Jacob M. Appel – Of Sanity, Illness and Ruin

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Of Sanity, Illness and Ruin. An Interview with Jacob M. Appel
by Bryan R. Monte
© 2017 Amsterdam Quarterly. All rights reserved.

Polymath Jacob M. Appel (b. 1973) is a lawyer, physician, psychiatrist, bioethicist, certified New York City tour guide, university professor and award-winning writer. He has won the William Faulkner-William Wilson short story award (2004), the Dundee International Book Prize (2011) for the novel, The Man Who Wouldn’t Stand Up, the Black Lawrence Hudson Prize (2012) for the collection Scouting for the Reaper, the Serena McDonald Kennedy Fiction Award (2014) for the collection The Magic Laundry, and the Howling Bird Press Fiction Award (2016) for The Topless Widow of Herkimer Street. Stories. Below is an interview conducted with him in January 2017 about his writing discipline, his literary influences, and the effect medicine and his Belgian-American background has had on his writing.

BRM: With such a busy life, as a bioethicist, doctor and teacher, how did you/do you find the time to write so many award-winning papers, novels and memoirs?

JMA: It’s easy to find time to do things I love doing. I’ll confess that my relationship with writing is much like the relationship some of my patients have with heroin. I look forward to sitting down at my keyboard each day, and if I miss a few days, I suffer through psychological withdrawal. Being a physician and teacher actually helps, as these are rather flexible callings. If I had to be at the coal mine twelve hours a day, six days a week, it would likely be much more difficult to write.

BRM: Do you watch television?

JMA: No.

BRM: Follow social media?

JMA: No.

BRM: Belong to a gym?

JMA: No.

BRM: Have any kind of a social life?

JMA: Yes. Of course, much of my time with friends and family is spent imagining how our conversations, lightly edited, would sound in short stories or novels.

BRM: Do you have any hobbies other than writing or studying for degrees?

JMA: Reading history, attending the theatre, flirting with barmaids. Since I don’t drink, the last proves rather challenging—most women find it odd when you tip five dollars on a glass of water.

BRM: Do you have a secretary who sends out and tracks your manuscripts?

JMA: I should be so lucky!

BRM: A regular time and place when and where you write?

JMA: I write whenever I can cobble together a few hours of down time, often at the hospital in a quiet nursing station or unoccupied examination room. But most of my best writing is done before I put pen to paper—inside my head, mulling over storylines and characters. The American short story writer Grace Paley used to say that she did her best writing in the bathtub. Metaphorically speaking, I assume, although I was never invited to bathe with Grace Paley. That’s sort of what I do, although rarely in the bath.

BRM: How do you shift gears between working on different genres and projects? For example, I knew someone in San Francisco who had separate tables for writing poetry, fiction, and non-fiction with the pertinent papers and books on each, and he’d visit each one over a three-day period. Do you have a similar system or schedule for your writing in four major genres (drama, fiction, essays and memoirs) or do you do a bit of each, each day?

JMA: That would involve the luxury of having an apartment with enough space for three tables, which might be possible in San Francisco, but is a pipe-dream in New York.

BRM: Yes, he had a three-bedroom house.

JMA: I generally only work in one genre at a time, although I may occasionally write a short essay or even a poem while at work on a longer project. As a rule, I choose the genre and project based upon the time allotted—if I am going to have a quiet month at the hospital, I might embark upon a novel, but if my opportunities to write will be sporadic and short, I choose a project that can be completed in days or weeks.

BRM: You seem to be a very prolific writer. Had you been writing and storing up work that you’d written years ago or did you experience a sudden burst of creativity in your mid- to late thirties regarding fiction?

JMA: I’ve been writing seriously for about twenty years. At least since I attended law school in the late 1990s. Through much of that time, I suffered from “publisher’s block” – this is sort of like writer’s block, only the obstacle to publication occurs at a different step in the process. Slowly (all too slowly!) this is beginning to change, as publishers are starting to show an interest in my work. Alas, my writing is about as commercial as soot, so I still have lots of stockpiled fiction. Particularly long fiction. If you know anybody who wants to buy a novel, please send her my way.

BRM: How have the topics, themes and techniques of your pieces changed over time?

JMA: I think writers have a “natural range” and part of developing as a writer is learning to embrace one’s limitations. Faulkner was wise enough not to write about Russian peasants; Henry James avoided whaling expeditions and tales of runaways on Mississippi rafts. Occasionally, a writer is fortunate enough to claim a very wide range. Henry Green. E. M. Forster. Or William Styron, who can write about the Holocaust and African-American slavery and clinical depression with equally powerful insights. When I started out as a writer, I tried to push myself outside my range of comfort – writing about people whose experiences were alien to my own. With time, I’ve come to focus on what I know well—upper-middle class urban and suburban professionals, clinging to order amidst the frustration and chaos of their narrow, tenuous worlds.

BRM: Have you gone through any stylistic/thematic experiments that you later exhausted and/or abandoned?

JMA: I’ve abandoned countless projects. In the 1990s, I wrote about 75% of a novel that retold the story of Mrs. Dalloway in the past and present…and a few years later, Michael Cunningham published The Hours (a brilliant, moving book) that did largely the same thing, and better, and that was the end of that.

