"Whenever I go into a restaurant, I order both a chicken and an egg to see which comes first"

Tuesday, December 23, 2014

How To Live With Risk And Stop Worrying

“Lipids’, said the doctor. “Lipids.  Got to get them under control”

Herbert Bottoms had known for a long time about his lipid problem, but was never able to get it under control.

“Your arteries are as clogged as an old ‘57 Chevy”, the doctor went on., “the gunk and sludge from years of bad diet, no exercise, and an entirely unhealthy lifestyle. But don’t worry”, the doctor concluded. “The space age is here, and there are drugs on the market that will clean you out better than Drano.  Leave the driving to me.”

Herbert was concerned.  Actuarially speaking, he should have many good years ahead of him, but with this high-risk factor, who knew?  He took the doctor’s advice seriously, began his drug regimen, and decided to drastically modify his food intake.  His diet of boiled, hand-pounded millet; roots, tubers, and triple skimmed milk was more severe and punishing than that of a Saharan nomad.  He upped his exercise to two hours daily on the most demanding machines, drank copious amounts of water, and kept his window open at night.

After three months he had lost twenty pounds and felt lighter of spirit and outlook.  He had licked lipids, of that he was sure, and he would be able to go back to his normal, if more temperate life.

“Sorry, Herb”, said his doctor. “Lipid count still off the charts.”

“Now what?”, Hebert asked.

“Try a new set of parents”, replied the doctor.

Not funny at all, although he knew that Dr. Perlman was trying to make light of a desperate situation and make him feel better so he didn’t hold it against him. In fact what he liked best about Perlman was his no nonsense approach to caregiver-patient relations. “Cancer probably”, he said to him once after rubbing ‘a nasty mole’ on his shoulder. “Get it checked out.”

Perlman had given him the unvarnished truth.  His lipid condition was genetic, permanent, and irremediable.

At first Herbert was devastated.  He had been given a death sentence.  Not terminal cancer by any means, but his future was iffy at best.  His poor wife, his grandchildren, and his autistic daughter still struggling at age 40 to make any sense out of the world, would suffer without him.

However, Herbert Bottoms was, like many of us of a certain age, on the fence of ‘fuck it’ and ‘do something about it’.  He was too young to cash in his chips, and it was worth giving it the old college try; but he was also old enough to accept the fact that something would soon do him in. 

One day, walking on K Street he noticed a flock of robins which had just settled on the holly trees in Farragut Square Park and were eating the berries, leaving only yellowish husks on the ground.

Epiphanies come in many forms and in the most unexpected places, and for years Herbert Bottoms wondered why this particular insight came to him in Farragut Square Park.  There was nothing apocryphal about the robins, nothing discordant in their chirping, nothing particularly unusual about their swarm-eating; but there it was as clear as day. If he was at extremely high risk from a heart attack because of his lipids, then that was certainly what would kill him.  Not cancer, Hepatitis C, or Alzheimer’s.  And since there was nothing he could do about it, then he could undertake the riskiest behaviors and be immune to their consequences.

He felt relief and an exuberant happiness.  He had gone through some kind of worm hole and come out into a universe without mortal angst, existential questions, and petty concerns. He felt like Scrooge on Christmas morning.

I don’t know what to do!” cried Scrooge, laughing and crying in the same breath; and making a perfect Laocoön of himself with his stockings. “I am as light as a feather, I am as happy as an angel, I am as merry as a schoolboy. I am as giddy as a drunken man. A merry Christmas to everybody! A happy New Year to all the world. Hallo here! Whoop! Hallo!

“Fuck it”, he said; and took up smoking again.  Much to his surprise, Lucky Strike non-filters were still being made, and although they had long ago been squeezed out by low-tar, low-nicotine ladies’ brands, he found them easily online.  Perhaps because of the anticipation of a long-forgotten vice or the association with adolescent sexual memories, his first drag was not the rough, coughing affair he feared.  He took down the rich, toasted tobacco smoke deep into his lungs, held it, and exhaled in white billows that filled the room, swirled up to the ceiling, and disappeared in the rafters.

He disabled the seatbelts on his Camry, bought the most marbled, aged Prime Angus steaks, cooked with European-style full-fat, cultured butter; had seconds and thirds on cheesecake, canoli, and ricotta pie, and cancelled his membership to the gym. He gained weight, let out his belt, and threw away the scale.

His wife was appalled.  Never in her life had she disregarded any practical advice, spent more than she should have on shoes and jumpers, or made any quick decisions.  She was a model of propriety, moderation, and care; and here was her husband throwing this very care to the winds, not watching his edges, rejecting all medical authority and received wisdom, and doing what he bloody well pleased.  It was just not logical.

