UNTIL THE MUSIC STOPS--CHAPTER X--CONFESSIONS OF AN UNCONTROLLED DIABETIC

CHAPTER X

KISS THE FATES

..."that the only way clear of the cool/crazy
flipflop was obviously slow, frustrating and hard work.
Love with your mouth shut, help without breaking your
ass or publicizing it: keep cool, but care. He might
have known, if he’d used any common sense. It didn’t
come as a revelation, only something he’d as soon
not’ve admitted."

"V"
--THOMAS PYNCHON


Katsuho came back to our apartment twice over the next few weeks. Once, to pick up her computer and more clothes, and the other to copy all of her favorite music into her iPod. Each time she did so she asked if I could not be there when she returned. I wasn’t. She told me that she would leave my keys at The Cedar Tavern. What she’d done was move into a Y on the Upper West Side and began to start piecing her life back together bit by bit. I was still managing to go to “taxi school” and waiting for her to come back to me. I had no idea just how badly she needed to get away from me and felt she’d eventually return. I would have promised her anything.
A few more days went by and I called her on her cell phone. Reluctantly, she agreed to meet me in Central Park. I’d gotten there early and was sitting on a bench waiting for her, thinking of all the things that she might say and my counter. Many conversations took place in my head before she showed up. I don’t remember if we kissed hello or not. What I do remember is that she told me that she needed time away; that she felt that her being was being taken from her; that she no longer knew what she was doing or who she was. I tried to listen attentively, all the while thinking of what to say to make her, force her, to come back and relieve this terrible “aloneness” that I was feeling. I thought that by not saying anything--and I really didn’t know what the hell to say to all that she told me--would in some way show her that I knew how she felt and would persuade her eventually to give our marriage another try. I did ask her if she was contemplating leaving or divorcing me, and she said she didn’t know. She needed time. I told her, in the most gracious, but still manipulative, way I could, to take it.
Katsuho did not come back to me. She couldn’t. I’ve only recently come to realize that. However, while we were still married and living together, she was introduced to a man, Carl Jacobs, a psychoanalyst, who needed one of his case studies typed. Katsuho took the job. Sometime later, when I knew and she knew I needed help she told me (and impressed by what she’d read in his case study), to call him. He was located down the block from where we lived. I’d always imagined myself in analysis with a doctor schooled in Freudian analysis who had an office in Greenwich Village. It suited the image I had of myself.
I began going to see him, while Katsuho and I were still together. I felt attuned to him the first time we met and his insights into my personality and behavior made a tremendous impression on me. But as I had done so many times before, I used some of our sessions together as a way of manipulating Katsuho into believing that these new and wonderful insights were sure to bring about the changes she and I wanted in our life together. Not that I knew I was manipulating her; I was really bullshitting myself. I’ve come to learn that there is no magic word, or sentence, or paragraph, or session, or drug, or woman, or anything that borders on the realm of fantasy and wishful thinking. Work, therapy, relationships, gratification, health, rent, writing, art, bricklaying, construction, everything, is hard fuckin work. All of the great insights mean shit if you don’t marry them to action. I was still an infant, thinking that by sucking on a tit, any tit, I’d get what I needed to get me through an hour, let alone a day.