BRM: Which writers do you admire?

JMA: I’ll confess I read mostly classics, often over and over again. I could read Anna Karenina or Middlemarch several thousand times without tiring. (My favourite scene in western literature is when Koznyshev takes Varenka mushroom picking in Anna Karenina and fails to propose.) I love comedies of manners—Fielding, Austin, Lucky Jim. And works that capture, to quote Doris Lessing in The Golden Notebook, the “long littleness” of life. But I can also be entranced by the magical if it’s magical enough. What sane reader doesn’t have a soft spot for John Fowles or Thornton Wilder? Among contemporary American writers, I’m very much a fan of Kevin Brockmeier, Dan Chaon, Robert Olen Butler, Elizabeth Graver, George Harrar. I also recently discovered Michelle Herman and Rebecca Makkai. Both geniuses! And I adore Philip Larkin’s poems—even if he might not have been the ideal guest for Christmas dinner. My formers students and mentees like Chanan Tigay, CJ Hauser and Brigit Kelly Young are also brilliant and deserve far more recognition.

BRM: Looking at your short stories, I’d guess that Poe’s atmospheric darkness and O. Henry’s snap endings have had some influence on your work.

JMA: You’re not the first reader to suggest that, but they’re less direct influences than one might think. Candidly, I haven’t read O. Henry (or Maupassant, for that matter) in many years. The most significant direct literary influence on my work probably comes from contemporary drama: Paula Vogel, Tina Howe, Sarah Ruhl. Playwrights who push the limits of the possible, often with humour and whimsy and madness.

BRM: How does a story or memoir first come to you?

JMA: That is indeed the $64,000 question. I wish I could say I’m struck with wisdom, or envision an image, or find my way through a dream, but the not-very-helpful answer is, it just happens. Like falling in love. Or a fatal heart attack. So that’s the best I can offer: coming up with a story idea is something akin to falling in love and suffering a fatal heart attack. I will just somehow know that my next story is about a curmudgeonly landlord who rents an apartment to a mime or an extraterrestrial who finds himself disguised as a Latvian chef opposite an Alabama abortion clinic.

BRM: How does it usually develop?

JMA: That’s an easier question to answer. Once I have a premise—let’s say my mime tenant or Latvian alien—then I map out the scenes needed to tell the story. I always write in scenes and I always know how many scenes I require before I start writing. Even from early childhood, I have always possessed a talent for causing a scene, at least according to my mother, so this part comes naturally to me.

BRM: How do you know when you’re finished?

JMA: Honestly, I know I’m finished when somebody agrees to publish the piece. Or, on occasion, when I return the galleys and it’s out of my hands. The perfect, as Voltaire warns, is the enemy of the good…and fortunately the modern editorial process renders even the illusion of perfection impossible.

BRM: You mentioned to me in another conversation that you’d applied to writing classes at Brown, as an undergraduate, but were rejected. Do you remember the reasons given?

JMA: In my memory, I tell myself they were full and closed to enrolment. But it’s also possible I was rejected “on the merits,” so to speak, but have chosen to block this out.

BRM: Does your publishing success in at least four genres in the last decade seem like a vindication?

JMA: I should begin by saying, while I appreciate the kind words, that my successes are somewhat limited. (I’m not even the most successful writer named “Jacob Appel”; there’s another non-fiction writer, for whom I’m often mistaken, who generally gets better press.) But even if I win the Nobel Prize – and don’t cash in your frequent flyer miles on SAS just yet—it still wouldn’t be vindication. I write from a deeply-held sense of inadequacy, as I imagine many writers do, probably a congenital affliction or one acquired in early childhood. I’m not sure publishing successes will ever cure that…although I am certainly glad to have them. Psychotherapy might, of course, but I’ve worked alongside enough headshrinkers not to trust them.

BRM: What is the significance of your Belgian-American upbringing on your writing? You’ve mentioned it in your memoirs and Allen Lewinter, the protagonist in your short story, “The Current Occupant,” in your most recent collection, The Topless Widow of Herkimer Street, mentions his relatives arrived as refugees in America with 15 Belgian francs between them. What influence has your grandparent’s flight from Nazi Europe and their Flemish language and heritage had on your writing?

JMA: I was extremely close to my late grandfather, who was born in Eastern Europe but raised in Antwerp, Belgium, and always considered himself a Belgian-American. He was one of the most generous human beings I’ve ever known; he was also an amateur poet in his youth, and apparently published Flemish-language poems in several small journals in Belgium, although none appear to have survived. (If anyone can find any poetry by Sander Leo Appel from the 1930s, I’d be forever grateful.) As a result of his influence, I also consider myself a Belgian-American: I studied Dutch in college and made a pilgrimage to the alley off the Terliststraat where he grew up. His flight from the adopted homeland that he loved, and the stories he told, have heavily influenced my fiction. Many of my characters are psychological exiles or refugees, even if they haven’t been physically driven from their homes.

BRM: What is the role of medicine in your writing?

JMA: The impact is largely indirect. Because I’m a psychiatrist, I hear the most amazing stories nearly every day…and I’m not allowed to share them with anyone. So I have to push my imagination in the opposite direction – to create new worlds that I’m 100% certain aren’t drawn from reality.

