Another Sixty Minutes

"So."

"So what?"

"So how are we going to deal with this?"

"We aren't going to do anything. I will do the angioplasty, surgically insert some stents and if necessary, bypass."

"And that's it. You're going to have open heart surgery and just...let it roll off your back."

"I can't do anything about it. Seems like the logical course of action."

"How are your kidney and liver function? I haven't had a chance to review the labwork."

"Wilson ask you to ask me?"

"Naturally."

"You going to tell him what I say?"

"You know that I no longer can."

"And you're going to honor that?"

"You have some reason to believe that I wouldn't?"

"It's about what you'd expect. There's some deterioration, obviously. My blood pressure is up…I've got some edema, some fluid retention. It's nothing that medication can't fix."

"Medication can't repair the damage to your organs, Greg."

"So?"

"So a transplant could buy you another five to ten years, problem free."

"Not necessarily. There are other blood vessels affected by FMD."

"..."

"And I'm not eligible anyway."

"You are for live donation."

"No."

"No what?"

"No. I won't let him do that."

"Why do you assume I meant him?"

"Who the hell else would you mean? You think there are people just lining up to give me their vital organs?"

"You don't think you're worth it?"

"That has nothing to do with it."

"I think it has everything to do with it. You've admitted to me on more than one occasion that you don't think you deserve to live."

"That's not what I...He's like ten years younger than I am."

"So?"

"So he could still…find someone else, have a life."

"You're not dying, Greg. It's a manageable, chronic disease."

"It's degenerative."

"Everything's degenerative."

"Precisely. One way or another, something will fail…heart, kidneys, lungs, brain. Some artery will fail to bring blood to some organ, and I'll stroke or pop an aneurysm. Anything repaired with surgery will eventually reverse itself. My life will be shortened."

"So you have more surgeries."

"Yeah, it's that simple."

"Maybe you don't want to have more surgeries."

"Who the hell does?"

"Death is an easy way out. It means never having to worry about whether or not things would have worked out between you and James."

"It has nothing to do with that."

"I think it does."

"It's just...he shouldn't commit to someone who is only going to weigh him down."

"Why?"

"He just shouldn't. No one should."

"All relationships involve give and take. Any worthwhile relationship entails some degree of personal sacrifice. Making a commitment to another human being means volunteering to be weighed down at some point."

"..."

"And he loves you."

"Wilson loves everybody. That doesn't mean he should give them his internal organs."

"He's going to want to."

"Wilson wants a lot of things that he shouldn't have."

"Don't we all?"

"Fair enough."

"When's the surgery?"

"Haven't scheduled it yet."

"Why not?"

"I thought I'd wait until you discharged me."

"Well, good. That's only a week away."

"And I'm...waiting on a second opinion."

"Second…to your own? You're a nephrologist."

"…"

"You don't trust your own judgment?"

"I've heard tell that it's a bad idea to diagnose yourself."

"It's never stopped you before."

"Yeah, and that worked out really well."

"You predicted kidney failure based only on wide complex tachycardia. You saved your own life."

"And what a life."

"What exactly are you so afraid of?"

"I'm not afraid."

"It's okay if you are."

"I just want to be sure."

"The tests were fairly conclusive. What do you think you're going to find out?"

"I'm just covering all my bases."

"Sorry, but…that's not you."

"It is now."

"Why?"

"…"

"What's changed?"

"..."

"I'm sure the obvious has not escaped you. If you have fibromuscular dysplasia, it would explain the infarction. It could even explain your continued leg pain, your deteriorating eyesight, your nausea and fluctuating loss of appetite, and any number of other miscellaneous symptoms that you've experienced during your adult life...symptoms that have always been attributed to your drug and alcohol use."

"…"

"How do you feel about finally getting a valid medical explanation for those things?"

"Thrilled. Gonna throw a great, big party. Liquor free, of course."

"It sounds like you're angry."

"Nope."

"I think you are."

"What the hell difference does it make? Being angry won't change anything. So why bother?"

"Because it's healthier to express that anger, than it is to keep it bottled up inside."

"I don't see the point in getting angry about something I can't do anything about."

"Now I don't believe that for a second."

"And besides, it wasn't rocket science."

"What wasn't?"

"A nurse practitioner figured it out, based on vomiting and lower back pain."

"Which nurse practitioner?"

"The one who did the ultrasound of my liver and kidneys."

"How did she figure it out?"

"Apparently she'd written a paper on it. If I didn't know any better, I would have thought she was excited."