I began driving a cab. It sucked. It was hard work, much different than when I drove in 1972. Three months after I started driving, I had the excuse I needed: my mom was sick and my father, who was never good in those situations, needed my help.
For the next few months I flew back and forth from New York City to Miami as if I was going to the corner store for smokes. During this period I helped my father find a nursing home for my mother, contact a lawyer who made it easy to get her on Medicaid--for a hefty fee--and watch as she went from nursing home to hospital and back again. He, while he and I met with the lawyer, had him give me power of attorney over her. It was easy for me to think he made the wise decision. I purposely spent a lot of time with her knowing that my father had always been emotionally unavailable to her and I was trying in my own guilt-stricken ways, to wash away our sins. One day, one of her more lucid days in the hospital, as I was ready to leave, I walked to the head of her hospital bed and leaned down to kiss her on her forehead. As I was picking my head up she said to me, “Have no fear.” I looked curiously at her. She had helped put the fear of God in me, certainly after I became diabetic. I didn’t know how to react. I said to her, “I won’t,” and left.
My father, too, was not doing very well, physically. He’d been very overweight most of his life, and now he was obese, and diabetic. I felt needed. And had no problem taking all the money I needed to help see him through this crisis.
Shortly upon returning to New York, and resuming my therapy, I got a call from my father telling me that my mom had took a turn for the worse. It seemed I’d just unpacked when I was aboard a plane heading south. I looked forward to getting back together with my father, going out to eat in some fashionable restaurants in Bal Harbour, and now drinking with him. Previously, I’d turned him onto high-end vodka and he took to it immediately.
My mother had developed dementia, aside from the multiple medical conditions she already suffered from. When I walked into her hospital room she didn’t recognize me at first and confused me with my brother’s wife, who she called out for repeatedly. Every time she struggled to find a word or sentence she began reciting the alphabet or multiplication table. During the next few days her condition worsened. One day, as I walked from her room, the doctor called out to me. He told me that my mother needed a feeding tube put into her. I thought for a second and told him no. He said that her heart was still strong and she had to have this tube in her to prolong her life. I refused. I didn’t return to her bedside either.
An hour later I was having an espresso and Sambuca at a corner bistro near my father’s apartment when my cell phone rang. It was a call from the doctor’s wife, a friend of my mother and father for the past twenty years. She told me that my mother had died. I asked how. Cardiac arrest I was told. I went back to my father’s apartment. He was not visibly upset, didn’t cry, and neither did I. We went to a local funeral home and made arrangements for her cremation. We came home and an hour later we were sitting at the same fashionable restaurant in Bal Harbour contemplating what we were going to have for dinner.
There were feelings I had that went unarticulated and even now I’m hard pressed to describe just what was going through me, let alone him, at the time. But the truth is the truth. My father and I did not really ever go into any of that stuff you might imagine family might when their mother or father or wife dies. In fact, that night, over dinner, my father began to tell me for the first time of his adulterous affair with a woman I knew in my teenage years who was a customer in his supermarket. She, he said, was what he’d always wanted in a woman, but because of us, his kids, he never left my mother. What to make of his disclosure hours after the death of my mother is hard to discern. It would not be unlike him to blame me for his inability to find happiness while projecting to me what a great, self-sacrificing, dad he was.
I stayed with him for the next few weeks during which we went to see my mother’s body before she was cremated. We were alone in this big chapel when they wheeled her out in a cardboard box in the clothes we picked out for her--one of her favorite Miami Beach blouses that had these sparkly fish--and placed her on this platform on eye level. The first thing I noticed was her expression: fierce. It was the anger and rigidity that she had carried with her throughout her life. I knew that lying inside this woman was “love,” though it couldn’t be seen. I went up to her body, leaned down and kissed her on her forehead. It was freezing. I wondered if they’d packed the inside of her with ice.
My father and I stood shoulder to shoulder, and I looked over at him to see what he was thinking and feeling. I couldn’t tell, nor did he tell me. I assumed he was cataloguing the sixty plus years they’d been married, like a dying person would.
We stayed about a half-hour. I guess we both felt that was sufficient. We really didn’t talk about her again for the rest of my stay. Reluctantly, a few days after, I flew back to New York City.
For a time I entertained the idea about going down to Miami to live with my father and find some kind of job. During the first few weeks I’d been back, my father began falling. I went back down there and found him a nurse’s aide that my father’s insurance policy would pay for. He liked her, and quickly developed a dependency on her similar to the one he had with my mother. And since she lived down the block from him, he quickly enlisted her services--for a few extra bucks--to be at his beckon call. He wanted me to set up Medicaid for him as we did for my mother. I contacted the same lawyer and put the wheels in motion. In regard to money, my father was a secretive and manipulative man. In fact, in regard to everything he was secretive and manipulative; but money to him meant power, and he was not about to fuck with that. To insure that I was not more of a burden to him then necessary, he strongly advised me to get government disability. Once back in New York I did exactly that.
Given what medical conditions I had it was not terribly difficult to get on Social Security Disability. I believed that in a short period of time, once I got my bearings, I’d be able to get another kind of job, get off the government tit, and make a life for myself. But actually my world had gotten smaller: Katsuho was obviously gone and who knew when she’d return. I began to drink more heavily and had stopped going to AA meetings long ago and so I couldn’t call the people I became friendly with there because I had no intentions of giving up drinking.
For quite a bit of time I emailed Katsuho, hoping my writing would seduce her into returning. I’d tell her about my recent experiences in Miami, my sessions with Carl, how my life had changed, were changing, and how, given the chance, we could make this work. She was careful to respond, but when she did, Katsuho made it apparent to me that that was not in the cards. I read, but couldn’t let myself absorb.
The Cedar Tavern had become my world. Joey had been to me the brother I’d always wanted and now he came even more to the fore. I never really had to pay for anything at his bar. I had endless conversations with him about both our lives, and we shared an intimacy, as those who are friends over the course of many decades would. The people who worked there liked me, and I also was friendly with many of the other patrons. And so, from the afternoon to the early evening, I’d be there, reading, writing, socializing, and drinking.
Jacobs was not a strict Freudian analyst. He was vocal, certainly with me. He knew the depth of my illness and used whatever tools he had to break me out of my lethargy. But by the time I left the session and got back to my pad, which was up the block from his office, my inspiration had waned and all my fears returned. I’d go into The Cedar and be sucked up by the darkness.
Very soon that no longer did the trick. One New Years Eve, I had a few drinks at The Cedar and became terribly anxious, almost panicky. My world began closing in on me even further than it had. I bolted from The Cedar and headed straight for Washington Square Park. I knew that drug dealers had hung out there since Broadway was a prairie, and quickly made the acquaintance of one. I told him that I was looking for heroin and he told me to wait for him on 8th Street. In fifteen minutes he was back and pressed a tin foil package into my hand and I gave him some money. I walked as quickly as possible back to my place, but when I opened the foil I knew I’d been “beat.” Just as quickly I walked back to the park, not to find and confront him, but to find someone else and try to be smarter. I did, and was.
We exchanged cell phone numbers and he told me he’d call me within an hour. When he called, I met him in the vestibule of my apartment, opened a bag, tasted it, handed him the money and went upstairs to make the internal pressures abate. Most of my veins had collapsed, but I managed to find a few near my wrist that were more painful to penetrate but carried the blessed liquid.
Jacobs was on vacation and I had no intention of calling him on the number he left. Because I was alone, and because I was alone, I shot drugs with impunity. I now had the cell phone number of a dealer who, even though he charged me a fee on top of what the junk cost, was reliable. In fact, when I didn’t call him, he called me and I almost made myself believe he was a friend.
When Jacobs returned I told him. It took me three months, probably because he took his customary break in February, but I stopped by “checking in” to a hospital, going through Lenox Hill’s emergency room. I’d been living on a diet of dope, sweets, and booze. I began to resent my having to eat any “real” food because of my ingrained attachment to life. My pallor was as gray as the last sight of a battleship sinking. I knew it was time to abandon ship.

