New Voicemail

The weather outside is frightful. Actually, for this time of year it is downright disgusting. As the holiday spirit continues to elude me, I await ‘the call’. It has been 6 months since the last clean scan. I am due. Happy Holidays. Felix’s Nativesdad and all that.

Public perception usually is dictated by television. Medical shows more often than not do a hatchet job, no pun intended, on the true happenings between patient and doctor. There is no haunting musical overtone alluding to a possible future. Doctors aren’t all good looking either. No offense to the fine staffs that I have had the privilege to be cut by. There is no priest standing by. There is no brilliant yet unorthodox in their approach medical scientist that will swoop in with a last minute idea that NO ONE IN THE WORLD thought of.

It’s more basic than that. There is a deadly silence. You always remember the lack of sound. All you hear is the singular voice speaking to you.

And there is no bracing yourself for it. It’s the good, the bad, and the ugly, in one distasteful swallow. In many ways, it is a standoff, only you are guaranteed never to draw first.

If subtly had a gravitational force, one may turn into a black hole. I attempted to draw first.

Process is king in the medical world. You don’t get a ticket to the show until your agent health coverage approves anything you do. So you wait.

I’ve never grown rich on my own patience. I called to see if/when I would get my next scan. Call it a To Do of life.

I always ask for Cindy. She is the best representative of any office. She’s pleasant. Informed, probably more so then she can ever let on. She has seen many walk through the door, some for the last time. She carries on with the same attitude and smile. She has a job to do. She knows me by name of course. I can tell when she picks up the phone that this is not the best of times for small talk.

“I’ll get back to you. There is a backlog.” She’s being polite but I know when to hang up.

Now you wait. You draw but can’t fire. Okay. Patience.

As with most things in life, the true triumph and tragedy comes from the fact that no matter what happens in your personal space, the world continues to rotate. It’s nothing personal. Just a reality.

I am at work - a place where it is easy to forget the joys and sadness of the real world. Your call, good or bad.

The task at hand was one of my favorites – lunch. Per usual, I didn’t realize my personal cell was flopping along my desk. Very few contact me this way. The small font is glowing NEW VOICEMAIL.

It is Cindy.

“Joe, looking at your chart you are now going to a yearly scan. Next one is in June.”

There is a pause that ensues like when answering machines ruled the landscape. They knew you were home and waited for you to pick up as you launched yourself over Scooby slippers to grab the reciever.

I can hear a smile. I know that’s not possible but I can.

“Have yourself a great Christmas, Joe.”

It is a long moment before I press 9 to save the message. It was subtle. No fanfare. No angels singing. No champagne to be poured. It just is.

I am still on a leash and probably will be for the rest of my life. For now, the leash has been let out a little.

And I’m okay with that.

Sweet Dreams

It’s called PTSM – Post Traumatic Stress Management. Not that I ever read up on it. This is a fancy term used nowadays by many to help those who have had a trauma in their lives that, well, basically they can’t get over.

It’s the domino effect. The ripple that never ends. I’ll tell you, it’s one helluva pebble in the water.

Sweet dreams are made of this

Who am I to disagree?

I was about 8 years of age. I remember my bedroom being cool, so I am thinking it was autumn or spring but I am not really clear on that memory.

The reel of that night keeps playing over and over. I am used to the sensations now after decades of deciphering, brooding, and burying.

I can clearly say I haven’t slept like a normal person since I was a teen, possibly longer.

I was floating. Everything around me was white. All I could hear was a booming voice that shattered my skull and shook me to the core. It was my dad’s voice.

I had to save something. What it was, I can’t remember. I probably never knew in the first place.

The voice boomed. I screamed to shout above the thunder. Nothing works. All I know is that I have to save ‘it’.

I remember waking up screaming. The dream had faded to the edges of my bed but the waves of terror never really left.

I was surrounded by my family. I had been screaming for a half hour or more. My mother talked me down and I can still feel the thrumming of my heart back then to this day. Some have called it night terrors.

The next day, I arrived back from school and promptly went to my room. A wave of haunting familiarity flowed over my skull. I swooned a bit, heavy with emotion, all of it tugging at my brain like so many rats eating something dead on the side of the road.

It was surreal in every sense of the word. Black art. It wasn’t the last time that my night would be plagued by such sleep patterns but it was one of the most memorable.

I have long ago faced these demons and such dread hasn’t infiltrated my sleep for some time. But demons never fully retreat – they recede. Always on the edges, always watching, and always waiting for your moment of weakness.