I do find that medicine, and particularly psychiatry, reminds me daily how close we all are to the edge—of sanity, of illness, of ruin. Friendships and relationships are fragile; promises evaporate under strain. These sentiments form the backbone of my writing.

BRM: How have medical concepts, procedures or cases informed and inspired your writing?

JMA: I have written about a few cases in my collection of essays, Phoning Home, including a piece about my favourite patient (with his permission): a nonagenarian who had once been the chauffeur for American President Harry Truman. But I strive to keep my clinical experiences out of my fiction. My worst fear is that one of my patients reads my latest novel and believes I wrote about him, even if I didn’t. Okay, that’s not my worst fear. My worst fear is nuclear winter. But it’s a close second.

BRM: For example, William Carlos Williams’ “A Difficult Case” could almost be considered a memoir of the treatment of one of his patients, yet it follows the standard arc of a short story. Have you had any similar experiences?

JMA: Williams, who was both a gifted writer and a skilled clinician, had a couple of advantages that I don’t have: he was a paediatrician, not a psychiatrist, and rules governing medical confidentiality were much laxer in his day. I can’t imagine hospital bureaucrats threatening to fire Chekhov or Maugham or Walker Percy over violations of federal disclosure statutes. So I work in a system that makes even fictionalised accounts of cases difficult to write and publish. In the United States, permission from the patient is often not enough to print these stories…one also needs permission from the hospital, from one’s colleagues, etc. It’s much easier to make things up entirely.

BRM: What informs and motivates your writing about euthanasia? You mentioned that when you get to the end, you want someone to put a plastic sack over your head. I, on the other hand, want a computer I can write with by moving my eyeball, and as a result of “live organ donor” horrors, I have decided to exempt myself from the proposed, automatic, organ donor programme here in the Netherlands if it becomes law. How do you feel about that?

JMA: I think the most important objective, which I do believe to be possible, is a system that allows both of us to have our wishes fulfilled. I don’t think there’s a “right” answer about how or when to die, but rather, a “right” answer for each individual. From my work with patients, I’ve found that many people who would never choose assisted suicide still benefit from knowing that it’s an option in theory—that there is an “out” if they ever wanted to choose it. So it’s very possible I wouldn’t go through with my “plastic sack” plan, but knowing that’s a possibility is comforting to me. Of course, I think it’s also essential to have system with meaningful safeguards. Failure to protect those who do not want euthanasia is absolutely unconscionable. As we know, many people can live very meaningful lives and contribute considerably to the commonweal while in the throes of severe illness or disability. Steven Hawking. Jean-Dominique Bauby. I’ll have a novel out in 2018 addressing these challenging issues.

BRM: Most of your books are published by what some would consider indie presses (Black Lawrence, Snake Nation, and Howling Bird Press). Is there a reason for this or is this just coincidental?

JMA: Adam Smith’s “invisible hand” is at play here. Unfortunately, large publishers in the United States are reluctant to publish literary short stories, especially by writers who lack a pre-existing following. My first novel was published by a mid-sized British publisher and I have a new novel coming out with Permanent Press in 2017, which is considerably larger than many of the independents that I have previously worked with—although obviously not Knopf or FSG. But there are upsides to working with smaller presses: The editors tend to be lovely people, deeply invested in the projects. I have made some wonderful friends working with these presses. It’s harder to imagine that happening with a “Big Five” publisher who also manufactures household appliances.

BRM: I’ve dog-eared many pages of your books that mention Creve Coeur, (Broken Heart) Rhode Island. What is the special significance of this place in your fiction?

JMA: I went to college at Brown University in Rhode Island and later taught there for many years, so “Creve Coeur” is my rendering of Providence. The name itself is pinched from a rather dreary bedroom suburb of St. Louis, Missouri, which happens to be the international headquarters of Monsanto. I have been to Creve Coeur, Missouri, and I cannot imagine any place less romantic—not heart breaking, just heartless. In contrast, Rhode Island is a magical place brimming with the ghosts of whaling captains and mobsters.

BRM: What new projects (genres/themes) are you currently working on that you’d like to share with AQ’s readers with giving too much away?

JMA: I have a novel on the theme of assisted suicide coming out in 2018. And I’m currently working on a mystery novel narrated from the point of view of a psychiatric patient with schizophrenia, who believes one of her fellow patients has been murdered. But mostly, like the rest of the world, I’m trying to keep the photocopier from jamming, and looking for that missing sock, and dreaming, not too realistically, of a date with the novelist Karen Russell. Ah, the glories of the literary life….

Nancy Ludmerer – Cara Cara

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Cara Cara
by Nancy Ludmerer

In a Florida hospital, I peel navel oranges to mask the smell of death. I sing dad’s favourite: “Gonna sit right down and write myself a letter.” As a girl, I’d pictured him, young, besotted, writing endearments in florid penmanship, pretending his sweetheart (mom?) had written the sweet words.

Retired to Florida a decade ago, widowed, he’d send Cara Cara oranges every December to Boys Town, the Doe Fund, me — lonely souls back North.

