Wednesday’s Child Part Two: Manhood

A: Training days


Bar Mitzvah: 1973

Saint Luke’s Hospital in New York City is a private voluntary not for profit institution located on the upper west side of Manhattan. It is also one of several satellite teaching hospitals belonging to the Columbia University Medical School, whose mother ship; The Presbyterian Hospital of Physicians and Surgeons (P & S) is located further uptown near the George Washington Bridge. Being nearly adjacent to the undergraduate campus of Columbia University to the northwest and separated from Harlem to the east by Morningside Park, the immediate surrounding neighborhoods consisted of a mixture of university students and faculty, hospital workers, the earliest vanguard of upwardly mobile yuppies as well as the dregs of slum dwelling humanity. The more impoverished elements consisted of Hispanics, mostly emigrated from Puerto Rico, and Blacks that had emigrated from the Southern plantations at the end of the Civil War. At this point in time neither Harlem nor Spanish Harlem were holding out any bright rays of hope or promise for these denizens of New York City’s populous infrastructure. The result was that the local indigent population marginally used the medical clinics for long term health care issues or more likely than not, only used the hospital when they were forced to because of emergencies, crises, critical illnesses or when they were in extremis. These crash-landing presentations usually fall into the vernacular medical designation known as “The Train Wreck,” often requiring an enormous dedication of resources and clinical acumen to reverse them and then get their victims properly back on track.

The hospital owned two rental apartment buildings that availed subsidized affordable housing to the Medical and Nursing staffs. Because both buildings were located directly across the street from the main building this made commuting to work or taking night call relatively easy. The commute was also safe, because before Rudi Giuliani took the handcuffs off the police and let them actually do their work; the city, under Mayors Beame, Dinkins and Koch was a denizen of thieves, muggers, pushers, pimps, prostitutes, junkies, drug dealers, professional street beggars and homeless people who squatted in and took over public areas such as sections of Pennsylvania Station, bus terminals or parks. Certain highly profitable street corners were actually for sale on the beggar’s underground commodities market, sometimes fetching prices as high as five thousand dollars. Conversely, any beggar who attempted to encroach on someone else’s established territory might risk a knife or a gunshot wound. Even an ordinary public citizen taking a casual or accidental stroll either through the Pennsylvania Station Homeless Homestead or the notorious Needle Park could risk buying a one-way ticket to the morgue or an admission to the St. Luke’s Hospital Intensive Care Unit.

This was when my brother’s advice rang true about how to survive on the streets of N.Y City―wear old clothes so you look poor, put on sneakers in case you have to run, keep your cash in the toe of your shoes and above all else do not ever make eye contact with anyone. I did learn to navigate the streets as well as how to anticipate and to avoid potential trouble. But after five years of street survival it took another five years of living in peaceful suburbs to stop continuously looking over my shoulder or jumping out of my skin if I heard someone running, jogging or walking briskly on the street behind me.

The teaching hierarchy of the hospital consisted of University appointed Attending Physicians who directly supervised everyone else who was in training as distributed in the following pecking order: Fellows, Chief Residents, Senior Residents, Junior Residents, Interns, and finally P & S Medical Students. The hospital’s forte was Internal Medicine and Surgery, in particular, vascular and cardiac surgery; with the open-heart program being headed up by one of the finest surgeons of the day, John Hutchinson, a light skinned black man who could easily have passed for white. In fact, everyone did think he was white; including the red neck Afro-American hating bigot from Easthampton who subsequently shit his pants when he found out that it was a black man who had literally held his heart in his hands when reattaching all the vascular plumbing necessary to keep his own dark soul alive.

For the most part the medical staff was required to take care of general ward patients, meaning those indigents admitted without private insurance that comprised the bulk of the hospital census. Required rotations consisted of general medicine, emergency medicine, intensive care, cardiac care and private ward medicine. Private patients, mostly from the white upper class, were segregated to another wing of the facility and taken care of by their own physicians, only some of whom had academic appointments, and others of whom did not  seem to have read anything current in medical advances since the day they left residency. Although this might at first glance seem to mean that indigent care was second rate, in fact the opposite was closer to the truth, as by default these people were being exposed to the latest and most current thinking that medicine had to offer; along with daily supervision of care by faculty appointed physicians. In counterpoint, for the few mandatory months we were required to rotate through the private wards, most of the house officers eschewed this responsibility because of having no control over case management, coupled with being looked upon by both the doctors and their patients as being lackeys and/or marginally competent nuisances.