I don’t sleep. That has been well documented. I am forever in search of a formula and my patterns have gotten better.

I understand the demons and I find some solace in that. You know the tracks so you know the animal.

As a young boy in a hospital, like most patients, I was awakened constantly for testing. 1 am. 3 am. Stabbed for blood. “How are you, hun?”

Some of them want to abuse you

Some of them want to be abused

I still can’t sleep on my back for some innate fear of being stabbed. Silly but an 8 year old mind has difficulties wrapping around nights filled with a cacophony of machines beeping, whining, and patients moaning for a nurse to come help them.

Brutal? By today’s standards possibly. It’s mine to deal with. No one else’s.

It was years of staying up all night. No college partying. Just staring at a TV test pattern.

Too many nights turned into dawn. So tired I trembled from exhaustion.

I remember feeling comforted by one prevailing thought – I lived through the night.

It’s been decades of working on sleep hygiene. Ambien. Melatonin.

http://www.webmd.com/sleep-disorders/tc/melatonin-overview

Nothing really is a silver bullet cure. Like any sculptor, I have to keep chiseling at the stone. Hammer and hammer until the flecks pile up. I know there isn’t an end to it. This is what I have to do to get by.

Mornings can still be very rough. I try to be anti-caffeine but the body and mind are forced by real life to charge up. I carry a glimpse of what a war veteran may go through. Just a peek anyway. I keep breathing. I keep moving. When there is some sleep, the difference is quite discernable.

The dominos have fallen long ago. The ripple effect continues. There is progress, albeit microscopic at times.

There are days of sweet dreams. Not many, but I savor them.

I’m gonna know what’s inside…

Put on a clinic...

Same walk. This time I was late.

For the first time I noticed that the sign above the clinic stated Edwin Forman.

I had learned that he had retired. He was my primary doctor back in 1974. Like what the late Steve Jobs did for computing, Dr. Edwin Forman forged the hospital's burgeoning clinical research to the forefront of medicine.

It was fitting that his name was above the door.

I am a bit of a museum piece. No, not chronologically. I get a nod as I walk in. He's here.

It's a tad unsettling. In a microcosm of surreality, I am the Elvis of the clinic even for a few minutes.

After the ceremonial information exchange, I go back to the waiting room that had sent me into consternation during the last visit almost a year ago.

This time was different. Instead of being surrounding by balding, bloated children who clung to IV poles while battles between Spiderman and Iron Man raged on, I was alone.

I picked a chair in the corner of the room facing the door. The lights were dimmed giving the room a morose glow.

When you are diagnosed, you feel like the loneliest person in the world. You are handcuffed to a roller coaster and you have to ride. Once you are done with the corkscrew, the nosebleed heights, and plummeting depths, you are asked to get off the ride - alone again.

And now I sit in a 20 x 20 room, a Wii glowing in the corner, and blocks scattered across the tables. Alone.

Looming out of the shadows, a tall eighteen year old male says "Good morning". He's totally bald with a dramamine patch under his right ear. He's lean with a basketballer's body. The IV pole was at his side of course.

I nodded in his direction, ashamed that I had hair.

He drifted back into the other offices.

The nurse practitioner flew in like the opening song from a grand musical. She's over-happy. I am always amazed by this. It's a gift that seems out of place in the clinic. It shouldn't be. I am just not in the right frame of mind.

She isn't alone this time. Her bright smile has eclipsed the young social worker that fell out of a spy novel. Her character replete with chart in hand was already jotting down notes before I said a word.

As the few hours pass, I am poked, prodded and jabbed like a basic prison film.

It's sobering. I feel guilty and it hasn't been an easy road, dammit. I just want them to leave me alone now. I can't of course. This is how it is. You are now in unknown territory. Alone.

"How do you feel? Are you losing weight?"

Hell, I am trying to drop 4 more pounds but thanks for asking.

The nurse leaves me and the counselor, a student intern, alone. She has a few dozen questions for me. She gets a kick out of the fact that I am Italian. She spent a semester in Italy.

Sad. I spent four years commuting, no less, to Smithfield, RI.

"How were your grades?"

"I was diagnosed with ADD. I flushed the Ritalin after two weeks."

"Interesting." (Jotting on paper) "Do you sleep?"

"Not since I was 14..."

More jotting...

She means well. In fact, I think she will actually do well. Part of survival is that the disease can be the ultimate mind-fuck. People like her will help those coming up from the ranks.

