Glass Shallot by Adam Baer | Adambaer.com

Mayo Dispatch 10: Medical Tourism and Bad Eats

[Note: Please scroll down to Mayo Dispatch 1, and then scroll up for each new dispatch, if you're interested in reading this account of my time a the Mayo Clinic in a chronological way. Otherwise it will just run in retrograde. Herewith, dispatch 10. ]

I have to prepare a last Mayo Dispatch, as I'll be kicked out of my Hilton in less than an hour, forced to roam Rochester's tunnels and skyways until the last shuttle of the day(!) can get me to my plane four hours early. Yes, there's no shuttle to the airport here after 4:15 p.m. on Saturdays. I don't get it either. But one of the nice things about being stuck in the tunnels--or rather one of the decent things I found do to in the tunnels--was traipse about a bookstore the way I once did as a young New Yorker. There's a large one adjacent to one of these tunnels, and I've spent time there, inside its "cafe," drinking subpar mochas while I page through 10 mags  and a few new notable books in each sitting--an activity that once made me want to be a writer and eventually led to me meeting my wife. Still, I haven't really done this since moving to Los Angeles--maybe it's the fact that you have to drive everywhere there. In New York, you just often have to kill time on foot--so where do you go? Bookstores and coffee shops. At any rate, it was at the Rochester superbookshop where I noticed a great and large "official" tome celebrating the Sopranos, written by Brett Martin with the cooperation of the cast and producers. Martin, a writer whose works have appeared in some of the same mags as mine (although let it be said, that he has truly outdone the author of this here Shallot with a hilarious and moving output of articles and essays for GQ, among others for This American Life, Vanity Fair, and beyond), seems to have won (hell, earned) the ultimate score here for Sopranos fans, of which I consider myself one. The book is extremely entertaining and does feature some information that has escaped even some of the show's scholars, but I also must admit that I had so much time to kill in the bookstore, that I read the whole thing. The point of all this? That sometimes you need a little distraction, and if your favorite TV show of all time is over, you didn't bring your DVDs, and you're stuck in a bookstore, well, by all means look for the official book celebrating your favorite show and see if it isn't great. Martin's book, for its part, deserves to be purchased wildly as a holiday gift, not just read in a store by word-mooching latte drinkers, so maybe get this one for your brother, dad, mob-crazed sister, or cousin--and certainly get it for anyone needing to dissolve from scary real life into pop culture references and diversions. It's fun to read about how Robert Iler basically got his role as A.J. just by repeating "What? No fucking ziti now?" 30 times in a tiny room on 72nd Street. But Martin has also elevated his book's genre with spot-on cultural criticism and articulate (but fun to read!) spotlights on issues in the show you may have never explored. Kudos.

How has the Mayo portion of my life ended? Well, last night we attempted to give Rochester's one tapas restaurant a try, and ended up with some seriously mediocre and overpriced food, one example of which had to be sent back. (I hate doing this, but honestly the food tasted like dirt, and I cook with sihtake mushrooms all the time, so I love the flavor that was supposed to permeate this risotto.) But Rochester being what it is--you mean my expensive plate of crap isn't great simply for being expensive?--the chef then sent the waitress back to tell us that he thinks the food tastes great and that we're wrong, but that he'll gladly do us the favor of removing the plate from our tab. How kind, I thought. After we just spent $12 on individual drinks (in Rochester!) with perhaps a quarter of an ounce of alcohol and endured your terrible pizza--excuse me, "Neopolitan pie"--as well as picked lemon aside one tiny piece of chicken that tasted like Ajax. One thing that appears certain about downtown Rochester is that while it remains podunk, some uppity entrepreneurs are attempting to upscalify the place and rob monied or simple less podunk Mayo travelers while flauting faux-sophistication. 

Have you ever heard of medical tourism? As medical charges increase in the U.S. and people don't necessarily want their procedures done at the nearest facility, it appears that a large group of travelers are hitting new cities and even leaving the country to receive medical treatment. And when these people aren't being cracked open like lobsters, sometimes they want to eat some. It seems like Rochester may be on the verge of turning into a medical tourism hotspot--it already has the built-in traveler base. But as it does, Mayo patients and even those traveling here for business need to be careful. Eating at one of these faux-gourmet restaurants is sort of like asking for psychotherapy from a schizo locked in an asylum. Other restaurants in town have been similarly Emeril-ized, but they aren't as offensive in their attempts to swindle. They either serve over-complicated food or bad attempts at the classics. This is much more acceptable to me. Nonetheless, read your Chowhound, and then still open your mouth with caution.

Mayo Dispatches likely to end now, though I may return with more info and commentary. But I have some nice newspaper articles to run on the west coast tomorrow, and I'd love to get back to some of the day-to-day. Keep your eyes open, however, for a large piece about this experience. It's definitely going to be a part of a forthcoming book as well as a script being developed with a partner right this very second. And yes, we can do this, even during the strike. (Thanks to all of you for writing, too.)

And now I walk out of hell and into the urban. Well, I fly, and it will take more than half a day to get there, but you get the drift. --Alexander Superpatient, Dec. 15, 2007 

Mayo Dispatch 9: Clinically Photogenic

Enlarge the above picture to learn about how Mayo has "one of the oldest and largest programs of medical photography in the world." Next draft pic? Mario Testino. Tell me you can't see it: "America's Next Top Model," Mayo Clinic Edition.

As Charles Mayo would have it (click on and enlarge the above pic to read his thoughts on how to tech people to stay well), this young man looks beautifully preserved.

"A surgical procedure should be planned so that the patient, with the least possible risk and loss of time, will receive the greatest possible benefit." Charles Mayo offered these words, seen in this exhibit of surgical tools, on display for anyone en route through the main building's subway level walkway. Did he have thoughts in 1930 on whether or not people would ever want to see the tools--even the historic versions of what we now employ--used to open up their body cavities for life-threatening procedures? America needs to know.

