Friday, April 16, 2010


Abraham Maslow always sneaks into my head at times like these.

He inevitably enters when I am sitting among a dozen or so people who are gathered in a circle. We are in a high-ceilinged room, perched atop blonde wooden floors, drenched in natural light. Just outside the huge windows is a field that sports a single stunning oak tree. It’s CEU time and we are learning about the Mind-Body connection, how we, our patients, the human race, can control the body by harnessing the power of the mind.

We are all white, employed, our employers are paying for this, and we are just about to eat a big healthy lunch. This is where I get stuck. This is when Abe comes knocking on my grey matter and whispers: “Hey smarty pants, ask this guy from California how your patients are going to get the biofeedback thing when their O2 SAT is 84, when the rent is due, when they are worried about their grandchildren who can’t go outside for fear of getting shot? Ask him that, go ahead.”

“Excuse me, I have a question about all of this.”

It turns out the presenter actually had done his doctoral thesis on Maslow, and has a pretty good explanation. He does not deny the hierarchy of needs, but he does leave room for people’s ability to leap from lower rungs to higher rungs, skipping the intermediate ones. His exact explanation is a bit mysterious. But he is from California. It reminds me of my Physiology professor’s explanation of renal function to a roomful of blank-faced freshman nursing students. She finally said in an exasperating puff, “Well, let’s just say, if you were half as smart as one of your kidneys, you girls would probably pass this course.”

On the third day, the California Buddhist/Scientist (who nonchalantly threw around words like hypothalamic-pituitary-adrenal axis as if he were explaining how to make tuna salad) lands on the subject of dealing with depression.

“Sometimes, you just have to be with it,” he says, his face placid and understanding.

This time Abe bursts through the double doors into my head as if were trying to stop me from killing myself. An old black woman, whose hands look like the gnarled winter vestiges of a climbing vine, quietly follows him. She shuffles in holding her walker, her head wrapped in a purple scarf. I recognize her immediately. It’s Myrtle Tucker.

I visited Myrtle a few years ago to fill her medication boxes with a myriad of colorful tablets and capsules. I’ll never forget those hands. Every joint that articulated in Myrtle’s body hurt. She was at least ninety years old, if I remember correctly, but she cackled and laughed as if an invisible prankster were tickling her incessantly.

“Does the medicine work for the pain?” I asked dutifully.

“It works a little bit, hardly worth talkin’ about,” she said.

“How do live with it?”

“Oh child, you got to make friends with Mr. Arthur Itis,” she said seriously.

As our mind/body, amygdale explaining, California presenter continued, he clarified what he meant by his words “be with it.” As he did, Myrtle shuffled up to Mr. Maslow, whose veins were pulsing in his temples, and whispered into his ear.

“Oh baby, you got to calm down, ‘cause all that worrying is going to kill you,” she said.

Then she laughed.

Friday, March 26, 2010


She is rail thin.

A coffee-colored woman in her seventies.

She sits amidst scatterings of mail and newspapers, bottles of pills, and a few glucometers that are piled on her kitchen table. Her husband, the owner of the evidence of this illness, sits quietly, removed, unshaven, a shadow of himself. I did not know him when he worked 100 hours a week. Now she is the caregiver, and she slumps a bit in her chair, looking exhausted. Her grandchildren, quadruplets, will be arriving soon. It doesn’t take a genius to understand the mix of joy and apprehension that shows in her eyes. The television, bolted high up on the wall, drones with a dull background noise.

I’m not sure how I came to know the following information. My guess is that it was after an exchange like this:

“Are you married?” she may have asked.


“Any children?”

“Yes, three. Two boys and a girl.”

“Good number.”

How many do you have?”

“Ten. Nine now. My Jimmy died when he was eighteen.”

“Oh, I’m so sorry.”

“He was murdered, not far from here. Shot.”

Awkward silence.

“That’s so awful. How did you carry on after that?”

“Well,” she says matter-of-factly, “I had nine more at home. What was I going to do? I had to carry on.”

She opens up a little note book and shows me her findings - all her husband’s blood sugars, blood pressures, weights, and the amount of insulin he has received, all neatly recorded in an elegant script.


It is a terribly hot and humid day, an unmistakable urban closeness that makes everything stick.

Marcus is stretched out on the white sheets, uncovered. He looks polished, shining like a piece of highly worked ebony. He wears only crisp white boxer shorts. His skinny legs are withered. His arms are stick-like and contracted. His eyes are wide open, white discs staring awkwardly up and back at the wall behind him. Or at nothing. It is impossible to know.

