Tag Archives: personal

How much suffering is too much?

August 16, 2023 By in Personal Tags: 12 Comments

This is by my wife, Bess. You can find her new writing on her substack.

For the second time in a two weeks, Jake tells me he’s ready to die. The first time he says it, he’s frustrated: red-faced and retching, trying to hack out a thick glob of the mucus of the sort that’s incessantly collecting in the back of his throat. Jake has squamous cell carcinoma of the tongue, and each new attempt to burn, poison or cut out the cancer has added to a list of losses that aren’t adequately balanced by gaining time on this planet.

The first surgery used a CO2 laser to cut out a cancerous portion of the left side of Jake’s tongue, and as soon as Jake recovered adequately from the surgery he got hit with radiation, which scorched away mucous membranes and skin. Radiation caused dry mouth and thick, ropy secretions—but the surgery and radiation didn’t prevent the cancer from recurring. As bad as the original treatments were, the new surgery entailed a “total glossectomy” and “partial laryngectomy,” which is medical terminology for “his whole tongue and part of his larynx were removed and replaced by a flap of tissue from his thigh.” The new treatments cost Jake the ability to speak and swallow normally, or to feel saliva pooling in the back of his throat and clear it. The thick secretions and abnormal swallow mean he’s constantly battling to expel phlegm, only to have it immediately return. The “goo,” as he calls it, is relentless. He is constantly spitting, hacking and choking.

“It never fucking stops!” he wheezes between attempts to hack that mucus up and out. He gets some out, but it’s obvious that he’s not getting all of it.  

The blue, v-shaped vein in his forehead is popping. He’s clutching the edge of the sink, trying to expel a thick glob that I can hear rattling as he tries to speak through it. His fingers are turning white. He attempts a sip of water—a skill he has just recently started to re-learn—which gets caught in the mucous, so he aspirates some in his lungs. He gasps stridulously but no air is moving into his lungs. For thirty terrifying seconds he’s not getting air. The muscles around his ribs retract, straining. I’m an ER doctor, but a Heimlich maneuver for a small amount of water isn’t going to do much. Anyway, in this moment I’m not thinking like an ER doctor, I’m a panicked wife. I need him to breathe again. I need this spasm to pass before he passes out. I’m hopelessly planning out how to get a man nine inches taller than me to the ground safely, when he turns red and gasps. Finally, he spits out a huge lump of goo. It’s quickly followed by another. He strikes the counter with his hand. 

“Enough!” he says. “All day, every day. It’s disgusting. I’m disgusting. I try to sleep and there’s goo, I wake up and there’s goo. I spit it out and there’s more goo. I’m ready for this to just be over. The only way it’s ever going to stop is when I finally fucking die.”

I stop reaching towards him and keep my mouth shut.  I just squint at him like I’m staring directly into the truth. He’s right. I don’t want him to be right.   

How does a person decide how much suffering is too much? I’ve spent nearly every day of my career faced with that question. Each emergency room shift brings patients with their tenth bowel obstruction after their fifth surgery for recurrent colon cancer, patients on their second transplant (with more organs failing) coming in twice a week to have fluid drained from their abdomens, their lungs, from around their hearts. Autoimmune patients and diabetics losing limbs piecemeal. All these people, trying to stay alive in a state of perpetual falling apart. Entropy is so clearly winning. I can see why they’d want to say “enough,” and let go of the gift.   

Before we knew for sure that Jake’s cancer had returned, we were walking hand-in-hand around downtown Phoenix after grabbing tacos for dinner (back when we could just grab food, put it in our mouths, chew, and swallow, like it was nothing at all). We knew Jake’s PET scan was abnormal, and that the CT scan was too. But Jake had just completed radiation, which frequently causes inflammation, leading to false-positive early PET scans. There was a good chance the abnormal CT showed destruction of the hyoid bone in his neck—a potential side effect of radiation—which, while not optimal, isn’t a tumor and thus wouldn’t kill him.

We’d met with his ENT surgeon, a Dr. Michael Hinni, earlier in the day, and we’d scheduled a biopsy to settle the “is it cancer?” debate. That night, we had the luxury of speculation. It was Schrodinger’s tumor: both present and not present, with us heavily leaning on the side of “not present” as a comfort. Dr. Hinni had told us that a recurrence meant “salvage surgery”, which would cost Jake half his tongue and part of his larynx, and could leave him unable to eat, swallow or speak. Dr. Hinni and the surgery team would have to replace half of his tongue with a flap of tissue harvested from his thigh. The other option was immunotherapy, which was estimated to have a 30% cure rate—a number which we now know is so overly optimistic as to be laughable. 

“If it’s cancer, I’d rather not have surgery and take the 30% chance at a normal life,” Jake says as we walk.  I grip his hand as if he were a balloon about to float away. “I know that isn’t what you want to hear.”

I nodded. It wasn’t. But I could be magnanimous. It was still a thought experiment at this point. So I say, “I understand,” because I do. But also because I could still say, “I just hope that isn’t a decision you have to make.”

It was cancer. When faced with the certainty of a diagnosis, Jake moved forward with the surgery. “It’s surgery or death,” he said, and he wanted to have a shot at living. For me, he said. He’d still get the immunotherapy, to increase the odds of a long-term cure. I felt as much relief in his decision as I did fear about what that meant for the rest of the life he might or might not get.  

The second, “salvage” surgery occurred on May 25 and lasted twelve hours. Around hour ten, I started to wonder if Jake wasn’t ever getting off the table. When Dr. Hinni finally called me in to tell me they were able to remove all the cancer, I was elated. He got what surgeons call “clean margins.” Then Dr. Hinni explained that, because the cancer had grown in the short time between the April scans and May surgery, he’d had to remove Jake’s entire tongue, not just half—and with it, Jake’s ability to speak, to swallow, to taste—and the relief was replaced by horror. I blacked out for a moment. Jake wouldn’t want this. I walked into the hot night air and hyperventilated in the parking lot. We hadn’t even considered the possibility that Jake might lose his entire tongue. I wondered what I would have done if Dr. Hinni had called me with an update and asked me if they should move forward with the removal? I threw up in the parking lot and felt sick relief that they hadn’t. 

In a panic, I called the one person I could think of: our speech pathologist, a woman named Jessica Gregor. She reassured me that, if the surgery hadn’t removed Jake’s entire voice box, he’d likely be able to speak after a fashion again. And swallow some liquids. She told me not to give up hope, and that the road would be long, but that not everything I feared and expected would come to pass. The surgical margins were free of disease. The cancer was gone. I needed to focus on that.

I spent the first night in the hospital sitting awake at Jake’s bedside, certain that he’d decide to die after learning the news. He didn’t want to live like this. It seemed entirely possible to me that he would just decide not to.

