loopinfinite

The platitude about the “meaning” of “it all” that people keep repeating is the one that says life is a road to some kind of destination. Traveling this road is achievement. Reaching the destination is success.

The destination is important for its own sake, and the road is important because it represents “the path” that you “choose.” The “journey,” people say, is in many ways more “rewarding” than the destination.

I think this rhetoric has appeared in roughly every commencement address ever given at every high school graduation in America. I think it’s supposed to be inspirational, and maybe in some cases it is. But this stuff doesn’t inspire me. I can’t make sense of the metaphor. I can’t see how the road is different from the destination.

The reason I’ve had so much trouble in med school (aside from the whole thing about me not actually wanting to be a fucking doctor at all – more on this later) is because I can’t “visualize” that “destination.” I don’t see a “goal” there.

People are mainly able to “get through” med school because they are capable of seeing it as a kind of highway that has a beginning and an end. They drive down this highway and then achieve their desired objective: doctordom.

The med program I’m in is a six-year program. That is how people refer to it colloquially. They don’t call it “that med school at UMKC.” They call it “the six-year program.” That is this school’s selling point.

The normal (I guess “traditional”) way to “become a doctor” is by graduating high school and then going to college, where you take a bunch of science classes and whatnot. You have to do really well in these classes. Then you take the MCAT. I don’t know or care what the fuck “MCAT” stands for (nor do I know what the test is like, because I’ve never taken it – more on this later). I just know that the MCAT is the test you take to get into med school. You have to do really well on this test.

Once you have taken the MCAT, you apply to various American med schools. If you’re lucky, at least one will accept you, and you will then go to that school and begin your “medical training.”

If you aren’t accepted anywhere, that’s not as big of a deal as it might seem, because then you just apply to a med school in a third-world country in the Caribbean. They’ll take anyone, and you’ll get the same M.D. in the end.

Whatever school you go to, your “medical training” will last four years. The first two years, you’ll take classes and shit. The second two years, you’ll be on “clinical rotations.” Then you’ll graduate. Then you’ll go spend a few more years in residency.

The net result: you will have used well over a decade of your life to drive yourself into debt and prepare yourself for a boring job that you have to perform while wearing a lab coat that makes you look like an asshole.

You will make a good living, true: enough to buy yourself an asshole house and an asshole car. Every year you’ll give the American Medical Association some of your money, and every year the American Medical Association will donate much of that same money to the Republican party. This is how doctors “help” people. I’m really going off on a tangent here. I need to rein this bitterness in.

The “six-year program” at UMKC is compressed. It allows you to get your undergraduate degree in two years, instead of four. After those two years, you don’t have to take the MCAT. You just immediately spend four more years doing med school shit, and then you graduate. So this “saves” you “time.”

“Saving time” is the only real reason to come here. The “six-year” aspect of this six-year program is a gimmick; it is designed to fool people into thinking that attending a shitty (and needlessly expensive) med school in Kansas City is a good idea. Man, I can feel another bitter tangent coming on. I need to stop this.

The gimmick works. The idea of a six-year program is incredibly exciting to a lot of people. It would be fair to say that most of these people are Indian.

“In India,” my father has always told me, “medical school is just five years long. And you go right after high school. And you don’t do this . . . undergrad thing they do in America. You just go right through. Medical school. That’s how it should be.”

He’s right. That is an advantage of the six-year program: if you’re 1) very “goal-oriented” and if you 2) “know” that “medicine” is what you want to “do” with “your life,” you come here, because yeah, it does let you cut out a lot of bullshit. If you truly see undergrad as a waste of time, then the six-year program is probably “a good fit” for you.

Here’s another, much more sinister advantage of the six-year program: if you’re 1) unlucky enough to be of Indian descent and if you 2) really give no shit whatsoever about “medicine,” then you’re an even better candidate than the go-getter.

This is because your parents, knowing intuitively that you lack the work ethic to get into med school via “the traditional route,” will decide that you should come here when you’re still twelve years old. They will give you no actual choice in the matter. Their hope will be that you’ll get slipstreamed into the “tightly structured” curriculum and end up a doctor before you even know what the hell happened.

It’s a tunnel. Six years. At the end, you are a doctor. What could be simpler?