In the aforementioned subway level mall that takes many people to their hotels or healthy fast food establishments (we all eat the lowest cal sandwich at Subway, right?), there's an actual store run by the Mayo Clinic for sufferers of sleep apnea. This is both extremely useful and extremely hilarious.  'No more sleepless nights' is not what I think of when I see that Darth Vadaresque mask in the bottom right corner. But if it will stop the snoring that keeps Lina painfully watching Carson Daly as I sleep with the remote tucked under a leg or head or something else, I say, let's get into the holiday spirit and patronize the joint

Mayo Dispatch 8: The Penultimate

We were comfortably shocked with our final MMD meeting yesterday. He was a lot more openminded and seemingly more concerned than we had anticipated--understandable given our experience, but it craved noting. And, drumroll!, he also provided what might be an answer to the problem--but it is, to be fair, the easiest of answers and may not have popped up until now due to time as opposed to proprietary Mayo technology or insight.  If it's not the answer, we're only a little further beyond square one and must move on. We'll move on anyway, leaving Rochester tomorrow at last for the Big Pomegranate I still call home. But it should be chronicled that if I hadn't asked yesterday's skin-sensation technician to test the right foot instead of the left, where I have permanent nerve damage from ankle surgery, she would have followed her orders to test the left, even though this information had been conveyed to MMD on Day One.

MMD also asked me if there were any other tests that I felt needed to be done. I appreciated the question--a doc who respects his patient's education about his own condition?--but I also didn't really feel that a doc should be asking a patient this sort of question and wondered if it wasn't just patronizing ego-candy. We want to believe in you, MMD--just do everything if you doubt yourself. Nonetheless, the man may have come through (or rather, my system may have made things more obvious, finally), and we'll find out more through the mail in the coming weeks.

So: Don't think you always come to Mayo for one (extended) visit and return with a cure, or even an end to your medical journey. That's sort of a misconception, and it should be known more widely that this place is much more like a major city university hospital than it is some super-unusual rare disease "let's get everything figured out immediately" kind of place. That said, some of its tests have been unusual and helpful, and it does figure out mysteries in one-week periods for others, I'm told. That's just not the majority. Too many people have told me that they return here frequently--not for treatment but for more chances to discover the culprit.

Another interesting Mayo fact: the docs don't trust pathology from outside labs. They believe their techs and docs do everything best. Which may be true but seems impossible in all regards on every day of the week. So they often hold onto biopsies from you longer than other places, and they also want to redo much of the testing themselves and then take their answers over anything else. It's less-than-curious in that creepy George W. Bush kind of way, and I worry about that sort of over-confidence and narrow-mindedness in every respect. But yes, they are good here. Retractions aren't necessary. But contractions of criticism about this place are. It's both less special and unusual than it wants to be, but it's also a fine, praise-worthy medical center. Let's just stop referring to it with religious devotion. In my case, it is helping me move in the right direction; it's not putting a stop to the trip.

Funny Rochester fact: We can't seem to find any movies to see here that don't have something to do with Christmas or fantasy or disease except for "I'm Not There," which we've seen.  I said to Lina: "That's an awfully artsy movie to be playing in a town obsessed with Fred Claus, I Am Legend, and the Chipmunks" (Could we combine both movies and pit Will Smith together with his cheeky friend Tom Cruise Hubbard?) But then I remembered where Bob Dylan grew up: Minnesota. It's also the place he eventually escaped, though. Thank J.C.--and Alvin--for that.

P.S. Some more fun facts about Rochester:

1. "Fine dining" establishments--and I use that term loosely--are open at 4:30 p.m. for dinner! Who's racing me to the early bird special? You don't ever need reservations here.

2. Hotel housekeeping employees *will* knock on your door at 8 a.m. if you don't have your Do Not Disturb door-hanger in full view on the outside of your temporary home.

3. The one store in the mall that sells mod home accessories--think Eames chairs and Alessi kitchen accessories--serves free chocolate toffee straight from a kitchen in Minneapolis! (That's how bad they need business...)

4. If I had gone to grad school in Minnesota--their MFA in creative writing dept once offered this here syntactically challenged blogger a fellowship that would have included having me teach a class on Hemingway--I might have had to come here pretty often for checkups.

5. Every time you have an test at the Mayo Clinic, the tech who comes to get you from the waiting room asks you to repeat your name and birthdate. I have tried variations on Alexander Supertramp just to see if I might get a smile or a scowl. I usually just get a  straight-faced: "Whatcha say?"

6. Lots of older folk here use the term "You bet" to say "anytime" or "you're welcome." Where does this habit come from? Was Minnesota a gambling hotspot at one time? Tell us in your next convoluted series, David Milch!

Mayo Dispatch 7: Digital Nature Interlude

There's probably nothing better for your spirit when you're foxholed up in a medical society--and this *is one contained medical community; everyone here has something to do with Mayo--than to escape it as thoroughly as you can. That proved physically impossible for us over the past few days. But thankfully we arrived with an academy screener of Sean Penn's "Into the Wild." I don't know that the movie was the best I've seen. But I do think Penn outdid himself in terms of visual and visceral scope. The film transports you (and in my case, reminds me why I've avoided a fulltime corporate job since the year following my undergraduate degree). I also don't believe like others that the flick necessarily glorified its protagonist: it showed him in frequent states of potheaded smuchkification for all his innate intelligence, ascetism, and Emory degree. Some people are just goofballs, and the film seemed to be honest about that. That Supertramp died so closely to supplies, a highway, and help seems only to enforce that notion. Maybe Penn could have made that more explicit about those facts. And maybe there could have been less original Vedder in the soundtrack. But locking up in a dark hotel room with a laptop DVD viewing session of this film after spending a day grappling with the unique blend of Mayo invasiveness and impersonality really brought Lina and I back home. L.A. may have the worst air in the country but it provides a lot more access to nature than Hell's Kitchen. After the flick, I put myself to bed re-reading Krakauer's Outside article, and thought yet again: This man is an extremely clear writer, but I don't know what his prose legacy will be. Which is not to say that every writer needs to be a great stylist. I love my plain sentences, my purist storytellers, my adventurers who return with tales that defy linguistic elan. But it seems to me that Krakauer's greatest feats have been finding (or living) content and packaging material with his pen. No pun intended. Still, "Into the Wild," the film, was about the best thing I could have watched last night, and Penn deserves some serious recognition for his work. Perhaps Krakauer or the new gen of Krak-type writers should look into the young pioneers who venture into the depths of the elite medical world as patients; these extended trips and transfixing diagnosis procedures should be viewed as intensely as wilderness. There are certainly more ways out of Denali--if you're smart.

