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Oct 29 12

Reshuffle

by kbanas

I used to be a writer. It’s a vague, kind of nebulous thing – to talk about writing, to talk about being a writer. Is there a word count for this club? A quota? A certain number of essays published, in a certain number of reputable journals? I don’t know about all that. When I talk of it, when I use that word, writer – it is a self-identification – a feeling, a yearning. I majored in English. I took courses in creative writing. I had stacks of notebooks and journals and I wrote short stories and essays and blog posts. In the most simple terms, I was a writer because I wrote.

I wrote a lot.

But then, awhile ago, I stopped.

For a bunch of reasons, really. I had to fix the dishwasher. I had to mow the lawn. I had to get a job. I had to be a step-dad. I had to wash my car. There is a list of reasons as long as my arm. And in that time, when I would sparingly pick up a pen with literary intent – maybe once every 6 months or so – I still fancied myself a writer – just a writer in waiting. I was waiting for some deus ex machina that would start the process for me. I pretended that I was seeing the world – that I was in a contemplative phase – that I was marinating in the juices of life, soaking up stories, so that I could be a better, more polished writer on the other side. I pretended that therapy would break open some dam of words that I had corked up inside, and, that, in time, at some unspecified future date, I would break open like an over-ripe fruit – and in the mean time, why bother?

All of these things are lies. All of these things are awful self-deception.

Listen.

The internet tells me that Michael Kanin once said, “I don’t like to write, but I love to have written.” The internet also tells me that Michael Kanin was a playwright and screenwriter, but I confess, I did not know this – I did not know him. I just like the quote. I feel the hard edge of its truth.

I made excuses for why I did not write, but here is the truth – the only real truth – I stopped because I don’t like to write, either, Michael. I feel you.

For me, the act of writing is a commitment to painstaking work. In my youth I entertained this romantic notion of Jack Kerouac, sitting down with a long roll of parchment and pounding out On the Road in one long, manic session; the book spilling from his head, fully formed and perfect. This is a dangerous notion. This is a notion that should be locked up. We should throw away the key on this fantasy. I can count on one hand the number of times I’ve plunked down with pen and paper and had the words just gush out of me in perfect rhythm. No. I write slowly. Laboriously. At a plodding, constant, forward pace. Writing is like working with hammer and chisel.

For me, the act of writing is to be laid low. The next time you go to Barnes & Noble or Amazon.com, look around you. Take in the thousands of books. The thousands of stories. The thousands of talented writers and editors and contributors. To put words down on paper and proffer them up for other people to read, even in the context of some backwater blog, is to dip a toe into this pantheon of talent, and feel you are left wanting. The world is full of amazing, talented, incredible wordsmiths, and I am not one, cannot be one. The act of writing makes me feel like I am no good, that I should give up, that I should go fly a kite, that I should run, run screaming, from the weight of expectation and validation.

For me, the act of writing is hard, it is uncomfortable. Think Gandalf and the Dwarves of Moria. He said that they had “delved too greedily and too deep” – and writing, often, is like that. It involves plumbing the depths, it involves critical introspection, it involves self-evaluation, it involves paths not taken. For those of us who live imperfect lives, lives with foundations that shift and creak, this is trying work.

All in all, it’s a shitty deal. So, no, I don’t like to write. It is hard, and I do not like it. I don’t like having a root canal. I don’t like having my fingernails pulled out with rusty pliers. And if that were it, if that were all – I could shrug my shoulders and go to work every day and get on with my life.

But it’s not – because I love to have written.

One of my all-time favorite TV shows is Aaron Sorkin’s The West Wing. If you’ve never seen it, first of all, totally shame on you, but secondly and perhaps more importantly this will not make a huge amount of sense, I fear. I’m sorry about that. Roll with it.

Toby Zeigler and Sam Seaborn are like Batman and Robin – they’re President Bartlett’s speech-writing duo, and they own it. These guys, these speech writers, they’re like language-samurai. They stand in the tall grass and balance a drop of rain on the edge of a katana sword or whatever the fuck, except with words. They are revered. They craft sentences that move mountains.