To the typical Indian, “becoming a doctor” is the most important, most respectable thing you could possibly do with your life. This is particularly true of Indians who are, themselves, not doctors. They view doctorhood through an idealized lens that’s not so much rose-colored as it is fluorescent pink.

I’m exaggerating, but not much, when I say that my dad (who is not a doctor) sees doctors as veritable demigods and/or shamans who never have to worry about anything. I think he imagines that they make, on average, fifty billion dollars a year. I think he imagines that they work, on average, half an hour a week.

Or maybe not. Maybe I have no idea what he imagines. There’s such a cultural chasm between us. I don’t think my dad and I have ever understood much about each other.

When I go home, my dad always tells me, “Just try to think of it this way – you only have x years left,” where x is the number of years of med school I have left until I graduate.

But what then? That’s not the destination. There is no destination. After I have the M.D., what does that mean? There’s residency. There’s working off all the debt I’ve incurred. It’ll be a pain. It won’t be worth it. It’s not like I ever saw anything worthwhile in medicine to begin with.

There are only two reasons people become doctors: either because they really “want” to “help people,” or because they’re Indian. I know there’s some overlap between those two categories, but for me there isn’t any. I’m in the second group, not the first one.

Don’t get me wrong: I like the idea, in the abstract, of “helping people.” That really does not mean I want to be a doctor.

Maybe I’m overthinking this. Maybe most Indians in medicine don’t give that much consideration to why they’re doing what they’re doing, and maybe they’re better off for it. Because if you take away the cultural pressure, what the hell is left? Is there any real desire there? Or are you just doing this thing because it’s front of you, and because you were told you should do it?

Why do you measure your life this way? Is it because you want to, or is it because that’s how your parents see things? If I were to drop out of med school now, then go write a Pulitzer-winning novel and tell my dad about it, he would, I think, be none too impressed. He would still think of me as “a failure” in “my life” for dropping out. Hell, he thinks of me as “a failure” anyway, and I haven’t even dropped out.

A while back, he told my sister, who is four years younger than me and will probably become a doctor someday, that she should study hard in high school in order to not be “a failure in [her] life” like “[her] brother.” He said this while I was in earshot. He knew I was in earshot.

My sense is that if you’re a father you should probably not say shit like this around your son because he’ll remember it forever, and he’ll resent you for it, even if he doesn’t want to. I have no control over my own feelings.

“You don’t want to be a failure in your life.” That was how my dad put it when I was in high school and was trying to figure out what to do about college. “You have,” he said, “a choice. You can go to UMKC’s six-year program, or you can be a failure in your life and starve to death in the gutter.”

This was not a real choice. I pointed that out then. He denied it. I point it out now, and he still denies it. My mom chimes in and says, “Well, really, it’s completely your fault if you don’t like med school because you’re the one who told us you wanted to do it,” but that doesn’t make any sense.

If you put a gun to a dude’s head, ask him a question, tell him to answer it in a particular way, and then threaten to shoot him if he doesn’t, then that dude will give you the answer you want, but he’ll also remember the gun. He will not forget it.

You can’t come by years later and pretend the gun wasn’t loaded, or that it was a toy gun, or that it never existed. You can’t do that. There is a word for that, and the word is “fucking disingenuous.” Wait, that’s two words. Okay, the word is “disingenuous.”

My resentment isn’t healthy, or good, or normal, yet I can’t get rid of it. I will hang on to my resentment, my insecurities, my neuroses forever. Nothing will change because the road is the destination. I already am where I’ll end up.

People spend their whole lives striving to achieve bullshit, and all the striving changes them. It changes the destination too, turns it into something else. People struggle, for years, to get where they think they want to be. Then they get there, and realize 1) that they were always there, and 2) that they actually don’t want to be there at all.

It would be funny if it weren’t so fucked-up and depressing and terrifying. An accomplishment doesn’t mean anything. You’re always the same person. You can’t separate your “struggle” from your “reward.” There is no difference.

A few moments ago I was by the sink eating cherries out of a bag with methodical inefficiency. I’d reach into the bag, take out a cherry, run it under the tap for a second, dry it off with a paper towel, then eat it. I should have just washed a bunch of cherries en masse, because that would have been faster, but it didn’t occur to me to do that. I was too tired.

I could have just not washed the cherries. That probably would have been okay. I have the habit of washing fruit because it seems like the right thing to do what with pesticides and so on, but don’t cherries grow on trees? Do people even spray pesticides up trees? Well, maybe they do. I know nothing about the logistics of harvesting cherries.