Mayo Dispatch 6: Purple Haze & One Inspirin' Gift Shop!

Earlier today, I recorded a little podcast (still in digital form thanks to voice-recorder software that’s failing to work with my Vaio) as Lina and I traversed the built-in skyways and "subways" (sans any actual train system) that link many Rochester buildings with different Mayo towers--so you can grab a Subway sandwich on your way to a shoe shine and lame doo-dad shop before getting stuck with needles or donating your kidney to science. Despite those virtues, however, it's a bizarre and poorly designed infastructure crippled (pardon the term) with counter-intuitive turns and connections. In fact, it's easier to walk outside to many places, including our "connected" hotel. But it's Minnesota, and there's snow on the ground. So if you’re in a wheelchair, like so many people here, it’s best to roll in comfort. On the other hand, many of the walkways are super-warm, and if you’re not in a wheelchair but also have some trouble doing a lot of walking (it can be miles to get back to your room through the indoor hallways), the “subways” only cause you more distress.

A funny tidbit about our podcast: We recorded it on the device we used to record the consult we had with one of Mayo’s top surgical minds. He really was the most impressive person we had met here. He offered to go beyond his assessment (that issues on the surgical side of my condition are stable) and “shop around” his thoughts to other surgeons and radiologists, concluding with a letter he’d send to both my home and temporary holiday-season address in New York. It might have been illegal to record this conversation, and I know this. I haven’t looked into Minnesota convo-recording laws yet. (I know it’s illegal in Cali but not in New York, for instance.) Still, it’s good to have a record of exactly what docs tell you. And if they’re not admissible in court later down the road (I’m more than half-kidding), so be it. Conversation tapes don’t always have to be legally made to inspire doubt on the part of lawyers and judges. Sometimes tapes lead to cause for investigation! In this case, it was just nice to know we have our surgeon’s thoughts on record.

We’ll perhaps use the recorder, tomorrow, with more ambition. We meet with MMD (my [primary] Mayo Doc) after his series of tests to learn his concluding thoughts. He moved up our appointment from Friday to Thursday even after I left him a note at his giant departmental desk explaining that we hope he received our biopsy slides from NYC (finally confirmed minutes ago), and that we hope he consulted with specialists who could be helpful in this mystery diagnosis procedure—in our case a neuro-immunologist and/or stem-cell-transplant-experienced oncologist who has seen patients with my history as well as some other specialists. Our response to this note? We received a newly printed itinerary of medical appointments from a secretary at the surgeon’s office an hour later. In other words, there was no personal communication. We just got a sheet saying that we now have appointments with specialists in the aforementioned departments next week and in January. Meaning, MMD expects us to stay in Rochester, M.N. for one week, doing nothing, to see the first doc, and then return in January to see the other before seeing him again.

Hell no to this, we say! MMD had his chance to be comprehensive and unusually helpful on Day One. We came to him for the Mayo approach of piecing together something complicated. He took his time, wasted ours, and didn’t think big or involve his colleagues in other departments, thereby breaking the unwritten but widely believed promise that Mayo does things differently than other hospitals. As I explained to Lina, it’s not that Mayo is renowned for always gathering a group of famous minds around a table to discuss your case from every perspective; it’s that they’re famous for the corporate, branding-specific concept of “group practice”: putting top specialists in one center together so you can be referred around in one medical center, thinking you’re getting the best of everything (often the case, but debatable) before a final decision on your case is rendered (also often debatable).

In the instance of the aforementioned baby with possible cystic fibrosis, the system seems to have worked: the parents arrived, thinking their kid had stomach problems, and were soon sent to a pulmonary doc who moved things in different directions for them. Neurologists—particularly the sort who don’t deal with the brain but with the nerves in the limbs, say—don’t seem to be as insightful and broad-thinking, even though their disorders often involve the complicated immune system. In my experience, the majority of them are technicians: they check your reflexes, prick you with pins, gauge your muscle potentials with needles, and then shock you with electricity before reporting the results. We came here for more: To meet a doc or team of docs who can do all this stuff with expertise in other fields of medicine and more systemic strategies. Let’s see if we get such results; after today’s events, we’re not optimistic.

Lina says that if MMD asks her tomorrow why a wire is sticking out of her sleeve (the wire from our voice recorder), she’ll say it’s connected to the battery that runs her wee, little heart. When she first said that, we laughed sarcastically. HAHAHA. Now that it’s been more than an hour since the comment, the thought seems to hang in the air like a matzoh ball. There's more gravity and truth in the mix.

Some comedy!

But wait: This morning, I was given the most bizarre test I have yet to experience anywhere: It was a test that measures your sweating so as to accurately explain the function (or dysfunction) of your autonomic nerves--i.e. those that control your automatic functions (like breathing or digestion; sorry, should have explained that yesterday).

