asshole

April 27, 2020September 4, 2023

Dying / Not Dying

I’d begun losing weight on the run-up to gastric surgery. The change in my controversial girth was noticeable and it was remarkably easy to maintain the pre-op diet. I saw light at tunnel’s end.

You can do anything if you know it’s going to end soon. So I quickly developed a taste for protein bars and spoke at length on the virtues of one brand over another. God, I must’ve bored the shit out of people.

I cut back on the beer and, although my diet was far from being a well-balanced ideal, it was helping with the goal: reducing my bulk, so there was less of me on the operating table.

After the surgery, I left the hospital and had the most splendiferous recovery of any of my multitude of medical procedures. The weight fell off in regular intervals. Within four months, I was buying significantly smaller pants — down eight inches. The wall in the kitchen where I measure family height showed another change. I appeared to be getting taller by an inch or two. I suppose it was a change in posture brought on by not carrying additional weight.

There was another possible bodily change about which I was curious.

I’d always struggled with weight. At one point, still in my twenties and living in Bowling Green, Kentucky, I joined Weight Watchers. There were about 85 regular members at the meetings and aside from me, only one male.

That male was an unusual bloke. Feeling outnumbered, we developed a habit of sitting together. He was like a character in a John Updike story. Like the protagonist in Updike’s novel A Month of Sundays, this fellow — Milton was his name, if memory serves — was a pastor who ministered to the women of his flock in secret and carnal ways.

He was much heavier than me and was in a long struggle with his body. I would estimate that when I knew him, he was circling 300 pounds, about ready to land. He’d been in Weight Watchers longer than me and had already lost sixty.

We shared a table and talked about our different lives. I was a young married professor with a new baby at home. He was a single, randy member of the clergy. This is when he bragged, under his breath, about his many physical and spiritual conquests.

“Have you noticed,” he asked, his eyes darting around the room to see if any of the women were in earshot, “that for every twenty pounds you lose, you gain an inch of your manhood?” The way he studied me from under his eyebrows told me that this was his main motivation for weight loss.

I lost about forty pounds during that Weight Watchers stretch. After gastric surgery, I lost 85 pounds and unfortunately can neither confirm nor deny that in either case the horny pastor’s speculation on genitilia was accurate.

I think about him now and then and wonder if he’s still alive, or if he was discovered by the husbands of his flock and summarily plucked.

Despite that relative disappointment, I had no complaints about other changes in my body. I’d often overcompensated by purchasing too-large clothes, even when I was at my biggest. I now floated in my garments and began to enjoy buying smaller shirts, going from an XXL in some clothes down to an L, and — in one shirt at least — an M.

The body changes helped my sleep apnea. Soon, I not only set aside my C-PAP machine, but I began sleeping straight through the night.

The hernia too seemed to go away.

The knee was another story. I wasn’t carrying as much weight, so the walking was easier. But Dr. Ghushe said two out of three wasn’t bad and that I should see an orthopedist. I did and we tried cortisone shots and physical therapy, with little result.

My mother had left me some cash that she wanted me to use to travel. “Take the boys on a trip,” she told me in one of her lucid moments near the end. “Take a real vacation. Show them the world.”

So two years out from my cancer summer, I arranged for a driving trip through Scotland, England and Ireland. It was a lovely and precious time with the boys. It was life-defining in a lot of ways — and perhaps the subject of a different story. Nothing conveys “I love you” as effectively as a road trip. It’s a nice way of saying, Hey, I love you so much that I want to spend a whole month confined with you in a hurtling piece of machinery. Man, was it great.

But when I came back from traipsing over Europe on two bum knees, I decided that I had to do something. I felt too good to feel so bad. We tried further treatments for several months, then decided we could no longer put off the inevitable.

I scheduled replacement surgery for my right knee in mid-August the year after the European adventure. The week before surgery, I took the boys to Washington, DC — again with the show-them-the-world mantra — and was in horrifying pain from walking. Hiking through the National Zoo, I felt so awful that being heaved to the hyenas would have been a relief.

I was glad to finally have my knee replacement scheduled. I had to go to a lot of classes, watch videos about the surgery and be able to explain the process to civilians. They really wanted me to know what I was getting into.