  • Who are you?
  • I’m your intern.
  • I want a real doctor. Where’s my real doctor?
  • Probably sitting home watching TV and into his fourth Martini by now. Want me to call him in?

However as just alluded to, some of the private physician’s lack of skill and judgment was typified the day that my Junior Resident found the patient of a doddering old Internist to be in severe congestive heart failure and on the brink of death. He amended the Internist’s tersely inadequate handwritten chart note of an hour before from: “Patient is short of breath. Let him rest” to: “Patient is short of breath. Let him arrest” by scratching in the “ar” in front of the “rest.” What the patient really needed was an urgent transfer to the CCU while the sarcastic forgery was motivated only by the fact that the Resident had become completely fed up trying to salvage and then cover up other people’s less than handy work. In fact, the only thing this aging monument to cavalier medicine was good for, and the only time I ever heard him speak up was usually during some clinical conference. Without fail he would correct anyone who ever used the phrase mitigate against” by suddenly piping up to say “militate. The word is militating.” That solitary fact he had down pat.

His terse interruptions reminded me of one of my private patients, an author and retired English professor who proverbially corrected my mispronounced use of the term ”angina,” every time I used it in reviewing his symptoms. The same brief monologue was reiterated. He said:

  • The word is Latin, ergo the “i” is a hard “i” and not like the soft “i” in the alcohol ‘gin’ but rather like the letter itself; and ergo―an-geye-na. When referring to the female genitalia, you do not say va-gin-a, do you?
  • Only if I am shit faced drunk, sir. Then I call it pussy. Derived from the Old German puse vulva; meaning a pouch, a sack, a scabbard or to stuff something.
  • What you really mean to say is when you are irrevocably inebriated, yes? And pussy is not German. It is derived from the Old English meaning: warm, soft and furry. Ergo pussy cat. Referring to it otherwise is vulgar.
  • OK then. When I am irrevocably inebriated, I like to stuff the warm, soft, furry, pouch of a female Homo sapiens with my pendulous penis. Now let’s get back to talking about the immediate problem with your dolorous cor viscus.

Of course, since every other doctor on the planet mispronounces the word, whenever I subsequently said ‘an-geye-na’ my colleagues skeptically raised their eyebrows, sniggered and shunned me like a pariah. This type of vulgarity, in heralding the end of the classical Latin period in medicine was only the beginning of many more vulgarities to come occurring somewhat in parallel to the same demystification in the Roman Catholic Church.

  • Per omnia secula, secula, seculorum. Amen.
  • Huh? What does that mean?
  • Forever and ever, Amen.
  • Then why didn’t you just say so? And by the way, what does “Amen” really mean?
  • Incontestable truth. No arguments.

Upon this backdrop, the arrival of my Medical Intern group in July of 1973 was as inauspicious as would be a personification of T.S. Eliot’s poetic line “not with a bang but a whimper.” It was like throwing a new cog onto a finely tuned gear that momentarily groaned and tried to reset itself without stopping to wait for the appropriate mechanical adjustment, but then went on relentlessly grinding, remolding and incorporating the offensive little kink. We were mutually introduced, given a cursory orientation, told what was expected of us, given our schedules, handed keys to our call rooms and then told to “go to work.” As joyous a day this was for the Interns ahead of us who were just now being promoted to Junior Residents, it was equally a sad anxiety provoking day for us neophytes. And even though the medical students who would be assigned to work under us were theoretically at the bottom of the totem pole, it was a false bottom because the real responsibilities resided with us. These duties would now include: admitting new patients, writing their orders, rounding on existing ones, coordinating care, ensuring complete and neat charts, collecting data, knowing all the pertinent data, drawing blood, starting IVs, staining slides, and worst of all, every third night having to be on call.

Being on call required staying on premises, sleeping in the building, carrying a pager; and for either twenty-four hours or, worse, for seventy-two hours straight through on weekends to be available for new admissions―while at night being responsible for problems on the entire ward. The Junior or Senior Residents provided backup, but it was conveyed rather sternly on day one that these individuals were only to be called for legitimate questions of management or if a person was too overwhelmed with work to be able to function. It was stated in no uncertain terms that all house officers prided themselves in being able to “suck it up” and that being “overwhelmed” was a relative term one should rarely if ever invoke; or if so, it had better be really and truly overwhelming; like a tsunami of critical illness. This was suddenly the real deal and very serious business. School was finally out for good but now it was going to be a litany of far more pencils, infinitely more books or journals and significantly more teacher’s dirty looks.