But Sam Seaborn is moving on, mostly because Rob Lowe wanted to go do something else with his career like guest star on Parks and Recreation or be on Dr. Vegas or whatever – and he’s replaced by Joshua Malina playing a guy by the name of Will Bailey. He’s the new speechwriter. And there’s this great scene where Will Bailey introduces himself to Toby, and hands him a note from Sam, and the note says, simply, “Toby – He’s one of us.” At least, I think that’s what it says. I tried to look it up on YouTube just now, but it is categorically impossible to go on YouTube and look up a scene from The West Wing. If you try, you will instead spend (at very minimum) an hour watching random clips from The West Wing on YouTube. It will be an entertaining hour, but still.

Toby – He’s one of us.

I love that scene. That scene gives me goosebumps, every single time I watch it.

And if you’re wondering what I’m on about, it’s just this – I love to have written. When I write, back when I would write – I would step back and read the thing that I had worked out, I be filled with a kind of awe. Not because it was incredible, not even because it was good – but because I had done it. I had created something. I had given birth to my voice, and something felt innately right about that.

The product justifies the process. The product incites me to start all over again. The product makes me feel, deep down in my bones, that this is my calling, that this is my vocation.

The product makes me want to say:

I can do this, and I am one of you!

I am one of you.

Every day, you make a choice. You either do something hard or you do something easy. I am tired of doing the easy thing. I have had enough of it. I have had enough minding my excuses, feeling jealousy and bitterness as writers, people I know, people who have come up with me through those same college classes and awkward first attempts at craft, those people do good – really good, really great things with their words.

Enough.

It is time for a new paradigm. I am one of you. I am one of you, and the easy path no more.

It starts like this:

1 hour. 60 minutes. Every day. In the morning. At night. At my desk. On the couch. On my laptop. In a notebook. With a pen. With a pad. For 60 minutes every day, I will write. I will not check Twitter. I will not check Twitter. I will not check Twitter.

I tell myself that these minutes are immutable, but we are but men, right? Sometimes, often, I don’t want to do it. I thrash and wail and buck in my harness. If it’s too early, or of it’s too late, or if I’m sleepy, or of I’m over-stimulated, or if there’s a basketball game on, or if I have to do the dishes, or if I’ve had a beer. Sometimes, I fall down and I check Twitter. Sometimes, instead of an hour, I manage 45 minutes. Sometimes, once in awhile, I give myself a pass to watch TV or play a videogame or read a book.

On these occasions, when I fall short, the next day I start again.

You walk around, thinking your thoughts, and sometimes something will come to you, and you will reflect, and you will say to yourself, “Yeah, I could write something about that.” For years and years, I have had this thought, and I have squirreled away those ideas like precious treasure, and thought, “Some day, some day.”

In 60 minutes, I have started putting those little zygotes of idea to work. And it goes fast and it goes slow – mostly slow, but it goes. And it is hard and it is easy – mostly hard, but it goes. And that is the entire difference between being a writer and not being a writer. That is the entire difference between bitterness and exultation. The entire difference between thinking, “Hey, I should write about that,” and staring down at a finished piece of craft.

There is no special incantation. There is no trick. There is no end-around the tough stuff. Everyone else – they don’t know about some secret Dumbo’s feather.

They are just travelers on the hard path.

From here on out, I am going to join them.

I am going to write.

Oct 12 12

The Advantages of Anxiety

by kbanas

My mom once tried to sell me on the advantages of anxiety. She did this by telling a story.

“You know,” she said, “back, thousands of years ago, the anxious ones were the ones who lived. They were always on the look out for tigers or snakes or lions or whatever deadly shit was on hand. They were always alert. They were always on edge. They were always worried.”

“The complacent people? The chill people? They got swallowed up, right off the bat. They would fall asleep in some tall grass and wake up and it was chow time for the Sabertooth. Not us. People like you, people like me, people who deal with anxiety all the time, we’re not so bad off. We’re engineered for survival.”

That was her story, and if I was roaming the Great Plains with my clan of hunters and gatherers, I would probably feel pretty good about being on the leading edge of the survivability curve. Alas, I remain dubious. I think the utility of anxiety has waned over the last few centuries.