Now I sit beside his lifeless form, white-sheeted. Neither of us has anywhere to go. I sort through his mail, which he’d asked me to bring that morning. Ralph’s Orange Groves has written: “Did you forget your orders this year, Morris?”

Should I tell them?

“It was time,” the doctor says, stopping by to express his regrets. But the doctor didn’t know him. None of them did: not the kindest nurses, the cheerful receptionist, the jaunty mortician wandering the halls saying, “Hopefully you’ll never need me, but just in case.” None had heard him sing.

None had tasted those oranges, skin burst, dripping with juice.

Except, of course, Ralph.

“Dear Ralph,” I begin.

Srinjay Chakravarti – Bitter Pill

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Bitter Pill
by Srinjay Chakravarti

The late afternoon sun was deliciously warm and mellow, and Mrs Lahiri, sitting on the park bench on that cold December day, had almost dozed off. Her head was nodding and the cashmere sweater she was knitting lay on her lap, forgotten.

The sound of sudden raucous laughter, harsh and discordant, roused her from her incipient slumber. She blinked her eyes behind her pince-nez glasses and looked around. There was no one to be seen. She turned around and looked carefully again. She could hear voices from behind the screen of dense foliage. Someone was talking loudly.

She yawned and picked up her knitting again. Suddenly some of the words wafted to her ears and she sat up straight.

“That old fool of a woman, Mrs Chitra Lahiri,” came a deep male voice, “did you look at her face?! It was a picture!”

A young girl’s laughter tinkled in the air. “The idea of the soap lather coming out from my mouth—that was too brilliant. Just wicked! Where did you learn it?”

The young man laughed. “From a friend who was in the army. He had read about it in a book. It’s a trick some young men had used during a war to act out epileptic fits. That way they weren’t drafted into military service in their country.”

Mrs Lahiri was aghast. Not just the mention of her name, but that voice—particularly that young woman’s voice—seemed rather familiar.

She raised her heavy body with difficulty from the park bench—her knees were rather weak—and hobbled around the bushes to see who all were chatting there.

The young couple had come and had sat down behind her while she was feeling drowsy. They hadn’t noticed Mrs Lahiri, screened as she was by the bushes, creepers and a large peepal tree.

They looked up as Mrs Lahiri came into view and stared at her for an instant in horrified shock. They had been smoking, but dropped their half-burnt bidis on the grass and fled. Mrs Lahiri, too, was reeling with shock, now that her worst suspicions had been proved true. Wasn’t that her maid Sabita, who was supposed to be in hospital?

The realisation of what had happened suddenly hit her and she felt quite, quite sick. She felt giddy, her knees gave away, and she fell on the grass in a dead faint.

When she came to, someone was sprinkling water on her face. There was a hubbub of voices and several people had gathered around her. A few elderly gentlemen, who had been walking in the park, some children with their mothers and ayahs, and a few young idlers. These young men were much like the scoundrel she had just seen—thin, swarthy, with scruffy beards or stubble, clad in skin-tight jet black or shiny blue shirts and t-shirts and skinny “butter” denim jeans, in various shades of beige or muddy brown. She looked at them in trepidation, but they helped Mrs Lahiri to her feet kindly.

“Are you all right?” one of them asked solicitously. They helped her to a park bench, where she sat down, fanning her face. Despite the cold, she was sweating.

“Where do you live?” asked a middle-aged man. She replied, “Quite close by. Left turn from this park, then right down Rhododendron Avenue.”

“What happened?”

Mrs Lahiri started to describe her encounter, but then thought better of it. “Oh, it’s nothing, just a spell of giddiness.”

“Shall we take you home?” asked a gangly youth, unctuously. She blinked up at him and was about to refuse, but then she nodded weakly. Two of the young men helped her across the street and took her home. They asked her, “Do you live here alone?”

“Yes, ever since my husband passed away.”

“Is there no one at all at home?” they asked.

“No, both my daughters live abroad, one in Canada, the other in Australia. I had a maid who lived with me all the time, but—” She was about to say Sabita had been hospitalised, but stopped just in time. She felt the tears sting her eyes.

She stopped for breath, then rubbed her eyes. “I’m so sorry, I can’t even offer you a glass of water now,” she said to the young men.

“No, no. It’s perfectly all right,” they replied. “Please take care of yourself,” they said courteously. “We’ll come back tomorrow and ask after you.”

First a dubiety, and then a kernel of suspicion, started to harden in her mind. Mrs Lahiri looked at the youths in trepidation. Now why were they so interested in her well-being? She wondered….

The old lady’s thoughts must have flitted over her face, for the youths looked embarrassed and left quietly soon after.

Mrs Lahiri plopped down on the sofa in her living room. Things were moving too fast for her. Yesterday’s events flashed like a 35mm reel of an old film through her sluggish mind—scratched, disjointed and discoloured.

Last afternoon, after they had had lunch, Sabita had complained of stomach pain, probably caused by indigestion. It was the maid’s wont to ask Mrs Lahiri for medicines for minor ailments. And the old lady often gave her tablets and capsules from her own stock, whenever she could.