I never felt as inadequate as I did on that first day when the full realization hit home that I now had to be a real doctor with real responsibilities for other people’s lives. The closest second to that would come later when I finished training and went into private practice with the full realization that even though I had a bit more experience, I now had no one to back up any of my reasonably solid or sometimes meekly tenuous clinical decisions. I reported as required to one of the general medical wards as my first rotation and was met by a gleeful newly promoted Junior Resident who would be my immediate supervisor. He gave me a patient list that was headed up by an elderly black male who had already been admitted with pneumonia. Then in turning over the pager said:

  • I don’t know if you are Jewish or not―but think of me handing off this pager as being your real Bar Mitzvah―because today, my boy is the day that you truly do become a man. And by the way, it’s very bad form to let your first patient die. So, good luck, and welcome aboard.

Mazel tov

As it so happened my veritable bad luck was to draw the lot of being on call the first night I worked. In being paired with another Intern in charge of another floor, we found ourselves assigned as roommates to one of the call rooms. At about midnight when we had finished enough work to attempt sleep, we opened the call room door only to be met with a spate of truculent curses from the two new first day residents we had rudely awakened. Apparently, they had not been informed of being assigned to other rooms. Nicer rooms. Nicer and better Junior Resident’s rooms. But because actual physical possession of the bed is 10/10ths of the law, we were greeted not with a soft mattress and pillows but rather with hard and harsh castigations.

  • Get the fuck out of here.
  • But this is supposed to be our on-call room; and we have a key.
  • Get the fuck out of here. Sleep on the floor, anywhere. We don’t care. Just get the fuck out of here.

We did find a place to sleep. Not on the floor, but as a close second, in the hardback plastic chairs located in the patient lounge on my ward, leaning back and using a small table for a footrest hassock. That was after cleaning up the filthy ashtrays and food remnants that were pocketed in various spots about the room, then snarling a territorial warning at any wayward wandering patient who happened to come in to satisfy his nicotine fit. Needless to say, we did not get much sleep, or even if we did nod off, one of the two beepers would go off periodically either beckoning us to: retrieve a new admission from the ED, or to answer some nurse’s call for an IV insertion, or an order for a sleeping pill or a laxative. Or worse; for someone whose status had deteriorated and needed us to make a personal appearance, an appraisal, or medical stabilization that could easily take the rest of the night.

That was not bad enough, as by the next day the black man with pneumonia had died suddenly in his sleep, leaving me to wonder why I had ever chosen this profession at all and second-guessing what I had possibly done to cause this person to die. I had no self-esteem, had gotten no sleep, while now having to face another workday, starting it off totally exhausted and fully believing I was an inadequate involuntary murderer. But the Junior Resident was compassionate when I told him how I felt. He said it was just a joke about letting my first patient die, that the man had such an advanced illness he had very little chance of survival anyway and that all physicians lose patients throughout their career. He said that the best you can do in retrospect is to believe in yourself. He added that in always second guessing everything you do for someone you will always find peace or solace if you can honestly say you did absolutely everything you possibly could. He also said you must at all costs retain a sense of humor, because this was the kind of business that above all required a person to have to able to laugh, just to keep from crying.

  • That’s why we are training you and that is how we will train you. I can also tell you for sure; there was nothing else you could have done for that man. It was entirely up to God and the antibiotics we used; so in the end it was obvious that for him, neither one of them worked out too favorably.

About eight months later when I was assigned to the ICU and got a patient with multiple interacting; terminal co-morbidities, this same Resident ripped me a new asshole when I suggested we should just go ahead and let him die.

  • You don’t know enough yet to decide about life and death. You have no right to think like that at this stage of your career. Yes, this man has very little hope, but any hope is enough to give him every benefit of the doubt. And since he is in renal failure, tomorrow I want you to give the group a small dissertation on treating the medical complications of uremia as well as an explanation for the mechanism of renal tubular acidosis. We are going to use this patient as an example of pulling out all the stops in treating every medical complication he might have. This is a major teaching center, for God’s sake. Now in the future, I’ll inform you Mr. “Let Him Go” when I think you are experienced and smart enough to be able to make those judgments. So, while you’re studying tonight for your uremia presentation, think about whether or not you would say the same thing if that man happened to be your own father.