I almost never buy or eat fruit of any kind. It seems strange. It seems more natural to just eat manufactured junk. If I live surrounded by processed bullshit, it would make sense for me to eat it too.

The cherry bag has “Product of Chile” printed on it. I bought this bag at the supermarket last night. References to Chile were all over the fruit section. The nectarines were advertised as “Chilean nectarines.” The plums were “Chilean plums.”

But Chile was the only South American country represented. I didn’t see any “Bolivian nectarines” on sale. I didn’t see any “Argentine plums.” There was no competition, so why did they bother advertising that this stuff came from Chile? Why is it important that a nectarine be “Chilean”?

The cherries I bought smell better than they taste. That will, I think, be true of all food someday. Once we’ve driven every species of plant on Earth to extinction, we’ll start making fruit in factories. We’ll make every fruit out of the same stuff. The sprayed-on scent will be the only way to tell the difference between a synthetic nectarine and a synthetic plum.

It’s 6am now. I woke up two hours ago. I went to bed six hours before that. I didn’t see much point in staying up. It’s not like I was studying.

Over these past two hours, I managed to read about six pages. This means, by default, that I got more done in the past two hours than I have this entire weekend.

I should get up early more often. Maybe that’s a way to force myself to study. At 4am there are no distractions. The guy in the next apartment hasn’t turned his TV on, the sun has yet to rise, and the street is silent. Few people have a good reason to drive anywhere at 4am on a Monday.

There is a downside to being awake now: I have a pretty intense headache. I think I get a headache anytime I do something my body wasn’t expecting. My nerves are bewildered. What the hell, they say, are you doing up at this hour? Get back in bed, you asshole.

Nerves, I say, I get where you’re coming from, but in another two hours I have to go to the hospital. So I can’t get back in bed.

The nerves are not happy. I’ll take some Tylenol in a moment to shut them up. I have no idea what I would do without Tylenol.

I’ve got a long, tedious day ahead of me here. I don’t think I’m up to it. I always need more energy than I have. If I could go to CVS and buy methamphetamine as easily as I can buy Tylenol, I think I might do it.

Thanks to the folly of “gifted education,” my secondary school experience was a six-year-long clusterfuck so convoluted that even now I can’t understand the details of what happened and why.

The gist of it is that after I “graduated” fifth grade in spring 1999 (yeah, “graduated”; we had an actual ceremony in the cafeteria and everything), I didn’t go to middle school. Instead I enrolled in a “program” for “gifted” “minds” at one of Springfield’s high schools, where I took “real” high school classes for “real” high school credits.

The main advantage of that program was that it made me feel “special” and “elite.” This was also its main drawback. The program turned me into a smug asshole with innumerable pretensions that muddied my thinking and made it impossible for me to form “meaningful” “relationships” with people.

It wasn’t until I’d been in college for about a year that I finally got off my fifteen-thousand-foot-high horse, and by then it was too late. The “emotional” “damage” had already been done. Someday I’ll make a therapist very rich. Or a prostitute. Maybe I could find someone who’s both.

A few years ago I wrote a story about that: a guy hires a prostitute and doesn’t want to have sex with her. He just wants to talk to her. I thought this was a cool idea. I mentioned it to one of my friends.

“Dude,” he said, “that idea is tired as fuck. That exact shit happens in The Catcher in the Rye.”

“Are you fucking kidding me?” I said.

“No,” he said, “it’s totally what the dude in Catcher does. He hires a prostitute because he’s all lonely and shit.”

“Fucking Salinger,” I said. “That son of a bitch. Traveling into the future, stealing the ideas right out of my fucking brain. Hell does he think he is?”

I still haven’t read The Catcher in the Rye. I keep meaning to, because what kind of charlatan calls himself “a writer” when he hasn’t read the fuckin’ Catcher in the Rye?

I swear, less than a week before Salinger died I was at Barnes & Noble holding a copy of the thing. I did not buy it, because fuck, I have enough books in my backlog as-is. More importantly: I didn’t have the balls to buy it.