Here's how it goes: First, you’re stripped naked, and left to lie on a table with a loincloth covering your stuff (modesty, beware). Then you’re fitted with sunglasses (rad!), and strapped in a few choice areas with constricting stretchy wires. Soon, a thermometer enters your mouth and stays there for a good hour. During this hour, you’re cooked. For reals! The technician first covers you in a yellow powder (slightly resembling saffron, and eventually rendering me a big naked hairy Big-Bird-looking thing that could potentially taste delicious). Then the tech slides you into a large cabinet outfitted with overhead infared lamps and Casio digital cameras looking down from above. You’re then heated like a duck in a Ronco rotisserie oven (sans the rotisserie) until your internal temp exceeds 101 degrees Fahrenheit. The yellow powder eventually turns purple if your nerves work, rendering you more Barney- than Big-Bird-like if you're "functional."

You’re allowed to listen to your favorite music during this experiment, which is a plus. And if you don’t arrive with your favorite CD, you can slide a basic iPod into the testing facility’s standard iPod dock. I was told this in the moment, so I didn’t have the preparatory time to dj for myself an appropriate playlist--for instance, no songs about toasters or meat or sweat. I just clicked on my “Breakfast with the Beatles” playlist, which basically includes every Beatles song from every Beatles album, including bootlegs and anthologies, as well as every solo song from each member of the Fab Four--including bad McCartney and hippy Harrison. Funnily, “Here Comes the Sun” bounced off the walls of my human oven as the lights reached optimal intensity and my body began to roast in its purple juices. The sunglasses rendered me even cooler. I could have been in Cabo, drinking a margarita, a member of Blue Man Group on cheesy holiday.

And the Casio cameras came in handy: During the procedure, they snapped photos of my naked grape-basted carcass. “You can probably sell photos like this—admittedly photos taken of better-looking people—to artsy magazines!” I told the technician. “You’re right," she said. “And we could double our revenue by charging for tanning and weight loss!”

After the procedure, I took the longest shower known to man, merlot-stained liquid raining down my sculpted extremities as I scrubbed and scrubbed only to emerge still somewhat ruddy. “Take a dip in a chlorinated pool,” said the technician. “That should get everything else off.” I think I’ll do that back at the hotel. Right after I fight some more with American Airlines about how to get out of this God-forsaken hell-town one day early without dropping an extra grand.

Because now that MMD has changed my last appointment with him, we do have a free 36 hours in Rochester. “It could be fun staying here,” said Lina. “We could go to the mall and holiday-shop!” We call this the D’Orazio optimism, but even Lina couldn’t convince herself and started laughing at her suggestion. Still, I don’t think she was kidding 100%, and I’d much rather see this quality in my partner than the “survivor realism” coloring my consciousness—a worldview most people would probably just call "depressing negativity tinged with black humor" despite my attempts to explain that I refuse to artificially “think positive” when I don’t have data supporting the future arrival of positive news. Is there something actually wrong with just not thinking or taking things as they come as opposed to “thinking positive?” I think I can still be buddies with Lance Armstrong and the Us Weeklyish live-strong camp while maintaining a little internal relativism and not trusting that everything is gonna be OK (unlike other patients here, J.C.--to say nothing of "Adonai"--and I never got along, believe it or not).

Perhaps I should have bought myself some prayers (yes, they're for sale!) in the Mayo Clinic gift shop (seen above), outside of which Mennonite volunteers direct people into elevators or explain where the history of Mayo exhibits lie deeper in the Rochester “subways.” I’d prefer reading Steve Martin’s newest book, in which he breaks down the germination of his absurdist comedy. This is a guy who knows something about how the world works. (It doesn't.)

Lastly, inspired by a Conan O’Brien rerun I watched on my laptop, here’s a medical SAT-style analogy:

(Most) neurosurgeons are to (most) Peripheral Nerve Neurologists as Confidence is to what? The answer: Lawsuit-worried, non-committal wishy-washiness found in people who watch their own asses before doing anything else. Seriously: Our surgeon today was oh-so-cool. He actually seemed to believe in what he was saying, cementing the notion that it's guys like these who should be consulted on all matters--even if they're wrong. Perhaps we should have asked him where to eat dinner--at least he would have said something with conviction. Last night, we had some "authentic" Chinese noodles that make 99-cent ramen taste five-star. But if he had told us they were good as we desserted on one shared Twix, we would have given him a badass high-five.

More as it comes…

P.S. We’re currently in a Hilton, and there’s a copy of Conrad H.'s “Be My Guest” in the bureau drawer (such pride on which to draw--huh, Paris?).  I’ve never seen a copy of this book even though I’ve stayed in Hiltons, so I find it sorta fun. Looks way more pleasant to read than more Mayo brochures—on everything from local activities (support groups, Dutch restaurants, yoga) to self-prep for various diagnostic tests. (My favorite directive? "Don’t use any mind-altering drugs for 18 hours." Who can—and should--stick to that? Talk about making your life really lame.) I shall perhaps give the kitsch book a shot after scouring the Internet for something about how to avoid making bad decisions like flying to the middle of nowhere for a Costco-quality attempt at getting all the medical advice you can from a so-called “elite institution.” What we’ve learned from all this so far? You don’t need to land in Rochester, M.N. for a comprehensive attempt at getting to the heart of a serious medical manner. You just need to find a well-connected doctor with a big, generous, highly functioning mind who actually cares about you. Meaning, it may be even less possible now than before.

But don’t leave this blog all blue: Remember, I’m the one who’s still kinda purple! And I have to say: It’s fun not seeming like an obvious Eastern European-brewed Ashkenazi-Caucasian Jew all the time. Especially in the friendly heartland, don'tcha knowww…

p.s. Says Lina to me: "I think you find inspiration in the tragedy of this trip, Ad." To this I just smile. "Well, shoot, inspiration is my middle name."

Mayo Dispatch 5: One liners

It was a day of tests, as you've read, so I really didn't have time to prepare anything cohesive. But here are a smattering of short thoughts.