For better or worse, anxiety has been my constant companion in life. It sits in the gut (always the gut) waiting for even the most innocuous of social situations to boldly assert itself. It can cause my body to sweat gallons, my stomach to roil, my chest to tighten, my brain to fog and seize. Anxiety compels me to flee. Anxiety compels me to avoid. Anxiety compels me to take the well-trodden road, and keep my eyes down.

In early 2005, I had landed my first job out of college and I had good, solid medical insurance and I had options, and I decided that dealing with my anxiety could mean more than just dealing with my anxiety. I don’t remember the catalyst – or if there even was a catalyst. Maybe the cumulative weight of social acceptance for mental health treatment finally penetrated my numb skull. Shrink stopped being a dirty word. My mom had a therapist. My sister had a therapist. I had friends who took pills to manage anxiety and depression and more.

Because I didn’t know any better, I made an appointment at a place I would later describe as being a mental health puppy mill. It was a large, nondescript building nestled a good distance off campus, with some sort of affiliation with University of Michigan Health System. I tried to look it up on Google as I was writing this only to find that it apparently no longer exists. It had a vaguely unsettling name, like “University Psychiatric Services.”

My recollection is that I filled out some forms, talked to a nurse, talked to a psychiatrist, and left about an hour later with a prescription for a powerful psychiatric drug and a cache of refills.

That drug was a selective serotonin reuptake inhibitor – an antidepresseant – called Celexa, and the next day I started taking it in a 20 milligram dose.

That was 7 years ago, give or take, and through all that time, I’ve continued to take medication to manage my anxiety. Of course, I wizened up a little bit. I kicked the Psychiatric Services Center to the curb and got a proper psychiatrist. I started to see a psychologist twice a week. I talked about my feelings. Working with both of them, I changed my medication, monitored it, and changed it again. And again. And again. I tried Prozac. I tried Wellbutrin. There were others – Lexapro, I think, and a few more. In the end, in 2007, we settled on Cymbalta and I’ve been taking it ever since.

I got to a point recently, though, where I started to ask myself certain questions with increasing and irritating frequency. The first question was, “Do I still need to take these pills every morning?” The second question was, “Why did I start taking these in the first place?” I guess it’s really par for the course. After all, we do a pretty good job of remembering things that have happened, but we do a less good job of remembering emotion. I mean, you might remember that something made you mad or that something hurt, but it’s a sort of abstract, blunted thing. We have a harder time connecting directly with the emotion itself. When I ask myself, “What did I feel like 7 or 8 years ago? What was was that anxiety I was running away from? What did it feel like?” That’s a hard question to answer. I still feel anxiety today. I feel anxious all the time. I run a whole cottage industry on anxious. It’s not like a series of long talks and a tumbler of pills have stripped that away. How is that anxiety different from how I felt way back then? How is it the same? How have I changed?

I was paying $45 a month in insurance co-pays and I was waking up every morning and going to the sink and taking some pills, but I could not – could not – answer the questions I kept asking, and although I carried on for awhile on the sheer momentum of routine, that started to drag on me in a major way.

So I came up with a plan.

I had a good job. I had a good marriage. I had good health insurance. I was in good health. I had solid fundamentals, in other words, and so I decided to stop taking my medicine. I decided to stop taking it in a controlled, reasonable way – in careful union with my psychiatrist and my psychologist and my doctor. I would stop taking this medicine, slowly and surely, and I would establish a new baseline, and I would see. To my mind, there were two possible outcomes to this venture. On the one hand, the experience might clearly remind me why I started taking medication for anxiety in the first place. On the other hand, maybe I would find that with the help of therapy and time and personal growth that I was OK – that I was in a place where I could have the same quality of life without pills.

Here is a little lesson if you are uninitiated to the world of psychiatry. You do not fuck around with brain chemistry. You don’t wake up one morning and flush your stash down the toilet. You don’t dose your brain daily the same way you throw back some ibuprofen. Small movies, Ellie. You work your way on and off a medication in small, incremental steps. You come at it with a plan.