That was the plan. I would be out of the hospital after two days, with Jack as my live-in caretaker and visiting nurses to help with therapy.

But the moment I came out of the anesthetic, I could tell something was wrong. Though he’d been dead forty years, I could hear my father the surgeon speaking to me: “There’s no such thing as routine surgery.” Every time you introduce anesthetic into your body, dad always said, you’re risking your life.

When I woke in the hospital, I had an odd sensation in that place that was of greatest concern to that carnal pastor from years before. It’s as if it was gone.

When I complained of numbness — something I’d never felt before in that region — following surgery, the nurse said it might be a reaction to the anesthetic.

A day later, everything was fine, except there, down in the valley. Still numb, it seemed that things just weren’t working.

I was sent home catheterized, since I was not functioning on my own.

Physical therapy nurses kept showing up at the house, but they were not conversant with catheters. Jack occupied my mind with endless episodes of The Simpsons — he wanted me to watch all thirty-plus seasons in sequence — and generally fetching things that needed fetching.

Finally, a catheter nurse showed up and removed the catheter. Still, not everything seemed right. In the middle of the night, unable to go, I called the nursing service. A nurse came over at three in the morning and hooked me up again. After the struggle to urinate for a couple of days, the catheter was a relief. A few days later, it was taken out again and a day later needed to be replaced. It was a merry-go-round of urinary equipment.

Soon it was time for Jack to go back to his mother’s. School was starting. I needed to get back to work soon but wondered how that would be possible with this tube and its attendant bag. (A bag — again!)

That’s when the Lost Weekend descended. I still had the catheter and was unable to stay awake. I retired to my room and went into another dimension, one absent of sight and sound but fecund with nightmares and bleached souls of memory.

I writhed in bed with the cold sweats. I woke up once because my son Charley was at my bedside, with his mother standing in the doorway. Was I all right? Did I feel OK? Did I need anything?

Oh no, I babbled. I’m fine. I’m all right.

Sarah with her daughter Pearl. Sarah is wearing one of my mother’s old sweaters.

They left. The next thing I remember: opening my eyes, and seeing my daughter Sarah there. This was the baby from all those years before, in my days with the carnal pastor.

Sarah was a grown woman now and she’d come in from New York. Nicole, standing behind her that night, had picked her up at the airport.

Apparently, by that point, I’d been in bed two full days.

“Dad, are you all right?”

“I’m fine, fine. You didn’t have to come.”

“You don’t look fine.”

I was clammy with sweat, my T-shirt stuck to my body. My face was covered in droplets.

“I’m good,” I said. “Don’t worry about me.”

Pause. “I think you need to go to the emergency room.”

“Don’t be silly. I’m all right. I have my checkup with the knee doctor tomorrow. I’ll talk to her.”

It was around that time that all hell broke loose. To describe it accurately would trigger a lifetime of terrifying dreams for you. Suffice it to say that it involved the part of my body affected by cancer and from that orifice suddenly burst strange rodents and mythical beasts in a Biblical torrent, all to a Wagnerian soundtrack. On the sheets, on the floors, utterly without concern for shame or modesty or any attempt at human control.

I hoped that no one would notice, but of course that was impossible, as the foul waste unrelentingly spewed forth. I set about cleaning my wreckage and staggered naked into my shower stall, to cleanse. I was still unsteady from the surgery and slipped in the shower. I then saw myself from above. I’d become an Escher drawing: a different part of my body filled each corner of the square stall and I could not move.

Befouled, doomed by the evils of geometry, it took the pulling and tugging of strong young Jack McKeen to extricate me from that tiled prison.

By this time, Sarah and Nicole had disposed of all of the bed coverings — there was no possibility of salvation — and Nicole had cleaned the floor and was mopping it with bleach.

I was pretty sure that I had ripped open my knee incisions when I fell, but no blood gushed from that joint. I got into some pajamas and got all parties to agree that I would re-examine my situation the next day after meeting with the orthopedic surgeon.

I promised. Before admitting defeat at the hands of my uncooperative body, I wanted to talk to the doctor.

Sarah said she would sleep in Charley’s room, across the hall from me. Assured, Nicole took the boys and went home.

All night:

I got out of bed every ten minutes, attempted urination, failed, returned to bed.

