A Bump In The Road

A bump in the road the last weekend of August

Saturday morning I woke early in Montauk with abdominal pain. Not bad and I thought it mihgt have been from last night's dinner. Chicken and rice. White rice. Not likely. I walked to Ditch Plains beach for a swim. The southernly wind was cool off the Atlantic. I laid on the sand. Low clouds cloaked the sun. Summer was comIng to an end. Another three weeks. The pain was not ending.

I returned to my tent and dressed for work. Shirts, a polo, summer jacket, Sperry Rand boat shoes. Looking a true New Englander on teh East En of Log Island. A taxi ride to 771 p5 Highway. Winick Fine Jewelry. A coffee. My young co-worker opened the door. Izsa regarded me with concern.

"Are you okay?"

"Maybe."

"More like maybe not."

"I'm calling my doctors." I pulled out my cell. It was a Saturday. None of my calls were answered other than by answering services.

The pain increased with spikes into my gut. This wasn’t food poisoning. Something more serious. I laid on the floor hoping for it to subside. No. I googled the symptons. Possibility of a blood clot to my stomach. Very dangerous. 80% fatality within twenty-hours. No more toughing it.

My co-worker, Izsa, was so alarmed by my state that she called the owner and said she was driving me to the hospital. Richard asked if she could wait till he got there.

"No."

She ordered me to do nothing. I obeyed every letter of nothing. Five minutes later she closed the safe.

"You have everything?"

Wallet, phone, glasses ,house keys. Ready to go.

Izsa drove over Hither Hills across the Stretch through the blighted Pine Barrens and Amagansett. Fast. She was the type to panic.

The pain blankled out my five physical senses. A boa constrictor was devouring my guts. I breathed slowly and deeply. No help. My hands grew cold. Not a good sign. We reached the hospital. Very much a Easthampton boutique. No lines. I informed the triage desk that I was in very excruciating pain and also a liver transplant patient. The pain 12 going onto 13. I aske if my Medicaid covered this visit. They said yes. All systems go.

After registration I was wheeled to a spacious private room andd put onto a bed for tests. The nurse injected a strong painkiller in my vein. I thanked Izsa for the ride and her TLC. She smiled knowing I was in good hands.

"Go back to work." I was used to being alone in hospitals.

"Okay, but I need you back at the store next week"

"Thank you." She left me to the care of a hospital. We both knew the routine. Wait.

After a half-hour a young attending doctor confirmed my suspicion with his suspicion that I might have a blood clot and the nurse fixed a blood thinner IV into my vein. More worryng was his mention of surgery. He admitted that Easthampton wasn't set up to handle this emergency. At sunset an ambulance transferred me to Stony Brook Hospital. Everyone in Montauk sai it was a good hospital. Sirens and flashing lights. I was in no pain on the two-hour trip down Long Island. I had received another shot.

Stone Brook Hospital was bigger. The ER staff IVed blood thinner and more painkiller, but the hospital also coouldn't help me. My status as a liver transplant recipient demanded specialized care.

Another two hour ambulance ride to my old hospital Weill Cornell in the Upper East Side. No lights. No sirens. Arrive near 9pm. I finally felt safe in the Liver transplant recovery ward. Two nurses remembered me. THree years ago I had recovered from the transplant here. I had been hospitalized more than once in this war. I received of scans and blood tests. One last painkiller shot. Morphine. My toes looked so faraway.

Constant blood work scans and tests. No food. No water. Only ice chips. I called my family in Thailand. I said nothing. I felt like I had passed the worst.

The next day the pain gone. I eat bad hospital food. Three friends visited in the morning . Raoul, Nussy, Jack. I hadn't called anyone else, but Izsa and Richie in Montauk.

"I'm good."

And Sunday afternoon I was released to go home. Out to the street. No one waiting. Down on the Q train to Bleecker Street. Alive as always. Another escape from death. Alive. Lazarus II Resting__I am okay__

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Much more to come.

Happy Yulemas 2022

Three years on Yulemas the transplant team of Cornell Weill unexpectedly called to inform me that there was a liver waiting for me at the hospital. Near death from impending liver failure I was overwhelmed by this turn of events. A miracle. A Yulemas miracle. I phoned my lifeguard Francis for a ride and then called my sister. Gina was silent for a few seconds, then said, "I was looking through my desk and a Christmas greeting sticker fell out. From a long time ago."

She read me the message.

Peter Merry Christmas Santa Claus.

It was in my mother's handwriting. My mother had passed from this mortal coil in 1997 and I cried realizing Angleine Nolan Smith's grasp on eternity.

We are always us.