Anyway, they take my blood. My phlebotomist is a middle child but her father's favorite. No lie. We talk about such things.

I am sent on my way with a hand picked Wolverine band-aid. They will send me another post card with my next appointment. Joe, Boy Wonder, will be back. I have no answers for their curious questions other than this is what I do. It is who I am. Sure, I can speak to someone who may be staring a similar situation. There is no formula. It's basic dike survival. Shore up the dam before the next wave hits. Pretty simple really. Grab anything, throw it against the wall and hope it holds.

It will hold. For now. I have a few more decades left in me.

After all, I am putting on a clinic...

Survivor Blog Questionnaire

To all Survivors...

I am seeking to catalogue via a series of queries on your life changing event. It will be a set of questions that will be posted to this blog. Outside of your first name, or preferred nickname, all personal information will be withheld. The point of the blog will be to document your life experience, aspirations, functions, dysfunctions, questions you may have, and help you may have to offer.

We are all related. Your words will help someone.

Thank you....

If you would like to participate in this event, please email me at the following:

joe.mazzenga@yahoo.com

Please put in the subject line: Survivor

Be well. Be strong. Be you.

JM

I can't stress enough...

Stress.

I call it the silent punisher. In the very least, it can be the ultimate agitation. The itch you can't scratch. The bill you can't pay. The grass you need to cut...again. And why doesn't the driver with the Massachusetts plate know that their blinker has been on for three miles?

Our ancestors knew stress. Neanderthals (some will state they are not part of the gene pool of modern human kind - sue me) had the stress of survival. Eat or be eaten. A broken bone sealed your fate. Hence, it was a miracle they lived to forty years of age.

Today? We live longer. Science and chemistry have seen to that. Instead of battling herds of wooly mammoth, we battle personal deadlines, inflation, money worries, wars amongst ourselves, social pressure, and diseases that may or may not be manufactured by the very environment we live in.

Same thing? Maybe. Where our ancestors had to fight for survival, more of their physical, instinctual and mental abilities were tested on the whole, daily.

Today, we are surviving on a different level. We match wits with styrofoam boxes instead of killing for our food. We sit all day in the name of being 'productive'. We don't walk miles to forage, rather, we jump on rolling treadmills to sweat for thirty minutes a day.

Still, there is stress. Like The Force, it surrounds us. Sometimes it obeys our commands. Mostly? Kills us slowly it will.

Like high blood pressure, it is silent. It can be seductive as well. Like a good cup of coffee, we grow addicted to heart pounding action. We feel we have purpose because "we're getting it done". To that end, we put deadlines on ourselves.

Is it worth it? Science tells us in many ways that stress is a great way to kill ourselves off.

Think of it if you take a car and max it out between each red light, eventually it will break. It's a fact not an opinion. The slower the pace of the car, chances are the more longevity.

As stated before, whenever I get cornered by stress (in certain areas of life it is inevitable), I repeat five things I am thankful for. Any five. It can be from the extreme to the extremely simple. Just do it. Repeat it. State it twenty times a day if you have to. And always remember to breathe.

It is all very mystic of me isn't it? Not really. It is clarity of thought and a restatement of what is important in life.

I can't stress it enough...

An Uphill Climb

This blog goes out to my Uncle Nicky and Eddie Paradiso.

Fifteen.

Today was the day. Another year had gone by. I felt the equivalent of tumbleweed passing by.

It was odd all around.

I just received news that Eddie, a friend I skated with for years, had passed away. Forty-nine years old. Pancreatic cancer discovered in April. Dead by July.

This was on top of the passing of my Uncle Nicky who fought for three years until he could fight no more.

Another friend’s dad was going in for a biopsy.

What the hell was going on?

I had to focus.

Fifteen.

I always walk into a roomful of stares in this office. Older people with walkers, wives holding up their husbands, and vice versa greet me in my running shorts and football tee.

I’m not here to be tested. I am here to break the rules.

They call it a stress test. You get on a treadmill and they jack it to College Hill scale and say, “go”.

It is my secret wish to never go to this place again. For now, I am here to show them, that is, show me, where my marker is. Today it is 15 minutes.

Eight years ago, because of well-documented treatments, I had emergency triple bypass surgery. Eight years of scars. Eight years of head shaking from therapists. Eight years to make a 5k my marathon.

It all comes down to 15 minutes on a treadmill. Every year I have extended my time a few seconds more. Last year it was 14:30. I could have gone longer but I was talked out of it and they pushed the big read, bozo button that stops the treadmill.