Sarah[from the doorway] : Dad? Are you all right?

Me: I’m fine, don’t worry, I’m fine.

In the morning, I struggled — at 16 revolutions per minute — to get dressed and prepare for the doctor’s visit.

It was a long night, which is like saying black is dark.

Sarah backed out my car and I stood at the open passenger-side door, reading her the address of the orthopedist’s office so she could plug it into the car’s GPS.

Then I was again — suddenly and without provocation — visited by the strange rodents and mythical beasts, which streamed down the pants leg of my jeans, onto the asphalt, and into my shoes.

“Oh, Jesus, Sarah,” I gasped. I staggered into the garage. “I’m so sorry.” The rodents finished their revolting journey in the darkness, while she stood by the car in the blinding sunlight.

I called to her, giving her the name of the doctor, and she looked up the number, calling the office them from the sanctity of the driveway, cancelling the appointment.

Meanwhile, I extricated myself from my loathsome clothing in the garage, thanking God that there were rags and bath towels on a shelf there. I tossed everything in the garbage, wrapped myself in a towel and told Sarah that I would go through the house, take a shower upstairs, then meet in the family room.

I envisioned an afternoon of sloth and recovery. When I got downstairs, I saw that Sarah had made other plans. She‘d conferred via phone with Nicole and made a decision.

“I called an ambulance, Dad.”

“That wasn’t really necessary,” I said, sinking into the couch. I’d brought down a towel from the linen closet, in order to protect my cheap-ass discount furniture sectional from further degradation.

A few minutes later, the ambulance crew appeared at the back door.

I have two questions:

Why are all emergency medical technicians so darn good looking?
Why must all emergency medical technicians fawn over my daughter?

As long as they were here, I expected the EMT crew to have some interest in me.

They began checking my vitals. I still had a fever. Heart rate was elevated.

Then the questions. I don’t remember the exact questions, but it was something like this:

EMT: Mr. McKeen, what is this? [Holds up set of keys]
ME: [After a thirty-two second pause] Keys?

A few other questions followed — simple questions, with me struggling for answers that were not simple to attain, that required spelunking to the deepest recesses of my brain to find. I’d never felt so lost and stupid.

I’d never been so unable to function, so unable to process the simplest of thoughts, so totally adrift on a sinking raft in a sea of unknowable knowledge.

And I was sinking. I could feel the water up around my ears and into my mouth and finally I realized I was drowning.

I had died before and I felt it coming again.

“I think we need to get you in the ambulance,” the handsomer of the two handsome EMTs said. “Call now,” he told his partner. “Tell them we’re bringing in a 63-year-old male, disoriented, dehydrated, high fever — hundred and three. Possible septic shock.”

That got my attention. The EMTs snapped the stretcher together, strapped me to it and carried me out into the front yard.

August 22, 2019August 22, 2019

Nothing Up My Sleeve

I grew up as a nomad. We didn’t wander the tundra in mastodon skins with spears — we weren’t that kind of nomad — but we moved a lot.

It was my father who dubbed us nomads.

Growing up in the Air Force made for an interesting life. We moved, on average, every 18 months. Sometimes, it was just a matter of being assigned to new quarters on the same base — a move of a couple of miles, or sometimes just one street over. (At Homestead Air Force Base in Florida, we moved from Louisiana Avenue to Texas Avenue, across the expansive, shared, unfenced back yard. I still play in my head the little song I made up to learn my new address: 1569 Texas Avenue, 1569 Texas Avenue . . . . ’Twas a lovely little melody.)

Sometimes the move was more drastic, moving from America to Europe or back again. We lived in Weisbaden, Germany, in 1959, and relocated to Bellevue, Nebraska, home of Offutt Air Force Base, headquarters of Strategic Air Command. I once got to see the command-center underground with big screens showing the location of every B-52 bomber on the planet. It was the kind of war room later depicted in Doctor Strangelove. But that’s another story.

So I never developed a life-long friend until I was an adult, and by then — due to the late start — could they really be called “life-long”? My childhood friendships were as deep and intense as anyone else’s, but they were of short duration.

(I wonder where my old pals are today. Sometimes, I’ll spend an evening trying to track them down through Google or Facebook, with no luck. Mary Savage … Alan Rinehart … Paul Franks — are you out there?)