"..."

"Not that I can't relate to that mindset. I mean, I should probably get a resume or something."

"Did Dr. Ahern confirm the diagnosis?"

"Yes."

"Then why do you need a second opinion?"

"..."

"Why does that bother you that someone else managed to figure out what was wrong with you?"

"It doesn't."

"It sounds like it does."

"It fits. It's perfect."

"So?"

"So it explains everything. It was there all along...I shouldn't have missed it."

"What do you think would have happened if you hadn't missed it?"

"…"

"You think you could have avoided becoming handicapped, could have avoided becoming dependant on pain medication?"

"Too late now."

"It's a fairly rare disease. I don't see how you could possibly have known. And a blood clot in your thigh would have been a rather odd presentation."

"Diagnosing rare illnesses is kind of what I do."

"Hmm."

"What?"

"You say you think it's a waste of time to get angry about things you can't do anything about. But then you have a tendency to dwell on things that you cannot change."

"…"

"Why do you think that is?"

"I don't know."

"But you're at least acknowledging that you do dwell on them."

"It's my nature to obsess about things. There's no reason failure would be any different."

"Are you still smoking?"

"Just here and there."

"How many packs?"

"Maybe two a week."

"That's not just here and there."

"It's not like there's much else to do here."

"I'm sure you know that cigarette smoking will only exacerbate whatever damage is being done to your blood vessels."

"I did go to medical school."

"Doesn't mean you're capable of discontinuing unhealthy behavior at will. Most people aren't. And considering your ongoing struggles with addiction, I think it's a valid concern."

"I'm going to quit...eventually."

"You said that before."

"Yeah, well. I've obviously got a different motivation now."

"You were aware that you had clotting issues before. How is this any different?"

"..."

"So again...how are we going to deal with this?"

"What's this we business?"

"Well from what I understand, you're not letting James in on this. I doubt you'd confide in any other patients, your colleagues, your employees, your boss or your mother. You're going to need a support system of some sort."

"He talked to you."

"Of course he talked to me. He knew something was going on and he didn't know where else to turn."

"What did you tell him?"

"That he should respect your wishes and mind his own business."

"I'll bet."

"You don't trust me?"

"I don't trust him."

"You think he could manipulate me?"

"Yes."

"..."

"Sorry."

"Why are you sorry?"

"It's not you. That's just...what he does."

"I see."

"I...you know, a couple years ago, I had a distended bladder. I couldn't pee for like four days. I went to Wilson for a prescription for alfuzosin."

"Why did you do that?"

"What do you mean?"

"I mean, you probably knew in advance that as your friend he couldn't possibly be objective. You had a legitimate, physiological symptom. Why not just make an appointment with some other doctor?"

"..."

"Right. So you went to him with a distended bladder and then what?"

"He told me to stop taking the Vicodin."

"So he assumed that your urethral stricture was a result of acetaminophen toxicity."

"Of course."

"Not a completely unreasonable assumption."

"..."

"Although he still should have considered other possibilities. And even if the Vicodin was to blame for your dysuria, discontinuing the drugs wouldn't necessarily reverse the problem, at least not immediately."

"..."

"But James was convinced that the source of your problem was the drugs."

"Yes."

"And now you know that was not the case."

"I knew then that it wasn't the case."

"But it didn't matter."

"Nope."

"And now you're wondering how many other ailments of yours James and other people have dismissed, or attributed to your drug and alcohol use."

"When you're an addict..."

"What?"

"Everything's about that. People look at you and it's all they see. The drugs, the alcohol...they're the reason for everything you do. It's not just what you are. It's who you are."

"Do you think people have judged you, based on your addictions?"

"I know they have."

"How does that make you feel?"

"I don't know...less."

"What do you mean less?"

"I mean, less than them."

"Ah. I could see how you might feel that way."

"..."

"That says a great deal more about them than it does about you, though."

"..."

"How did you eventually regain the ability to urinate?"

"Catheter."

"So you did seek some sort of medical attention."

"No."

"No?"

"I did it myself."

"You cathed yourself?"

"..."

"I didn't think you could do that."

"Where there's a will, there's a way."

"That must have been very painful, or at the very least, extremely uncomfortable."

"..."

"He thinks you're pushing him away."

"Of course he does. Everything is always about him."

"Are you?"

"Am I what?"

"Pushing him away."

"..."

"Why?"

"Wilson...doesn't handle losing people very well."