Even though the man did die several days later, the episode did serve to be humbling as well as educational, and from that day forward, every terminal illness served to teach me not only the natural history of numerous disease states, but also afforded me the opportunity to do everything in my power to abort or to favorably modify the end-game; Meet the Reaper.

Secondarily, it taught me better judgment and widened my perspectives. Taking care of someone in the downward irreversible spiral staircase leading to death is sometimes like holding back a flood by sticking your finger into a cracked dyke. These situations serve to occasionally allow for the earlier interception of a reversible clinical problem in someone else who might die the same way; if not for the physician’s personal experience, anticipation and diligence. As physicians, we never “let people go” unless they are terminally ill, or brain dead. As a rule, we exhaust all resources to save people. Then again, sometimes people simply die no matter what you do.

One exception to not letting someone go occurred during my training when I was a Senior Resident and finally let a twenty-eight-year-old man bleed to death. He was a hard-core alcoholic with cirrhotic liver failure that caused the portal hypertension resulting in massive recurrent bleeding from esophageal varices. His liver was dead, and the rest of his body was trying to catch up. It was also before technology advanced to the point of liver transplantation. My heart went out to him initially because had no family or friends and I fully believed his environment had conspired to provide such little hope in life that finding solace in booze was his only means of escape. The real problem was, as it is with most dangerous addictions, that the escape eventually does become permanent. But in taking a protracted course, as the ship slowly sinks; the addict also sucks too many other people or other valuable resources into the vortex along with it. That is of course unless the addict does everyone a big favor by inadvertently taking a lethal overdose. Being naively enthusiastic, I spent time with him, counseled him, got him briefly to go to AA, and arranged for social service support; but to no avail. He always coupled the vacant eyes of a lost hollow soul with the inadequate personality that had already put him beyond reasonable reach. There was simply no humanity left inside the thin remnant of his human shell. As with any addiction, I eventually came to recognize his look as the same predictive look of recidivism I would encounter repeatedly in clinical practice, especially when counseling against tobacco use. When you tell someone they must stop smoking, their eyes immediately glass over vacantly then either roll up or glance to side. Their facial expression suddenly becomes a blank mask. This lets you know immediately, simply because they do not want to, that there is no hope for that person to break the habit.

This man then, had multiple admissions due to relapses of the drinking habit that caused repeated massive bleeds. It finally culminated in a hospitalization that required 28 units of blood and depleted our blood bank. With every possible treatment option exhausted, the case went beyond even the gastroenterologist’s or surgeon’s ability to stop the crimson flood, such that even the best minds on the subspecialty medical staff capitulated and gave up. They unanimously pronounced that there was nothing else to do. If he kept bleeding; he would eventually die. His intern called me one night to tell me the patient was going into shock and should we “just let him go?” After I gave him the same lecture that I had received two years earlier, then telling him I would handle the rest, sent the Intern to bed. After he left, I pulled the curtain around the young man’s bed, sat holding his hand for the rest of the night, and let him peacefully die. He could not be saved, either in body or in soul, and we desperately needed the bed and the blood for people we could help. It was a judgment made in the context of reasonable experience as well as one sanctioned by the academic staff. It also let my intern entirely off the hook, in a situation where any plea I might have made for help had a pre-ordained denial by the powers that be. Don’t call us; we’ll call you.

Ironic, I thought, that this man with nothing at all going for himself had understandably fallen under the spell of evil spirits, but that the likes of the Grateful Dead’s Pigpen Mc Kernan, who had the world by the balls, died exactly the same way at the age of twenty-six. He chronically poisoned his own liver with a mixture of Strawberry Kool-Aid and Ripple wine. Believe me. At that young age this is very hard to do and, requires an enormous quantity of fermented grapes mixed with sugar water to accomplish the task. It was said by some eyewitnesses that Pigpen started drinking at breakfast; and that breakfast lasted pretty much all day. One of the most difficult problems to deal with as a physician is the addicted patient. The cure rate is only about thirty percent and after you do all that you can do, there is still only so much that you can really do. The rest is up to the patient. The only thing understandable about it all is the fact that each addiction is the indifferent demon that does not care at all: whom, what, where, when, how or why. Hollywood, the music industry and Mount Everest are littered with the corpses of dead addicts.