It’s The Catcher in the Rye. Everybody – except me – has read that shit. Everybody owns it. Many people were required to read it in high school. In fact, a good way to determine whether someone actually reads books without being “required” to do so is to look at his Facebook page and see if his list of “favorites” consists entirely of The Catcher in the Rye, The Great Gatsby, and To Kill a Mockingbird, because if it does, that dude is not a reader.

I’d feel like such a tool, bringing Catcher to the front of the store. People would see me as an uncultured moron. It’d be embarrassing.

The Catcher in the Rye doesn’t have the same value as hip literature that it might have had back when it came out. If this were 1951, I could buy Catcher with no embarrassment whatsoever; hell, I might even look ahead of the fuckin’ curve. The salesperson might say, “Oh, this . . . this Catcher book. I’ve not read it myself, but I’ve heard a little buzz. I hear it’s supposed to be pretty good, yeah?”

And I’d say, “Yeah, that’s what my well-connected friends in the literary world have been telling me.”

In 1951, reading Salinger was cool. Now, especially given that the guy’s dead, reading him is less cool than ever. The day after he died, I looked up The Catcher in the Rye on Amazon and it was on back-order, because so many thousands of people were rushing to their computers and ordering it. They wanted to be part of the collective “cultural” “moment.”

It’s like how people bought Michael Jackson’s records en masse last year the moment they heard he died. That’s how we Americans mourn when celebrities pass away. We spend.

Now that Salinger’s gone, buying Catcher wouldn’t just make me look like a quasi-literate plebeian; it’d also make me look like some tasteless jerk who’s only buying the book because the guy’s dead now.

As far as I’m concerned, the only reason Amazon exists is so guys like me can order books like The Catcher in the Rye from our homes without any fear of being sneered at.

Now, I know this is partly (read: entirely) just my own neurosis. I bought T.S. Eliot’s Selected Poems not too long ago, and it was only after standing in the bookstore for forty minutes, sweating and panicking, worrying that buying a book of T.S. Eliot would be a disastrously uncool thing to do.

Everyone’s read T.S. Eliot, I kept thinking. If I buy a collection of his poems, I am admitting that I don’t already own one. I am outing myself as a loser. Should I buy something else? Something less obvious? Some Seamus Heaney, maybe? Is that credible enough?

I eventually worked up the nerve to do what had to be done. I remember the salesperson looked at the book I handed her with this disconcerting delight.

“Ah,” she said. “Mr. Eliot! One of the finest poets we have known. What an excellent choice.”

I had no idea what to say to this.

“A slim volume,” she said. “But such good stuff inside! I do hope you enjoy it. It’s very good. Eliot is really quite good.”

Who the hell talks like this? (Answer: People who work at Barnes & Noble.)

I just need to stop going there and switch over to Amazon completely. The salesperson, no matter who it is, always makes some comment about whatever I’m buying, and it’s always traumatic.

When I bought Blood Meridian several months ago, the lady up at the front sighed and said, “Oh, McCarthy. I do love his writing. Such beautiful writing. Have you read Cities of the Plain?”

I admitted that I hadn’t. She looked at me with (what I imagined to be) scorn.

“You have read The Road, though, haven’t you?”

“Yeah,” I said, “I’ve read that one.”

“Of course you have,” she said. “A lot of people have read that one. Because of the movie that’s coming out.” She snorted.

I was too flustered to defend myself, to say, wait, look, lady, I didn’t even know they were making a movie out of The Road when I read it. I had no idea. I didn’t know anything about that. Please believe me.

Though I guess then she would have assumed I’d heard about The Road from Oprah, so it wouldn’t have made a difference.

I don’t think I can ever forgive Oprah for my copy of One Hundred Years of Solitude. It has this huge fucking “O” on the cover, and in big block letters: “Selection of Oprah’s Book Club.”

I can’t take that book out in public without feeling incredibly self-conscious about it.

I can’t do anything, really, without feeling incredibly self-conscious about it.

I’m aware that they make pills for this, but that’s not a route I want to pursue right now. I already take “antidepressants,” which don’t seem to work at all, and I’m comfortable with that. It’s a good setup.

It means I get to take a pill every day that makes me feel like I’m overcoming my problems, and I simultaneously get to wallow hopelessly in those same problems because the pill doesn’t do shit. Whoever said you couldn’t “have your cake” and “eat it too” had no idea what the fuck he was talking about.