+They give you light-up beepers at Mayo radiology. It's just that when your little red box lights up, you're not on deck for a seared ribeye.

+Today I had a fat aspiration. It's a test rarely done elsewhere. It has nothing to do with how fat I am, apparently, which is nice. But I still couldn't help asking the practitioner inserting the needles into my belly if she could take out a little more than planned. I wasn't met with a laugh, sadly.  I'm sure I was the 23rd person with that question today. But that's what they get for aspirating my fat. Trust me, it's some cultivated shit. I'm one well-fed, free-range, mostly Kosher bastard (which means a juicey breast). Whether or not I'm stress-free, however, is another matter.

+When I fist arrived, I was given autonomic nerve functioning tests, wherein I was tilted on a bed and given blood pressure tests as well as fitted with little round disks that burn and poke at you like saucers tipped with needles. (Fun? No. But not half as cruel as many of the things here people are asked to do.) During the test, the technician asked me if I knew anything about cold weather coming from L.A. I told her I am an original New Yorker. She then asked me why I moved to L.A. Was it for your job? she asked. Partially, I said. What do you? she asked. I'm a writer, I said. Oooh, she said. Movies, TV, books, or magazines? I do a little bit of everything. Whoa, she said. Do you write under your name? Of course, I said. Are you going to Google me? Not until you leave! she said, violating HIPAA privacy laws in an entirely new way.

+Which led me to wonder: What happens to famous people at Mayo? Are there names called out in the waiting rooms the same way they call ours?

+That didn't seem like much of a concern in the radiology dept. I was left in a long hallway of wooden stalls waiting to be called while a professional dairy farmer who looked to be about 25 ("Won the family's 200 acres when I hit 19," he said) and a machinist ("Shoot, I enjoyed loggin' for a few years in there between working on heavy equipment") chatted each other up, Brokeback-style.This wasn't completely new to me. I'm not some weirdo who's never met people without MFAs in poetry. But it was kind of odd listening to them size each other up, literally, while I stood there text-messaging like a wannabe-man. At the end of the day, it should be noted, however, that we were all wearing big blue gowns and looked equally like fools. And that we were all called for a similar test. Apparently you can need the same test if you write blogs or carry logs. Not surprising, but worth mentioning, I think, if only to provide you the image of the type of men who hit this place up. (I.E. For all of its rep as being a medical destination among the movie stars and America's wealthiest, I really haven't seen anyone here, including me, who doesn't look like he or she will pay through the nose for this care. Said the dairy farmer: "Sure is hard on the checkbook, this place. Then again, there's really no point to the checkbook if you're not kickin'.")

+Apparently, it's crazy in Rochester to ask the one food delivery service which Chinese food is the best. Are you getting a feeling that they don't like those antitrusts up here? If so, it only applies to cabs and Chinese food. Not doctors.

+At any rate, Lina believes word is spreading about us in town as if we're some couple of big-city hardasses who need to be avoided. Huzzah.

+One thing's for sure: Just because you have the checkbook for Mayo doesn't mean you have the brains to understand what disease you've just learned you have. Very sadly, a young mom on our shuttle phoned her friends incessantly this afternoon proclaiming happily that the mystery was nearly solved with her baby and that he "probably just has cystic fibrosis." A dark note to end on, I know, but it had to be mentioned. Her father sat next to her shaking his head in what could have been disappointment. For his sake, I hope he didn't know any more than his daughter--at least not for the moment. (One potential wrong-assessment possibility, of course, is that the baby could have also been up for more dangerous futures than CF. Immediate death, perhaps. Still, it was an odd thing about which to hear a young mom make four happy phone calls. In public.)

+Someone--a young doctor, actually--asked me today how "my axons" are performing. Then he laughed. I felt bad for him so I gave him a half smile and returned to trying to get my phone to provide me some information on the heart attack of known serial killer Alex Trebeck. What is...karma? Oops! Lost a halo...

Mayo Dispatch 4: All Bidness (Sorry!)

It was an unusual first day at the clinic-or maybe it wasn’t? I’m a newbie. I’m young and look healthy, remember? Anyway, nothing really much happened. After mall-walking through an enormous lobby, replete with fleets of empty wheelchairs (not including my friend above), we checked in at a massive desk and then received notice that there was no confirmation on whether or not my biopsy slides or reports had arrived from NYC.  Routine for hospitals (on the sending and receiving sides), but I was surprised there were no additional attempts made, especially given the “exceptional” service. I was, however, called in for my first consultation early. That was new. 

My Mayo Doc (MMD), the young man of the no-biography, was pleasant enough. (So pleasant, in fact, that I forgot to tape our conversation for your listening pleasure. Because that's what it would be, readers, right?) Still, when MMD found out that the biopsy slides hadn’t yet arrived, he asked: Why didn’t you just have the procedures done here? After waiting nearly one month for these biopsy results, after knowing that such results do take weeks, I answered plainly, “Because I wanted the results to be here for the clinic to assess.” He smirked, I think. But I don't wanna assume.

In fact, I couldn’t tell if he was laughing at me or just being smiley in that way that health psychologists (like Lina) teach med students to be (so regularly lacking are they of human social skills, that such classes are necessary). But MMD  seemed genuinely friendly. His rundown of my medical records and subsequent exam wasn’t exactly detailed (though maybe he’s the type who keeps a lot to himself). I also had to remind him that it might be beneficial for a certain type of surgeon to assess an MRI that I had given to his desk assistant. (I wasn’t told whether or not he had actually seen the film, but he agreed with my comment. Thankfully, I took the chance to make it.)

Then, I was told I’d have a number of days full with tests and that we (me, Lina, and MMD) would meet on Friday to learn “what [he] thinks.”  Kind of odd and independent for what I believed to be a “group approach.” Especially given that I wouldn't have chosen this person based on random biographical information--or the research he's produced. Of course, it’s possible there’ll be discussions about my 10 lbs of medical data (yes, I carry these in hard-copy form; more on that later in the week). I wasn’t told about group assessments, though. Instead, I was given a sheath of papers, stapled together with an itinerary of some basic and unusual looksees – including a tissue aspiration I had never read about. (100 points for originality, Mayo.) So, that’s what will happen for the next couple of days.