I learned this the hard way the first time I missed a dosage of Cymbalta. I was careless. I meant to go to the pharmacy. I meant to call my psychiatrist and settle up. I meant to do these things, but I didn’t, and then next thing I knew I woke up one morning, walked to the sink, and found the orange, plastic prescription bottle empty. While I called and left voice-mails and made appointments and tried to get an emergency resupply, I missed a day.

That was a bad day.

I was fine, really, perfectly fine, until 2 or 3 in the afternoon. Then I started to get moody. I started to get irritable and wound up. I started to feel manic and slightly off-kilter. We all have off days. We all have bad days. And it could have just been one of those, except soon after that I started to get the Brain Zaps. I didn’t know what to call them at the time. I just knew the sensation. Every time I would turn my head or try to focus my eyes on something, I felt little sparks of lightning jumping across my skull. Not painful, these little sparks – but uncomfortable, and definitely unsettling.It was only much later, when I started to do some research on my own, that I found out that this phenomenon is well-known to people who take Cymbalta. On some forums they’re called Brain Zaps. Or Brain Shivers. Or Brain Shocks. The instant I read those words, I knew implicitly what was being discussed.

I went to bed early that night, and the next morning I didn’t leave the house until I got my psychiatrist on the phone. She called in a refill. I explained what had happened when I missed my dosage the day before.

“That’s because Cymbalta has a really short half-life,” she said, by way of explanation. “Don’t let that happen.”

Noted.

That’s why you need a plan.

In early May, at the outset of this experiment, I was taking 90mg of Cymbalta (3 blue and green 30 mg pills), every morning with a long draw of water.

My psychiatrist suggested that I drop down to 60mg, sit at that plateau for 2 weeks, then drop down to 30mg for another 2 weeks, and then be done. 30 days to a drug-free baseline.

“We’ll see how it goes,” she said. “We’ll readjust as necessary.”

Noted.

That’s why you need a plan.

The next day, I took 2 pills instead of 3, and life more or less went on. I felt a little jittery, like I had had a couple extra cups of coffee, but I was otherwise functional. For two weeks, this went on, and I felt like I was on my way.

Two weeks later, in early June, I dropped to a single 30mg pill.

The first day went OK.

The second day, I lost my mind. It’s uncomfortable to write about, because, well, it’s my mind, and I lost it. I was, for a few days in early summer, vulnerable and lost, and that’s hard – to experience, to share, you name it. I’m sitting here, looking down at the keyboard, thinking I am OK. I am aNORMAL. I don’t have MENTAL BREAKS.

But I did. I really, really did.

I didn’t even make it as far as going to work the second day.

The Brain Zaps returned, furiously returned, before I even made it clean into the shower in the morning. As a prelude to bad times, it served as a good prognosticator. Shortly after, I fell into the thrall of manic mood swings. I started crying. I got angry. I got depressed. I felt confused. I was harried by the sensation I was strapped to a malfunctioning gimbal, a wonky suspension – every time I moved, the world seemed to lurch awkwardly after me.

I had no idea what to do. I called my psychiatrist, but she was unavailable. I left a voice mail. I started to think that if I kept myself busy, I could stay ahead of the thunderclouds forming in my head. I thrust myself outside, into the garden in the backyard. I grabbed up my broad-brimmed hat and my spade and a pad for my knees and I tried to immerse myself in what was in front of me. I didn’t know what else to do. The zenith of all this was a surreal attempt to go to Home Depot to buy mulch – a misadventure that turned into three hours of driving aimlessly down long country roads, feeling lost and despondent and broken and absolutely terrified.

I called my wife from a Taco Bell outside of Dundee.

“I don’t know what to do,” I said. “I don’t know what’s happening to me.”

“Come home,” she said. “Come home to me.”

And I did. I limped home, came into the house, and collapsed into a pile of sobbing that would not abate.

The next day started no better. My psychiatrist called me back, and through gritting teeth I reiterated my narrative.

“Yeah,” she said. “Sometimes that happens.”