Where did that expression come from, anyway? It makes no sense. I’ve had cake many times, at birthday parties and stuff. I’ve always been able to eat it. I can’t think of a time when I’ve had cake and not been able to eat it too.

Back to the “gifted” program. One of the worst things it did was jack up my schedule by letting me take classes before I was supposed to. When I entered “actual” high school in January 2003 as a freshman, I had consumed too many credits and was running out of classes to take.

My counselor told me that the solution was to compress my schedule: to graduate in 2005 rather than 2006, like I was supposed to. She said I could fold sophomore and junior year together.

This seemed like a good idea at the time. Remember, I was still a fucking asshole then; I believed that I was some kind of genius, and that graduating early was therefore inherently a good thing. But now I wish I had just graduated in 2006. I would certainly have been better off in just about every way imaginable.

Even with the compressed schedule, there were holes, gaps to fit classes into. This is why, in spring 2004, I took “Sociology.” I didn’t want or need the class, but I just had to take something, so Sociology it was. It was a “quarter-length” class, which meant it lasted only from January to March. After that, it would be replaced by “Discrete Math,” which would last from March to May.

The Sociology teacher was a kind of crazy dude. Like many teachers at my school, he also coached a sport – in his case, basketball. I got the impression that coaching was what he was really interested in. He only taught because he had to.

On the first day, he told us that sociology (which he referred to as “soc,” pronounced to rhyme with “coach”) was “all about verbiage.” He said that a few times. “Soc is verbiage.” We all waited for him to explain what the hell that meant. He never said.

His lectures consisted of him rambling about stuff that had very little to do with what was in the textbook, something I had no problem with at all. The day before a test, he’d hand out a practice test and say, “All right, guys. This is the scrimmage.”

The practice test would comprise about ten multiple-choice questions. We would attempt to answer them, and then he would tell us what was right and what was wrong. The next day he’d pass out the real test, which would be identical to the practice one.

He didn’t even look at the tests once we’d handed them in. He didn’t keep a gradebook. He just gave everyone an A.

He was a big fan of The Karate Kid. He showed it to us twice.

I remember thinking it was weird to watch that movie in 2004. The whole aesthetic of it seemed quaint and dated in all these minor ways that added up: the way the characters dressed, the slang they used.

The movie was on an aged VHS tape, and everything was all sepia. Every once in a while the sound would drop out. But we managed to get the gist of the story.

“The thing about The Karate Kid,” the teacher said, “is that it’s got everything you need to know about life in it. Absolutely everything.” He was serious.

I would say he was a cool guy, but I did have one beef in particular with him. He talked politics sometimes, and the dude was frankly bigoted as fuck. For instance, he was a huge homophobe. I learned that during a “class discussion.” Someone had brought up the 2003 MTV Video Music Awards, in which Madonna had “shockingly” and “controversially” made out with Britney Spears.

“Yeah,” the teacher said, “that kind of thing – those kind of people – I have to wonder what’s wrong with them. It’s just not natural. Men kissing men or women kissing women. It’s not normal. It’s not right. And we shouldn’t have to see that kind of thing on the TV.” And so on. Whatever. It’s not important.

Here is something very important: my favorite Madonna single is “Into the Groove.” I’m ashamed of that, because if you’re going to say you like a Madonna single, “Into the Groove” is the stereotypical “cool” choice. Sonic Youth covered “Into the Groove,” for fuck’s sake. The song is certifiably hipster-approved. It’s too bad. I wish my favorite Madonna single were something lamer and more embarrassing.

What else is there, though? “Borderline”? No. “Like a Virgin”? I don’t like that one either, though I am glad it inspired Weird Al to write “Like a Surgeon.” As a song about a guy who’s a really bad doctor, it does a great job of describing what my future’s going to look like. “I was last / in my class,” Al sings, “barely passed / at the institute / now I’m trying to avoid / yeah, I’m trying to avoid / a malpractice suit.”

“Into the Groove” is a little weird, because even though it’s supposed to be this upbeat dance tune it has a certain, hard-to-define underlying stiffness. It plods. This is, I guess, something Sonic Youth picked up on when they covered the thing; their version is a sinister drone. But so is Madonna’s.

The song paints a scene: Madonna is, right now, dancing. You, the listener, are watching her dance, and Madonna can tell that you totally want her. She suggests, in fact, that you not “try to hide it” because “love wears no disguise.” She can, apparently, “see the fire burning in your eyes.”