In the lobby of St. Luke’s hospital in Manhattan, there is a large statue of the hospital’s namesake, standing in front of his mascot, an ox. Saint Luke, a healer himself, is the patron Saint of physicians and surgeons, who was also a famed iconographer who specialized in portraits of The Virgin Mary. His own iconic mascot is usually considered to be imagery representing sacrifice, and possibly the ultimate sacrifice made by Jesus. But don’t ever tell that to a Hindu. They believe the cow is sacred, but not necessarily its owner.

The first and last time I saw this statue was when presenting myself for duty. But for some strange reason, I never went in or out the front door after that day. This somehow created an inadvertent disconnect between my call to a supposedly high vocation and its necessary guiding light. From that point forward the hospital only became a generic base for my practical clinical education, as I never again thought of any associated spiritual implications or ramifications.

There were too many situations to come along in the future in which there was nothing fair about who lived or who died, about what age it happened, about who got what terrible disease and who did not, or about who really deserved to die and who did not. There was no logic to it, no discernable divine plan, and no last minute intercessions from some divine being or Saint for the many hapless people I saw who had fervently prayed but who then had their prayers go up with the same smoke of their cremated remains.

By the time I had survived my first day at St. Luke’s Hospital not only did I never believe I was going to make it as a physician, and in taking little solace from the good saint’s inspiring statuary and legacy, simply concluded by muttering to myself:

  • Holy Mary Mother of God, why did I do such a ridiculously insane to myself?

As expected, no one answered. And then my beeper went off again.

I then spent the next thirty years of my life sacrificing myself to night call; to the point that not only did it literally nearly kill me, but it also to eroded or destroyed most of my intimate interpersonal relationships. It then secondarily caused me to change my religious orientation as I began to direct all my subsequent prayers from Jesus, instead to Hypnos, the Greek god and patron saint of sleep. Keep the cow. I would rather take a Valium and a get a few extra REMs.    



To sleep: perchance to dream; ay there’s the rub.









Interview 2

Interview 2 

My reverse interview experience paled next to that of a student who was one class ahead of me at Tufts.

John M. , who wanted to be a surgeon, also aspired to get into to the Massachusetts General Hospital, or MGH training program. At that time, it was well known that Harvard never took anyone from Tufts into their Internal Medicine programs and that even attempting to Intern match at the MGH would be a waste of time. To be accepted in surgery might afford a little more flexibility or lenience but once again would almost be an impossible feat. Harvard simply did not like, and more to the point, did not at all respect Tufts. They were so picky in general that their applicants were even subjected to two rounds of interviews in order to sift out potential riffraff.

John had already stacked the deck by electing several surgical rotations in the Harvard system and by so doing was already somewhat known as a personal entity. He passed his first interview after a grueling set of questions, the last of which was:

  • And so, Mr. M., if you were to be accepted at this prestigious hallowed institution, and then go on to a greater career as a Harvard trained surgeon, tell me then―what would be your greatest ambition and your legacy as a physician?
  • That’s easy. To cure Death

He passed and got a second round interview.

At the second interview, he faced the Chief of Surgery at the hallowed MGH, a person of great talent and reputation and a person not to be trifled with. This doctor occupied a seat at the very pinnacle of the medical food chain. He also occupied a large antique oak desk.

  • Mr. M. I heard from my colleague of your last interview. Very impressive, even to the point of your quick witted and amusing statement of ambition. However, I am looking for something a little less facetious and sarcastic. So in the same vein I will ask you again, if accepted to train in this highly sought after competitive position, what indeed would be the noble ambition that would lead me to believe you are better in every way than anyone else I have interviewed to date.

Facing down the icy stare, John hesitated for only a moment before he replied:

  • I thought that curing death was every physician’s penultimate goal; weather real or in the total realm of the abstract. So, if that answer does not stand pat, my greatest ambition then, if accepted into this elite and privileged program, would one day soon, to be sitting on the opposite side of this desk.

He passed interview 2 and was accepted as an MGH Surgical Intern.


The reason that most of us remain healthy is because 10% of the people get 90% of the diseases.