“How long can this last?” I asked. “I mean, I have to get through it eventually, right?”

“It can last a couple of weeks,” she said.

She presented two options. One was to immediately give ground, and retreat back to 60mg. That made me uncomfortable, because I had already spent two days in a no-man’s land of batshit. I didn’t want to let go of those two days. If I gave up, if I went back, then two days of suffering were for nothing, and that was a difficult idea to grapple with.

Her other suggestion was that I could start taking a cocktail of Prozac and Cymbalta. Prozac could help off-set some of the side-effects of the Cymbalta, she said, and make coming down from the whole thing easier. This sounded fishy to me. It sounded, in fact, like some invasive species bullshit – like, you’ve got a problem with mice, so you buy a bucket full of snakes. And then you have a problem with snakes, so you buy a mongoose (or two). And then… well, on and on, until somewhere down the line you’re left with an infestation of Border Collies or something. Moredrugs somehow didn’t feel like a viable plan.

I did not want to go forward. I didn’t think I could go forward.

I did not want to go back.

And I was angry.

“Sometimes that happens?”

Sometimes that happens. Sometimes you lose your mind.

Oops.

When I was lying on the floor in the living room, clutching my knees to my chest and losing my mind, I kept repeating the same phrase. “No one told me. No one told me. No one told me.” It was my mantra of blame. When I left her office in early May, she gave me my marching orders and wished me good luck. We’ll see how it goes, she said, with nary another word, except to say thank you when she took my check.

Doctors of all stripes are eager to talk about all the good things that psychiatric medication can do, and they’re not lying – I believe, truly, that for millions and millions of people, these little pills make all the difference when it comes to living a normal, functional existence. But, in myexperience, with my doctors, I felt like it was a story told with rose-colored glasses. No one talked about the consequences, the dependency, the withdrawal – the raw stakes of mucking about with mind. And by the time I realized the danger, truly realized, I was a muddled mess.

It’s easy to project all that anger on everyone else, but let’s not kid ourselves – when it came right down to it, I was also plenty angry at me. I felt how my body and mind reacted as I transitioned between medications; how Celexa wound me up, how Prozac wound me down, how Wellbutrin made me break out in hives, how Celexa made me endlessly grind my teeth. I saw what happened after I missed a single dose of Cymbalta. I was there for those things. They happened to me, and each and every incident along the road should have been a giant, red, flashing, neon warning sign that I was playing a dangerous game. Instead, I was content to be glib about both the pills and the process.

Why? That’s a good question. Because I had a prescription. Because my doctors didn’t seem concerned. Because, for a long time, the medication felt like it was doing something, even if that thing was vague and shapeless and hard to quantify. Why does anyone ignore potential consequences for present results? Because we’re selfish and short-sighted.

In the end, I opted for retreat. The next morning I went back to my 60mg dosage. On that day, I decided I needed a new psychiatrist, and I through a recommendation, I got one. Together, we concocted a new plan. Slowly, surely, I would reduce my medication by 10mg every two weeks until all was done. With a bottle of 30mg pills and a bottle of 20mg pills, I played a sort of adding game. A 30 and a 30, a 30 and a 20, a 20 and a 20 – things didn’t start to get interesting until I dropped down to 10mg. This involved corking open a 20mg pill and trying to spill exactly half of its insides down the sink – something that is about as difficult as it sounds.

As simple arithmetic will tell you, my metered journey from 60 to 0 took 12 weeks. There was no crying or wild mood swings; no Brain Zaps or floating – I was copacetic. I was A-OK.

And then, one day in early September, I woke up, took a shower, shaved, brushed my teeth, and walked out of the bathroom without taking a pill. A little thing, but a big thing.

That was six weeks ago. It still feels weird, having dropped that part from my morning routine. I still feel flashes of panic. Oh no! I forgot my pill! And then I remember. I remember that I’m done.

In some ways, I feel like maybe I’m writing this too soon. To provide closure, to provide a satisfying narrative arc, I should be able to answer the questions I set out to answer. Do I still need to take these pills every morning? Why did I start taking these in the first place? What did I find at the end of the rainbow? The answers to all this is, honestly and truthfully and Hand to God, I don’t know. I’m decompressing. I’m gaining perspective. I’m mulling – but it’s just too soon.