I’m often in awe of people who still, as adults, hang out with friends from kindergarten. My son Graham’s best friend (and best man) is the same guy he’s known since they were six. I envy the profound depth of their friendship.

My transient life affected me in so many ways that I probably don’t realize. It’s given me an ambivalence toward routines. I work hard to establish routines, but after a few months I find myself restless and impatient — and, occasionally, enraged — by these routines, and then I indulge in radical change.

I had a 15-year gap between marriages and for many of those years lived in a nice, conventional house in a nice, conventional subdivision. (I prefer the word neighborhood, but this place truly was a subdivision.) We were expected to conform, to develop routines for lawn-mowing, gardening and exterior painting.

I used to come home from work every Monday — garbage pickup day — and see my gigantic garbage bin tossed back into the yard. Seeing this every Monday depressed me. It made me think of the week before, with the garbage bin tossed in the yard. Then there was the week before that. And the week before that, always with the garbage bin.

That garbage bin represented the passing of life. Is this it? I kept asking myself. This routine, this sameness . . . is this what my life will be until it ends? I’d roll the garbage bin back into the garage and go inside, gulp down three or four beers, and wonder how long my life would be defined by routines and garbage bins and lousy beer.

I did my best to escape from this trap of routine. When I married again, my routine was affected by the shifting deck of another person’s steerage. New routines emerged: waking a second generation of children, getting them fed and off to school. I drove the same route every day, but then rebelled by snaking my way through different streets, just for some kind of change. I could never stand same for very long.

So now, here I was on the precipice of major life change — of surgery that would radically alter my body. I’d go from the perennially-rotund me to some-other-kind of me. It would require, my doctor said, a whole new routine.

That fucking word.

I wondered if I was up for this. I was on the cusp of being a candidate for this surgery, navigating the tightrope between eligibility and rejection. I could conceivably lose enough weight on my own to no longer be a viable subject for weight-reduction surgery. But I wanted it — I needed to do something radical, even though at 62, there was little chance to suddenly become a marathoner, a ballroom dancer or change my face into something handsome and desirable. I’d survived cancer and was a year cancer-free. It was time to do something to take care of this loathsome vessel of mine, to turn it into a thing worthy of preservation.

And if that meant a mind-numbing routine, then so be it. I could suck it up for the interminable months of pre-surgical routine.

I vowed that I was going to do this right. In addition to the routine, there was the add-on nutritional program. Fuck it. I knew the rule: eat good stuff, don’t eat shit. Did I need that drumbeat into my head?

Though it cost more out of pocket and required more of a time commitment, I decided to suck it up again and sign on for the nutrition program that went along with the surgery.

As soon as Doctor Ghushe (goo-shay, remember) told me he’d do the weight-loss surgery, I was ready to go. Hell, I’d drop trou right there in the examining room and let him start cutting on me — with a butter knife, for all I cared.

Let’s go, Dude.

I’d joke with Ghushe: “Hey, I’ve got a couple days off this week — want to cut on me now?” But he never took the bait.

I was joking but I was serious. I wanted to do this before the routine pushed me off the cliff.

So I immersed myself in the long process of waiting and education. It’s an agonizingly long waiting period. You’ve decided to do this, but now take a couple of months to read about it and study it.

(Weird, of course, that such a period of contemplation isn’t required for, say, buying a gun.)

I began my course of study: reading, films, web presentations. If I really was going to do this right, then I’d have to bite that bullet. The accompanying nutritional program included Shelby, a young woman in Ghushe’s office, and other nutritionists. I confess: I learned a lot.

I was, first of all, put on a diet. Since this was somewhat short-term — until the surgery, scheduled four months away — I had no trouble sticking to the regimen. I was proud of my newfound willpower. I could make hamburgers and hot dogs and spaghetti for the boys, but confine myself to salad and protein bars. I wasn’t ordered to cut out beer, but I did anyway. Beer wouldn’t be allowed for several months after the surgery, but I decided to go ahead and start my sabbatical from hops and barley.

The protein bars became a good part of my diet and I soon developed fondness for certain brands and composition. Several of them tried to mimic the taste of Reese’s Peanut-Butter Cups. None came close, but they were edible, enjoyable and filling. I also had six packs of protein shakes in the home and office refrigerators.

