•   •   •

Yesterday I took a piece of lint-covered gum out of my pocket and ate it anyway. I don’t even care anymore, man. My diet consists entirely of spinach, cabbage, and gruel. I have lost seven pounds in the last month. Despite working full-time, I have negative money left over at the end of the month. What a fine time to be an American citizen!

My left eye twitches every few seconds, and the center of my vision is blurred just enough to drive me insane. My right eye, which is my good eye apparently, attempts to compensate for this new abnormality, but this only makes it worse. I have never in my life had vision problems before. I have taken to wearing an eyepatch until I can afford to fix myself, which might not ever happen, given that no matter what I do I can’t get anyone to give me health insurance.

I have called dozens of 1–800 numbers, and have talked to dozens people about it, but no one can really tell me why my health insurance applications were denied. One guy said that I “failed to provide proof of income.” I told him I had never received notice. He said a letter had been sent to an address I have never lived at. I wondered aloud, to myself and maybe to him as well, how I could have possibly done anything about that. I asked if I could still enroll anyway—that I had a paystub in hand, and could at a moment’s notice get it to him—and he said he wasn’t sure if it was too late or not. I felt really sad just then. I told him my eye hurt and that I needed to see a medical professional of some sort, possibly a few of them for different reasons, and I imagined him shrugging as he referred me to yet another bureaucratic nightmare that I don’t have the mental fortitude to deal with right now.

I walked over to my bed and put on a sleep mask. I had only been awake for five hours, most of that time spent on the phone trying to get someone to care about the state of body, but I went to sleep again anyway. My eye was hurting too much and I couldn’t concentrate on anything. I thought that maybe if I was asleep I wouldn’t feel so bad anymore.

I had a dream. It is a dream I have been having a lot lately. In this dream my right front tooth breaks while I’m eating or staring at it in the mirror. In real life, my right front tooth is a crown, and I really did break it when I was in high school. I have this constant fear of it breaking again. I’ll wake up from a dream, and touch my hand to my tooth to make sure it’s still there. I have been doing this for ten years.

•   •   •

This next part is not a dream, though it may as well be:

Ten years ago, I was a senior in high school. I was a two months away from graduating. At that point I was hardly ever going to school. I was too busy driving around late at night, and avoiding authority figures, and sleeping in my car in parks and behind gas stations while I was supposed to be completing my final coursework.

I knew a girl named Megan. She was my good buddo. I had a big ol’ crush on Megan, though Megan didn’t have a big ol’ crush on me. I don’t think I knew that yet. At any rate she seemed to like having me around, and I liked being around her too, so I went over to her house whenever she asked me to.

One night, on a school night, I was at Megan’s house with a few other creeps I knew around that time. We were jerking around in her basement. We were laughing like hell about God knows what. I do remember putting on her mom’s high heels, and clacking around on the hardwood floors. At some point we all got on the trampoline. We were having us a good old time that night.

And here is a crucial point in this story: All of my friends had big ol’ crushes on Megan too. She was real pretty, and she was real funny too—which, as any fine American will tell you, is a dynamite combination. That night one of the creeps I was with was my friend Brent. Brent was not immune to Megan’s Megan-ness either. He had a crush on her too.

Brent was laying it on thick. He really wanted Megan to know he liked her. I don’t know whether or not she liked him back. After we got off the trampoline she stole his shoes and ran around with them so that he would have to chase her. Maybe that means she liked him. Or maybe she was just the sort of person who got her rocks off stealing other people’s shoes.

In the darkness of my mind I remember her mother telling everyone they had to leave, on account of it being so late. We still had to pretend like we cared about getting up and going to school the next day, and so we pretended to.

I can see Megan standing on her porch. She is waving and asking me to do my impression of Marty McFly one more time. I say, “Doc, are you telling me you built a time machine out of DeLorean?!” She laughs. Brent and I start walking to my car.

And then something stupid happens: Brent, who was larger than me, jumps on my back with no warning—maybe to impress Megan somehow, who is now already inside. I don’t have time to brace myself and so I lose my balance right away. I fall to the ground, into a grassy slope in her front yard, with Brent on my back. His weight pushes my head forward into a pipe. What in God’s name is the purpose of this pipe? I wonder later. What was this damn thing doing in the middle of the yard?

I fall face-first into it. I feel no pain. I push Brent off of me and call him an asshole. My mouth is numb. I reach for my front tooth but it is missing. I have already swallowed more than half of my tooth, which had been immediately pulverized by the impact, and turned into dust. I taste blood in my mouth. The dust is coating my tongue. This image and that feeling will haunt my dreams for the next ten years of my life.