"But you're not going to die."

"Not today. But eventually, yeah...sooner than later. People with FMD don't typically live past the age of sixty."

"So you're just protecting him from that potential loss."

"..."

"That's big of you."

"I'm protecting myself."

"Right."

"..."

"The two of you bought a condo together."

"So? It's not like I've been using it. I've been here for the last two months."

"But you'll be going home very soon. Living together, owning a home together, that's a huge commitment. Makes it pretty hard to cut him out of your life."

"I'm not trying to cut him out of my life. I'm just..."

"Just backing off a little."

"..."

"How much is a little?"

"He makes enough money. It's not like he couldn't afford the monthly payments on his own."

"..."

"And from what I understand, my old apartment is still vacant."

"Are you serious?"

".."

"You can't be serious."

"..."

"You've just been diagnosed with a debilitating, degenerative illness and your instinct is to push away the sole member of your support system."

"Nothing's changed, doc. I'm just as sick today as I was last week. The only difference is that now I know about it."

"And you don't think you're going to need help to get through this?"

"You don't understand."

"What is it that you think I don't understand?"

"Wilson...he won't get over this."

"So?"

"So If I stay..."

"What?"

"It will become our place."

"So?"

"So if it becomes our place, when I die..."

"If you die."

"When I die."

"He's going to turn it into the Taj Mahal?"

"He barely knew Amber for four months and he has pictures of her all over the damn place."

"So you've said. And you're clearly bothered by that. Yet you've failed to address it with him or tell him how you feel."

"I've addressed it."

"Really?"

"..."

"You've said I'm really uncomfortable having these pictures up in our home...can you please take them down or consider other options?"

"..."

"I'll take that as a no."

"..."

"So you think that if he reacted that strongly to the death of someone he barely knew, he would be completely ill equipped to handle yours."

"I don't want him to sacrifice what's left of his life for me. I've cost him enough already."

"I don't think he sees it that way."

"Well...then he's an idiot."

"..."

"Trust me. He wouldn't be able to deal with this."

"And you think you can deal with it alone?"

"I'm used to flying solo."

"That hasn't worked out so well for you, in the past."

"I'm fine...I don't mind going down in flames, as long as I don't drag anyone else down with me."

"I don't believe you."

"..."

"I think you're terrified."

"..."

"I think that you want to be able to depend on him right now. I think you long to trust him that much."

"..."

"But you don't."

"I have my reasons."

"I know, and they're very good reasons."

"..."

"But there comes a time when you have to be willing to take that risk."

"..."

'You need to give him a chance. He can't be there for you, unless you give him a chance."

"You don't...I don't know."

"What? Finish your thought."

"When he found out that Amber was dying, I mean at that exact moment...the look on his face was like..."

"Like what?"

"I don't know. I just know that I don't ever want to see it again. I don't want to be the reason it's there."

"You can't protect him from this, Greg."

"..."

"Even if you pull away. Even if you move out. Even if you tell him to go screw himself and that you never want to see him again, he would still be devastated by your death. He would still be deeply affected by that loss."

"..."

"And you don't want to bear that responsibility, do you?"

"Nobody should have to bear that responsibility."

"I want you to accept that there are some things that are out of your control. I want you to learn to depend on people, to risk becoming attached, to risk them becoming attached to you."

"It's not like there's anything he could do about it."

"So?"

"So...there's no reason for him to know. He'll want to do something about it. He'll delude himself into thinking he can. In the end, he'll just be disappointed."

"So why not just let him be disappointed? He's a grown man. He can handle it. It should be his choice."

"No, it should be my choice."

"And you don't think he's going to notice a massive scar running the full length of your torso?"

"..."

"You're the one who's sick here."

"So?"

"So why is it that you feel guilty?"

"I don't feel guilty."

"I know guilt when I see it, and this is guilt."

"..."

"You obviously still blame yourself for Amber's death, for the pain that it caused."

"Obviously."

"And you think that by dying, you'd just be adding insult to injury."

"No..."

"..."

"I'm afraid of what he might do...because whatever the hell it is, I won't be around to stop it."

"He's an adult, Greg."

"Yeah...sometimes I wonder."

"Hmm."

"What?"

"I'm curious why it is that the two of you expect so little of one another."

"Experience."

"Either way, you're both responsible for your own feelings and actions."

"I don't want to tell him."

"You have that right. But I feel professionally obligated to tell you...that I think you're making a mistake."

"..."