“But it is logical”, Herbert said to her. “The most logical thing in the world.  My risk of dying of a lipid-induced myocardial infarction is astronomical.  Perlman himself says I am a one-in-a-million genetic anomaly. By comparison every other risk is minimal…No, miniscule. Think about it.”

For the first time in their 40 years of marriage, his wife was nonplussed and silent.  To her credit, she knew irrefutable logic when she heard it.  “So what does this mean?”, she asked.

“I am going to have a good time.”

Not only did Herbert eat everything discouraged by medical science and slack off completely from the aerobic ellipticals, treadmills, and rowing machines, but he left his car unlocked, never changed his passwords or his motor oil. The shackles of routine and responsibility had been thrown off.  He was for the first time in his life a free man.

Herbert, however, was not a selfish man; and although he threw caution to the wind, he was careful to avoid any behavior that might cause injury to others.  He did not smoke in the house, for example, drove especially carefully when others were in the car, took the time to prepare leaner cuts of meat along side his fatty ribeyes and pork shoulder, and encouraged his wife in her fight to lose a roll of flubber around her middle and keep her balance.

On a recent trip to the dentist – teeth cleaning was in the Not Sure category of risk, and there seemed no point in deliberately causing decay and infection – he was told he had to have a tooth pulled; and that he should consider an implant. “Fuck it”, he said to the dentist, “I am investing in nothing which will outlive me.  Bad economic sense.”  The dentist countered with the same actuarial tables his wife had always trotted out, assured him that he had ‘many good years’ ahead of him, and said that other than the temporary bite of the $20,000 fee, there were no side effects whatsoever to the procedure.  Of course Herbert was not convinced.

His friends commented that they had never seen Herbert so happy, and wondered what had come over him.  Up to a year ago he was in a morose period, mired in the nihilism of Tolstoy and the existentialism of Sartre and Camus.  “I need to know what’s what”, he had told them as he reread The Brothers Karamazov for the third time, pondered good and evil à la Dostoevsky, Nietzsche, Kierkegaard, and Wittgenstein. He had even begun a study of the Bible, surprising because he was not religious in the least, but thought that going to the mother lode of Judeo-Christian culture, he might learn something.

Now, his friends remarked, he was as happy as a lark, and all this morbid concerns seemed to be things of the past.

“Risk”, he said, “and lipids.  A heady mix, but a great cocktail for chasing away the blues.” 

A close friend to whom he had confided his secret had trouble understanding how a death sentence could be good news.  “Nonsense, old boy”, Herbert said.  Read Ivan Ilyich. Ivan worried his whole life about dying, and when he finally reached the end, he said, ‘Oh, that’s all it is?’

Speaking in loose metaphors was another feature of his post-epiphany period.  He knew what he meant, and that was all that mattered. Loosening his emotional and psychic belts seemed to give his brain freer rein as well.

As fate would have it, Herbert did not die of a lipid-induced heart attack, but in a freak accident.  Irony or ironies he had actually been run over by a bus, and he certainly didn’t know what hit him. In his metaphorical phase, Herbert liked to reread the Hemingway short story, The Short, Happy Life of Francis Macomber especially the last lines:

Macomber say the bull coming, nose out, mouth tight closed, blood dripping, massive head straight out, coming in a charge, his little pig eyes bloodshot as he looked at them. Wilson, who was ahead, was kneeling shooting, and Macomber, as he fired, unhearing his shot in the roaring of Wilson’s gun, saw fragments like slate burst from the huge boss of the horns, and the head jerked, he shot again at the wide nostrils and saw the horns jolt again and fragments fly, and he did not see Wilson now and, aiming carefully, shot again with the buffalo’s huge bulk almost
on him and his rifle almost level with the on-coming head, nose out, and he could see the little wicked eyes and the head started to lower and he felt a sudden white-hot, blinding flash explode inside his head and that was all
he ever felt.

Wilson had ducked to one side to get in a shoulder shot. Macomber had stood solid and shot for the nose, shooting a touch high each time and hitting the heavy horns, splintering and chipping them like hitting a slate roof, and Mrs. Macomber, in the car, had shot at the buffalo with the 6.5 Mannlicher as it seemed about to gore Macomber and had hit her husband about two inches up and a little to one side of the base of his skull.

Hemingway had it right, Herbert had thought. A short, happy life is better than a long, tedious one; and any of us would be lucky to be drilled in the brain or hit by a bus.

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