This time, however, events had taken a dramatic turn. Mrs Lahiri had taken out an antacid from the medicine cabinet. A few minutes later, her maid’s fiancé—what was his name now? she had clean forgotten—had come running. He often came to visit Sabita.

“Sabita is very ill! She is foaming at the mouth…”

Mrs Lahiri had at once rushed to the kitchen to find Sabita lying on the floor, hands clutched to her abdomen, writhing in agony. Foam had indeed been coming out of her mouth.

The pimply young man had exclaimed, “What’s happened to her? She fell ill right after taking the tablet you gave her. It’s all your bloody fault! You’ve given her the wrong medicine.”

Mrs Lahiri had not known what to say. She had stuttered, “I mean… not I, it isn’t my fault…the medicine… I mean…”

Sabita’s fiancé had snarled, “Shut up! I’m going to take her to the hospital at once. Perhaps we’ll be able to save her!”

Saying that, he had taken Sabita away and put her on a rickshaw.

Mrs Lahiri had stayed back at home, her heart beating a drumbeat in fear and anxiety, waiting for news. After some time—for the life of her, she couldn’t remember his name—he had come back.

“I have admitted Sabita to Oriental Nursing Home.” It was a well-known, expensive nursing home nearby. “Her condition is critical. They have asked for a deposit of ten thousand rupees.”

Mrs Lahiri had stared at him, speechless.

“Where will I get so much money?” he had demanded. “It’s all your fault. You’ll have to pay the deposit.”

Mrs Lahiri had been shaking with fear by now, yet had protested feebly, “It’s not my fault, I never knew that—that—the medicine was wrong…”

The brash young fellow had said, “How dare you? If you don’t give the money for the hospital expenses, I’ll bring a thousand people from my bustee and burn down your house! You old witch—!”

Mrs Lahiri had been terrified. There was no one she could turn to right then. She lived in a secluded stretch of the upscale Rhododendron Avenue and most of the residents were elderly people like her. Next to her was a single-storey house that had been lying vacant for the past few months ever since the tenants had moved away. In the other house next to hers there lived an old couple and the gentleman was ailing. She had not liked to bother them. Opposite her house lived a middle-aged couple, both of whom were doctors, but they were both at hospital at that time of the day and their daughter was at school. Her only relative in the city was her nephew, who lived in another part of Calcutta, several kilometres away.

At that point of time she had been so frightened that she had not known what to do, she had not known whom to turn to. What if something happened to the girl? The very thought had filled Mrs Lahiri with dread.

As it was, she was not sure if she had given her maid the right medicine. She had thought it better not to argue with the young man and, with a trembling hand and tremulous eyes, had made out a bearer’s cheque for fifteen thousand—“to cover all hospital expenses and medicines,” as he had so rightly pointed out—on her savings bank account. Before he had left, the young man—what was his name now, she tried desperately to remember—had threatened her yet again: “If something happens to Sabita, I swear we’ll get even with you…”

There had been no news of Sabita, that day and the next day, too. Mrs Lahiri had feared the worst. Sabita’s fiancé had not come back at all.

The maid used to live with her. She had come to Mrs Lahiri’s home as an orphaned young girl from a remote village in Medinipur district. Sabita had been with her for some ten years now. Mrs Lahiri recalled how the malnourished Sabita had first come to her, frightened, innocent, and alarmingly thin, and under her ministrations, had blossomed into a dusky beauty, doe-eyed and lissom. Mrs Lahiri had done all she could have done for her, and not out of pity either…

Mrs Lahiri didn’t know much about the young man to whom Sabita had recently got engaged. He lived in a slum on the other side of the railway tracks nearby and did odd jobs for a living. But she didn’t have his address.

Mrs Lahiri went to the park only occasionally, but today she had gone out in the evening for some fresh air, having passed a sleepless night. When she saw Sabita and her fiancé, she realised how badly she had been duped. But was there much she could do about it? What information could she give the cops? She didn’t know their whereabouts or even the ruffian’s name.

A sudden thought struck her. She went to Sabita’s little room on top of the empty garage. She was thunderstruck, as they say. All her belongings were gone! Not even her comb or mirror was there, nor even a scrap of her clothing.

Mrs Lahiri came back to the living room on wobbly feet and collapsed into a divan. Her nephew Saikat came in just then.

“So it was all meticulously planned,” Saikat said heavily, after hearing her out. Saikat Bhaduri was her nephew, the only son of her late brother. She had called him up yesterday itself, but he had not been able to come over from Circus Avenue. He had promised to make it that evening, and there he was, as good as his word.

A thought struck him. He picked up the phone and called up Oriental Nursing Home. “Has any patient by the name of Sabita Mondol been admitted to your nursing home yesterday afternoon? Yes, could you please check? I’ll hold on.”

He listened, grim-faced, when the nurse on duty answered at last, then said, “Okay,” and hung up.

Mrs Lahiri knew the answer even before Saikat told her. As she sat on the sofa, talking to her nephew, she felt very weary indeed.

“It’s a pity you can’t recall that scoundrel’s name,” sighed Saikat. “That would’ve made the cops’ jobs a lot easier. Still, I’ll have a word with the officer-in-charge at the local police station. They might be able to trace Sabita somehow, though I fear it is too late—they must be miles away by now.”