MY mother and me outside 8 McKinly Road Falmouth Foresides Maine - 1953

Merry Yulemas December 23, 2022

In August 2021 I woke from sleep and vomited several liters of blood. The next day NYU ER doctors diagnosed my situation as life-threatening. An operation to staunch the bleeding was my only option other than death. The staff wheeled me immediatly to the Operating Room. I was knocked out with Profopol. Michael Jackson had ODeed from a strong doses. I only drifted for hours in the white limbo. Upon coming to consciousness the nurse said, "The doctor will be right with you."

He was young and read my condition from a chart.

"You have liver cancer, cirrohsis, Hep-C, and Diabetes. Your tumor is too large for an operation of chemo. It doesn't look promising."

"That's alright, I've had a good life." I had instantly constructed a short future in which I left New York to see out eternity with my family in Thailand accompanied by a large jar of morphine. THe next day their transplant team offered another path. The previous night's surgery had stop the bleeding. Later radioglogy shrunk the tumor to a size allowing a potential transplant and I regularly attended alcohol and drug treatment as prescribed by the antional liver transplant control. Six months went by without my being putof the list. While the surgeon and radiologist were brilliant, the rest of the staff were neglient and after eight months and after a serious bout with ammonia poisoning I realized that NYU had no intention of replacing my liver. They were too Christian to forgive an old reprobate like me and mine. In July I transferred to Cornell Weill. I had to undergo another six-month wait to clear the drug and alcohol ban, although the surgeon said that, "You're not on the list, but you're on the list."

August became September into October into November and December. I lose weight and suffered hallucinations thankfully without too much pain. As much as I wanted to see my kids and wives, I was in no tcondition to survive a demi-circumnavigation of the globe. The Cornell-Weill liver transplant team had forbidden any travel farther than two hours from the hospital. My blood work worsened and my health deteriorated drastically. Cornell said I would be put on the transplant in January. My body was capable of waiting that long and even a little longer without any complications. As December 2022 came to an end, Iggy left for California. We hugged and said good-bye.

"I'll be here when you get back."

"You better be," the leader of the Waif Movement and I had grown quite close during the last three years. We were as close to family as family can be. Blood isn't everything.

I awoke alone the next day.

Charlotta and Shannon were up the Hudson. It was the holidays. Everyone had someplace to be except for me. My universe had shrunked to a bed in a fourth floor apartment wit a view of Lower Clinton Hill. The occasional roar of a motorcycle broken up the monotomy of traffic on the Brooklyn Queens Expressway. I sorted through old photos of my many trips to Africa, Asia, Europe, and South America, gratified to have seen the world.

The phone rang.

Cornell. A nurse.

"Mr. Smith, can you come in?"

"Sure." I thought it was for blood work. "Is noon good enough?"

"The earlier the better. We have a liver for you."

A transplant."

"Yes."

The good news sank in fast.

"Take your time. The liver and heart are last on the list." Her words made sense. A body couldn't live long without a liver. It died instantly without a heart. "We'll see you soon."

I called Francis X, my life guard. He offered to drive me to the hospital. I packed a bag. I had been hospitalized several times in the last year and a half and packed accordingly my glasses, a journal from 1978, earphones, iPad, chargers, my blankie, and a few tee-shirts. Cornell kept the rooms cool. Thirty minutes later I was passenger in Francis' old Saab. A sunny morning I rolled down the window. We crossed the Manhattan Bridge. The city all around us in its glory. Frances and I spoke not of life and death or the operation and thankfully nothing of the Christians' God of Faith ever so clos to Christmas. I said, "I'm really surprised that they called me. I'm not even on the list, although they always said I was on the list."

My blood type was amenible to all donors.

"You are an atheist and maybe everyone in front of you had gone away for Christmas. Gone farther than two hours."

"You might right." I thankeed the Godders for believing in Jesus and his birth as the child god.

Only an hour has passed since the phone call and wwe were only twenty odd minutes from the East Side hospital. Francis pulled into the emergency entrance as I had been instructed and I got of the car. I told Francis he didn't need to come in, which would have meant paying a dear price for parking.

"I'll call you when I know what's what. Thanks. Really thanks."

I shut the door and went to the ER's admission desk. Everyone was maskeed against COVID. I was as wlll. They were waiting for me and swiftly process me and a masked orderly wheeled my stretcher into the elevator and we rode up to the transplant floor. Nursses dressed me in bare-ass johnny pajamas. The surgeon explained the ten-hour operation. I had no questions. The procedure was 95% successful, but there was a 5% chance of my ending up dead. The head nurse had me sign a waiver.

No worries, I've had a good life. Just three things. No God no DNR, adn no Oxys." I hated the Sackler family for addicting millions of Americans to a crappy synthetic opiod and I wanted to live no matter what. AS for God I was comfortable with his non-existence.