A few years after having becoming president of the American Diabetes Association, Jerry Bernstein decided to retire from private practice. I had an impossible time finding a replacement. The doctor I was now seeing had provided me with an ample supply of pain medication, which he wasn’t able to wean me off. He consulted a psychiatrist who specialized in addiction who suggested because of my long history of opiod addiction, I go on a methadone maintenance program. I balked at that. I’d read about a new drug that had proved successful in treating “motivated” addicts: Buphenorphine. When I asked the psychiatrist he told me that it was quite expensive and he didn’t think Medicaid would cover it. I didn’t believe him.
I checked myself into a hospital to get detoxed. The addiction specialist I met with there told me the same thing about Buphenorphine: it’s a good tool, but expensive.
Two days after I got out of Lenox Hill I was shooting dope again. Two weeks later I was back in the same emergency room at Lenox Hill, but this time I landed in the psych ward. It was humiliating. They took away my sneaker laces, belt, cell phone and the rest of my possessions, except for my sweat pants and shirt. I saw one of the same psychiatrists who was assigned to me my previous stay and asked him if he could help me find a Buphenorphine program that would accept Medicare/Medicaid.
The psychiatrist found a program for me on the west side and gave me the information and contact number. The day I was released from the psych ward I made the phone call, but I could not keep myself away from junk. When I arrived to be interviewed and screened by two doctors, one who would be monitoring me and the other who owned the clinic, they told me I’d have to remain clean for at least 72 hours and be in withdrawal before I could be administered the first dose of Buphenorphine. It took another two weeks before I could manage that.
Buphenorphine/Suboxone is a pill that is taken sublingual--under the tongue--until it dissolves. The opiate attaches to the opiate receptors--the same mu receptors that our endogenous opiods attach to from birth--but block the “high feeling” effects of ingested opiods. Like methadone, it can be lethal, if the dosage is overridden. It could cause respiratory distress and failure. But unlike methadone it promotes energy and enthusiasm and reduces cravings. Once finding a stable dosage, I was able to take home a month’s supply, and had to adhere to the rules of the clinic: come once a week to see the doctor, once a week for counseling, and once a week for group. The psychiatrist there had me on hefty doses of a combination of anti-depression medication and my mood lifted. I felt more positive than I had in quite a few years.
My sessions with Jacobs were becoming more intense. The way I would pronounce certain words, put together phrases or the syntax of my sentences were subject to his dissection. My perceptions and assumptions were scrutinized. Sometimes I was afraid to go into sessions knowing he’d have me see the way “the other” might. Gradually, I began to develop a growing intolerance to my subterfuges, both internally and externally. What he was helping me do, which of course I’d never been able to do before, was integrate the disparate and contradicting nature of being alive. The “black” and “white” which had been my bedrock was being dismantled, rearranged, and glued together with a new kind of ambiguity. This is not to say that therapy with Jacobs did not obviate the anger, frustration, and wish for fantasy all at once. Many times I said to him: “fuck you.” And my worst fear was that he’d say, “You’re no longer my patient.” But he’d say, “Fuck you,” back, in those words. And he’d stick with me.