Mrs Lahiri’s voice trembled. “And what would the police have done if they had managed to nab him?” she asked.

“Well, they’d have dumped him in the lockup and beaten him up black and blue, of course,” replied Saikat. “You would have got your money back, and both of them would have gone to jail.”

She shook her head, dispiritedly. “That’s no solution at all.”

“Then what to do?”

“I really don’t know… Ten years Sabita had spent in my home, I looked after her like my own daughter, and now this—this—betrayal…”

“I can’t bear the thought of her going to prison,” she went on, with a heavy sigh. “If they come to me and say sorry, and return my money, then I’ll certainly forgive them.”

“That seems hardly likely, does it? They have skedaddled—and I’m sure they won’t return to Calcutta, ever,” Saikat murmured.

Susan Lloy – Mademoiselle Energy

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Mademoiselle Energy
by Susan Lloy

“Straightjacket. That’s what I’ll order if you keep this up and I’m sure you won’t like it much either.”

I was restless, it’s true. The halls were paced over and over, the nursing station at Emergency frequented time after time.

“How much longer? Can’t wait any more. I need medication. A pill. A shot. Anything! If you don’t give me something I’ll make a complaint. My psychiatrist is staff here and when he’s through with you – he’ll give you a kick up the ass like it’s the biggest dick you ever wished for.”

My words weren’t kind, but then again, I was under duress. Restrained. Ugh. However, I decided to heed his advice and silently trolled the corridor eyeballing patients. Calculating urgencies. My psyche was bruised from the overindulgence of mood enhancers and mild hallucinogens. Sleepless nights. I felt like Lady Macbeth and my brain bled tears as if they were raw exposed nerve endings. I held court with myself sustaining solitary conversations that ran day and night, blurring the boundaries of light and darkness. So goes the ritual of mood.

A young junkie rocked her arm, which was a deep red – almost purple – swollen like an active volcano waiting to erupt. An abscess. It was raised, perhaps four inches from her puncture site. It scared me, I could end up like her. My head rested between my knees and my palms at the base of my skull. Sound and light were the enemies now. Capsules and liquid meds the allies. Occasionally I lifted my head and confronted the nursing station with glaring pleads ‘When?’ On and off I heard muffled comments, Mademoiselle Energy, laughter and hushed words. Scrubs and white lab coats turned to me, distracted and for a minute their eyes met mine. Often moans and sighs, fast-moving stretchers and the clicks of heels on hard-polished floors assaulted my covered ears.

After several hours a young man approached me. An orderly with a wheelchair stopped and said, “Lets go.”

“I’m perfectly fine for walking.”

“Just get in please. It’s procedure.”

We travelled a corridor. Coloured directional signs were mounted on walls: Surgical, Medical, ICU, Psychiatry and so on. We waited for the elevator, heading to the psych ward, which was six floors up. My tour guide was rather emotionless and barely said a word. No doubt he needed a rest as well. He rang a bell, a nurse opened the door and he handed a chart to her.

“Hello Grace.”

“Hi.”

“Come this way.”

I got up from the wheelchair. The orderly had disappeared through the door already.

“You’ll be staying here.”

It was a small rectangular room with space for only a single bed. No furniture and empty walls. A porthole in the door replaced a window. I must have really pissed off that ER intake doctor, because he had slotted me for the violent section of the unit. It wasn’t long before the nurse approached with medication.

“Here, take these.”

I didn’t even ask what they were.

Whatever she handed sedated me enough for a few hours of slumber. The door to my room wasn’t secured and I could navigate between the sitting room, dining area and cigarette roost with ease. My own psychiatrist came soon after and questioned me in the private confines of my enclosure.

“You know, I feel that these compounds are very similar to vitamins and they’re helping my illness. Don’t you agree?”

“I’m not sure about that Grace, however, you’ll be transferred over to the other unit. You don’t belong here.”

Within an hour I was moved across the hall where I had a normal-sized room with a proper window and bureau for clothes that I didn’t have. There were a few patients in the sitting room and the television was annoyingly loud. I sat in a chair. It didn’t take long before another inmate approached me.

“You’re new.”

“Yeah. Via the lockdown.”

“Know it well. I’m Karl”

“Grace.”

“Don’t you find that television aggressive?”

I headed in the direction of the set and turned down the volume. The woman sitting opposite immediately put it back to where it had been. I lowered it once more. When she went for the third time I sternly stated, “Leave it alone. Or I’ll put your head through it!”

She mumbled inaudible words and slowly trudged along out the door to an unknown location.

“Consistent. That’s what she is. It’s always deafening. She doesn’t involve herself with any of us. I think the more thunderous – softer are the voices.”

“Poor thing.”

“Yes. There are many poor things here.”

“Why are you here? You seem absolutely normal to me.”

“I was digging up a tree in Westmount Park. They arrested me. So I ended up back here.”

“Oh. So you’re a regular then?”

“Pretty much.”

“And you? First time?”

“It is actually. I’ve had a few suicide attempts, but always with a noose. Never had the guts to kick the chair over. What if I fucked up and ended up with a broken neck? Why can’t things be simpler? For instance, if I had a driver’s license – I’d simply rent a car, go to a nice spot and gas myself. But it wasn’t suicide this time. I overdid it with drugs and endured weeks of insomnia. I just got so sick of myself. This never-ending restlessness.”