"You'll be not out by Propofol. The anaesteolgist is very good. HAve you eaten anything?"

"Nothing."

"We'll be coming for you in a couple hours. Just relax."

That was no probelm and three hours later a nurse and orderly entered to transport me to the operating room. There were many people; doctors, nurses, technicians and orderlies. The equipment appeared new. Everyone was correectly attenive and appeared very professional. The anaesteolgist asked if I had any reactions to drugs. Everything was on my chart, but he ran down the list. I asked him the drug on choice.

"Propofol."

"Good, I'll be back shortly. You ready to go?"

"Yes." I listened to ANARCHY IN THE UK and STREET FIGHTING MAN, sipped some water, and texted everyone in my world. My wives in Thailand, my family in Boston, and 2.6% of my friends and everyone around the world.

"It's time," announced the nurse.

I handed her my phone and nodded okay. THe doctors stood aside and the anaesteolgist hooked me up the the needle.

"Tell me when you do it. " I was to see if I can count back to zero."

"You got it."He waved his finger down and I made it to a personal new best.

Seven.

White limbo>

No God.

No Gods.

Nothing just like always.

This eternity lasted forever until a dream emerged from the whiteness. I was on a large butcher's block at London's Smithfield Market. Butchers were slaughtering animals and my guts were scattered across the wood. I had no pain. No shock, but expected to get up and go to the 24/7 pub and have a bacon sandwich and a lager as was my friend David and my wont after working at the Cafe de Paris in the 1980s. The Londoner was nowhere in sight and the dream segued to consciousness.

The operation room.

I was in the stretcher. No blood in sight. I asked the nurse.

"When are we staring the operation?"

"It's over and was a success. You have a new liver. It came from a woman forty years old and who weighed 300 pounds without any Hep C or cirrohsis.

A Yulemas miracle and I was wheeled to my recovery room. A single overlooking the East River. It was night. I was hooked up to more than a few machines and an IV drip connected to a bag of morphine. They had obeyed my request for no Oxys. I hadn't done any drugs in over a year and a half. The nurse handed me the dosage control.

"The Propofol will be wearing off soo."

"Will I feel pain?"

"Yes, just try and be slow with that."

"I will."

As soon as she was out of the room, I pressed the button twice and turned on the iPad. The Celtics were playing. I made it to the second quarter. All in all it had been a great day as Yulemas turned into Morphinemas nor forever, but at least to the dawn of tomorrow and tomorrow's tomorrow. I felt the scar. It was angry. A woman's organ lay inside me. I called them Paula. They were in no condition to argue adn after another bump neither was I.

Yulemas was not the darkest day of the year, but the first day of the new light.

The Universe of Genders

The Bugis of South Sulawesi embody a fascinating alternative to a binary gender framework. They recognise five genders; makkunrai, oroané, bissu, calabai, and calalai. and each is considered essential to the maintenance of balance and harmony in Bugis society.

Now our culture identifies seven genders; agender, cisgender, genderfluid, genderqueer, intersex, gender nonconforming, and transgender. I personally wonder how many we will have once we abandon the confines of the male or female paradigms.

Ancient Jewish tradition accepted seven genders.

All called Moishe.

On December 23, 2022 I received a female liver to save my life. Paula is forty-two and we co-exist on the cellular and spiritual level. We feel no need to define 'we'. Of course when I asked the transplant team, if Paula's liver affect my DNA, they sternly answered, "No."

Since their usual answer to any medical question is "We will see." I took this to men that they had no idea. As do I, but I think Cis works well.

Sie gesund.

Re-Alive Again

In early October I headed north to attend my nephew's wedding on the South Shore. First time in a year leaving New York. With Jack Haven. I noticed a hospital tag on my bag. Dated 12-27-2022. The day of my liver transplant. Lazurus II wanders the world.

Everything Versus Nothing - Lazurus II

Everything I thought about life disappeared with my first death.
On a hospital operating table
I was Michael Jackson on profopol.
Feeling
Nothing but nothing
And the promise of more nothing throughout eternity.

The hereafter was exactly as I had expected.
A wasteland.
White.
Formless.
Nothing.
No God.
No gods.
No Satan.
No heaven or hell.
No purgatory.
No fear.
No pleasure.
No pain.

Then
I sensed something else.
More nothing.
My math education taught
That nothing times something equal nothing.
Nothing was more powerful than everything
And I was okay with eternity with nothing.

Year ago in Thailand
My father had once appeared in a dream.
In his fifties. Strong. Not old. Not young.
I complained about my problems.
He stopped me.
He knew something I didn’t know and said clearly, “Don’t worry. When you’re dead none of those problems will mean nothing.”
I believed him without question.
He had never lied to me.
I wish I could have claimed the same.