Not this year – 15.

I’ve had the same nurse for three years running. I like her. She talks a lot. I get the whole life story from the kids in the neighborhood to the fact that one of her workmates can’t even download a ringtone to her phone. She talks to me while the time passes on the treadmill.

“Joe? Joe Mazzenga?”

I am the only one in the room and someday I’m going to not answer just to see if they come over and check an ID or something.

It’s not the nurse. It’s not my nurse.

Her name is Faith. She’s a little thing standing about five foot nothing with silver starfish for earrings.

Truth, I can tell she might be new to the place.

Harder truth? She is quiet as a mouse.

The silence brings back all of the thoughts and questions. What if I don’t make my goal? Does that mean I am taking a step backwards?

The old technician from last year is waiting for the both of us. He’s never overly friendly. He just likes to take cold gel, a blunt instrument, and stab my ribs in an effort to impale me. No worries, I’ll show him too.

I am sore. Everything aches. I just need 15 minutes.

We go through all of the paces, wiring me up, asking me the same questions, and finally hooking up a battery belt in a last ditch imitation of the 6 Million Dollar Man (http://www.youtube.com/watch?v=HofoK_QQxGc).

“Your BP is 106/60. Ready?”

I want to shout out, “No! Wait. Group hug!”

“Yup.” That’s all I got.

Stage 1 is a walk in the park. Okay, maybe with a breeze in your face and a slight uphill. Here is where my old nurse would start talking about dancing, her son in college, or her boyfriend that needed a job.

Faith just looks forward. “A little steeper. A little faster.”

I keep thinking she will sprout wings and grant me a wish. “What is Stage 2?”

“Excuse me?” she asked.

“Sorry I thought you wanted it in a form of a question.”

Lo and behold. Things got faster and steeper. I think she did it on purpose.

To be quite honest, screw stage 1 through 3. I know I have these. Cut to the chase. Stage 4 and I am usually running uphill for real.

“Steeper and faster.”

Keep thinking and breathing. Since there is no conversation, all I have to do is breathe.

Fourteen minutes have passed. I can do this now. I know that for sure. I want to high-five someone.

Now I sense a presence. The old tech.

I look over my shoulder and he is watching intently, arms folded.

“Fifteen minutes,” Faith states. She is now smiling. “Want to go over?”

I had to ask. “Did you change the test?”

I wasn’t running. I was walking very fast. I was breathing but I wouldn’t call it all out gulping for air.

“Yes. I want to go fur-”

“No. Shut it down.”

What’s with the old man tech? Is there some sort of train coming through he had to catch? An old man tech convention where they were giving out prizes?

I was peeved.

“Shut it down.”

Faith hit the big red, bozo button and my 15 minutes-plus faded into a sagging ramp slowly puttering to an inchworm’s crawl.

I have to throw myself onto the bench where Vlad the Impaler hits me with a blunt instrument.

I wait for Faith to leave for a moment.

“I could have gone farther.”

“I know. If you go beyond 15, and something happens, she will be to blame.”

I think he just wanted to go to the convention.

Fifteen. The new goal conquered.

Dammit, I am having my cardiologist write me a note next time. Do I sound bitter?

Faith is back with water. It’s over. All of the tension that was built up over the days has faded now. It’s back to the real world. I want some sort of bad plastic trophy or maybe those lick on stickers to celebrate.

Eddie, I skated with you for years. I went to your Facebook page and saw you actually had an ID. I wanted to hit the ‘friend request’ but I knew that was now futile.

Uncle Nicky, you and your smile will always be with me and my family.

To Uncle Nick and Eddie – I may someday see you again, smile, and maybe even skate.

I dare say not for some time, though. I have a little Faith seeing to that.

Two Years and Counting

It’s always the wait.

It is hot today. I took my simple driving pleasure to the parking garage. It’s really cool to rev the engine throughout the echoing levels of the surrounding cement columns. Someday, I am going to go for it and smoke ‘em when no one is looking. Not today, though.

I jog down the stairs to the cluttered main street below. As part of my day job, I have an ID I keep forgetting about, attached to my hip. I’ve been asked once or twice for hospital directions because of it. I just might throw on a lab coat one day and run through the halls screaming, “It’s alive!”

Not today, though.

No matter how many times I’ve been to the same office, I always look up what floor it is on in the main hallway. As I wait for the elevator, I keep re-running the scene from Aliens when Ripley is waiting for the elevator before the harrowing beast gets her. Nice tension builder, but I don’t need any more anxiety as it is.