“There are easier ways.”

“How?”

He got up and rummaged through his pockets and handed over a few pods. These are pods from the Black Locust tree – Robinia pseudoacacia. There are also Honey Locust trees in the city. The Honey Locust is more beautiful.

“Look.”

Karl held bean-like pods. The backs were darker. The fronts were a shiny warm silver. Thin bands stretched horizontally on one side with raised seeds attached. They were intricate, as if woven embroidery on a period dress.

“They’re lovely. How’d you get them?”

“I’ve been here a few weeks now and have more privileges than you. I can go outside for cigarettes and air”.

“Why were you digging up a tree anyway?”

“He told me to do it.”

“Who?”

Karl tapped on the side of his head.

“He’d been at me for weeks. He said it was wrongly positioned. It required optimum light, cloud cover and asylum from the wind. The cool breath of the stars and the moon’s crafty grin. We enjoy nature’s riddles and truths. When I get out of here I’ll calibrate myself according to the number of seeds on each pod that are always random. For each day I’ve been in this hospital, I’ll subtract a week’s worth of medication. The Honey Locust seeds are edible, but not the Black Locust’s. They’re poisonous. Effortless.”

Six months later I was back for an intentional overdose. I hadn’t managed to locate the Black Locust trees that are scattered throughout the city, but funny enough, I had the same Emergency doctor.

“I think the last time I was here I was rather rude. Sorry.”

“Not a problem.”

He came to me with a long plastic tube. “Open…”

Darya Danesh – A Letter to Round One

/in

A Letter to Round One
by Darya Danesh

I was terrified.
I was so afraid of what you were going to do to me.
I didn’t know what to expect.

E said you were the worst thing in the world. That you burned in his veins. That you turned him blue.

Mom was scared, but she didn’t dare tell me. I could see it in her eyes; I could feel it in the way she held me, trembling. I could tell she was holding back her tears, trying to be strong for me. In our days of silence, I could almost hear her asking God or whatever it is she believes in: Why is this happening?

What had we done to deserve the horror of this meeting?

Round One.

It was September 1st when they told us we’d be meeting you soon.

The nurses knew you well.
They knew what harm you might cause me. They knew that maybe you would sink into me and do nothing. That your presence could very well just be a Band-Aid on a terminal problem. They knew that the minute our chemistries mixed together — the moment you and I became one — that I would never be the same.

In the days leading up to our meeting, I fought hard not to be afraid. I kept on my biggest smiles and reassured everyone that I was fine. I belly laughed and hobbled around like it was just another normal day in a normal life.

It wasn’t a normal day or a normal life, was it?

It was 9 p.m. when a panic set in.
F asked if I was a spiritual person, if I believed in anything. He said this was the time his patients would normally reconnect with their devotion, their Gods. This was the time they would ask for guidance and for the strength to survive.

I’d never believed in God.
But in that moment believed in the power of you, and in the power of the Universe. I still do. I believed that — along with my unwavering positivity — you and the Universe would work together to get me through this.

I took my mom’s and F’s advice and took a small tablet to calm me down, help me sleep. Just a few more hours until our dreadful meeting, I thought.

The plan was for us to meet at 3 a.m., and to be together — without pause — for an uninterrupted seven days.
For seven days, you would hang atop the cold, metal pole and be pumped through me. You’d be on your homicidal mission, killing anything and everything in your way.
For seven days, we would be confined to those three silent halls, always smelling of alcohol.
For those seven days, we would hang out with family in that cold, uncomfortable room with the windows that looked out onto the university campus where I so longed to be.

The nurses woke me just minutes before the moment of induction. They asked for my name and date of birth; quietly so as not to wake E who was sound asleep in the opposite corner of the room.

It was 9 a.m. when your friend joined us for a few hours. Mom sat next to my bed but we refused talk about you. We acknowledged your presence, wondered how long your friend would stay, and carried on as if things were normal.

But things were still. not. normal.

Weak.
Cold.
Each day more awful than the last.

You made me sick.
You had me shivering and feeling brain-dead.

Some days, you had me throwing up more than I care to remember.
The first time I was sick, I rang for help. I held it in as long as I could but my body couldn’t fight the feeling.
When G finally walked in, I’d already made a mess of the floor.
I felt horrible.
Like a burden.

I won’t ever forget the feeling of knowing our week was up.
Freedom.

My hair was still long and H had finally arrived. We headed downstairs with the tiniest sense of relief in our hearts.
Finally together.

Day fourteen the alopecia kicked in.
It took a fever and the chunks of hair falling out of my dreaded locks for me to accept that you would do to me what you’d done to many before me. It finally started to kick in that I was not immune to your nightmarish side effects.

With my legs trembling and hope filling my heart, I left the hospital twenty one days after our first meeting.
Three days until we’d meet again.

You were the first, Cytarabine.

But you weren’t the worst.
No, definitely not.