Test. Test. Test. Maybe some lunch. Maybe some water. Maybe I won’t wear my coat to the hospital tomorrow because it’s so damn cold here, every building is overheated to the point that you always feel like you’re in L.A.—you know, short of The Hills cast eating brunch at the table next to you. Another thing: You (meaning I) come to a major medical center for a chance to get to the bottom of a mystery condition most likely linked to a cancer you once beat but must remain careful about, and there’s no mention of including an oncologist or immunologist on the team? I mean, maybe an onc will get a phonecall from MMD, but I wasn’t told about such plans. Oh, MMD, you sly devil, you.

Bottom line, though? I feel as if I’m spending a lot of money—to say nothing of Lina’s time (mine at this point is besides the point)—and may be in store for nothing more than more confusion. Or at the very most, a few blanket statements that I can’t even trust given how casual all of this has seemed, despite the official testing, for which the hospital will be able to bill my insurance company thousands and make me sweat. I’m sorry I’m not 90 and disabled yet, but young people who aren’t children still deserve to be taken seriously. Let’s see how it goes tomorrow. So far, the trip’s just been more of a chance for Lina and I to be silly among a very barren midwestern city full of (literal) sickos. Only to then return to the hotel to watch Heidi and Spencer fighting it out in my beautiful homeland. Oh, the hills. We miss you and your fabulous moving photography of Angel Ciudad.

P.S. I know some of this hospital-trip reality (and disparagement) could be in bad taste for those whose last hopes lie in M.N. But I'm already here, and I need to be here, too. You gotta allow me some shenanigans. Even if the strike was over, TV just wouldn't be enough for me right now.

P.P.S. Guess what city only has only one taxi company to service it? Rochester, M.M. And guess what? They don't have enough cars to handle all the people who need to get to the Mayo Clinic for early morning appointments. So as much as you hate driving on thick sheets of ice, rent a car (and boycott the taxi company at the number 507-282-2222. They're not just a small taxi company; they're run by morons unique to the low -IQ businesses peppered throughout the city). Then again maybe you'll be smart enough to stay adjacent to the Mall of Medicine, a strategy we chose because we're not Sultans. Yet. You heard it hear first.

Mayo Dispatch 3: Waffles and Wha?

The wind howls in Rochester like the cries of nearly dead WalMart employees. 

Last night, we ate at the one Italian restaurant said by Chowhownders to offer quality sauce. Lina called it Ragu on a good day. My capers were as hard as, well, use your imagination.

Today, at breakfast, a nice old man asked me: "You goin' for a ride?"

I asked him: "Wha?"

He said, "To the clinic. When you going?"

I smiled, genuinely, and said, "Thank you."

Being vague can be fun.

Plus: How did he know I was going to the clinic? Was he watching my tears stream into the plastic bowl of froot loops on my table just moments before?

I kid. I didn't eat Froot Loops. Or weep.

That is, not until I saw two waffle irons set up to sear right next to a brilliant machine that dispensed  artery-clogging batter into plastic cups for your carb-induced suicide pleasure. See above for a picture of said device. If I were Tim Burton, I would have used it for a scene in "Sweeney Todd." Who says meat pies are the only ways to dispose of your victims?

* * *

Note to self: Get a good look at the Rochester business) eco-system. There have to be people in town to do business at or around the Mayo Clinic. Big Pharma reps. CT Scan techs. Construction reps. Hell, medical professionals. On our plane, there was a young sharp-looking whippersnapper with a garment bag that said "University of Pennsylvania Hospital." I've never been much of Philly fan, but is it really worth a year of your life to even come here for a fellowship? Probably, but at what cost? What's more, where do the rich docs and their families live? Not in this iced-over ghost-town. Although, if they did, I could potentially see their children starting some righteously innovative rock bands. Isn't that what happened in Scandinavia? Oh, I forgot: Scandinavia is far more interesting than the heartland of the U.S.A. Or is it? Do they have our waffle tech?

Mayo Dispatch 2: The Trip

“Lily Allen or Dylan?”

“Dylan,” she said.

Despite her activist dance card and Brown degree (a liberalism earmark as her righter-wing but lovely father would have it), Lina, my new wife, had always considered Dylan a downer. That is, until today.  (Or maybe she still considered him a downer; the important thing is that she felt ready to accept him, or at least roll on his page.) It was, to be fair, 6 .a.m, and she was, I admit, driving my car to the airport—driving isn’t impossible but it's also not super-easy anymore, so I’d recently relinquished my role as main family locomotorist, which can sometimes make things a little one-sided (I help out by d.j.ing superior tunes, of course).

We were heading out of town—not on a merriment-filled Decemberist holiday trip but to LAX, so we could connect in O’Hare with a peashooter full of wheelchairs and breathing machines up to Rochester, M.N., home of the Mayo Clinic. (There. For now on, I will use the definite article before the hospital name except for when I refer to the place as simply "Mayo," all creamy and white and cold as it seems.)

Was it coincidental that “Blood on the Tracks” was the album rocking the Altima sound system? Was it a Dylanesque “simple twist of fate” that Lina and I married each other just over a month ago and were now all tangled up in more blue—and black, red, and brown--than we ever would have imagined as happy New York daters just over five years ago? (It's not like I had a clean medical history, but we thought all was on the mend.)