It’s amazing what people learn to live with: Paralysis, dialysis, blindness, deafness, pain, the loss of a limb, impotence, incontinence, the loss of a tongue. For some patients, the losses accrue by degrees. I’ll see them dwindling across years of emergency room visits. Their suffering slowly compounds, each gradual change requiring a small adjustment, yet adding up to tremendous deficits. But for others, like Jake, the door to the person they were before shuts so suddenly and so loudly that it shakes the whole foundation of the building. There’s no getting used to the idea of a new life, slowly. There is just a new life. I’m not sure one way is better.

But there’s a lot we think we can’t live with that, once faced with having to live with it, we do. I’m constantly amazed by patients, like Jake, who are incredibly resilient, finding reasons to live in a landscape they expect to be desolate of motivation. Maybe we don’t even need the motivation. Maybe it’s just what we’re programmed to do. Survive.

Still, I try to give Jake something to live for.  

The big things: love, affection, and (hopefully) a kid—if he can make it that long and science is on our side. And I try to remind him of the things he loves to do that he has always lived for: writing, thinking, learning. Me.

But there’s also the unexpected gift of rediscovery. Eventually, Jake gets his tracheostomy breathing tube capped, and we can speak to each other. It takes time for me to get used to his new speaking patterns, but I now understand him without great difficulty, although I need to clarify what he’s saying to people who aren’t around him frequently. Incredibly, just a week ago, he swallowed water for the first time, with the support and instruction of Jessica Gregor.

The ability to swallow escalated quickly—what time was there to lose?—and he discovered that when he swallows, he can taste, probably using the taste buds left in his esophagus and on his hard palate. So now I’m blending brownies and cookies and melted ice cream as many times a day as I can, stuffing him with sugar like a foie gras goose, hoping it’ll be pleasurable, but also in the hope that it’s one more thing—and no small thing—to live for. A way to feel reconnected to himself. Victories that distract him from ruminating on the question: how much suffering is too much? How much mucus and hacking and struggles breathing can a man tolerate? How much pain? How many things taken away? Without the victories, I’m scared that the more Jake thinks about the questions, the more he’ll settle on an answer that is: less than the suffering he’s experiencing now.

Just two months after the horrific surgery that was supposed to buy us years together, the cancer has reappeared in four new places along the margins of his tongue flap, neck, floor of the mouth, and larynx. It’s metastasized to the lungs. Suffering, it seems, just begets more suffering. It’s hard to see the person you love suffer. But even when Jake suffers, I’m glad he’s here. Here to lie next to me at night, to edit this essay when I’m done with a draft, here to just exist in the same piece of spacetime. I’m glad he’s here, because he’s still trying so hard to be. But I think I’ll probably also be glad he’s here when he no longer wants to be. I won’t be able to help myself. I want him to stay through the pain, the mucus, the feelings of drowning. And I wonder if that makes me a monster.  I’m so greedy for him—for time with him for his body next to mine—that I wonder, if it hasn’t yet, will it turn me into one eventually?

I’ve seen it happen. Finally faced with the actual end, families have begged me for medical violence in the ER. As if only more technology, procedures or sheer force will solve the problem of every human’s inevitable decline. “How Doctors Die” describes the way doctors understand that medical violence at the end of life isn’t a good answer, and that compassion often means declining the last possible bits of care, which resemble torture more than medicine. I’ve felt the ribs of a desiccated 95 year old break under my hands while doing CPR. I’ve seen a heart failure patient’s family refuse comfort care in the hopes that more meds and devices will convince the heart to squeeze harder. I’ve heard the words “do everything,” so much that my relationship to futility has changed.  

It would be easy to say that families’ desires for more medicine, more effort, is a product of medical ignorance—too many TV shows convincing people that CPR has more than a 10% survival rate. But that’s not the whole story. I realize now how easy it is to forget that something doesn’t work when you want it to work so badly. Sometimes, we justify these requests by hoping for a miracle. We ask ourselves: can I live with myself if we won’t try everything?

So I have been trying to ask myself: can I live with myself if we do?

I ask our friend Fiona, who was Jake’s charge nurse when he first had cancer in 2005, and who lost her own husband after caring for him through a prolonged illness just five years ago:  “What if Jake is going through surgery and chemotherapy and suffering just to stay with me because he knows how badly I don’t want to lose him?”

“What if he is?” she says “If that’s the gift he wants to give you, let him. If he wants to stay for you, he wants to stay. Let him.”

“I’ve told him he doesn’t have to,” I add, hoping for absolution.

“He’ll tell you when he’s had enough.”

            The second time Jake tells me he wants to die was just a few hours ago. We’re sitting in the chemo cubby, as I’ve come to call it: the semi-private, three-sided cubicles in the Mayo infusion center, where you can hear the other cancer patients—the coughs, the chatter, the pumps beeping—but not see them until you get up to find a bathroom. We’re walled off by windows on one side, and while it’s bright and a little hot, the light is nice. From here, we can see the 101 freeway, which we agree is admittedly less exciting than watching First Avenue from our folding dining room table back in our old Manhattan apartment. Both of us would love to go back and visit our old life, to walk down 14th Street together, hand in hand. But cancer makes your world small, so much smaller than your old life, and the prospect of a transcontinental flight for a pleasure trip in the face of so much exhaustion feels impossible. The place I most want to be these days, is just wherever Jake is. Even if it’s the hospital. We’re adjusting our expectations.

The nurse comes into the infusion cubicle with the pre-treatment medications. She pushes six different meds, including Ativan and Benadryl, which cause sudden psychomotor slowing. It’s like watching the batteries running down on a wind-up toy. Jake fights the wave of somnolence, and he starts to mutter. He asks the nurse about the coordinate tattoo on her arm.  He closes his eyes and says he sees visions, patterns, but can’t clarify more. Are they psychedelic or dream like? Both? He’s not sure. He’s making some sense but is clearly affected by the meds. Suddenly, he opens his eyes, looks out the window, and says, “at least I have a good view from here.”

Then he starts to cry.

We’ve been doing a lot of crying. But the suddenness of it, the way it feels like the reality of the situation is spreading through his veins along with the sedative, breaks my heart. There’s not a moment when we aren’t aware of the sand running so rapidly out of his hourglass, but there are moments when we feel time slipping away more acutely.  Did he cry during the first infusion? I think so. I could go back into my journal and look, tell myself that this is a medication reaction and not a sign of worsening despair (of course it is, his, and mine, as I’m crying along with him now), but I’m almost positive it is despair—how could it not be?

Chemo is so brutal, and for squamous cell carcinoma patients it is only “palliative,” in that it may extend his life but won’t extinguish the cancer. He’ll have more time to say goodbye but will trade the suffering from chemo for some months more. I hold Jake’s hand and kiss his face and look at his color in the bright daylight—which is sallow, but brighter than it’s been the last few days. He just stares out the window, glassy-eyed, and weeps. I squeeze my body against his to hold him firmly in the chair beside me.  His Dad, who is visiting during the infusion gets up to hold his other hand, which is limp.