From the hip, here and now, I feel like Cymbalta rounded the corners, if that makes any sense. Cymbalta turned the volume down. It took the sin wave of emotion and chopped off the top and the bottom, for better or worse, and here, on the other side, everything seems louder and more amplified. I cry more. I laugh more. I feel the tightening grip of anxiety in my chest, the sheen of sweat on my brow, and I grimace – but I smile, too, because it feels familiar. Something I lost. Something rediscovered.

I don’t know if that’s good or bad. I don’t know if I’m better or worse. Right now, I simply am. The journey down this path was eye-opening and frightening, but the journey is finished.

We’ll see what the destination is like. I haven’t been here long.

Oct 7 12

Vigo the Torturer

by kbanas

On Wednesday, when the alarm went off, I slowly unlimbered myself from bed and shambled into the bathroom. I took a piss – a fact that is in and of itself completely unexceptional. It’s the first thing I do most mornings. If I had been fully awake, or paying even the scantest amount of attention to the toilet bowl, I would have noticed the sickly brown color of my urine. Later, the doctor would explain – when you piss blood, this is what it looks like.

I made it a few steps out of the bathroom, bare feet on wood floor, when the pain started. It was uncomfortable and insistent, there, right there, on the left side of my abdomen. I ignored it. Part of growing up, of growing old, in my experience, is the barrage of indignities you must endure as you get up in the morning and your body gets right. There are creaks and cracks and pain that comes and goes, and it is all part of getting your motor running.

I walked down the hall, holding a hand to my side gingerly. My plan, my routine, was to shuffle into the office and check my e-mail and fuck around on the internet for a couple minutes, before I had to get into the shower and get ready for work. I figured the discomfort would abate.

I did not make it to the office.

Half-way down the hallway, the pain did not abate – it began to sharply increase. I grunted and doubled-over for a moment, leaning against the wall for support.

“Oh,” I said. “Oh!”

I turned around and headed back toward the bedroom.

“Honey,” I said, shaking my wife awake. “I think we have a problem.”

….

Now that it’s all over, I want to say a couple things about pain. In particular, I want to say a couple of things about this pain. I do not hesitate for even a moment when I say that it was, without question, the most extraordinary agony I have ever felt in my entire life. I’ve thought about how to put it – this pain – into words that would do it adequate justice. I don’t know. It was like two burly, offensive lineman types were playing a rigorous game of tug of war with a piece of red-hot steel rebar that happened to be speared through my mid-section. Maybe that’s an exaggeration, but if it is, it’s really not all that far off.

There’s that old joke that starts, “Hey, Doc, it hurts when I do this!”

There should be another version of that joke that starts, “AHHHHHHHHHHHHHHHHHHH.”

If you twist your ankle or sprain your wrist, there are things you can do to alleviate your woe. Put a brace on it. Put pressure on it. Take pressure off. Ice it. Heat it. Wrap it. Leave it alone. You’ve got a standing list of options to help you manage while you’re on the mend. This, though – this anguish – this was pain without escape or relief. From the outset, I tried to stand, to sit, to lay – to contort myself into all sorts of different kinds of positions in some hope of finding even a momentary reprieve, but there was nothing. It was full-on. It was all-the-time.

I knew what it was. I knew what it had to be. The location, the pain, the severity – it had to be a kidney stone. It had to be. I had never had a kidney stone before, but I had heard the stories. Everyone’s heard the stories. The stories are all variations on the same refrain and they all go something like this: “I had a kidney stone. It was like giving birth, that kidney stone pain. I hope I never, ever have a kidney stone again.”

It was in the car, on the way to the ER, covered in sweat, shaking violently, sobbing – really, truly, weeping in anguish – that I think I started to come to terms with this. I was either passing a kidney stone, or I was dying. Or I was doing both at the same time.