I turn to Brent and ask him if I have a front tooth, and he makes a horrible face and tells me it has broken. I run over to my car and flip down the visor mirror. I have one perfectly normal front tooth and one jagged vampire fang. There is blood splattered all over my face. I shriek. I tell Brent that the least he can do is drive me home. He gets in and does just that. I stare at the tooth in the lighted mirror the whole ride back. When I get home I sink into a deep depression and force myself to fall asleep.

My dentist didn’t have any openings the next day, so I hid in my father’s basement for a week. I practiced talking in the mirror and looked like a bumfuck yokel. I covered the windows and wrapped myself in a blanket and tried to disassociate. I wanted to forget that I had a body, and that a part of it that I liked was broken. I was stupid and vain and dramatic about the whole thing. I was also a teenager.

I saw my dentist the following week. He had worked on my teeth since I was in elementary school. Now that I was eighteen he inexplicably started talking to me differently. He found a way to insert “fuck” and “shit” and “ass” into nearly every sentence he spoke. He told me his new dental hygienist had a great ass. I supposed this was what it meant, to him at least, to “talk like an adult.”

He had me open my mouth. He examined the serrated stalactite that was once my tooth. “Aw hell, this li’l fuckin’ thing? Shit, man. This is nothing. I’ve seen way worse, trust me.” He took out a little plastic wrapper that had a tooth inside. It was whiter than my other teeth by far. It looked like a Chiclet. He told me I would have to wear it for a month while my permanent crown was made by “some hippie dudes down the street.” Then he took dozens of pictures of my perfectly intact left tooth. He said they’d mirror it and make it match. No human eye, he said, would be able to detect the difference between the two.

I said, “All right then.” He glued the Chiclet into my skull. The dental cement, he said, was strong—but not strong enough to withstand a whole lot of wear. He told me not to eat with it. I told him I wouldn’t. He held a mirror up to my face. I grinned menacingly and saw the fake tooth. It was like a spare tire in my mouth—like a little donut wheel: ugly, and unlike the rest, but hopefully only for a short while.

A month later I got a call from my dentist saying my crown was completed. I drove to the office where the “hippie dudes” had made it. The place was being renovated so the guy met me at the door. He was in his forties and was wearing a T-shirt and jeans. I suspected that my dentist considered a guy like that to be a non-square, and thus, somehow, lumped him into a great big nebulous sub-category of humans that were superficially different than him.

The hippie dude lead me to the back and showed me my crown. It really was a perfect copy of my left tooth. He told me that making a crown involves more artistry than science. He gave me the crown and said my dentist would set it for me. I thanked him and drove to my dentist’s office.

My dentist removed the Chiclet. He cemented the hell out of the new crown, cemented it right into my skull. He held the crown in place by creating a sort of vice grip with his gloved hand. Soon it became part of me. His hygienist, the one with the great ass, handed him that little hyper-laser tool they use to lock in sealants. He fired it up a few times. It made the inside of my mouth glow blue. He set it down and picked up the drill. I protested, but he said it was necessary to sand my bottom teeth so the crown would fit properly. It made a violent, terrifying noise. I screamed inside my skull. It didn’t last long. The whole process, from start to finish, took maybe ten minutes.

I asked him if I was set for life, pending some horrible accident, and he told me I’d get maybe ten or fifteen years out of the thing. “Though, by the time you go to get the next one, dental technology will likely have advanced to the point where you can keep that shit till your dying day. In fact I’d bet on that happening.”

A week later I was at a restaurant with my girlfriend. I had started dating her in the time between the incident in Megan’s yard, and my new crown being created by some cool dudes in blue jeans. I didn’t like her at all, and she didn’t like me either. That day we were joylessly eating sandwiches. We were hanging out in a sort of sad perfunctory way. I bit into the toasted bread and felt the bottom of my crown hit something hard. It licked it and it felt off. I asked my girlfriend if anything looked any different. She studied it closely. Listlessly she said: “It looks like maybe it chipped a little.”

I went back to my dentist. I told him a sandwich had chipped the bottom of my brand new, very expensive crown. “That’s crazy. There’s no fuckin’ way that happened.” He had me open my mouth. “I don’t see anything. It looks fine to me.”

My tooth was definitely chipped. It wasn’t a big chip. When I slid my tongue across it I could feel the smooth little break line. I didn’t do anything about it. It would have been too expensive to fix something so minor, so it stayed that way for a decade.

•   •   •


Alone at night, and miserable as hell in a city three thousand miles away from where I was born, I sat in the darkness of my bedroom wondering about my life. I had just made a sandwich. I had toasted the bread and everything. I was very excited to eat that sandwich, because it would be my only meal that day. I was, and still am, consuming less than a thousand calories a day. It felt good to put something inside the great big emptiness of my body.