“You can give me a squeeze back,” his Dad says, because he needs reassurance, too. I’m not the only one. Jake squeezes. His Dad seems relieved, but not reassured. For a few moments, we both cling to Jake, as if we could grip hard enough to keep him here as long as we need him. When his Dad sits back down, Jake drops my hand and picks up his phone, holding it so only I can see. He can’t really speak any more, but he types:

“I’m ready to die, but not wanting to. Key difference.”

I don’t know if he’ll remember telling me after the Benadryl and Ativan wear off. That this declaration came after being disinhibited from the drugs, though, makes it likely that this is what he really feels. Strangely, it feels like a terrible, heartbreaking reassurance. Not yet, he’s telling me. But one day. Once again, I say nothing, but this time I do reach for him, and I hold him.

I think gently about all the people who have asked me to try futile, frustrating things to try to save the person they love; doctors may “know enough about modern medicine to know its limits,” but most people want to burst past those limits, though they can’t. I think about the way people look at me when I explain that there’s nothing more I can do to help, and anything I do will only to make a bad situation worse. I think about their anger and their fear. And for the first time, I think about the relief they must feel when I, not they, am the one who tells them that enough is enough. No more. They don’t have to be the ones to decide.

It doesn’t make them monsters to want to cling to hope past the point of sense, it just makes them human. It makes me human, too.

I’m both not ready for him to die, and I don’t want him to. But I don’t get to decide, either. All I can do is try to tip the balance in favor of the life he has, until Jake, or his disease, decides that it’s too much. Because the only moment when you can answer the question of how much suffering is enough, is the moment that it stops. 

If you’ve gotten this far, consider the Go Fund Me that’s funding ongoing care. This essay is part of a series; click here and then scroll down for the others. See especially “On being ready to die, and yet also now being able to swallow slurries—including ice cream.”

Are you taking care of yourself?

August 9, 2023 By in Essays, Personal Tags: , , Leave a comment

This essay is by my wife, Bess.

“Are you taking care of yourself?” Francesca asks. It’s a fair question: my husband, Jake, is dying of a metastasizing squamous cell carcinoma. I say I don’t know whether I’m taking care of myself, and Francesca asks if I’ve gotten enough “me time.”

I think Francesca means: Am I sleeping? Eating? Bathing? I sniff an armpit, and peek down at my waistline. I’m down to 116 pounds, a weight I haven’t seen since senior year of high school, but my hair isn’t harboring small critters and I smell nice, like Dr. Bronner’s peppermint body wash.

I’ve heard the questions about taking care of myself before, but when well-meaning friends ask if I’m taking some time for myself—an analogue of asking if I’m taking care of myself—I laugh. My big concern is that I’m about to get way too much time to myself.

“I bet you look killer in a swimsuit,” Francesca says, to make me smile, not because she means it. She’s Italian, so what she really means is that if she weren’t 2,500 miles away, she’d force feed me pasta until I felt the full force of her calories and affection (which are the same). Only a select few people have asked “Are you taking care of yourself?” and meant it. Some know that my new figure is secondary to the stress and starvation diet I’d accidentally adopted when Jake’s tongue was surgically removed due to a recurrence of that squamous cell carcinoma, and they still say I look good from having lost weight.

Like it’s a consolation prize.

I defend myself to Francesca, saying, “Listen, not a single tooth has fallen out in the last three months, and it appears that I still have most – but realistically, not all – of my hair. Which has a white patch now.”

She makes a clucking sort of tut-tut sound, like I’m a simple child, and asks, “How can you take care of him if you don’t take care of yourself?”

Easily. I like spending time with him. I worry that, soon, he’ll either be killed by cancer or suffer so much that he justifiably chooses to exit. So many people have equated self-care with me taking some time away from the apartment, the hospital, the appointments—time away from Jake—that I get the impression a surprisingly large number of people don’t much like their spouses or long-term significant others. Being away from him, especially right now, isn’t a relief, it’s punitive. Francesca and I chat some more and she admonishes me to make sure that someone takes care of the “caregiver.” And then Francesca goes back to her life and I go back to reading, researching, trying to find some magical combination of medications or the perfect clinical trial that might save Jake. I want to fix. I want to find the right thing to do.

And, I believe, so do the people asking me the dreaded self-care questions. They are nice people who care about me. They want to  figure out the right thing to do and to say.  They also want to fix it. A clinical trial might help, but barring that, the best most of us can do is sit with the situation and be present. Sometimes, most of the time, there is no right thing to say. And that’s fine. Some situations suck and there are no words to make them not suck and there is nothing people can do to make them not suck. American culture infuses us with the desire to help and fix and suggest (things I’ve done too), but some situations can’t be helped or fixed or suggested away, and the hardest thing to do is to sit in discomfort with the truth.

On a recent evening walk with one of our closest friends, the day before that friend left to go home to New York, Jake said to him, “I’m sorry if I’m not very good at saying goodbye, but it’s my first time dying, I’m learning as I go.” It’s my first time doing this, too. At first I’m not sure what to say to friends who want to know if I’m taking care of myself.

Lately, I’ve been thinking a lot about what “care” means. When (numerous) hospital people call, they usually ask if I’m Jake’s “caregiver.” This translates, I guess, into wanting to know if I’m the person who makes sure he doesn’t pass out when he gets up to go to the bathroom after chemo, grinds his meds for his peg tube, and worries about keeping the areas around various post-op wires and tubes clean. They confirm that they can call my number to schedule appointments, review test results, and schedule delivery of medical supplies.

They’ve never asked me if I am the person who takes his hand in the dark while he’s sleeping and whispers to him that we’re connected forever by an eternal golden braid. He doesn’t have a tongue any more, having had a “total glossectomy”—which is medical terminology for “cut out the whole tongue”—meaning he can’t chew at all, or swallow normally. They never ask if I’m the person who burst into tears with joy when he learned to swallow again, a little bit, and managed to get down a pureed cookie a few days ago; he actually tasted the cookie with just the tastebuds left on his hard palate and esophagus. They’ve certainly never asked if I am the person who tells him that not only is he loved, but who gives him a solid grope and reminds him that he’s still very, very sexy.

You can hire “caregivers” online. It’s a job description consisting mostly of a hospital’s definition. I don’t think—though I could be wrong—that they provide a few of the services I render, but not the best ones, not the loving ones.

If caregiving is officially about physical and administrative upkeep—what do people think I, a person who doesn’t pass out when she goes to the bathroom, can swallow pills, and has no tubes to clean—need to do to care of myself?

What secret things do I need to whisper to myself in the dead of night to keep from falling apart?

Because that’s really what the question about taking care of myself is: What am I doing to make sure that I make it through this experience in one piece? For him, and for myself.