Marcus is in is thirties now. Ten years ago he was in an accident. The type of accident is irrelevant here, really. What’s relevant is the pristine condition of this handsome young man’s skin, the place he occupies in the house’s dining room, the only room in the small house that could accommodate all the trappings of his fate. The neatness and orderliness of his surroundings all speak of an unyielding dedication and respect. This young man has been cared for so tenderly and meticulously that love and tenderness emanate from him like warmth from a fire.

His mother, a woman who long ago should have retired to enjoy the fruits of her lifetime of labor, walks around the bed calmly. She adjusts Marcus’s legs, the pillow between his knees, the lamb’s wool protectors on his heels.

“You know,” I say, “I have to tell you that I really admire what you are doing here.”

She looks at me with a little smile, one of appreciation and puzzlement at once.

“Well, he’s my boy isn’t he? Of course I am going to take care of him. What else could I do?”

It seems so simple to her.

But I know it is hardly that.

Wednesday, February 10, 2010


Pearl lived on the fourth floor.

She was just one character among a stack of characters piled atop one another like theatrical cordwood. They were far more interesting than their medical diagnoses.

Frankie Bustamonte’s “dolls,” which leapt into life when you opened his door (James Brown, Rodney Dangerfield, Dean Martin), were infinitely more entertaining than his ulcers that wept like Italian fountains. Angel Martinez’s kitchen chair, which exploded in a cloud of nesting roaches when I knocked it over, was far more heart stopping than his diabetes. The little “casitas” that Jorge Pimental built, shrines to the Blessed Mother wired with blinking lights, far outshone the troubles he had managing his cardiac medications. And the three-story speakers that Julian Johnson had hooked up to his TV (I always arranged my visits around Soul Train) rattled my gut much more dramatically that Julian’s super-pubic catheter ever did.

But I remember Pearl more for her stories, and for that one sentence she said to me one day. And maybe for her wigs. They were fabulous.

I was dressing the wounds to her right foot. The apartment smelled of cake baking in the oven. This foot was very important to Pearl, because, well, because it was the only one she had. The other had been unceremoniously sawed off a number of years ago. A fine scar ran from in between her toes and along the top of her foot.

“How’d you get that Pearl,” I asked, as I began to wrap her foot in white gauze.

“Oh baby, that happened a long time ago, but I’ll never forget it as long as I live,” Pearl said, leaning back in her chair.

“My brother was chopping wood and he went inside for something. When he walked past me he said, ‘Girl, don’t you go touching that axe.’”

“Now that was all he had to say to me, because then that axe was the onliest thing I could see in the whole yard. So I went up to it, took a big swing like I seen him doin’, and put that thing right into my foot.”

Pearl laughed a big hearty laugh and looked at me to make sure I was engaged.

“Well then my father, who knew a lot about healin’ things, took me on down to the river, washed it out, covered it in clay, and then wrapped it in some cloth. Look at how beautiful it healed. Ain’t that something.’”

As I was packing up my bag, Pearl went into the kitchen and came back with a big cake wrapped in aluminum foil.

“Take this with you now.”

We danced around for a second with the “No, I couldn’t,” and the “Yes, I want you to,” and the “I shouldn’t,” and then she sealed the deal with the sentence.

“Now girl you got to take this cake because the cake I make is so good it’ll make you want to slap yo mamma.”

I began to laugh as she put the big cake into my hands.

“Slap your mamma?” I said, practically choking on the words, “What’s that mean?”

“It’s just something we say,” Pearl said. “It means it’s real good.”

The cake was warm in my hands, and the smell rose into my face like wonderful memory.

It was fabulous.

If you don’t believe me...

Wednesday, January 27, 2010


I met him twenty-six years ago.

Josiah Eldredge lived by himself in a shingled house that was built when James Monroe was President of the United States. When Josiah himself was born in this very same house, William McKinley defeated Williams Jennings Bryant and moved into the White House, pushing Grover Cleveland out into the January cold.

Josie, as everyone called him, used to fish for a living. As a very young man he walked the beaches as one of the early “surf men” of the U.S. Coast Guard, walking from station to station in foul weather on the lookout for ships grounded on the shoals.

When I entered his kitchen I could see that Josie was riding the outgoing tide. He was ninety-something now, and was dressed in his signature matching khaki pants and shirt. People said they never saw him wearing anything else. There were pens and pencils his pocket, a white t-shirt showed in the V of his open shirt, and a cluster of keys hung from his belt. His grey hair stood up in a short military crew cut.