Bob Ward – Screens

/in

Screens
by Bob Ward

Moored in our beds, a few in plaster boats,
   as long-term patients we observed routine.
With breakfast clear, daily at Sister’s nod
   the screens were pulled around each bed,
   beeps issued, whether you felt the urge
   to go, or in denial courted castor oil.
So mounted privately on chilly steel,
   you puckered up your stern resolve,
   thought hard of Nelson, while in parallel
   grunts and moans broadsiding from the crew
   amidships signalled battles being won.
Alone. That’s when Sister chose to call
   to hand out mail, solicit confidence,
   be personal as at no other time,
   (despite the whiff) play proxy mother/wife.
Duties done, the screens were drawn aside;
   we rigged our faces fit for public life.

David Subacchi – Medicine Tin

/in

Medicine Tin
by David Subacchi

Our medicine cabinet, a faded biscuit tin,
Circular with scratched roses,
Appearing only when sickness called
Or sticking plasters were required;
Air-tight it sighed when the lid
Was lifted clumsily by bloodied fingers,
An old bandage once used for a sling
Smothering the rattle of pill bottles,
Protecting against injury
From spread-eagled scissors.

Nothing remained, no crumb
Or other trace of past treats,
No odour of sweetness,
Only the sticky residue
Of congealed cough mixture
And a faint trace
Of smelling salts
Awaiting deployment
To revive consciousness
In some emergency.

And those Liver Salts
In a rusting container
“For a pick me up”
Our mother would say
In a tired voice,
Rummaging roughly
For her favourite
Headache pills;
But we knew they were
Really for hangovers.

Richard King Perkins II – That’s the Last Norco There Is

/in

That’s the Last Norco There Is
by Richard King Perkins II

How am I going to get my Norco tonight?
I can’t walk.
I don’t want to take Tylenol.

I want my Norco.
I’m supposed to get it in the morning
and in the night.

They won’t let me see my ledger.
Why do I have to be treated like a criminal?

Who’s going to give me my Norco?
I need to go to the hospital
but I don’t have anybody to take me.

What am I supposed to do, walk?
They give me no help anyway.

I need to go to the Mayo Clinic.

The doctor told me to go back to my room.

He walked in and walked out.
He did nothing.

All they did was give me a blood draw.
I don’t want a pain shot.
I want my Norco.

I’m dying of oestrogen poisoning.
Doctors don’t know anything about oestrogen.

I fired all my doctors.
I’ll call the police if they ever come near me again.

I’ve been butchered here for months
and criminalised.

I can’t see the doctor. I can’t get rid of my pain.
I can’t see my ledger. I can’t walk.
I guess all I can do is die.
I knew the outcome before I ever got here.

The head x-ray didn’t show anything.
Why do they keep taking x-rays of my head?

That’s the last Norco there is.
I’m going to die tonight. Period. That’s it.

Bryan R. Monte – The Rattle

/in

The Rattle, photo & dry brush, © 2017 by Bryan R. Monte. All rights reserved.

The Rattle, photo & dry brush, © 2017 by Bryan R. Monte. All rights reserved.


 
The Rattle
by Bryan R. Monte

“You’re so brave!”
the young woman
from my flight says
as she catches up with me
at baggage claim and stands
next to my wheelchair
waiting for a response.
She watched me wiggle
twice down the plane’s aisle
to the toilet, cane in one hand
the other skimming along
the overhead luggage rack.
‘What’s my choice?’ I think,
but instead I say “Thank you,”
as she tells me her father
with MS no longer travels.

I’m not brave, just grateful
for the leg braces and walker
that keep me upright,
and for the little, colourful pills,
those modern pharmaceutical miracles,
that freed me from a hospital bed
and my maternal grandmother’s
morphinated, rubber-sheeted,
institutionalised nightmares
her last five years.

In her memory every Sunday
I refill my plastic pillbox,
more regularly than I attend meeting,
with orange and green Tamsulosine
to plug the leaks in my underpants,
oblong, orange-brown Valsartan
to keep the pipes upstairs from bursting,
white Atenolol to slow
my irregular, frantic heart
and tiny Hydrochlorothiazide,
that slips or jumps through my fingers,
to prevent both grandfathers’ fatal strokes.

Not to forget red and white Lyrica
to extinguish the sub-dermal fire,
the tingling sunburn inside my feet
that starts the moment I step out of bed
and slowly kisses and licks its way up my legs
until by lunch I’m burning at the stake.
And lastly, green and white Cymbalta
to keep Lyrica’s suicidal, side-effect fireman
from self-immolating.

Once a week I pop pills from foil packs
into seven plastic compartments
refilling the shaman’s magic rattle:
the real courage in my chest.

Marissa McNamara – The Falls

/in

The Falls
by Marissa McNamara

The words flow
too well: the alliteration
of a testicular tumour, syllabic
slide of metastasis that speaks
like a tongue twister until you say it
so often it glides from your tongue; the nasal
beat of nausea, simplicity of just a node, proud
and round, like a stone; lymphoma is far too mellifluous,
a tiptoeing nymph waiting to be seen; and who knew something
as luxurious as platinum based chemo could produce the metric precision
of residual masses or pulmonary side effects? The words descend like the beauty
of water over the falls until it is you in the barrel approaching the swirling rapids.