If the internet and well-meaning friends are to be believed, the well from which I give is running dry, but I’ll have more energy after a massage, a glass of wine with a girlfriend, a dinner out, a few hours a week in the gym to get some endorphins going, and a therapist. A therapist who’ll charge me $250 and hour to tell me I should sleep, get a massage, a glass of wine with a girlfriend, and exercise to get some endorphins going.

“No, you’re wrong, the therapist will help you figure out what it is you need,” one of my other well-meaning friends says. Well, what I need is for Jake to not die. And that is probably outside of the therapist’s scope of practice. But because I love this well-meaning friend, I say, “I’ll think about it.”

I think I find the question of “self-care” so absurd because no amount of meditation or yoga can or will change the fundamental truth: watching the person you love die means accepting that parts of you die with them. You can’t save them. You can’t save yourself. I will never be the same. I suspect accepting that truth is the most caring thing I can do for myself.  

The night before Jake went into the hospital to have a massive surgery to remove his cancerous tongue (a surgery that involved splitting his lip and jaw in two, flaying his face and neck open, and replacing his tongue with a “flap” of tissue from his thigh), we got married. He was having debilitating headaches and I wasn’t convinced he was going to make it through the night, or through surgery; I’ve never been so relieved to see another human being as I was when I saw his swollen, anesthetic-addled face in the post-anesthesia care unit (PACU). Alive.

All I wanted to do was sit sentinel in the hospital to make sure he stayed that way. Not just as a physician (though being one certainly helps), but as his new wife.

For the first few nights in the hospital, a nurse came every hour to check the flaps’ blood supply. Nurses responded to call lights. Nurses made sure he had his meds. You couldn’t have asked for more attentive care, or a better nurse-to-patient ratio—especially with today’s hospital staffing. The point is, despite the platinum-level care, I couldn’t relax unless I was in the room—watching, waiting to see if he needed anything, and quickly.

For the two weeks after his total glossectomy, the nurses would tell me I should go home to get some sleep. His Ear Nose and Throat doctor, Michael Hinni, who is probably the most considerate surgeon I’ve ever met, told me that I wasn’t allowed to stay in the hospital 24/7, because I needed to get some rest. I needed take care of myself. There were those words again.

And yet, I inflated my Exped MegaMat camping pad and wedged it across the reclining chair the hospital provides for family to sleep on.* There, during the day, I could make sure Jake knew he had company. I could monitor meds and orders, I could talk to the doctors, I could double-check what was happening—even though the doctors and nurses were already keeping track of everything. At night, I could press a button to call the nurses if he had a mucous plug in his the tracheostomy tube (“trache”) and felt like he was suffocating. If I could only rest when I knew he was within reach, I wasn’t going to get any sleep at home. How could I, when I’d be wondering: what was happening at the hospital? Was Jake okay? What if he wasn’t? How does anyone think that the simple act of being physically distant from the situation makes the mental load better, not worse? Being there was taking care of myself.

Of course, the one night I was convinced to go home and sleep, Jake almost passed out alone in the bathroom, while he was attempting a stool “self-disimpaction,” due to constipation caused by the opiates he needed for pain control. The nurses apparently wouldn’t help with that, and didn’t stay in the bathroom with him; although it sounds like the butt of jokes, for someone just after surgery, self-disimpaction is a dangerous act. Knowing I could have helped was the end to further nights in my own bed. We want so badly to have control, and, while I didn’t think I could stop bad things from happening, I wanted to be there to stop them from being worse. It was for me as much as for him. Really, it was more for me.

I’m an ER doctor. ER docs are routinely expected to care for patients when they themselves are in labor. Or have appendicitis. Or have a fever of 102. Or are emotionally distraught from worrying that their husband is going to die. As long as you show up to take care of others, that’s all that counts in emergency rooms. Some colleagues asked how Jake was doing, and if I was okay—often in the kind of tone that assumed I’d respond in the affirmative. Because that’s an implied part of the job: being okay, even when you’re not.

I spent over a decade being expected to separate my personal needs from my ability to address the needs of others. That never appeared in employee handbooks but it was everywhere, a cultural miasma that seemed bizarrely opposed to what medicine is supposed to be about. I wasn’t used to the type of concern I was getting once I crossed the threshold from doctor to patient’s spouse upstairs. It was strange. Didn’t you just do what you had to do, and then push through the moment when you thought you couldn’t? Didn’t you dissociate? Isn’t that how you survive?

Near the end of the hospital stay, Jake and I watched videos describing how to take care of the various new medical devices Jake would need to breathe and to eat and to take pills. There was a video for caring for the trache. Another video for how to care for the peg tube, the peg tube being the tube that connects the outside with the inside of his stomach. For the rest of his life, he’ll ingest most calories through the peg tube. There was even a video describing how to carefully crush a pill using the plastic crusher (spoiler alert: twist to the right and don’t use your teeth, both of which also apply to beer bottles).

Jake survived the surgery and the hospital recovery, and I survived too. I’m writing this in August 2023, and we’re both at home, but the cancer has returned: at least four locally recurrent tumors in his neck, and possibly two metastases in his lungs. I don’t know how long Jake has, and part of the answer depends on finding a good clinical trial. Trying to find one of the better clinical trials is my self-care right now; almost no one survives long with what Jake has. Recurrent head and neck squamous cell carcinoma (HNSCC) kills. Chemo may give him more time, measured in months, but it isn’t curative. Nothing we have is. Barring a miracle that seems increasingly out of reach, he’s going to die.

So I find myself missing those simple, clearly digestible videos about trache care and peg tube cleaning and pill cutting. I wonder, where’s the video that tells you how to find the clinical trial that will put your terminal husband into magical remission? Where’s the video that tells you how hard it is to hold your husband’s hand when he says goodbye to his closest friends, one after another, for the last time? How do you to plan to have a baby he’ll probably never meet? How do you deal with the tears when you talk about cremation, because it’s relatively eco friendly, and getting a plaque on a park bench in New York City, so people have somewhere to go when they want to be with him? Why isn’t there a primer on how to say goodbye to him yourself?

The truth is, right now caring for Jake is mostly a matter of the heart and of logistics. In the month after surgery, and during the first week of his first round of chemotherapy, a lot of my attention was spent monitoring physical practicalities. Then, he improved. Before the cancer circus started, Jake was an energetic person—in the gym, riding bikes, taking long walks, extolling the virtues of the standing desk, working, learning, doing. For a dying man, he’s still surprisingly lively, and very much himself. The other day, for example, he moved a bike that had been living in our common room into his office, and when I asked what had happened to the bike, he innocently asked: “What bike?” And he continued to obstinately pretend not to have known about the bike in our apartment until I finally thought to check the office. He looked extremely entertained. This is normal Jake behavior, and I was equal parts infuriated and relieved by it. I should’ve known better by now and checked the office right away.