His kitchen was more like a shop. His table more like a workbench, complete with a vice bolted to one end. There were jars of nails and screws next to the pepper and salt. Tide charts, a picture of him holding a fifty-pound bass, and another of his fishing boat, the “Vineyard Belle,” covered the walls. The clock was set into a lighthouse. It rang ship’s time.

“After my wife died in sixty-seven,” he said, his voiced tailing off, “Well, lets just say I’m not baking pies in here like she used to.”

Josie was dying. He didn’t know from what. No one did.

“Jesus, what difference does it make?” Josie said, shuffling around the kitchen, “I’m going to shit myself to death, that’s all I know. You want some tea?”

He was thin, ashen, and looked as worn down as a man can look.

Josie had said “no” to all tests and treatments. He didn’t seem at all frightened by the prospect. The prospect, of course, was death, and Josie didn’t dance around that word like many of us do.

We talked about tackling the problem of the diarrhea, and I agreed to bring him some adult diapers that we had in the office. He wasn’t happy about that idea, but he knew the alternative. He had a bucket of soiled clothing and sheets in the bathroom.

“Bring ‘em over,” was all he said.

He spoke like a captain who just got word that his big marine diesel engine was blown and needed replacing. It was equipment that he couldn’t afford to buy. However, it was also equipment that he couldn’t afford not to buy. A captain needed an engine to get to the fish. A captain needed fish to pay the bills.


Yankee logic.

In the middle of my visit, somewhere between taking Josie’s blood pressure, calling the doctor, and looking at his swollen legs, he reached into his back pocket and pulled out a small coil of dark string. He held it out, reaching across the distance between us.

“Here, take this,” he said, “It’s twine for mending nets. I always keep some in my stern pocket. Comes in mighty handy.”

He placed it in my hand. At once I noted its smoky odor, like pine tar soap. The twine was coated and smooth, like candlewick, and had a chocolate color. It seemed to possess an inherent strength.

It was such a touching offering. Perhaps Josie did not have the skills to speak gracefully about his feelings. I can imagine Josie did not travel in Jungian circles. I assume he was not in touch with his inner child. A teary-eyed “thank you” was probably as far from Josie’s repertoire as the sun is from the earth.

Net mending twine was Josie’s simple offering. I have kept it on my desk for all these years, and it still speaks to me as powerfully as any eloquent, perfectly put together bouquet of words ever could.

Tuesday, January 19, 2010


The doorman took my keys. The concierge asked me to sign in. She called up to the tenth floor condominium and then guided me to the elevator. Everything gleamed. A black Jamaican woman answered the door and led me down a long hallway, through a heavily decorated living room, a dining room, and then into the bedroom. The woman I had come to visit was in bed, buried under mounds of down and 800 count cotton sheets. She wore tailored stylish pajamas that probably cost more than my first car. Her skin was polished, more pink than white.

I mention her only as a point of reference. The patient I saw next was the one who really made me stop and think. The woman with the silk pajamas was as sick as anyone I have seen. But if it was discovered that eating caviar could cure her cancer, this woman could have had cases delivered in an hour, and her personal attendant could scoop it out with a silver teaspoon.

Marie Jean Baptiste, on the other hand, came out from her bedroom dressed in a loose fitting stained dress. She was a stocky Haitian woman who avoided eye contact, only stealing furtive glances at me when I asked her questions. She was a diabetic, her sugar out of control, and the doctor had adjusted her medications. The apartment was stark, naked, and all around us were stacks of boxes. Her daughter was sprawled on a couch in the next room, and four or five small children kept popping out of the bedrooms, dancing and laughing.

“It’s a mess in here, I know,” said her daughter, her eyes closed, “They just got finished spraying the apartment for bugs. We had to move out for a couple of days. We’re trying to put it back together, but I’m sick too, diabetes like my mother, I can’t see.”

I checked Marie’s blood sugar – over three hundred.

I asked her what she had for breakfast this morning.

She answered in a heavy Creole accent, covering her eyes with a leathery hand as she spoke.

“Bread, coffee, spaghetti.”

I began my spiel.

“Carbohydrates are like sugar,” blah, blah, “You should eat more fresh vegetables,” blah, blah, “Buy chicken without the skin,” blah, blah.

Then it struck me as I was talking. This woman, and the entire family that was stuffed into this freshly fumigated apartment, probably could not afford to buy fresh vegetables and skinless chicken. The closest supermarket was a Whole Foods supermarket. Closer, there were two convenience stores, a Chinese fast food take out, and a pizza joint.

