shows. But the way Facebook operates now it sure seems to come from a mind that would do such a thing.

This fun experience led me to wonder why something as clearly deceptive and annoying as Facebook has been embraced so widely which of course led to a rant. Rather than make this post even longer, I dumped the rant into a comment. Your choice to go there or not; no warranty available.

I heard an interview on Fresh Air with Tony Judt, a British and American historian, or, as he preferred to call himself, a teacher of history. Judt’s interview with Terry Gross starts with his battle with ALS, which consumed the last two years of his life. As compelling as that story is, it was his description of his last book, dictated during his medical travails, that riveted me.

Ill Fares the Land is a summing up of the lessons Judt learned from his lifetime of studying and analyzing the 20th century.

Short and to the point, the book is a brutally honest description of our world today: what we’ve we’ve surrendered as a society and who we’ve surrendered to.

Given the hellacious election season now underway in sad and mad America, what Judt says about politics and politicians pierced like a honed dagger.

Below is an excerpt describing our current crop of “leaders” that really caught me.

Ill Fares The Land

By Tony Judt
pg 133-135

The men and women who dominate western politics today are overwhelmingly products or, in the case of Nicolas Sarkozy, byproducts of the ’60s. Bill and Hillary Clinton, Tony Blair and Gordon Brown are all ‘baby boomers’. So are Anders Fogh Rasmussen, the ‘liberal’ prime minister of Denmark; Segolene Royal and Martine Aubry, the bickering challengers for leadership of France’s anemic Socialist Party and Herman Van Rompuy, the worthy but underwhelming new President of the European Union.

This cohort of politicians have in common the enthusiasm that they fail to inspire in the electors of their respective countries. They do not seem to believe very firmly in any coherent set of principles or policies; and though none of them-with the possible exception of Blair-is as execrated as former president George W. Bush (another baby boomer), they form a striking contrast to the statesmen of the World War II generation. They convey neither conviction nor authority.

Beneficiaries of the welfare states whose institutions they call into question, they are all Thatcher’s children: politicians who have overseen a retreat from the ambitions of their predecessors. Few—once again, with the exception of Bush and Blair–could be said actively to have betrayed the democratic trust placed in them. But if there is a generation of public men and women who share responsibility for our collective suspicion of politics and politicians, they are its true representatives. Convinced that there is little they can do, they do little. The best that might be said of them, as so often of the baby boom generation, is that they stand for nothing in particular: politicians-lite.

No longer trusting in such persons, we lose faith not just in parliamentarians and congressmen, but in Parliament and Congress themselves. The popular instinct at such moments is either to ‘throw the rascals out’ or else leave them to do their worst. Neither of these responses bodes well: we don’t know how to throw them out and we can no longer afford to let them do their worst. A third response-’overthrow the system!’-is discredited by its inherent inanity: which bits of which system and in favor of which systemic substitute? In any case, who will do the overthrowing? We no longer have political movements. While thousands of us may come together for a rally or march, we are bound together on such occasions by a single shared interest. Any effort to convert such interests into collective goals is usually undermined by the fragmented individualism of our concerns.

Laudable goals-fighting climate change, opposing war, advocating public healthcare or penalizing bankers-are united by nothing more than the expression of emotion. In our political as in our economic lives, we have become consumers: choosing from a broad gamut of competing objectives, we find it hard to imagine ways or reasons to combine these into a coherent whole. We must do better than this.

[Emphasis added.]

It is a pity that so many who see the world through clearly wait until their life is at its end to send their observations out into the world.

If you are, have been, or may become a Rod Serling fan, you’ll understand how I came to write this poem a few years ago while staring out the window on a long flight.

Descent

by Ed Brownson

Through acrylic
I expect to see Rod Serling sitting on wing
Legs crossed, flashing that famous half smile
A tray table in front of him fastened to nothing
Holds his ancient Underwood, the sort with
Circular keys in bleacher rows and the “W”
Improbably missing. Lack of a “W” is no
Impediment for Rod: his forefingers push
Letters onto a sheet of paper carefully
Avoiding the bare metal lurking between
The “Q” and the “E”.

Once in a while
He leans back for a frown or forward
Into a thought and I worry he’s conjuring the deep
Or bringing us down on some crepuscular
Island where deception holds court and Rod has
A lock on the rules because – no question here –
He wrote them. Then turbulence, and all of us
Who chose window over aisle press eyeballs
To plastic thinking angels or speed bumps or
Aliens at least but Rod just flashes the rest of his
Smile and shrugs.

Now the Underwood
Transforms into a flight recorder box – how in hell
Do I know what that thing is? – and unflappable
Rod starts tearing it apart. I bang on the window
Loudly objecting: dismantling a recorder while sky
Diving doesn’t seem very wise. Next, no warning
We’re inside a cloud and Rod and the tray table
And the box disappear along with the wing
As if we’d snapped tight those cheap shutters
That cover the windows. Long seconds pass by
Before we break back into blue.

Rod’s gone!
No sign of his seat on the wing, no tray, no
Recorder even the Underwood’s not to be found.
Panicked I crawl over the guy snoring next to me
Sprawl across a couple in the seats beyond the aisle
Hoping he’s only switched wings, but Rod’s not there
And I have to think hard about where else I can
Look ‘cause I really need to ask him how to write
A story with no “W’s” and while I’m at it find out
Why his skinny black necktie never once
Blew out in the wind.

END

I’ve published Descent with a Creative Commons license.
You can print the poem but you can’t rewrite it and  you can’t publish it without contacting me.

xkcd.com

Wrong spot?

Of course I had to investigate. Turns out the “spot” is the gastroesophageal junction, and if that term doesn’t ring a bell, the spot itself’s likely crossed your mind when you were gagging on something or trying desperately not to puke. The junction’s where your throat meets your stomach, and like all junctions, traffic there can get pretty messy. The esophagus is one area of the body where some say God made a design mistake.

For this endoscopy I saw the best of the best gastroenterologists, a man with a stellar reputation and the only one willing to take on the difficult stuff. He was direct and confident and I liked him instantly. Memo to world, ”direct” does not equal “rude”, and as to confident, maybe you want a hesitant and humble doc poking around your innards but not me. During our pre-procedure visit he told me he wouldn’t know what was possible to fix until he took a look inside and when he did, he managed to fix the unfixable and for the first time in years I have no signs of leaks. Amazing, that.

Which got me thinking about duct-taped radiator hoses, exhaust pipes kept from dragging asphalt by coat hangers and all the other kludges we did when I was a teenager to keep our $500 cars on the road. Tape it, tear it apart, put it back together and don’t fret the leftover parts then see if it goes: that was how it was done. I learned how to pop the engine from a VW with a spare tire and one wrench, how to set timing with a wire and a cannibalized tail light bulb and how to disconnect antique smog devices called “gulp valves” which produced more smog than they prevented when they malfunctioned which was all the time. All this in the name of going a few more miles, lasting six more months in Southern California’s car culture, and yes, in total ignorance of the environmental costs.

Which seems to me exactly what the docs are doing these days with my body. One more layer of medical duct tape in my throat and I’m good to go again – for a while. Then comes  time to disassemble some organ or maybe top up leaky fluid levels. A blood test here, a scan there, and we wait to see what fails next. All in the name of  lasting six more months, traveling a few more miles on this wonderful, demented carnival ride we call life.

Strange, this path.

I should write something witty now about knowing when to junk a clunker, but that’s the spot where this ramble falls apart.