"So...again...how are we going to deal with this?"

"I don't know."

"Do you want to talk about your diagnosis or your treatment options?"

"Not especially."

"I really think we should."

"Yeah...maybe later."

"After you get your second opinion?"

"Maybe."

"So we are going to discuss this."

"Eventually."

"Okay. We still have a few minutes yet. How should we spend it?"

"Yodeling?"

"It would be wrong of me not to point this out that you've been clean for eight weeks now. That's quite a milestone."

"Yeah."

"Congratulations."

"Thanks."

"How does that feel?"

"Better than I thought it would."

"I'm glad to hear it. I want you to be able to take pride in your accomplishments."

"I'm not sure this qualifies as an accomplishment."

"It most definitely does. Remember what I said about success being subjective?"

"..."

"You don't seem all that happy about it though."

"I am."

"So this is you being happy."

"..."

"What's the problem?"

"I just…it's Wilson."

"What about him?"

"If I didn't know any better, I'd think he was…happier before."

"Happier before what? You mean, when you were still using?"

"…"

"Why do you think that is?"

"It's going to sound petty."

"So what? This is therapy. Petty away."

"I think there's a part of him that doesn't want me to be sober. I think there's a part of him that...doesn't want me to succeed."

"Mmm hmm."

"That's it, mmm hmm?"

"Greg there's a part of all of us who doesn't want to see other people succeed, even the people that we love and care about."

"..."

"I'm happy that you're better, that you're doing well. But there's probably even a tiny part of me that wishes you would continue to be sick, so that I could continue trying to make you well."

"Why?"

"Because...I enjoy making you well."

"…"

"Not the answer you were expecting?"

"No, actually."

"You thought I'd tell you how ridiculous you're being, that it's all in your mind, that you're just projecting your insecurities onto him?"

"Yeah."

"I think the opposite is true."

"Meaning?"

"I think he's projecting his insecurities onto you."

"Meaning?"

"When and if an addict finally does become clean, they and their loved ones have to scramble to reevaluate that relationship. As much as James wants to see you sober and free of addiction, there's a part of him that's mourning the loss of that dynamic. He has to redefine himself, now that he is no longer your enabler, your rescuer, no longer the person who picks up after your messes and takes care of your mistakes."

"..."

"It also means that he no longer has the security of knowing for sure that he's morally superior."

"I like that last part."

"I kind of figured you would."

"..."

"James has been defining himself as your enabler for far too long. And you're just as guilty of perpetuating that. You've enabled his enabling. You two are codependent, to an almost toxic degree. You have to become clean of one another, before either of you can move forward towards a healthier life. That's one of the reasons I wanted to extend your stay here."

"..."

"I'd say from your expression that you agree."

"Yeah."

"..."

"So how do I deal with this?"

"You're actually asking me?"

"Hey...that's why I'm here, right?"

"Right."

"..."

"You should find ways to reassure James that even though you're doing better, he's still needed, that what he means to you isn't dependent on you being an addict. It isn't dependent on anything at all."

"What if he doesn't believe it?"

"Then that's on him."

"..."

"I think letting him in on what's going on with your health would be a great start."

"..."

"He's going to want to try to fix you, to save you. Maybe this is a good opportunity for him to learn that you can still need him, even if he doesn't play that particular role."

"I'm not sure I know how to do that."

"Start with boundaries."

"What kind of boundaries?"

"Everything needs boundaries. Take responsibility for yourself, for your feelings and your actions. Let him know that any support he gives you is appreciated, but you're not dependant on it."

"Sounds simple enough."

"Speaking of boundaries...have you had a chance to talk to your mother, since we spoke last?"

"Mmm...sort of."

"Sort of?"

"I called her. But we didn't really talk."

"When was this?"

"Last night."

"You don't seem too thrilled about that."

"That's because I'm not."

"How did it go?"

"Pretty much like I expected."

"How so?"

"She...refused to talk about anything remotely important. I persisted, of course. She deflected. I persisted some more and she cried. I persisted some more and she got angry. I persisted..."

"And then what happened?"

"She hung up."

"Really?"

"But not before accusing me of lying, of course...and letting me know that I was exacerbating her hypertension. You know...because that way if she has a stroke, it can be my fault."

"That's...incredibly manipulative."

"You have no idea."

"Has your mother ever made comments like that before?"

"She used to say I was the reason her hair went gray. She'd say that one of these days, I was going to give her a heart attack."