I took one bite. I felt something hard in my mouth. I spit it out onto the plate. It was white and glassy. I figured some foreign object had ended up a stowaway in my sandwich. I picked it up and held it up to my desk lamp. I knew right away that is was half of my front tooth. I put my hand up to my face and felt around for my crown. It was sharp and jagged. I walked into the bathroom and smiled into the mirror. I groaned. My tooth was broken. It was a perfect diagonal break. I wondered if I were dreaming. I decided I probably wasn’t dreaming. Mentally I added the event to my growing list of things that are rapidly making my life less and less worthwhile.

With great sadness I returned to my room and attempted to eat the rest of my sandwich. The little vampire fang, newly exposed to the world for the first time in ten years, was extremely sensitive to even the smallest change in temperature. Breathing made it ache. On top of that, I couldn’t eat without my front tooth. It was too severe a break. I threw the sandwich away and sedated myself so I could fall asleep.

Next day I called four or five dentists in my neighborhood. All but one refused to cement my crown back onto its brother, who was living a lonesome life inside my mouth. They told me it was “impossible.”

The dentist who did agree to see me said it was no sweat. They fit me in at three p.m. I drove over a half hour before my appointment and filled out a single page of paperwork. I handed it to the receptionist. She said, “How are you, Ryan?” And I gave her a hideous toothy grin, saying, “I think you’re looking at it.”

A nurse lead me to an examination room. She took a look at my tooth. “We can fix this,” she said. “It may not be permanent, and it may not be super strong, but we’ll get you all fixed up.”

The dentist came by a few minutes later, asked me to smile, and said the same thing. He said mounting shards of a broken crown was like “trying to fit two pint glasses together,” but that a quick and dirty job would buy me at least six months if I was delicate with it.

“I can make you a new crown—a real good one, even.”

I inquired about gold: “I heard gold is tough as hell. Could you make me a gold tooth?”

“Like . . . like a straight-up gold tooth? No porcelain veneer over it?”

“A solid gold tooth.”

“Sure. I could make a green tooth if that’s what you really wanted. I can make it whatever color you want.”

“I want a gold tooth.”

“If you’re not concerned with the appearance of a gold tooth in your mouth, then sure.”

“I’m going gold.”

“I can make it. You just let me know and I’ll make it.”

“Uh, give me a few weeks to get health insurance.”

I took out the tooth shard, which I had stored in a little plastic container in my pocket. The dentist held it up to the light. “It really is a perfect break. You couldn’t have hoped for a better way for your tooth to split in half.”

He glued it back into my skull. He used the little laser tool to seal it. He reminded me about the gold tooth, said he’d make it whenever I called him up. He was very friendly. He shook my hand and stepped out of the room. I heard him tell the nurse to only charge me for the procedure, and not the X-rays, and to give me a discount. Well, gosh. There you go. It still cost me $130 that I didn’t have.

•   •   •

A week later the vision in my left eye had got progressively worse. Or rather the blurriness stuck around, whereas before it had appeared intermittently, and was ghostlike. Mysteriously, there was also a dull ache in my left testicle that wouldn’t subside either. And then I experienced what I have determined was something resembling a UTI, which apparently is pretty rare in men. I weighed myself and found that I had lost seven pounds in thirty days. My body was conspiring to destroy me.

And so: with failing eyesight, and phantom testicular pain, and a possible urinary tract infection, and a duct-taped-together tooth, and the diet of a fifteenth-century peasant, I set out to solve my health issues one at a time, in order of importance. I started with my eyes. With no health insurance I made an appointment with an optometrist in St. Johns, near the Cathedral Bridge. I told them I was uninsured, and they said to come on in anyway.

A few days later I showed up in St. Johns. I was twenty minutes late. They were very kind to me at the front desk anyway. The three women working there were covered in tattoos. I immediately formed crushes on all of them. They gave me a cup of coffee and had me fill out a single page of paperwork, which was just a health background. I wrote that I had no chronic illnesses, and there were virtually none in my family either. My current bout of bad health, I told myself quietly, was due to my near-constant state of poverty, and the fact that I lived in a morally-bankrupt country where money and material possessions, and the rabid desire to obtain as much of both as possible, outweighed the human lives that were casually discarded in doing so.

I turned in my paperwork. One of the nurses took me into an examination room and performed a few tests on my eyes. She numbed them with drops, and then did a “puff test.” She asked me when was the last time I’d seen an eye doctor, and I told her it had been over twenty years. She refilled my coffee and left.

The optometrist came in thirty seconds later. We shook hands. She saw that I was holding a cup of coffee. She asked me how I took it, I guess to make small talk, and I said: “Black, just like . . . uhhh, my heart.” I cleared my throat. “Actually, I think I’m just kidding about that last part.”

She did a few more tests. I read big letters and tiny letters with my God-given eyes, and then she put a huge machine over my face, and I read a few more lines of random letters while she doubled and tripled my vision. She told me I had 20/20 vision with no need for corrective lenses. I then had to distinguish on what side of a white light a thin red laser appeared. I aced this too. She told me I most likely didn’t have a brain tumor. It was the best news I’d heard in months.