He makes me dinner in the Instant Pot, most often using the slow cooker setting. After peg tube feeds, we go on walks. We still have moments when we talk about ideas and books, and where we read together. We’re a book club hiding in a marriage. I cry a lot—I am what I am—and mostly, I spend the bulk of my day on the Sisyphean task of searching for clinical trials.

It’s good to have a project. Without something to focus on, I’m like one of those domesticated African Grey parrots who pluck their own feathers out for want of something to do. I try to do as many of these things within reaching distance of Jake. Even better if I can have a hand or an entire limb draped over him.

We are trying to carry things out the way we always have—together. Jake says he’ll make me dinner until he can’t. Both of us fear that the moment he can’t is coming, soon. I puree him pastries and call about clinical trials. I cannot feel more loved than when Jake hands me a bowl of lentil soup, and the act of eating becomes a comfort to me. I’ll be 117 pounds in no time. And, hopefully, he feels something similar when I get his name added to another trial waitlist and oversee appointment scheduling. Finding ways to take care of him is taking care of myself. And vice-versa. Being asked if we’re taking care of ourselves, is, in itself, a form of being cared for by others, from afar. I’ll try to hear less of the actual question and more the intent: We’re worried about you both. We hope you’re doing as well as you can, day-by-day, until the darkness takes him.

So now, when I’m asked: Are you taking care of yourself? I’ll answer, honestly, “no.” This isn’t the time for self-care; I have decades of that in front of me. We’re caring for each other. 

If you’ve gotten this far, consider the Go Fund Me that’s funding ongoing care.

*If you’re never slept on one of these chairs, know that they’re terrible, and they’re also ubiquitous. Eventually in your life, you you’ll probably sleep on one, for tragic reasons similar to mine, and, when you do, realize that the one un-padded area is the one where you hip will land if you try to sleep on your side. But the camping pad, along with a blanket wedged underneath the parts that dip, turn those chairs into a passable sleeping surface. Try to remember this information, because the most important thing is that this sleeping surface will be five feet from the person you love most.

What it’s like to be married to a dying man

July 24, 2023 By in Personal Tags: , 5 Comments

My wife, Bess, wrote this. For more context, see “I am dying of squamous cell carcinoma, and the treatments that might save me are just out of reach.”

Jake is sitting on the couch beside me when he asks, “What’s it like being married to a dying man?” At first, I think I’ll be able to answer easily. I’ve been answering it implicitly for the last seven months, although I didn’t really know he was going to die, soon, until Friday, July 21—three days ago. I’ve been keeping a journal, so I’ve had a place to record the difficult, confusing, and sometimes banal details, like the pitch of the feeding tube beep, the smell of the hospital rooms, the myriad of administrative frustrations. But when Jake asks me what it’s like being married to a man who won’t be here in six months, for his 40th birthday, I’m speechless. I open and close my mouth a few times, because “what’s it like?” isn’t just about loss, although it partially concerns that, and it isn’t about regret, although that’s part of it too—and many other intrusive thoughts find their way unbidden into my stream of consciousness.

“What it’s like” is: it’s like gaining enormous, terrifying clarity. The moment when you realize the right path, the yes or no answer, the end of the debate. Clarity might sound great— don’t we all want clarity? But clarity is cruel, too. We’re fond of illusions, and we’re fond of fictions, which are themselves a sort of illusion. We lie to ourselves about how attractive, capable, intelligent we are. Staring into the face of what matters means reconciling with all the time you spent focusing on what didn’t. And it turns out, that was a lot of time. Why was I watching TV? Browsing Instagram? Holding my phone instead of a person? Fighting the silly fights? Prosecuting pointless arguments? Clarity shows that love matters, as does recognizing love, so that you can nurture it and appreciate it. Romantic love matters, but also friendship love. And yet so many of our daily behaviors and practices are antithetical to these clear, high-level principles.

With clarity came the realization that I’d done a lot wrong—time spent, for example, not recognizing love because I was nursing my own wounds and chasing some kind of made-up ideal, would be the great regret of my life, if I chose to carry it.

I’m an ER doctor, so I’m used to delivering existentially bad news, but no one I’ve given a life-threatening diagnosis to has turned to me and said: “I wish I’d held onto my grudges. Maybe one will come visit me in the hospital.” I’ve seen a lot of people die, or learn how close they are to death. The things they say and regret tend to be similar: not being kinder or more loving, not mending broken friendships and family ties, spending so much time at work (where I am, when they tell me these things). No one says: “Doc, I should’ve spent more time pursuing petty grievances.”

Clarity removes the opaqueness that leads to misunderstandings. How do we ever know another person? How can we? One woman in a Facebook group reported that, after a five-year cancer bout, her husband was dying and she’d never really loved him and he didn’t know (she didn’t think he knew).  What do you do with that? What was her life like? How did it take her so long to reach that conclusion?

My perspective is the opposite of that woman on Facebook: I really really love Jake, and now he’s being taken from me. For 15 years he’s been the greater part of my world. I used to think we couldn’t know another person. But in the last few days, I realized that much of what I have come to believe about both Jake and myself are true. We are human. So we’re petty and small and easily irritated. We too often resemble gerbils or hamsters in too small or too befouled a cage. We too often choose the wheel instead of the larger universe.

But we are also capable of profound intimacy and love and awe at another person. And I realize that, when I look at the measure of our almost 15 years together, it’s the angels of our better nature that’ve won. It’s a gift to sit with your regrets, and realize that they are not important. You can put them down. The future I’m walking into will be heavy enough without the extra baggage. And anyway, I don’t believe in checking bags.

Clarity after someone dies isn’t, I think, all that uncommon. Innumerable TV shows and novels explore what people do when faced with an unexpected loss that causes them to take stock, usually as it applies to their own life moving forward. Posthumous clarity focused only on yourself is like holding a bag you can never truly unpack, and the person motivating your change is gone, and only half the contents really belong to you. It’s a story with only one real hero, the person left behind.

But clarity when someone is still alive, when you have the gift of some time, is the most difficulty and incredible gift I have ever received. You’re not looking at yourself. You’re looking into the eyes of the other person, and seeing them, as well as yourself. And if you’re really lucky, you find that there isn’t much of a difference anymore.

So when Jake says to me “I don’t want to leave you,” I tell him, “You can never leave me, because I have parts of you that I will never give up, and that is what fills the spaces left by the parts of me you have taken.”

I don’t want those parts back, because they don’t belong to me anyway. Those, he takes.