I had lied to me all the time.
In this white nothingness that didn’t matter.
The nothingness absolved me of everything.
I searched for something in the nothingness and found nothing.
My humanness argued there had to be something.
Not true.
I had no eyes, nose nose, no ears, no skin, no tongue,
Yet I could feel the nothingness,
Even though it was nothing.
I couldn’t shut off the nothingness.
It felt like forever, then I segued to a dream.
I was on a cutting block. In London
The Smithfield Market.
Butcher's chopping my body.
My guts scattered across the wood table.
No pain.
No terror.
Simply a vacation from the nothingness,
Except it was something worse.

I emerged from death.

Snap.

My eyes opened.
My body on an operating table.
Profopol fading.
My abdomen opened to transplant a liver.
There were no guts to be seen.
No butchers either.
Nurses surrounded the OR table..
“Are you okay?”
The voice from behind me.
I croaked out yes.

Life.
Not death.
Not nothing.
Breathe.
Feel drugs.
Morphine.
Maybe Dilaudid.
I recall saying no Oxys.

This was not a new life.
I had not died.
I had lied to myself.
The nothing was not real.

A doctor
“Everything went well.”
Everything?
But what about the nothing?
Both were simple answers on morphine

Lazurus In My Blood

Two summers ago in the black night of Brooklyn
I spewed several liters of blood into the bathroom tub.
After wiping the retch from my face
More blood surged from my body.
Something was not right.
Something was very wrong.

I crossed the East River.

Inside the NYU's emergency room.
The staff took one look at my face.
A scrum of nurses, technicians, and doctors sped my body into ICU.
Hands stripped my body nude.

"Sir, can you hear me?" asked a young intern.

Nod.

“You are bleeding to death from the varices in your stomach.”
“Varices?”
“Small fissures. Do you have any family in New York?”
Head shakes from side to side.
“Do you want to be revived?”
“From the dead?”
“Yes?”
“Yes.”
An oxygen mask covered my mouth and nose.
“If you have any prayers, say them.”

“Aathegue.”

The Celtic word held no meaning to Christians.
The hiss of gas.
Profopol.
Blackness swarmed my consciousness.
I was dead on the other side of life.
White light.
Nothing, only white.
There was something else.
Eternal nothingness times zero equals zero.
This was deathand I was cool with that.

And then I was back.
Life.
Here.
Pain.
The Here was not my own bed.
This had not been a dream.

I sucked air.
Another patient in the room.
Not breathing.
Never again.

Hospital.
Nurse.
Doctor.
An earnest doctor.

“You were very lucky.
We stopped the bleeding.”
“I like luck.”
“But I have bad news.”
Plenty of bad news.
Cancer, cirrhosis, the looming threat of death.
I was seventy.
Alone in a hospital bed in a city of millions.

Bad news

I was dead not alive.
Straddling eternity.
No fear
I had died before.

Car crashes.
Beatings.
Broken hearts.
Whatever didn’t kill me made me wish it was dead.
This time same.
Why fight?
Why not?

I was released two days later.

My friends saw death in my eyes.
My children in Sri Racha thought I will live forever.
I thought the same.

Once.
Not now.

I had had a good life.
Maine, the South Shore, the East Village, Paris, Thailand, Africa.
Months passed.
Jaundice, weight loss, pain predicted by my last days.
Then a miracle.

Yulemas

An avaiable transplant.
That night I was in the OR.
The room cuts to black.
Clear light.
I know it well. No gods, no heaven, no hell.

Nowhere. Nothing. No one. The white light of death.
I was gone again.
My body on a chopping block.
Parts scattered.
Like a beef slaughtereed in Smithfield Market.
Then I come back to life.

Antiseptic smell.
Clean sheets
The machines beep.
None followed a Max Roach beat.

A nurse gave me water
It tastes of nothing.

This was not my body.
A black scar marks the execution of the old me.

I am alive.
Lazurus the Second.
Bracketed by pain.
But alive with another soul within me. Paula.

Old School Lazurus II.
Back from the white profopol eternity extinct.

No Maine, no South Shore, no New York, no Paris, nor Thailand.
No permanent record.
Tabula Rasa.
Not a trace.

I am Lazurus II and Paula.
With wicked scars.
Photos reveal the massitude of my transition.
I was never dead before my time.
Only dead to the time before now.

Now under a gray winter sky o’er Brooklyn.
Time eternal, because there is no time in nothingness.
Only Nothing and Lazurus II and Paula.
We are not too lonely together.

Living forever again.
Remember from whence thee came.
Ashes.

Foto by Shannon Greer