"But surely you've considered the possibility that she was just being hyperbolic."

"Everything my mother says qualifies as a hyperbole."

"Has she ever hung up on you before?"

"Not to the best of my recollection."

"What exactly did she think you were lying about?"

"I don't know...everything, it seemed like."

"Did she actually say you were lying?"

"She implied it."

"Did you ask her how she reached the conclusion that you were being dishonest?"

"Yeah. But she didn't really have an answer for that."

"She must have told you something."

"She seems to think I orchestrated all of this."

"All of what?"

"All of this, that I'm having some kind of nervous breakdown just to spite her and my father. I'm punishing them, see."

"Punishing them for what?"

"She didn't say."

"But the fact that she would even make such a suggestion implies a guilty conscience, or that she and her husband may have done something that they think they deserve to be punished for."

"Her maybe. But not him."

"You don't think your father was capable of feeling guilt or remorse?"

"I don't know. Maybe he was. But I saw no evidence of it."

"I'm sure other people could make a similar observation about you. Yet I know from personal experience that you are in fact capable of feeling remorse."

"..."

Is it possible that your perception of your father is biased?"

"Of course it's possible."

"Did your mother provide any explanation for her belief, that you're having a nervous breakdown to spite her?"

"No."

"Did you ask her to?"

"I didn't get that far."

"Did you get a chance to ask her some of the things you've been wanting to know?"

"I tried to."

"What did you ask?"

"Who my biological father was."

"Wow."

"Yeah."

"And she refused to respond or she just ignored the question?"

"She wouldn't even acknowledge that my father wasn't my father."

"Did you explain to her that you'd already run a DNA test?"

"Like I said, I didn't get that far."

"What exactly did she say?"

"She said there are some things that I just don't need to know."

"Did you tell her she was wrong?"

"I tried to, several times."

"And then she hung up."

"Yep."

"Are you going to try again?"

"I don't know. I mean, what's the point?"

"Well I can certainly see why you'd be discouraged. But there are some issues here that obviously need to be addressed."

"Which is fairly meaningless if she refuses to discuss them."

"How old is your mother?"

"She's seventy-three."

"In good health?"

"Not especially."

"How so?"

"Well l ike I said, there's the hypertension and then she has a family history of heart disease."

"You think it's possible that she's going to die soon?"

"Define soon."

"In the next few months, let's say."

"I think so, yes."

"Why?"

"Most of the time, when someone's spouse of fifty years or more kicks the bucket, they aren't far behind."

"Agreed. But that tends to be more true when the first person to die is the wife, not the husband. Statistics show that women bounce back from the loss of a spouse more easily than men. And men are quick to remarry, in order to recreate the lifestyle that they had become used to. But given the degree to which your mother was dependent on your father, your theory certainly has merit."

"..."

"All the more reason why you should make every attempt to get closure, before it's too late."

"I don't even know if that's possible, at this point . "

"But you're still going to try."

"I think I'm going to try one more time to call her. And if she still refuses to discuss anything, I'll just...write up a letter and send it."

"Do you have any reason to believe that she'd be more receptive to a letter?"

"Maybe. Or maybe she'll just rip it up or throw it away. "

"Do you think that she would?"

"I don't know. I don't really have anything to base it on. I can count on one hand the number of times I've actually written to her in my lifetime. I think the last time was when I was a sophomore in college. And generally those were rather quaint and superficial."

"Even if she isn't receptive to the letter, I think the experience of writing it would be therapeutic for you. Whether she chooses to deal with these things or not, perhaps this would be a good opportunity to release some of that emotional baggage you've been lugging around for the past thirty years."

"..."

"You're going home o n Sunday. Are you planning to call her back before then?"

"I thought I'd give her a few days to cool down. So maybe...Friday evening, after dinner?"

"Please be sure to let me know how it went."

"..."

"And I must say, I'm rather proud of how well you're handling all of this. "

"Handling what?"

"Well in light of everything that's going on in your life right now, both physically and emotionally, I think you're functioning rather well."

"Oh...well, thank you."

"Hmm."

"What?"

"Thank you for saying thank you."

"What do you mean?"

"Usually when I give you a compliment, you deflect."

"So?"

"So...saying thank you means acknowledging the fact that you might be worthy of praise."

"..."

"Because you definitely are worthy of praise, Greg. What's important is that you've begun to believe it."

"Ah."

"And I can see that you're uncomfortable now. So I'll just...stop drawing attention to your progress."

"I appreciate that."