I’m not the hero of my own story. He is. So are my parents, my friends, and the people who are going to make sure that I am carried forward into a future I cannot actually imagine and don’t yet know how to navigate.  It’s not about me, it’s about the network I’m embedded in. Trying to look into that future feels like looking into a haboob—a dust storm that we get here in Arizona, that turns everything from earth to sky into one solid, brown, inviolable wall. I don’t know how to find a path through that storm in a world where Jake isn’t here. Mostly because I can’t find my way out of a paper bag, having no sense of direction or geography, and still rely on Jake to guide me when we walk to the same corner drug store we have been going to for the last three years.

He is still sitting next to me while I type this, typing on his own computer, and we are reading over each others’ shoulders the way we have done for the last 15 years. The present is hard, but the path is clear: wake up, spend time with Jake, sleep, repeat. Past that? In the future? Who knows. 

Being married to a dying man inevitably, cruelly, means that one day soon he will be dead. I don’t really believe it, but he won’t be here beside me to edit another essay and run ideas by, go on walks at night and try to catch the lizards that hang out on the stucco walls of our apartment building, read to me before bed, pet my head when I’m anxious, and smack me on the ass when I’m climbing stairs in front of him, and yet, somehow, impossibly, I’ll still be here. Jake won’t be. The world will keep moving whether or not I feel like screaming for everything to stop. When that time comes, I will have help. My friends, my family, my network, my people: I’ve learned to quit being stubbornly independent and let people help me. But mostly, I will look inside myself, and find Jake still there, and once again he will help guide me to find my way.

If you’ve gotten this far, consider the Go Fund Me that’s funding Jake’s ongoing care. We’ve also written a number of other essays, including “Turning two lives into one, or, things that worry me about Bess, after I’m gone” and “Attachment is suffering, attachment is love.”

How do we evaluate our lives, at the end? What counts, what matters?

July 23, 2023 By in Personal, Philosophy Tags: , 7 Comments

One estimate finds that about 117 billion anatomically modern humans have ever been born; I don’t know how accurate the “117 billion” number really is, but it seems reasonable enough, and about 8 billion people live now; in other words, around 7% of the humans who have ever lived are living now. I’ve had the privilege to be one. At current levels of technology, however, the gift must be given back, sooner or later, willingly or unwillingly, and sadly it seems that I will be made to give it back before my time. I have learned much, experienced much, made many mistakes, enjoyed my triumphs, suffered my defeats, and, most vitally, experienced love.* So many people live who never get that last one, and I have been lucky enough to. The cliche goes: “Don’t be sad because it’s over; be happy that it happened.” That is what I’m trying to do, at some moments more successfully than others. I try to focus on those ways I am so lucky and blessed, but I am often failing. Bess (my wife) and psychedelics taught me to love, and the importance of love, and yet too soon now I must give everything back. Too soon, but, barring that miracle, there is no choice.

What really matters, sustainably, over time?** Other people, and your relationships with other people. That’s it. That’s the non-secret secret. As the end approaches, you’re not going to care about your achievements or brilliance or power or lack thereof; you’re going to care about the people around you, and how you affected them, and how they affected you. That’s what will matter. I’m not saying you shouldn’t learn economics or calculus or programming or landlording, but all of those things, done optimally, will also bring you in touch with other people who are trying to hone and develop their skills in those domains. It’s not just the achievements, though the achievements matter, but the people collected and improved in the course of mastering a domain.

I’ve spent my life trying to learn to develop the skills necessary to connect with other people, which were, shall we say, not strong elements of my parents’ personalities. I’ve heard a cliché that goes something like: “What the rich know, the rest of us pay for learning with our youth.” I can’t find the true wording or source right now. It’s supposed to be about money, manners, and refinement, and so on, but the more generalizable version of it is more like: “The important life skills you lack growing up, you’ll need to learn later, or suffer without them.” So I had to learn how to relate to other people synthetically, on my own, and suffered greatly for it. Even something as seemingly simple as “maintain eye contact” or “search for common ground.” Since the inability to relate to and connect with other people was one of my great deficits, probably I overemphasize it now, like many people who have overcome challenge x and now relentlessly over-apply challenge x to everyone else.

There are a lot of things I wish I’d done differently, but it’s obviously too late now, when there are weeks or months left. But there’s also little to hide, or be ashamed of at the end. I did the things I did and made the friends I made and spent longer having fun in the city than was wise, letting the the time pass instead of focusing on having a family. So many parties, such high rent, so little time: I am a creature shaped by my times. Studied the easy thing instead of the valuable thing in school, too many student loans, foolishly believed the “you’re learning how to learn!” line (Andy Matuschak is 100x better on learning how to learn than most humanities undergrad majors, or things like shudder law school).

That is life, however. Beautiful and cruel. The two are inextricable. I made many mistakes and paid for them. The best thing I did was meet Bess, who is just the right person for me, to the point that people have said things to us like: “You two are really well-suited for each other” (and not meant it as a compliment). The truest mistakes are of the “not been as generous as I should have” or “decided to let those projects go” variety. The things undone and that will now never be done. But I feel lucky, at the end, to have heard from many people who say they love me and mean it, and who I can say that I love and mean it. When I hear that, I know the positives of my life outweigh the negatives.

* Bess edited this and wrote in a comment: “No matter what happens to me, loving and being loved by you has been the crowning experience of my life. I will think about our happy times when my own time comes. You have given me the greatest gift and we are so lucky, even now.”

** That’s essentially another form of the question: “What is the purpose of life?” The answer can’t be imposed from the outside, but I think its true shape takes the same form for most people.

Praise, criticism, and hypocrisy around people you know

October 19, 2015 By in Culture, ideas, Personal, Philosophy Tags: , , , Leave a comment

I got some pushback on two recent posts, in which I said “Bess Stillman is the best med school essay writer there is” and that Mate is good but that I’m not an unbiased observer. The basic thrust of the pushback is that I shouldn’t talk about books or services or people I have a direct connection to. But I don’t think it’s true: Dr. Stillman is the best person in her genre I’ve ever seen, and Mate is the book that young straight guys (and probably some older straight guys) need to read. It’s possible to praise those works without compromising intellectual integrity, and indeed if I thought either of their works weren’t good I’d be silent. Silence is often tact; I’m sure some people I know dislike or feel neutral towards Asking Anna or The Hook, and for the most part they’ve said nothing. But approval matters too, and Dr. Stillman’s admission consulting and Mate are worth your attention; attention is the scarcest commodity in the modern information economy and I don’t want to waste mine or yours.*

We live in an information-rich and insight-poor environment. Much of the writing masquerading as insight isn’t, really, and I want to imagine that I’m ever-so-slightly changing the ratio of information to insight. That happens not only around books or ideas I write about, but also about books or ideas or services by people I know—and there is still a key difference between people who I know in real life and people I don’t. For as long as humans are humans personal interactions will matter. That’s why I only do book interviews in person: there’s a different energy there that unlocks ideas not unlocked via written interviews. I’m not saying one medium is better than the other—they’re different—but I am saying the outcomes tend to be different in ways hard to define but easy to feel and notice.