By now, a wall of impatient patients surrounds me. Everyone is a Ripley. I know the routine. The Pavlovian bell rings as the elevator hits the ground floor and I mouth the same words each time it does.

“Wait for it.”

No one does. Like an attacking force, they batter the people trying to get off the elevator like it is the last elevator of the day. I hop on last and remember to take off my ID. I can’t diagnose today. I’m off the clock.

There is the ceremonial ‘last guy’ who always dives onto the packed cabin. I keep scanning the last inspection notice. You never really know when that weight limit will truly be tested.

We are all partners for a few floors. Friends sucking in the same oxygen. Rescuers to those who try to get off on the wrong floor. Personal space monitors as the doublewide baby carriage squeezes in.

Fourth floor. I take a left. Wrong. It’s a right. Damn, I’ll never get that correct.

I walk past the disinterested “parking validation clerk”. I actually don’t know what she does outside of validating parking passes and looking disinterested.

It’s all deep breathing down the long hall until I meet Mrs. Claus as the main desk. She is a jolly woman, glasses, portly, and always ready with my chart. I had overheard her talking to a patient about the anniversary of her husband’s death. It had been twenty years. I’ve always felt sorry for her after that but she keeps smiling. I suspect she still smiles even when the disinterested validating ticket person gives her grief about walk “all the way down the hall”.

The patient types are wide and varied. I’ve seen the shock and awe. I’ve seen the beginning of their journey. The muttering as to what’s next, losing weight, even tears. I’ve seen old and young. I just try to keep to myself.

I pick up a holiday magazine – 2005. I make a mental note that every recipe in there would take me three hours to prepare. Someone had a three-page article on how lard is making a comeback. That was 2005. I wonder how that worked out for him.

I am not usually a patient person. Today, though they can take their time.

A mother daughter combination sits next to me. I am lost in a chocolate ganache recipe when I am overcome with perfume laced with the pungent scent of Marlboros Unfiltered. The daughter is in her late forties, I’d guess and she keeps cutting off her mother’s sentences. I see the signs of the children becoming the parents. She slugs a diet coke to suppress her wet hacking cough.

I put down the grand year of 2005 and go through some hockey saves. I have a habit of compulsively going over situations where I am playing goal and making saves. It’s a habit. I’ve wakened myself in the middle of the night, kicking out a leg many times.

“Joe, come on in.”

Damn, I’m the only Joe in the room.

The examining rooms are cookie cutter. I wave to Cindy as I walk by. She’s one of my angels. She brings order to the chaos by making appointments and always smiling with her Patriots smocks and funny colored scrubs. I wish my day job had a scrubs-only policy.

“Have a seat and he’ll be right with you.”

What she really means is – I will hear heavy footfalls, a rustle of paper then a large man with the face of a ten year old, will shoulder his way into the room. Literally.

I use sanitizer on my hands for the third time in the office. Why the hell not?

My doctor is a surgeon. Not just a surgeon but also the surgeon. Head of Surgery. The dichotomy between his scalpel and his blunt approach was noted from the beginning. He doesn’t hold back, mince words, sing or dance. I like to think I am his pet project since I am one of ten cases in the world for what they found.

He shoulders his way in.

“Hey…Two years. It’s been two years,” he says. He doesn’t even have my chart.

“Yup.”

“The images were perfect.”

I don’t celebrate. I don’t lift The Cup, kiss the girl, drink the milk or pour the champagne. This is my moment. It could have been a moment that would turn back time. It didn’t. It cements my present. It paves the way for my future.

“Good.” That’s about all I got today.

“You are different,” he says. “We will do this in six months again. But everything is negotiable. You are still high risk.”

That’s why I don’t celebrate. I know the picture. I don’t think about it – much. For the moment, I am normal. It is his duty to give me the crude truth. He just doesn’t know that I am going to outlast him into his retirement.

I shake his hand. He has plumber’s hands, which is odd to me given the delicate cutting he does daily. No matter. He could use a jackhammer for all I care.

I stop by Cindy and give her a wink. It’s my “See you in 6” wink.

The whole office nods and I give the final Pope Wave.

Someone someday might cause me to pause and think about my future. Some blip may show on my personal radar.

I will do what I do and that will continue to be whatever it takes. Simple stuff really.

Someone may tell me I have an issue someday.

Not today, though.