I stopped talking and watched Marie wipe her wrinkled hand over her face. She looked drawn, defeated. He daughter was reclining now on the couch, a pillow over her head. A smiling two-year old came running out of a bedroom, stopped in front of me, giggled, and then ran away. I noticed the huge cereal boxes on top of the refrigerator.

Back in the downtown condo the woman in the silk pajamas might have been eating a chicken salad sandwich on thinly sliced white bread. The crusts would have been cut off.

Wednesday, January 13, 2010


People might call it installation art, something like Christo wrapping the Reichstag in cloth.

Making the piece would first involve creating a colossal detrital mountain of newspaper, mail, plastic, shoes, forks, car parts, and then letting it sit and settle for thirty years. Maybe you would have to compress it somehow, water it, and turn it into a solid sedimentary mass. Then you would tunnel through it like a West Virginia coal miner, creating tiny caverns as you went, connecting them with a maze of narrow arteries. Your shoulders would brush the walls as you wandered through, and as you looked right and left, the stratified walls would tell a story, like growth rings of a downed oak, or the walls of the Grand Canyon.

Or you could visit Ralph Bennett at 5 Maynard Street. Lucky for me, I had official business. You’d need official business. I’ll bet not too many people except Ralph have been in here for thirty years. No one else could fit.

When the door opened, there was Ralph, bent sharply from the waist, dressed in layers of frayed sweatshirts and sweatpants. In his right hand he held a rough walking stick. His left hand was held out to steady himself against the wall.

The wall.

My eyes were drawn past Ralph down into a hallway, a tunnel really, that ended in darkness not to far away. All I could see behind Ralph see were layers of “junk” (debatable) piled from floor to ceiling. A narrow footpath cut neatly through it all, as if the walls had been sliced with a huge knife. I thought of lasagna.

“Come on in,” Ralph said, as he executed a shuffling turn within the confines of the tunnel. He walked toward the darkness and called back to me.

“Just close the door behind you,” he said, his both palms were held out now, brushing the walls, the cane hung from his wrist.

Then after a second he added, “Not much room in here.”

This he added, not apologetically, but more like a Park Ranger at Carlsbad Caverns. In retrospect I wonder if he was letting me know that my visit should be brief and to the point.

There was one anemic bulb hanging above us. It shed a buttery light, enough to make a cursory inspection of the strata. It was an amazing layering of newspaper, scrap metal, books, radios, mail, paint cans, boxes. They all fit together with a kind of precision, the rounded car alternator tucked perfectly against the concave shape of copper flashing, the cigar boxes of various shapes, all knit together like mosaics. When the tunnel turned to the left, and Ralph turned with it, the walls did not make hard angles, but rather bent softy like they might in a natural cave.

The only open space was the path through which we walked. Ever other literal cubic inch was filled with Ralph’s collected world. A trash compactor could not have done a better job

Ralph’s bed had been carved into a wall somewhere along the way. I say “along the way” because I had quickly lost any sense of being in a standard square roomed apartment. I could not say that Ralph’s bed was in a bedroom, or that it was next to the kitchen or across the hall from the bathroom, or that the walls were yellow or the floor was tiled. I now felt as if I was in a Grecian cave, and Ralph was some monk who had stumbled upon it and had taken refuge.

It was Ralph’s nest, however, with its few but eccentric touches, that put me entirely over the edge. The gently curving walls and their content might be dismissed as a display of some sort of pathology. But Ralph’s walls were not just flat expanses of sheetrock, they were three-dimensional masses of depth and character. The walls, however, are but a mere peek into Ralph Bennett’s mind.

For example…

A dozen or more guitars hung down from the ceiling, above and around the recessed niche that held Ralph’s narrow mattress. Some were half shattered. Some were fairly exploded, pounded into the floorboards by some deranged rocker. Most had the varnish worn off. More than a few were painted red and orange. The entire guitar curtain somehow made me think of those plastic beaded ones. But Ralph is not the beaded curtain type of guy.

“I used to repair ‘em,” Ralph told me, “but I can’t get to it like I used to do. It was the only thing I really enjoyed doin’ back then.” He became very quiet.

I never did find out much more about Ralph. I wanted to know about the things Ralph did “back then,” what makes him tick now, how did this masterpiece come to happen. But that wasn’t to be.

I had no sooner put the last piece of tape on Ralph’s stomach than he swung his feet down from the mattress and grabbed his cane.