Throughout the song, Madonna argues that you should come over and dance with her: you should “get into the groove, boy” because “you’ve got to prove” your “love to [her], yeah.” She is interested in getting “to know you in a special way.” She believes you and she might conceivably “be lovers if the rhythm’s right.” And if you would be so kind as to “touch [her] body and move in time,” she will “know you’re [hers].”

Madonna’s argument is rather compelling. “Into the Groove” came out in 1985. I wasn’t even born yet. I was negative three years old. How old was Madonna? Was she hot? I can only assume that she was.

I think I am in love with my hazy, imaginary conceptualization of what Madonna may or may not have looked like in 1985 when “Into the Groove” came out.

“Into the Groove” is insincere. It’s a complete lie. Madonna is not really dancing. She was not dancing when she sang the song in a studio in 1985. She does not want to dance with you. She does not even have any idea who the hell you are.

She sings that when she’s dancing she feels “free,” and at home, “at night,” she “lock[s] the doors where one else can see” her dance. This is clearly bullshit. Madonna cannot possibly be the kind of person who would be willing to dance where no one can see her. If she were, she wouldn’t be where she is today, or where she was in 1985, for that matter.

“Into the Groove” is really best heard in a nightclub in 1985. It was designed for that context and that context alone. If you’re listening to the song through earphones in 2010, as I am now, the song means something totally different. It becomes creepy.

I don’t know what it is about the way they produced pop music in the 1980s, but the songs always sound cavernous and empty (yeah, I know that’s the kind of sweeping generalization that only a dude born in 1988 could make). The singer, whoever it is, sounds alone, floating somewhere above echoing drum machines and tacky synth hits.

No way Madonna’s really dancing. She doesn’t sound like she’s in a nightclub. She’s theoretically dancing by herself somewhere. You are theoretically watching her, even though in reality you are not. She doesn’t exist; the entity singing “Into the Groove” is an insincere projection. This projection began dancing in 1985. She is still dancing now.

Two weeks before the end of the semester, my sociology teacher got a job coaching basketball at one of the local universities. We saw it in the paper. It was a big deal, a big job. The day he got that job, he vanished.

He never came back to his classroom. He was just gone. Nobody could find his gradebook, because there wasn’t one. Another teacher in the social studies department had to take over our class for that last week and a half. She ended up giving everyone an A because she had to. What else could she have done? She didn’t have any data.

In retrospect, that sociology class was probably the best class ever. Everyone got an A, nobody had to worry. The teacher even disappeared towards the end. More classes should be like that.

I don’t know what the point of this post is.

The first patient I saw today was on the phone when I stepped into her room. She waved when she saw me.

“Hey,” she said, “I gotta go. I’ll call you back in ten minutes, okay? I love you.”

“Sorry about that,” she said. “My daughter.”

“I’m sorry for interrupting,” I said. “I won’t be too long. I just wanted to ask you a few questions about how you’re doing this morning, if that’s okay.”

It was a canned phrase, devoid of any meaning, not put together so much as called from my mind fully-assembled. I saw this exact woman yesterday morning and I said the same thing to her then, too. “I just wanted to ask you a few questions about how you’re doing this morning, if that’s okay.” I say that to everyone. Always the same sentence.

I hate that. I don’t do it on purpose. It’s fake and sickening. I can’t believe I fell into a pattern so quickly. In my defense I could say that it would have been hard not to. Except that’s no defense.

“It’s fine by me,” she said. “I remember you from yesterday. What team were you on? Were you one of the surgery dudes?”

“No,” I said. “I’m oncology. I’m with the cancer dudes.”

“Oh!” she said. “That’s great, because I got questions for you. I mean, I don’t know if you’ll be able to answer them, but – ”

“It’s cool,” I said. “Ask whatever.”

“Okay,” she said. “Well, I was – I just had my second radiation treatment, right? And I was reading this book they gave me, and some of the side-effects are . . . I was a little freaked-out.”

She grabbed a booklet off her bedside table. Before she opened it, I caught a glimpse of the title. “Whole Brain Radiation Therapy: What You Need to Know.” Something like that.

She flipped through pages of side-effects, each more disconcerting – nah, let’s be blunt here – each more fucking terrifying than the last. Fatigue. Nausea. Weakness. Permanent dry eyes. Permanent dry mouth. Permanent facial numbness. Permanent hair loss. Permanent difficulty swallowing.