My father decided to go into a nursing home, the same one that my mother had been in. In a way, I breathed a sigh of relief knowing that his care would be looked after by someone other than me, and that whatever money he had left would go to me, or so he said. My brother had been on “the outs” with him and my mother for years--he’d not come down for her funeral/cremation--and I did nothing to encourage my father to try and repair their bond. In fact, I secretly felt pleased that this had happened. My brother and I, especially in regard to my father, was in and out of his grace, translated into “largess.” We alternated years of speaking and not to speaking to him or them. Now, I felt that I’d “won.” How fortunate I felt at times knowing that I was the favored son. Then the outcast, then the favored. Finally, I was ready to pick up all the marbles.
I must have “lost my fucking marbles” believing my father, but I did.
A few days before Christmas, my father called me to let me know that a strange rash had developed on parts of his body and that he’d be going to a mini-hospital unit in the nursing home. A day later I got a call from his doctor that my father had died from congestive heart failure in his sleep.
I thought for a couple of minutes before calling Jacobs, who was on his Christmas break. Quickly, he called me back and I told him what had happened. I said that I didn’t want to go down to Miami to arrange for the cremation, but could do that from up here. He advised against me doing that. Anthropologically, he said, we need to see our dead so that the grieving process can begin.
I made arrangements for a first class round trip ticket. Hell, I deserve this, I said to myself, even though Jacobs had often repeated the line from the Clint Eastwood movie, Unforgiven, Deserve has nothin ta do with it.
I’d hadn’t spoken with my brother for the better part of five or six years, but I called him and left a message that something had happened and to call me back. When he did, I told him that our father was dead. He asked if I was going to Florida and I told him I was. He told me that he wasn’t, which was all right with me. It made me feel superior.
I’d called up the same funeral home that my mother was cremated in and made arrangements for my father to be picked up. I flew in and out of Miami in a matter of a few hours. The only other person inside the chapel was my father’s nurse’s aide. They’d taken a liking to each other, based on mutual need. I was happy she was there. Unlike my mother, my father looked pretty peaceful lying there dead. He was still wearing his hospital pajamas. His aide and I stood over his cardboard resting place and she said softly to him, much like a wife, “I told you that he’d come.” I wasn’t too surprised by her statement. My father, to my knowledge, never trusted anybody, except strangers and then, only until he got to know them.