(John M: Tufts Med 1972)



Reverse Interviews

Reverse Interviews 

Interview 1 

When nearing the end of training a Medical Student takes Part 1 of the National Boards which then qualifies him to enter a lottery known as the Intern Matching Program. You pick a place or a city where you want to train, locate the accredited training programs available in the various hospitals, and then make up a ranked preference list, which goes into a central data bank. Conversely, the teaching hospitals get the lists and decide by rank which applicant they might want to take as an intern, usually based on the medical school he attended. After that the student gets a letter stating he has been accepted for an interview.  No letter. No interview. No job.

Because so many students pick so many hospitals, the overlap leaves those hospitals not quite sure who will pick them at the end of the process. This forces the students to hedge their bets by over-booking interviews, like an airline overselling reserved seats, or the aforesaid Venn diagram of the double negative question. Interview, yes. Guaranteed pick by the candidate, no―and vice versa. Over a short period of time as the match progresses, the spots become progressively filled as increasingly limited spots become available. This is why foreign medical graduates tend to default to the second tier of community hospitals that do not have either good training programs or if they do, the programs are not accredited teaching programs. An ideal match is a Number One with a Number One plus a good interview; notwithstanding the usual politics and nepotism that goes with any such process.

In general, Harvard Hospitals choose Harvard Medical students, and so on and so forth across the country, not only because of effete arrogance but also because of the practical fact that any student applying to a system in which he is already a known entity obviates the risk of that teaching program becoming stuck with a potential loser. It is also the case that a teaching hospital will lean heavily toward a candidate if it has already had a good experience with someone else who trained at the same medical school. I had already decided I wanted to relocate to N.Y. City principally because I wanted easy access to my parent’s summer home for R&R, and so applied to about six major teaching hospitals in Manhattan. I got three interviews in return; Montefiore, Downstate and St. Luke’s Hospital. I received no answers at all from Columbia Presbyterian, New York University and New York Hospital Cornell; not even the courtesy of a polite “no, we don’t want you.”

Montefiore was the only hospital I received an interview with that was the central teaching center at a medical school, the Albert Einstein College of Medicine. The other three major teaching hospitals did not want to see me at all and the two that did were teaching hospitals closely affiliated with the major players, but not the primary or the elite hub. When I showed up at Montefiore, I knew immediately that I was in trouble. Every one of the twenty or so candidates that were batched for that day wore a Yarmulke, as was just about everyone else in the facility. In the preliminary phase before the one on one interview, we were made to introduce ourselves, then give a thirty-second personal introduction. As the names were called out: Silverman, Bernstein, Schwartz, Jason, Milliman, Saperstein; I knew my first name would hold some truck but that the last one would probably raise a few eyebrows. Being stupidly naïve, I had no clue that the institution was predominantly Jewish along with significant overlays of Jewish Orthodoxy. How was that for proactive thinking? Sign up for Albert Einstein and then be surprised that everyone there is Jewish.

When it was my turn I loudly stated Alan, and then softly mumbled my last name. The group leader shouted: “What? Say that again. Nobody heard you. What’s your last name?” With the cat now out of the bag when I loudly repeated my last name, you could hear a pin drop. This was followed by everyone turning their heads to stare with incredulous wonder at the interloping little guinea goy boy with a bona fide Jewish first name but without the funny little hat.

Passing on to the one on one interviews, I sat with a very pleasant physician who beside the usual queries wanted to know because I had a Jewish first name if my mother was Jewish and was that why I was here. I couldn’t lie, then told him no, to which he responded it really didn’t matter as he escorted me to the cafeteria for lunch. I figured there was no chance in hell I would be picked and that he was just being nice before the inevitable soft-landing rejection. At that point, even if I did think I could make a sincere effort to fit in, my hopes were dashed by the fact that all of the cafeteria food was pareve or kosher, making it so unrecognizable to my ordinary culinary tastes that on the food factor alone I knew I would never make it in this institution.

Imagine my shock then when I was taken aside at the end of the day and told that it was unusual for them to do this, but that if I agreed immediately I would be given an internship at Montefiore. They said I had interviewed well, that a few students from Tufts had passed through their training program from time to time, and that they had been so favorably impressed with their performances this legacy counted for very high marks in their overall assessment. Although I was sincerely flattered, I was leaning toward the jaded paranoid belief that I was going to be their affirmative action token Christian and told them I needed a day or so to think about it. It was chancy, because I had not yet heard back from St. Luke’s Hospital; which I had already decided on as a first choice. However, as luck would have it, within a day or two; I was, in fact, accepted there.