Within this context, it’s possible to be silent when something is not worth attention and loud when something is. If you’re writing bad things about your significant other in a public space, you should really reconsider who you are married to, dating, or sleeping with. Actually, the person you are married to, dating, or sleeping with ought really to reconsider you. The place to offer (suitable delicately phrased) criticism is in private, not on the public Internet.

I of course am not the first person to discuss these matters and I won’t be the last. They’re matters tact, money, and interest, which never go out of style and are always a challenge for every era, and arguably moreso for ours. Authenticity is a bogus concept and yet it’s everywhere (and its bogosity makes it attractive to marketers and other people with shit to sell). I like to think I’m disinclined towards bullshit, in the Frankfurt sense, while still being able to speak to books, works, products, and services that I know through personal connections. So I include disclaimers about potential conflicts of interest where they’re relevant and otherwise try to say things that are true and interesting. The world has an eternal shortage of statements that are true and interesting.

* That’s also one reason why I no longer write negative reviews of books or other materials that are bad in uninteresting ways.

My novel, Asking Anna, is out today

January 17, 2014 By in Books, Fiction, Personal, Writing Tags: , , , , , 6 Comments

Wordpress cover image-3My first published novel, Asking Anna, is out today as an eBook; the print book should follow next week. It’s fun and cheap and you should definitely read it. Here’s the dust-jacket description:

Maybe marriage would be like a tumor: something that grows on you with time. At least that’s what Steven Deutsch thinks as he fingers the ring in his pocket, trying to decide whether he should ask Anna Sherman to marry him. Steven is almost thirty, going on twenty, and the future still feels like something that happens to other people. Still, he knows Anna won’t simply agree to be his long-term girlfriend forever.

When Steven flies to Seattle for what should be a routine medical follow up, he brings Anna and hits on a plan: he’ll introduce her to his friends from home and poll them about whether, based on their immediate judgment, he should ask Anna. But the plan goes awry when old lovers resurface, along with the cancer Steven thought he’d beaten, and the simple scheme he hoped would solve his problem does everything but.

Asking Anna is a comedy, in the tradition of Alain de Botton’s On Love and Nick Hornby’s High Fidelity, about how the baggage you bring on a trip isn’t just the kind packed in a suitcase.

I’ll be writing more about Asking Anna next week. I’ve been writing fiction with what I’d call a reasonably high level of seriousness since I was 19; I’d rather not do the math on how long ago that was, but let’s call it more than a decade. It took me four to six false starts to get to the first complete novel (as described in slightly more detail here) and another two completed novels to finish one that someone else might actually want to read. Asking Anna came a couple novels after that.

People who don’t write novels are often surprised to hear about aborted and unreadably bad novels, but producing a few before finding the knack is a pretty common trajectory among writers who, again, produce work that someone else might actually want to read (this may sound like a low standard, but even hitting it is much harder than is widely supposed). It takes a long time to really figure out how to tell a story and how to use the primary tool authors use to tell stories (words) effectively. It’s also hard to find other people who can a) know enough to give good feedback (which doesn’t mean “nice” feedback), b) who are sufficiently sympathetic to what you’re trying to do to not dismiss it outright and c) are interested enough to really talk about writing in general and one’s work in specific.

The preceding paragraph may be getting too far into the weeds of novel writing, but everything in it was a surprise to me when I finally figured it out, and surprises are often worth sharing and worth writing about.

Don’t Fuck With My Money; or How I Stuck it to the Man and You Can Too!

December 19, 2012 By in miscellaenous, Personal Tags: , , , , , , , 2 Comments

A friend wrote this story and sent it to me, which I post both as a warning and for its own sake.

rack_city_3Police officers have a long and storied history of lying during arrests, on police reports, and even perjuring themselves under oath. They’ve lied about me, in front of me. As Americans, we’re fortunate to live in a country where the burden of proof lies upon the law enforcer instead of the lawbreaker. This is why routine traffic stops should follow strict protocols. Even ruthless murderers have gone free because of technicalities. My particular story contains more of the former (protocol violation) and none of the latter (murder), but if you follow my recommendations you may find yourself where I was this morning—at the end of a gavel hearing the words, “Case dismissed.”

Throughout my life, I’ve had piss-poor luck when it comes to getting caught by authority figures. I nearly got suspended in middle school for de-pantsing a friend in biology class. Freshman year I was suspended for dicking around in English class (and inexplicably promoted to an honors class as a result). Junior year was a whirlwind of parties, subpar oral sex, and death threats from parents of said subpar fellatio perpetrators. The cherry on top of this year was a cold, rainy weekend in November where the police caught me drinking before a football game with a freshman girl. The very next night, I had the supreme idea that I should drink a beer and get behind the wheel of a drug dealer’s car. This left me with one DUI, a narrowly avoided felony possession charge, a night in jail, and $10,000 subtracted from my parents’ bank account.

In college I had a few brush-ins with the law. A couple of fake ID charges, a minor in possession conviction, and assault charges (dropped because I was defending myself, of course). My point is this: I clearly never had a future as a cat burglar, or any other kind, and learned that I have the dubious ability to get caught every time I do something bad and/or illegal.

I live in Los Angeles now, a city which not only thrives on the fumes of automobiles but willfully ignores the need for public transportation. About 45 minutes south of LA lies the idyllic, WASP-y cove of Newport Beach, made famous by moronic reality television depicting the spoiled teenagers and the neurotic housewives who produced them. One of my best friend-girls, “Anastasia”—not her real name, but it’s equally stripper-esque—was dating one of Newport’s denizens and invited me to join her on his massive yacht for Memorial Day. She promised enough silicone to keep me afloat for days should the boat sink, and unlimited expensive booze served by nubile models and tennis instructors. Needless, to say, I agreed.

I invited “Kelly,” another of my best friend-girls along for the ride. Kelly is the rarest kind of woman in LA: an attractive blonde with a brain better served for advanced biochemical formulae than destroying douchey pseudo-actors in Hollywood, but she regularly used it for both (this will be important later).

The day passed as you might expect: I hopped onto an 80-foot yacht with thirty incredibly attractive women and five men I didn’t know, and I proceeded to drink and eat my way into perpetual bliss. Just kidding—you wouldn’t expect that unless you’ve been living in Los Angeles for long enough to meet these types. I met Anastasia’s boyfriend, “Alladin”—the owner of the boat. Curious about his opulent lifestyle, I asked him what he did for a living. He mumbled something about buying and selling “web properties.” I was in a similar industry at the time, but I elected not to press for details: I’ve learned many things in LA, and one of them is that if someone can’t explain to you what he does for work, you probably don’t want to know.