I turned into one of those guys who ate to stay alive, not for pleasure. I was particularly pleased that when I cooked for the boys, I didn’t snitch any of their food.

Within six weeks or so, the effects of the diet started to show. As I said, I was never over-the-moon overweight, but I was always at the least on the chubby side — as in chubby cheeks. Weight goes first from the face, so my porcine appearance began to fade and cheekbones emerged. My belly began to recede and I became reacquainted with my feet and some other estranged parts of my body.

I began to think that maybe I had finally found the right diet. Did I really need this surgery?

Yes, I did. As the weeks wore on, protein bars lost their allure. My hatred for routine began to take over. I was restless and irritable. Let’s get started on this fucking surgery, doc!

Doctor Ghushe wanted me to lose a little weight to make it easier to perform the surgery and, as I continued my regular checkups with him and nutritionist Shelby, I was advancing toward the goal. But I knew a changed diet was not enough for me, because my need to rebel against routine would emerge. I needed to do something radical — like cutting off part of my stomach.

That would do the trick, I thought. I needed a fundamental change to my body because of the hatred for routine embedded in my DNA.

The old Peter Bent Brigham entrance to Brigham and Women’s Hospital.

I was out of my element for the surgery. Ghushe booked me for the mothership — Brigham and Women’s Hospital in the heart of Boston, not South Shore Hospital, where almost all of my surgeries had been done. South Shore was affiliated with Brigham and Women’s — and Dana Farber — so it was all one big health-care industrial complex, but it was weird to be in a strange hospital for something so intimate.

Ghushe was / is a decent, affable, extremely skilled guy. There wasn’t the slightest whiff of bullshit about him. He’d described the surgery and on the day of the operation, his face appeared over prone-and-gurneyed me and ran through again what they were going to do. We’d talked about it for months, but protocol required he tell me again, from the beginning, what would happen in the operating room.

“We’re going to perform an operation called a sleevectomy,” he said.

“That sounds made up,” I said. “That sounds like a word Scooby Doo would use.” The stuff the nurses had given me to relax me had obviously kicked in.

“No,” he smiled. “It’s a real thing.”

The sleevectomy required removal of a significant portion of my stomach. Then he’d seal it up, and my life would change.

“What do you do with the part of the stomach you cut off?”

Ghushe looked at me, puzzled for the first time in the year I’d known him.

“Could I have it?” I asked. “Could I encase it in Plexiglas and keep it on the coffee table?”

“No,” he said. “I would advise against it. It’s bio-waste.”

I scowled. “You’re not as much fun as Corwin.” Christian Corwin, my cancer surgeon, was partner in a practice with Ghushe. Alas, he’d also declined my request to keep part of my removed rectum as a surgical souvenir.

I’ve always loved anesthesia. I love that moment when you feel yourself fading, falling off the end of the world into nothingness. Is that what death will be like? Then, afterward comes the awakening, the giddy grogginess, the sounds of the hospital suddenly rising as God turns the volume knob to the right.

I awoke. I took my meal in the hospital room, chasing it with the hospital’s delicious butterscotch pudding. When I finished, I moved the tray aside and looked out on the trees freckling this Boston neighborhood. It was a lovely spring day, with that impossibly blue sky that seems to favor Boston. Here’s where we insert cliches about new beginnings.

Ghushe came to check on me and the nurses were, as always, kind and attentive. Of course, I developed a crush on Jeannie, the nurse who came into see me every hour or so. I often believe my life was defined by the last sentence in “The Open Window,” a great short story by Saki: “Romance at short notice was his specialty.” (I changed the gender.) I’d spent so much time in hospitals, met so many nurses, had so many crushes.

The next day I was free. I was wheeled out of the hospital, as was custom, and when I stood, there was no wobbliness or frailty. I felt tremendous. There was no surgical hangover. Twenty-four hours after having my guts rearranged and I fucking felt great.

Maybe I was getting good at this — the being-a-patient stuff. I looked like the same guy who had been admitted to the hospital the day before, but now change was imminent. A good portion of my stomach was gone and life was about to be redefined.

Time would tell if it was for the better.