It wasn’t a surprise—that’s for damn sure. The wedding, in fact, was a premeditated respite from the doctor-seeking, the diagnosis-receiving, the MRI-taking, and pathology decoding. We had some serious shit hanging over our heads, but we decided to postpone it all to get together and do the deed we felt had almost already been done after committing to each other so fully in LA once Lina arrived to begin her PhD in health pysch, researching the chronically ill and the way their infirmity affects their social, personal, and inner lives (appropriate, you think?). And no, the wedding didn’t go as planned. How could it have? Who deserved it to go well more than us? And was it coincidental that we would arrive for our plane to Chicago (nay, Mayo) just one gate next to the American Airlines planes leaving for Cabo, where we spent our pre-honeymoon flight-waiting eating the same crap Burger King breakfast. 

More important and cultural (this *is the new Glass Shallot, after all—tomorrow, it becomes another blog, perhaps the same one it was yesterday or one-legged version of what it will be next Friday at noon), Lina had just come to appreciate Dylan more from seeing “I’m Not There,” Todd Haynes’s chopped up and self-re-interpreted meta biopic of the poetic Minnesota-raised troubadour starring Cate Blanchett. “Someone’s got it in for me, whoever it is I wish they cut out quick.” That was the spirit this morning even though we had promised to make the trip as wacky and wild as only a bunch of sarcastic rejuveniles would have it.

So what’s with all the gloom? You want to laugh, right? 

Here’s something.

This morning, I argued with the oh-so-prescient guy working the long-term parking on La Cienaga in the hell-section of L.A. surrounding LAX, which is oddly a few miles from shiny Manhattan Beach and all its Starbucks-pumped boogie boarders.

It happened--the argument, that is—because upon parking my car in his safe-seeming lot, he told me I had to leave him my car keys.

“Why?” I asked.

“It’s policy.”

“My policy is never to give anyone my car keys.”

“You gotta relax and enjoy your trip, man.”

Wrong thing to say.

“Do I?”

“Yes. Relax, mi amigo.”

“Do you know where I’m going?”

“It’s vacation time, man, you should relax.”

“How about if I was going to bumblefuck Minnesota for cancer surgery?”

Yes, I assumed he might even understand the word “bumblefuck”; I like to give people the benefit of the doubt. And I wasn’t of course headed to Mayo for cancer surgery, per se (though who knows what’s in store for me and my friendly white blood cells?). Still, I was about done with all this SoCal braindeath. All the halfwitted garage workers and baristas and copy-shop owners saying how “Relaxed” they are and how smart it is to be like them.

No more “calm downs” from people spitting out explanations of nonsensical “policies” I find unsatisfactory. Apologies, Southland, for having the agency to express a thought based on intelligence. But aside from your dearth of employees with even some basic street smarts (Upper Manhattan, when I lived there, wasn’t exactly filled with physics professors, but ask the guy washing your car the best strategy to do your business taxes, and you might be surprised with his answers), this trip was helping me become myself again. I speak kindly and clearly to people—especially to people who are about to serve me food, watch my car, take blood from my arm. So don’t tell me to relax when my voice isn’t raised, and I simply refuse to follow rules I can’t endorse.

“Well, look man,” the schmuck replied, “You don’t have to get all excited.”

I wasn’t excited, as I’ve just explained. I know what excites me, and it’s not conversations with parking attendants on the 6 am shift.

“I’m just not leaving my keys, dude,” I said. “And I’m not letting someone like you tell me that I have to when I’m about to pay $200 to leave my car in a spot from which it will most likely be stolen anyway.”

“Well, you can pay ahead of time and not leave the keys.”

“Really. Is there a reason you didn’t tell me that before?”

“You didn’t ask.”

“Take my credit card,” I said, now completely dispassionate and wanting to move things along as quickly as possible. “21 days of parking. Ring it up.”

I held out my Amex and looked him plainly in the face.

“Look, man, I am verrrry sorry for what you‘re goooing through….—

“Please take my credit card.”

“Ok, ok, just relax man, relax, relax.”

“If you tell me to relax one more time, sir, I might actually get, well, less than relaxed and cause all of us some trouble. Do I have to ask you to take the card again?”

He took the card. I did relax. Then Lina and I stood outside the garage only to receive an offer from another garage’s shuttle driver offering to take us to the airport for $10 since our free shuttle was running late..

“Please thank him for his generosity,” I told the nicer lady-attendant at our garage who had presented us with her neighbor’s charitable gift. “We’ll just wait.”

And we did. And we laughed. And then Lina did a little dance.

Herewith, the love of my life making every nonsensical and frustratingly contemporary situation better.

Go, Lina!

  (Click on below arrow to launch Quicktime.)

***

Two more Mayo trip highlights so far:

1. When we waited for 20 minutes to exit our plane to Rochester so a disabled man could leave first, the flight attendant said that we would all get extra halos for our patience!!! I currently wait for my gift from the J man. And grow impatient. Some angel.

2. There is nothing in Rochester except lots of white, and it's 4 degrees here. I feel like I'm in that terrible John Cusack and Billy Boy Thorthon movie set in Kansas on Xmas eve. You know, the one when they try to rob the mob and everything goes topsy turvy.  Except, I'm not here to do something as fun as steal money, hang with strippers, and then almost get shot.

More a'comin'...For how often do you get the skinny on an experience like this from a dude who should be sitting in Los Feliz dive bars laughing about how Kiefer can't join us for a Guiness 'cuz he's locked up in Glendale for being stupid?

P.S. Am I scared that I have to be here? Many have written with this question. The answer is yes. But not any more scared than I was two years ago when I began noticing the progression of this weird syndrome messing with my muscles and nerves. Not any more scared and frustrated then I am when world famous docs in NY or LA tell me they don't know what to say. It's just that now that people believe me it seems more real to everyone else. So I'll be as flip and honest about it as I feel like. And at the moment, I don't feel like cryin'. I've got DVDs to watch and access to a world renowned medical system just begging to be assessed and skewered-my forte. But let's hope none of that's necessary and we can just do Quicktime dance videos for the rest of the week. I know Lina's got a lot to teach me. The question is: Can you compete?