Several glasses of a champagne, a few beers, a couple Grey Goose and tonics, at least five makeout sessions with some of the MILFier attendees, and one botched threesome attempt in the captain’s cabin later, we found ourselves heading back to shore. We ordered enough Chinese food to feed a clan of Hutts and watched the sun go down over Newport Harbor. Three hours later, after Kelly and I made the expert determination that I hadn’t imbibed for several hours and thus was capable of driving, we said our goodbyes.

This was my first mistake of the day, aside from failing my attempt at a threesome. Kelly and I were busy jabbering about how awesome our day was and how we couldn’t wait for our next yachting adventure. About fifteen minutes after getting on the 405 freeway (known as the “four or five hours” to LA residents), Kelly noticed a black-and-white pacing us. I remained calm—I wasn’t speeding and, to my knowledge, I was no longer drunk.

It turns out that the opposite was true in the eyes of the law.

The cop, who will henceforth be known as Officer Dipshit, turned on his flashers and directed me to get off the freeway. Before I could let out the breath I didn’t realize I was holding, he’s yelling at me over his PA system. Within five minutes he’s at my window telling me he detects the odor of alcohol and administering a preliminary eye test (without my consent) known ominously as the “Nystagmus.” He’s asking me to exit the vehicle. He’s asking me to submit to voluntary tests. Remembering my first encounter with a potential DUI in Washington State, and the video “Never Talk to the Police,” I raise my hand and emphatically state, “I REFUSE.”

Police don’t like their authority being questioned. They especially dislike it when a citizen knows his rights and chooses to exercise them. Read these words very carefully: voluntary DUI tests are designed for you to fail. You can be Michael Phelps or Usain Bolt on a midsummer’s day in 2012, sober as a rock, and still fail the tests. DUI tests were created to stack evidence against you in order to give the officer a defensible reason for arresting you. Let me repeat: if you have had anything to drink, ANYTHING AT ALL, do not submit to these tests.

Some of you are familiar with Tucker Max’s work, but most of you haven’t read his poignant piece (written with friend and business partner Nils Parker) about the different types of people who become cops. My arresting officer was certainly a “High School Napoleon”—5’4”, 220 lbs of seething, blubbery vengeance for all the wedgies and rejections from women throughout his life. I’m not stupid enough to be disrespectful to a cop. Should you find yourself in my position, do what I did: give him short, courteous answers, do not admit any guilt, and above all do not submit to his tests, no matter how much he tries to scare you.

Upon rejecting his voluntary DUI tests, Officer Dipshit threw his pad into the air and informed me of my imminent arrest. He pushed me against the car as he slammed the cuffs on my wrist, whispering that his colleagues had “Fucked up bigger guys than me,” and tightened the steel links until my hands went numb. I knew that I was in for a joyous night. The officer then proceeded to threaten Kelly, telling her that he was going to arrest her too, asking her if she would like to spend a night in jail. The only thing I was guilty of thus far was driving a red sports car with a hot blonde in the passenger seat.

I was arrested, taken to the police station, and booked for DUI. After sixteen miserable hours, I was released to my disappointed mother. Eventually they got around to testing my blood. You must submit to this test, otherwise you’ll be automatically convicted of a DUI and your license revoked for a year, but you want to have it administered at the police station. The results wouldn’t be known for weeks, but it turns out that my Blood Alcohol Content was .09, otherwise known as the equivalent of a little more than a beer per hour. In the eyes of the law, I was intoxicated. It doesn’t matter if you think you’re drunk. It only matters what your blood says (Dexter Morgan would appreciate this sentiment).

After receiving a citation for a DUI, you have a few options. You can go to your hearing, plead guilty, go to your alcohol classes, attend the M.A.A.D. panel, install the breathalyzer in your car, and deal with a suspended license for six months. Most people choose this—especially the ones that have an egregiously high BAC. All told, your first DUI will cost around $5,000 even if you choose not to hire a lawyer. This doesn’t count the peripheral costs, like explaining to your employer why your license is suspended, telling your date why you have to blow into a tube before you can start your car, or attempting to bum rides from your friends while you’re carless.

I hired a lawyer and went to war with Officer Dipshit. The truth is that most of you won’t be able to do anything about your DUI. Your case will be open and shut, the same kind of case that passes through municipal courts hundreds of thousands of times a year in the U.S. However, there are a few things that you can exploit to your advantage:

  1. If you were smart, you didn’t take the voluntary tests. Now the officer has to prove that he had a legitimate reason to pull you over in the first place.
  2. Your lawyer should subpoena the dashboard video of your arrest. Ever gotten stoned and watched an episode of COPS? It’s hilarious, right? Not so much when you’re the perp. Luckily for you, most states require police to videotape their arrests—thanks, Rodney King!
  3. The dashboard video will sometimes allow you to systematically refute most of the cop’s police report. As I mentioned in the opening paragraph, police will almost always embellish or outright lie on the police report. In my case, the cop claimed that I was speeding, swerving, driving erratically, refused to pull over, stumbled upon getting out of the vehicle, displayed an aggressive demeanor, and generally acted like a drunk lunatic. None of this was true. Cops, incidentally, are trying to eliminate the ability of citizens to record them, because they dislike objective evidence that documents their actions.

My lawyer built a case against Officer Dipshit, culminating in this morning’s hearing. Officer Dipshit took the stand and said all the “facts” in his police report were accurate. The police report was inadmissible as evidence – the dashboard video, however, was admissible, and showed him contradicting himself. Officer Dipshit lied his way into a corner, and the prehistoric judge presiding over the hearing ruled that he was an idiotic, lying, power-tripping asshole, just as we suspected all along.

Total costs:

Lawyer fees: $5,000

Hours spent worrying: countless

The look on the cop and district attorney’s faces when they realize that their asses have been handed to them on a silver platter: priceless

Your life lesson: Don’t talk to cops, and learn how to fight the system.

I’ve been working:

May 5, 2012 By in Personal Tags: , Leave a comment

A couple of readers have written to ask why I’ve posted very little over the last couple of weeks. The answer is simple: I’ve been writing for people who pay me to do it. Whoever gives me money automatically moves to the top of the writing pile.

I've been working:

May 5, 2012 By in Personal Tags: , Leave a comment

A couple of readers have written to ask why I’ve posted very little over the last couple of weeks. The answer is simple: I’ve been writing for people who pay me to do it. Whoever gives me money automatically moves to the top of the writing pile.

Not disappeared, just traveling:

March 20, 2012 By in Life, Personal Tags: , , , , , Leave a comment

I hate these kinds of posts, but here goes: I haven’t disappeared. I’ve just been traveling, first to New York then to the International Society for the Study of Narrative’s conference (hence “How to keep your customers happy on planes“). Said conference demanded a paper, which I’ve spent all my literary energies on that paper, rather than the usual blog posts, and academic tomes are dense and time-consuming, which cuts into “normal” reading time.

In other words: blah, blah, blah; normal posting to resume shortly.