My father had told me, for years, he was leaving whatever money he had to me. He justified that decision by angrily explaining how my brother and his wife wouldn’t let him and my mother live in their home unless they turned over their funds to them. And so, when I got back to my pad in New York City and opened for the first time my father’s Last Will and Testament and found that he left my brother half of his estate, it shocked the shit out of me. But after a few seconds I began to laugh. Fearing if he told me the truth about his plans I’d no longer do what he wanted--come down to Miami, take him in and out of hospitals and nursing homes, be a friend, a son, a whatever--he did what he’d done his entire life: divide and conquer.
When my brother and I began speaking again, we compared notes. It became apparent to us that from an early age my father would tell my brother and me two different things about the same situation. Whether he feared us “ganging up” and not do his bidding or if he promoted our suspicions of each other to “work us” at his convenience, we’ll never really know. It wasn’t just coincidental that when I was speaking with my parents my brother wasn’t and vice versa. And given the fact that there were huge chunks of time that my brother and I weren’t speaking to each other, and certainly not honestly, there was no way for us to see how our father was playing us off one another. In fact, the flaws in our characters and personalities, and our shared jealousies and mistrust and anger toward each other run so deep, that after trying for almost two years to repair our relationship we are now not talking with one another. He, of course, grew up in the same house with the same parents. And had the misfortune of having me as an older brother. Many of my experiences growing up are his as well, even though there’s more than a six-year difference between us. But in a strange way I might have been luckier. My diabetes provided me with a structure that needed to be adhered to. The disease forced me to develop an intelligence and curiosity that were polar opposites from their world in Brooklyn.

Everybody has the “Dawn Phenomenon.” Between two and four in the morning, the body starts secreting glucose in order to begin waking. In those “wee small hours of the morning,” a recent scientific data show, insulin has a tendency to break down or become weaker. What this means is that diabetics, who have had nothing to eat from the time they went to sleep until the time they awoke and, who had blood glucose readings within the normal range (80-150), could find themselves with a higher or elevated morning glucose reading. There are different interventions to combat this given the differences in each of our physical profiles and our body’s idiosyncrasies. Bernstein knew and understood this. He also understood that positive, absolute control is impossible. Some mornings I’m higher or lower without explanation. This is because each night, or early morning, my body capriciously secretes glucose. I could eat the same thing, at the same hour, in two, three, and sometimes four consecutive days, and my blood glucose readings would fluctuate, some days wildly, even when I’d done the same amount of physical exertion during those periods. I’m not going to say that glucose readings are arbitrary, they’re not. But this, like living and dying, is not an exact science.
Good diabetic control implies structure, work, planning, and deprivation, food deprivation. If you adhere to some rules and regulations, your odds are better of living a life relatively free of too many problems and complications. My gut instincts are to rebel against such a life. I’ve got to try to control them, too. I’m all too familiar with what Nietzshe said, “Be wary of casting out your devils, for that may be the best part of you.” Well, Freddy, I love you, always have, but I’ve got to try to figure out some way to stay here a little longer, not so much to figure it out, but to fuck with it some more. Under the best of circumstances, I’m operating with a cylinder missing. This is not to say that if I take care of the car, I can’t put some serious mileage on her, but I have to take care of the car, and get lucky. I have to try to keep the “revs” somewhere in the middle where the engine functions best, make sure I take her in for periodic mileage inspections and have a very good mechanic.
Jerry Bernstein, my doctor, friend, and confidant, is now working as an educator and administrator in a major teaching hospital complex, Beth Israel Medical Center. He’s just returned from a trip to Russia and has become a great force in the field of endocrinology the world over. I’m happy he still returns my phone calls.
After Jean returned to San Francisco, she fell in love with someone, and they’ve been happily married for over a decade at this date. Jean and I speak often; unusual for the way I used to end my affairs of the heart.
Diane, too, while not married, has moved out of Manhattan and is living in a little town outside of Atlantic City and while we don’t speak often, we try to keep up with each other. I’d carried a torch for her for many years after our affair ended, but some women, no matter how hard you’ve loved them, and no matter how much they’ve loved you, the reality destroys whatever desire, no matter how feverish it had once existed.
Katsuho has become an owner of a business. She’d been working, as I said, as a designer and maker of furniture. When the owner of the shop decided he wanted to go back to North Carolina, he asked Katsuho if she would take over for him. Nervously, she accepted. I told you she has moxie. Except for exchanging emails once or twice a year we aren’t in touch. However, I did get an unexpected email from Katsuho not too long ago. I’m sure she struggled writing it and thought twice before sending it. She told me that she’d gotten married a few months before and said as unambiguously she thought possible, “I am happy.” Katsuho went on to say she did not want me to be surprised when I get a letter from the church regarding her and her marriage. Her husband, a practicing Catholic, felt he could not comfortably practice his faith in a church of his choosing unless he received some kind of Papal Dispensation. For Katsuho, as devout an anti-organized religion gal as one could imagine, I was somewhat taken aback by her request to fill out whatever the church would send and get it back to them. But a second later I thought: What’s true for Katsuho is true for all of us: Love will make you do the damnedest things at various times in our lives, and only the further passage of our time will reveal, from moment to moment, if it was worth it.