In the ten minutes it took my wife to drive aggressively through city traffic to the Emergency Room, I tried in rapid succession to fall back on every piece of new-age mysticism I had ever heard. I was grasping at straws. I don’t know much about new-age anything, but it has always kind of existed on the periphery of my being. I have spent time in a bookstore downtown called Falling Waters. I went to Buddhist meditation session once when I was trying to impress a girl I wanted to sleep with. I gathered up all the knick-knacks of this existence up into my brain and I tried to apply it all at once in a ramshackle kind of way. I tried to control my breathing. I tried to escape into my brain. I tried to visualize. I tried to think of a spirit animal. I tried to imagine the pain away, away, away.

What total and complete bullshit.

“It’s going to be OK,” my wife said, holding my hand, as she turned toward the giant red sign that said, EMERGENCY.

“Nnng,” I said. “Nnng.”

….

While Nicki parked the car, I shambled into the ER like a zombie, my gait broken and awkward. My clothes were soaked through with sweat. I was shaking uncontrollably, like someone had run me through with a live wire. Nausea broke over me in great waves, and I had to stop every few feet to ensure I was not about to projectile vomit everywhere.

The nurse working the front desk checked me in, and told me to have a seat.

“Someone will be with you,” she said, like she was watching paint dry.

I groaned and compelled myself toward a chair in the corner. A few minutes later, Nicki sat down next to me. She held my hand and said again, said resolutely, that it was going to be OK.

Time crawled by. I waited. I stood up. I sat down. I cried.

In the moment, it can be hard to understand why everyone isn’t running around screaming, “Holy Jesus! Fuck! That guy looks like he’s about to die.”

I fractured my wrist when I was a boy, maybe 10 or 11, and I spent a cold January night in an Emergency Room with my dad in downtown Pontiac, but that recollection is fuzzy. All I remember about that is the neon-blue cast on my arm, and how I amassed a collection of expertly contorted coat-hangers to relieve that near-constant itch. It is a vague and fleeting memory, and did little to inform my expectations of what an ER visit would be like. What was I expecting? Maybe a cavalcade of doctors; a SWAT team of health-care professionals to descend on me with drugs and charts and medicine and care?

When you’re feeling pain you’ve never felt before, when you’re not sure what’s happening to you, when you don’t know if you’re going to be OK, it can be hard to grock the idea that everyone around you is just going about their business. In fact, paired with unmitigated suffering, it can make you downright rageful.

Fear? Pain? Suffering? This is potent, primal stuff. This is how Anakin Skywalker becomes Darth Vader.

A guy across the way was eating a hearty meal of scrambled eggs, toast and hashbrowns from a plastic travel container. The smell of burnt eggs and the sickly-sweet over-abundance of ketchup was overpowering. I was suddenly gripped by an impulse to grab him and shake him violently. I was dying. I was dying! How could he eat food? How could he sit fifteen feet away from me and pour packets of ketchup into his hashbrowns and shovel bite after bite into his mouth? How could he just go on?

A woman was standing at the nurses station, chatting idly and rummaging through her wallet, looking for something – her ID, her prescription card, her insurance card, a scratch-off lottery ticket, a picture of her pet fish – I did not care. I was suffering. I wanted to grab her purse and dump it all over the floor. I wanted to toss the thing across the parking lot.

Two security guards were standing by the door, talking about – I don’t even know what they were talking about – but they were not looking at me, they were not paying attention to me, they were not helping me, and in that moment, I hated them for it.

I squirmed in agony, and shot angry rays of hate out as the world around me turned on.

Once a triage nurse started in my direction, but was intercepted and re-directed toward another patient at the last moment.

“Sorry,” she said.

“Nnng,” I said.

Fucking seriously?

….

The awful part of the story ends with Sonya. When the admission process was over and I had been spooned into a wheelchair and pushed down an anonymous maze of hallways and helped into a bed, there was Sonya. Tall and thick like a great tree-trunk and a great walking, talking force of nature, she came into the room and took charge. Mostly, this involved finally giving me a wonderful drug that I never learned the name of, but that she described as being “one better than morphine.” I’ll take it, because five minutes or so after she stuck a needle into my arm, I had started to feel OK.