“What really concerned me was this.” She pointed at a heading – “Cognitive Decline” – and started reading aloud.

“‘You may experience memory loss, personality changes, or difficulty doing math. You may also develop slow, slurred speech, and have trouble keeping your balance when walking.’”

She looked back up at me.

“See, it’s some scary stuff. I just don’t want to do this if it’s gonna turn my brain into pulp. You know what I mean?” She laughed; it sounded forced. “I know it’s silly,” she said, “but it kinda freaks me out.”

“It’s not silly,” I said.

“I like my brain. I want to keep it. It’s the only thing I have left. You know what I mean?”

“I know what you mean.”

“I mean, ‘difficulty doing math’ . . . I teach high school math. That’s my job. I kind of need to be able to do my job, right? It’s not time for me to retire just yet. This is like, it seems like one of those cases where the cure’s worse than the disease.”

I know something she doesn’t, though: I know her disease has no cure. She was diagnosed with lung cancer two years ago. She went through chemotherapy and was told the cancer was “gone.” Now it’s back.

That’s what cancer does. It comes back. When it does, it’s a bad sign.

The cancer is in her brain now and it won’t go away, ever. The radiation therapy’s only going to buy her a little time. She’ll live for maybe six months instead of maybe three months; that’s all.

She doesn’t know she’s going to die soon. Somebody will tell her this next week. It’ll be a calculated “disclosure” of information. I’ve had entire fucking lectures about it. How to Break Bad News.

Yesterday she told me her daughter doesn’t know the cancer’s back.

“She knows I’m in the hospital, but I said it was no big deal, you know. Just a little bronchitis. I’ll tell her the truth someday, of course. It’ll be great. I’ll say, hey, remember when I had bronchitis a few years ago? It was actually cancer! She’ll get a kick out of it.”

She is younger than both of my parents. Her daughter is younger than I am.

Her daughter knows she’s sick, but doesn’t know about the cancer. And she knows about the cancer, but doesn’t know it’ll kill her. And I know it’ll kill her, but I’m not supposed to tell her.

If she stops getting radiation because she’s afraid of cognitive decline, the tumor in her brain’s going to grow until cognitive decline happens anyway. Her brain is pulp either way. She’s pulp if she does, pulp if she doesn’t.

Her cure and her disease are the same thing: brain damage and brain damage respectively. And then death.

“I know probably it’s no big deal,” she said. Talking about radiation therapy again. “But it freaks me out.”

“Look,” I said, “it makes sense that you’re freaked out. if I were in your place I’d be freaked out too. I’d have the same misgivings. Radiation really is some scary stuff.”

Not the “correct” thing to say. Like I give a fuck.

I left soon afterwards. I had to. There were more people to see. You can’t spend more than ten minutes in somebody’s room. People start asking tough questions if you do. Why are you such a slacker? Why aren’t you more efficient?

In the hallway I saw a guy with ripped jeans, rotted teeth.

“Hey,” he said, “hey, doc.” He was talking to me.

“Hi,” I said.

“You think you can give me something stronger for this back pain I got? I got real bad back pain, man. Real bad. You got OxyContin or some shit like that? You write me a script, man? I need a hundred OxyContin.”

I threw up my hands. “I’d do it if I could,” I said. “Believe you me. I wish I could give you a million OxyContin, man, enough to get you high every day for the rest of your life. But I can’t write prescriptions. I’m just a student.”

“It’s okay,” he said. “I understand. I’m just a patient myself.”

“Yeah,” I said. “You are.”

I remember this great episode of The Wonder Years where Fred Savage’s character was working as a delivery boy for a Chinese restaurant. He went to an apartment with a bag of food, knocked at the door, and the guy who answered was this hippie.

“Oh man,” the hippie said. “Food! Great! I gotta – I gotta tip you for this! I gotta give you something!”

Then he reached for his wallet, opened it, and looked at its contents with shame.

“Of course,” he said, “I wish I had something better. Something more worthwhile. I mean, I’d give you rainbows, if I could, man. I’d give you sunshine and love and happiness and peace. But all I got is this” – he sniffed – “money.”

He stuffed a wad of bills into Fred Savage’s hand and closed the door.