“You go ahead,” he told me, pointing with the tip of his cane.

On my way out I noticed a few more alternators, a number of computer keyboards, an eight-track player, phonebooks and a George Foreman grill. The thousands of pieces of paper, the mail, the odd piece of cloth, wove through it all, binding it like mortar.

When I opened the door onto Maynard Street the light struck me like some sort of atomic flash. The visual expanse seemed incredibly open and endless compared to Ralph’s tight cavern.

When I turned back, Ralph was folded over in that arthritic jackknifed posture, looking at the ground. He had one hand on the doorknob and the other on his stick.

“Thank you,” he said, and then he closed the door.

Tuesday, January 5, 2010


Marilyn was being interviewed by a transvestite.

In the video they sat across a small cocktail table from one another in So-Ho. The interviewer was long and gorgeous, perfectly prepared, the kind of woman that would turn a man’s head, the kind of woman that a man might indeed take home, only to find out the ultimate unalterable truth.

Marilyn was dressed in her signature attire – ridiculous flipped blonde wig, six-inch long eyelashes, makeup that seemed to have been painted on with a two-inch sash brush, a number of rings the size of baseballs. Her ample 80 year-old body was stuffed into a tight sequined gown, bulging and erupting like an over-yeasted mass of dough.

I am exaggerating, but not by much.

These were two generations of performers. The younger was oozing city sophistication and style. The elder was simply oozing, regaling the younger with tales of the outrageous, the indecent, the off color, and the barely repeatable moments in her career as a nightclub performer.

Marilyn gave me this video, along with a wonderful signed promotion photo of her dressed in all her glory. I was seeing her for a bothersome diabetic ulcer, visiting her in her fourth floor apartment that had not been cleaned since the Mets won the World Series. I gave up attempting to wash my hands at the kitchen sink after one visit. Racks of ridiculous gowns hung in an overstuffed closet. Her room was accessed by parting a heavy purple velvet curtain. That very gesture was a dramatic moment, like entering a chamber to visit the Queen. Boxes were stacked everywhere, like three- dimensional bar graphs surrounding a large rumpled bed.

In it reclined Marilyn, a bizarre Cleopatra, who without her costume and wig looked more like a large retired Jewish tailor you might see on the boardwalk in Rockaway. She never missed an opportunity to tell a story that was meant to shock and embarrass. The challenge, when in the presence of this ribald member of royalty, was to appear totally unfazed, as if her world were yours, as if she were talking of the quality of bagels.

This was indeed, a difficult task.

For example:

Case #1

“Oh girl,” she said as I washed her feet, “You should have seen the faces in the audience. It was absolutely marvelous. I remember it like it was yesterday. I had taken my panties and melted a bar of chocolate on them, then I pulled them out and…”

Case #2

“Girl, why don’t you get into bed with me. You know I give the best head in the City.”

Case #3

I parted the velvet curtain, announcing my presence. My supervisor, Kathleen Kelly, followed me. Kathy was a very attractive middle-aged Catholic woman whose mother probably had a first communion picture of Kathy on the wall of her apartment in Greenpoint. This would be the picture where Kathy, dressed in frilly white, had her hands folded piously at her breast. I had called Marilyn to let her know that my supervisor was accompanying me for a routine evaluation visit. Although this was a polite and necessary thing to do, I sensed potential danger.

I held the velvet curtain open for Kathy as I turned away from Marilyn, and at once I saw them both in my peripheral vision.

Marilyn, reclining amidst her hundreds of pillows and mountains of down, lifted an enormous, but otherwise very realistic dildo. The ridiculous plastic penis pointed skyward in an instant three-foot erection. Simultaneously I watched as Kathy’s eyes and mouth rounded like three huge O’s, taking over her face like three donuts on a flat plate.

“Welcome darling,” Marilyn said, her voice dripping with Hollywood drama, “Has D told you all about me?”

The rubber dildo bounced in the air between us, like a fishing pole with a nibble. Marilyn measured the reactions. I tried to stay as impassive as possible, but I shook my head in a gesture of wonder.

“Marilyn,” I simply said.

Kathleen Kelly, herself a wily veteran of this world behind the doors, also tried to remain implacable. But I knew that Marilyn had seen what I had seen in Kathy’s eyes. Marilyn had succeeded once again, if but for an instant, to peek into someone’s naked soul and see the unvarnished astonishment, disgust, embarrassment that lies within us all.

I admired her for that.

I changed the dressing and Marilyn put down the dildo.