She dilated my eyes, saying it would take fifteen minutes for my retinas to fully open. “It’s going to get very bright in here for you,” she said. “I have some sunglasses if you need them.” I said I was all right, fine like this, and so on, and she left me alone in the room to feel all jittery and tripped out in semidarkness that would soon become brighter.

Gradually the light in the room did indeed become vaguely uncomfortable for me. I lost focus of things close and far away. I got up and looked into a mirror on the wall. It looked as though I had ingested an entire cauldron of ayahuasca. My pupils were huge empty zeroes.

When the optometrist returned, she wheeled out yet another machine. I rested my chin on a plastic platform and she looked into my eyes. She turned on handheld light and shined it into my pupils. It was excruciatingly bright. “Your pupils turn into little pinholes when even the smallest amount of light enters them, my friend.” Well: there you go. That explains my need for dim lighting, and my sensitivity to oppressive overhead lighting, and my great love of darkness and nighttime.

“Some people have a lot of pigment in their retinas, some do not. It seems you don’t have much pigment. That’s perfectly normal.”

“All right then,” I said. “Hasn’t bothered me yet, and I’ve been here for almost thirty years.”

And then she looked deep into my retinas—all the way to the very backs of them. And she told me she saw something odd there. She had me go into another room where she took a series of photos of my retinas. I had to focus my eyes on a blue target. When it turned red, I had to pull back. I needed to make the target green. I figured the correct placement of my head, and she quickly took the pictures. We went back into the first examination room and studied them under various filters.

“You see here,” she said, pointing to a cluster of white flecks inside the deepest layers of my eyes, “these are abnormal. In fact, I’ve never seen something quite like this, especially in someone so young.”

She showed me a picture of a normal retina. It looked different than my retinas.

“You have some sort of inflammation going on in there, more on the left than on the right.” She circled some gelatinous globes of eyeball-stuff with her finger, which was fortified by a spiderweb of thin veins. “See this? This looks a little off.”

“Um.” I didn’t know what she meant, but I took her word for it.

“It could be nothing, it could be something. You’re going to have to see someone who specializes in retina imaging.” She leaned in close, and, in a low voice, perhaps to cushion any embarrassment I might feel from the words that she was about to utter, said: “You should get health insurance before you see them. That’s going to get expensive very quickly.”

“Oh, OK. Man. So you have no idea what it is?”

“I really don’t. And I don’t want to give you false hope, or scare you either. So I can’t say for sure. All I can tell you is that you need to see someone about this just to be sure. I’m just general care. A specialist is what you need.”

“Yeah. I gotta do that.”

“Have you seen a doctor recently? When is the last time you had a physical?”

“Probably over three years ago. I’ve been trying to get a physical for that amount of time, actually. Even in California, my insurance wouldn’t cover something as simple as a physical. I’ll tell ya, this country sure don’t care if you die.”

“Yeah, it’s pretty bleak, huh? Still, you should get blood work done. The inflammation might be caused by something like a systemic virus. There’s no way to know for sure today.”

“Whoa, baby. OK.”

“Don’t freak out, just see these guys whenever you’ve got coverage.” She wrote down a phone number on a Post-It note. “I’m going to tell them you’re coming, and send them the images of your retinas. They’ll be able to tell you exactly what it is.”

“Man. This blows big time. Though, hell, it’s gonna be what it’s gonna be. But then when is that not the case?”

The optometrist lead me to the front desk. In a low voice she told the receptionist to only charge me for the visit, and not for the retina images. The visit and all the tests cost me $140. I put it on my credit card, and groaned big time internally, knowing it would probably take me three months to pay it off.

The receptionist printed out a receipt for me. “With your eyes dilated like that, it’s going to be a weird couple of hours.”

“It’s . . . hell, it’s going to be a weird rest of my life, man.”

She laughed. “Yeah, tell me about it.” It was the best response I could have hoped for.

“Do you need sunglasses?” said another receptionist. “We have disposable ones.”

“No, I’ll be fine. I have some in the car. Though, hey, if you see me walk into a lamppost, or get hit by a bus, feel free to call 911.”

I stepped out onto the sidewalk. If it was a nice day, I had no way of knowing. For me it was a sun-blasted nightmare. It made me nauseous, having my eyes filled with all that godawful light. Blindly I walked across the street. I looked around. It was a great big blur. Nothing looked familiar. I figured I had gone the wrong way. I crossed the street and returned to where I had just come from. I forgot where I was and why I was there in the first place. I closed my eyes. I stood there for a long time. I took a piece of gum out of my pocket. I held it up to my dying eyes. It was covered in lint. I put it in my mouth. I crossed the street to get back to where I had already been.