Mayo Dispatch 1: The Getting Ready and Holding Steady

I will soon land in Rochester, M.N., home of Mayo Clinic and, well, very little else. I am not excited--I've been told to prepare for a short-term residency of five to seven business days. But as some readers of my recent health writing may know, there's a bit of a mystery going on here. And guess what? Just because I published an essay, written at one point in time, in a major men's magazine, diagnoses and docs can change. Or in my case, miracle meds may disappoint and due to a lack of any better advice, all the major docs in a major city may pass the buck up to Minnesota, because, really, why try anything else when you can cost your patients thousands of dollars and divorce yourself from failure?  Heartening in this ego-driven, diagnosis-starved medical environment, no? But for young adult survivors of the mystery conditions that arise after sub-lethal cancer treatments--we first-gen crazy-chemo-and transplant mutations (call us The Chronics) often forced to research our conditions and communicate personally with the top of the toppiest docs via e-mail, so as not to miss out on something groundbreakingly helpful--this ain't anything newsible.

In my case, of course, there's something odd and apparently less-than-obvious hoppin' with my immune system. The result? Some damage to my peripheral nerves (think carpal tunnel in more than a few locations). But don't be scared: I look normal (and isn't that what really matters?). I just don't run up Runyon Canyon or bench 180 anymore. Plus, sometimes the hand slips when I'm mincing the shallots or trying to open the wine.  Ok, I have a lot more serious complaints, but, seriously, you'd never know it from looking or even hanging out with me, and I'm not letting it impact my work. (Though, for those people who do look different, I'll probably be in your shoes one day, and I'm down with your sitch. Keep on rollin', and I'm sure I'll see some of you on the pea-shooter out of Chicago.) Indeedio, I'm writing more than ever now. I have to. I have the impetus. Medical bills pile up, I'm newly married, and the more I write, the more the cash flows. Besides, this is my passion. At least that's what readers and editors tell me. Gotta follow your dreams.

Anyway, I plan to record and comment on what happens at Mayo for a multitude of reasons, not least to provide a candid report card on the most elite medical institution we know written with a real live young man's point of view. In the past, I've used some of the esteemed hospital's sources for magazine stories, and I've read many of their studies. Impressive--by golly. Still, I haven't been given an appointment there with anyone that competes, bio-wise, with any of the bigwigs I've seen at other top U.S.  hospitals. And maybe that's actually great: I haven't yet found too many famous researchers who exactly care about the people in need of their science, but I haven't looked everywhere (just 88% of everywhere), so I'm not that negativo yet. It's just that me and the corporate "branding" initatives, well, we don't mix too well (see my quick and dirty rejection of a publisher's offer to have me do a new-era Chicken Soup for the Soul). I just find it hard to trust a corporate approach, whether it's choosing Time Warner Cable for their excellent customer service (ha) or putting my faith in a guy about to shoot new, clean antibodies up my arm simply because he wears a white coat with words that come up a lot on Google when people are worried about spine cancer.

There's an "integrative"--"multi-specialty, group practice"--approach at Mayo, of course. Which is not to say that they push wheatgrass on you but that you're seen by more than one doc and discussed by teams in a concentrated amount of time. That's good, because I have issues concerning multiple specialties and subspecialties. I'll need the brain waves of--and more important, some human concern from--oncologists, nerve specialists, immunologists, endocrinologists, neurosurgeons, and others. One thing I'd like to make clear, though: nothing's happening to my brain. So apologies to anyone who thought I might get: cooler, nicer, stupider, or funnier from the progression of this insidious little condition. None of it's going to happen (you may be less bummed than me, believe it, champ), though I must say: my sense of humor has definitely skewed darker over the years (certainly in the more marketable direction), and if I have to thank something for that it's the stem-cell transplant in 1997 that saved my life from Stage IVB Hodgkin's Disease. Thank you, baby stem cells. May you never meet anyone from cold-ass Washington, D.C., right or left wing, and may you please keep on working as hard as the Los Angeles firefighters who saved our home last spring.

But to your question, readers: Is this here Shallot blog-thing becoming a diseased man's message board? Fear not. I can't stand those Google hell-bombs anymore than you can. But how many people visit the Mayo Clinic (should I precede the place's name with a definite article or not?) after my kind of multi-year diagnostic experience gone wrong. And less people have a viable way to chronicle the experience, and perhaps help, enlighten, and entertain some people along the way. Shallot to the rescue. Just know I'm certainly not doing it to "express myself." I don't need that kind of release. Trust me. If I did, you'd be watching a movie or reading a book about me now instead of reading this measly blog. I haven't ever been ego-maniacal enough to go gonzo on myself in quite that media-whorish a way. But stay tuned. For now, meaning this week, I just want to take good notes and fill people in on what the experience will be like. I'm generally private about this stuff (national essay, excluded), but now that I'm finding my close friends so removed from my day-to-day medical reports--to say nothing of some family--I might as well open up the floodgates. So, in summary: Keep on rockin' in this high-co-pay, insurance-fraudulent world and check back in tomorrow. I may well have something more interesting to discuss other than my serious need of a very warm winter coat and decent sushi delivery.

**Mayo Fun Fact #1:

 The hotel I've reserved in Rochester includes the following text on its Web site description of its town as a "fun" city with much more to offer than medical services. Talk about great marketing copy and an uplifting spirit for those in distress:

Adventurer, novelist, and Nobel Prize winner Ernest Hemingway was admitted to the Mayo Clinic in 1960. Diagnosed as suffering from depression, he underwent two months of electric shock therapy. Unfortunately, the treatments were not successful, for in July of 1961 the man who wrote such masterpieces as "A Farewell to Arms" and "The Sun Also Rises" returned to his Ketchum, Idaho, home and committed suicide.

What inspiration for a young writer descending on fair Rochester. I should be so lucky, no?