And me? I’ve become an “Everythingian.” Knowing that the brain of an ant is more complex than our most advanced computer, how the hell am I going to choose one explanation for how I developed and survived? I could pin it on genetics, certain pre dispositions, psycho and neurobiology, the psychic tensions between Eros and Thanatos, attachment objects, environments, social lubricants and maturation, or dumb luck, capricious and arbitrary. It’s all those, and more.
The field of Evolutionary Psychobiology interests me because it focuses on “adaptation” rather than “disease” as currently understood by medical literature. An “adaptation” is an evolved trait that solves some particular problem for a particular organism that enables it to survive, grow, and of course, reproduce. That’s what we’re about, ain’t we, to keep it going. So imagine a person casually walking around his forest, not thinking of much, maybe a little hungry, maybe pissed off about his wife, or girl, or kid, or tribal leader, or his gods, and he sees an apple lying there. He picks it up, takes a bite, and it tastes different, not bad, but different. In a little while his mood changes. He doesn’t feel so shitty, but a little silly. The next day he sees another apple and does the same as the day before. Before too long he moves his whole fuckin family and builds a house near the apple tree. Then he turns some of his family and friends onto this. For all we know he wrote The Bible tipsy, and later, while sober, invented what we call capitalism today.
Then I began thinking about God in relation to evolution. If there is someone or something orchestrating this mad affair, than that “forbidden fruit” sure did lead to and make a lot of things possible. It enabled a person to either hold on for a little while longer and it provided some incredible insights. And any insight can potentially father future insights and inventions from science to industry to the arts to academia to just about anything. Of course, there’s also a very fluid and dangerous line of demarcation when that same substance tears away at the fabric of a person or society, but the mystery, the magic, is not knowing where that line is. One thing I do know: as of this writing I’ve survived and that’s triumph enough.

I’m reminded of a wonderful story I heard about Miles Davis and John Coltrane when they were playing together. It seems that Trane was at that point where the musical ideas that were exploding in his head were being played out on the bandstand with Miles. The ideas would come so fast and so furious that often times he’d forget that he was playing with other cats, and the sound would just jump out of his horn. After one particularly long solo by Trane, he was walking with Miles off the bandstand during a break in the set. “Miles,” Trane began, “I know that I’m taking all this time during my solo, but I can’t seem to stop. The ideas are happenin’ so fast and my fingers are just flyin’ and I’m tryin’ to keep up with all of them. How do I stop?”
Miles looked at Trane and with all the love that Miles could ever muster said, in a voice that could be described as a kind of marbled grit, “Take the horn out yer mouth.”

There are days when I wish the syringe I was holding in my hand was filled with junk instead of insulin; there are days when I order a club soda in a restaurant and for the briefest of seconds I actually taste Chivas Regal. There are days when I know that a taste of sweet reefer would make this picture better, or book deeper, or food more delicious, or laugh sillier and I’d be able to make a whole lot more sense out of my life than anything else. And those aren’t days I’m feeling particularly bad. I still can’t go by a liquor store, a drug store, a hospital, certain locations in New York City and elsewhere and not be seduced by my history. But so far, I’ve managed not to dance to that tune.
Now, however, at age sixty plus, I feel that I have a kind of foundation, a hedge, against this mad and beautiful refrain that’s been playing in my head ever since I was old enough to walk to a melody that has the confluence of all that I experienced growing up, grooving to my very own originality.

But now it’s time to take the horn out of my mouth. This tune’s over.

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