I stopped shaking, I stopped sweating, and the pain diminished from a nuclear fusillade to a hum-drum pounding.

“Nicki,” I said, when I had regained the ability to form coherent speech. “I like her.”

Nicki laughed.

Beyond her role as great harbinger of pharmaceuticals, she also, on a more fundamental level, cared for me. She explained what would happen next. She brought me a hospital gown to trade for my damp, heavy clothes. She rolled me down the hall toward my CAT scan. She brought me an illicit glass of cranberry juice, which almost made me vomit, but I did not care, because it was cold and sweet and bitter and perfect. She laughed frequently, a deep and soulful thing, and in doing so reassured me that I would be OK, that I would not die. Sonya saved me with grace and great empathy.

Finally, Sonya came back to the room and said, “Yep, it’s a kidney stone. Doc will be along shortly.”

….

When all was said and done, they sent me home with a prescription for Percocet and a collection of cheap wire and paper sieves. The kidney stone, I was informed, was still lodged somewhere in my ureter.

I was reassured that, at 3 millimeters, my stone was small and manageable. I refrained from mentioning that up until that point, it had not particularly felt like either.

“You’ll pass the stone into one of these,” the doctor said, holding out one of the sieves. “We need it.”

In this way, it turns out that passing a kidney stone is not entirely dissimilar from panning for gold.

“It won’t even hurt,” the doctor reassured. “At that size, once it gets into your bladder, you’ll pass it painlessly.”

“You’re sure?” I asked.

“Absolutely,” he said.

Then again, he wasn’t going to be there. I eyed the collection of paper sieves skeptically.

This exchange, as cataloged here, approximates the sum-total of my exposure to a doctor during my four or five hour stay in the ER. They’re busy people, and I don’t hold it against them – I mention this free of judgement – but, by God, let’s give nurses more money, huh?

When I got home, I went into the bathroom and promptly vomited everywhere. Then I went to bed and tried to be very still. The pain had abated, due to some combination of the magnificent narcotics and the progress of the stone as it sawed through my insides. I took a Percocet anyway, just for good measure.

For the next 24 hours or so, every time I had to pee I grabbed one of the sieves from under the sink, held it awkwardly over the toilet, and let fly. Every time I finished, I held the sieve up to the light and inspected it, looking expectantly for my kidney stone.

This entire process filled me with doubt.

What would my kidney stone look like? What if I missed it somehow? What if it wiled its way through the netting of my trusty pee-sieve? What if I never found it? Could it get lodged somewhere on its way out, waiting to surprise me some new morning? Would I have to pee into a sieve forever?

With each passing trip to the bathroom, this anxiety grew.

And then, the next day, I finished my business, held the sieve up to the light, and there was.. something.

And here’s the thing. Maybe I’m just speaking for me, but when something has so completely laid you low, when something has so completely humbled you, when it has reduced you to a shivering, mewling, raw nerve, praying for a quick death – you kind of want to be impressed when you finally lay eyes on it. You want it, in a strange way, to kick and scream on its way out the door. My imagination was ripe with images of John Hurt’s chest-bursting scene from Alien, except, you know, from my penis.

But this? This was it? This thing, that might also be a piece of dust? Or a crumb from the bagel I had this morning? I guess I knew that it was a 3 millimeter in diameter conglomeration of calcium would not really be much to look at, but still, I’m not going to lie, it seemed like a whimpering end to such gravitas.

I was grateful, honestly, yes, I was grateful – but I will not lie. In a way that defies explanation or logic, I felt sort of cheated.

Transferring it from the cheap, urine-soaked sieve into the little plastic container they gave me was an exercise in patience. There were several times when I actually thought I had lost it on the counter, or on the floor, or in my hair – but I did it. I vanquished my stone into an 80ML plastic sample jar and clamped the neon-orange lid shut, like an Ecto-Containment Unit from Ghostbusters.

It’s sitting now, on the corner of my desk, waiting for an appointment with a urologist in a couple of weeks.

My kidney stone is passed.

It had to be like giving birth, that kidney stone pain.

I hope I never, ever have a kidney stone again.