Having ultimately decided to reject the theory of religious relativity I went with the hospital named after the Patron Saint of Physicians and Surgeons. This was despite the institution, in an effort to be more pleasantly generic than hard core Christian, had adopted the venerable Saint’s mascot, a cow, to represent it’s symbolic logo; a little knock-off iconic version of the animal that bore an eerie resemblance to Bon Bel cheese company’s laughing cow: La vache qui rit. Except that this one has angel wings for ears.



Thank you very much. And I hope we passed the audition.

(John Lennon)



Medical Board Exams

Medical Board Exams 

In order to qualify for an internship and be granted a license to practice medicine one must go through a series of National Board Examinations. These tests are given in stages that occur at the end of medical school, the end of internship, and again at the end of residency. If a person wants to on to a subspecialty, there is yet another exam at the end of a fellowship. Unlike the Law Boards, which mirror the infinity of legal time and allows a flunky to have an infinite number of second tries, the Medical Boards only allow three strikes.

For example, John Kennedy Junior finally made the Bar after his seventh try, only to discover that practically applied examinations in aircraft Instrument Landing Systems are much less forgiving on a first-time failure. They do not allow for multiple mulligans. Perhaps this accounts for why parole boards are so lenient when they give convicted felons so many second or third opportunities to get out of jail only to again become offenders .This contrasts with a physician’s opportunity that allows only one chance to get the heart attack diagnosis and therapy or the gall bladder surgery done correctly the first time. Personally speaking, I would not want to deal with any attorney or physician who had to take these tests more than once, because if a person fully applies his or herself to the required study time, the tests are incredibly difficult to fail. This makes it a reflection of personal ethical dedication and pride.

Required study time is another issue altogether, as for example in order to pass Internal Medicine, I devoted one entire year to reading and re-reading the 2000 page text of anything and everything that can go wrong with a person― how to recognize it― then how to treat it. The same process applied itself to the Cardiology Boards that were more difficult because the studying had to be done at night after my regular workday was over.

The only good aspect of “studying for the Boards” was that it made for convenient alibis to avoid mandatory attendance at boring or undesirable social events and family gatherings―or for good excuses to break up with a girlfriend.

  • I can’t see you anymore. I have to study.
  • OK. I get it. You have another girlfriend, you cowardly shit-heel. Why don’t you just say so?
  • No. You don’t understand. I really do have to study.
  • What, you don’t want me anymore and you’re throwing me over for a book? I always thought you were just a closet queer anyway.

Fostering a perpetual feeling of being in school, endless studying also went a long way to ensure the continued delay of gratification that goes with medical training and helped to postpone having to face up to the horrifying prospect of one day having to grow up. For example, even though I was paid a salary as a house officer, it was still not equivalent to having a real job, as well as the fact that because of how long it took to be trained, I was not able to go into private practice or be fully responsible for my own professional actions until I was thirty years old. Any colleague who had become a schoolteacher, a police or fireman or any other litany of civil service jobs, including a career in the military was already halfway to a pension before I had even opened up shop.

The entire Board process was also thankfully made easier before I had to endure them by eliminating the grueling experience of having to take oral exams. The terrifying prospect was dealing with either a pleasant and forgiving proctor, or as some people I knew, having had to deal with an unpleasantly unforgiving oral inquisitor the likes of Dr. Iber. (prior post). In fact, it was because of the imbalance in personalities―combined with the excessively subjective and personal bias inherent in oral exams―that the system eventually abandoned this torture and reverted to multiple-choice tests.

Under the oral exam system, some professorial proctors who equally qualified as bastards, were blackballing truly qualified individuals for no good reason other than effete arrogant spite. The interviewer at Harvard who nailed his window shut would have qualified as being one of these pigs. On my part, I had no doubt that with my luck, that if orals were still being given, I would have drawn this old Tarot nemesis to be my proctor; The Black Card Iber: Death.

While Board exams do in truth test a broad knowledge base, they are also really a test of being able to understand double negatives, as well as being able to reason by a process of exclusion or exception. The best way to take them is to burn through them quickly and to answer every sure question, then go back and boil down any unknown answer to at least two choices. This improves the odds of the guess to a 50:50 chance of being correct. The worst thing to do is to waste time fretting over choices and to leave questions blank. Blank answers always ensure complete failure.

Why these tests are structured as such is beyond me, except for my roommate’s theory that they were designed to weed out foreign graduates who were not facile with the English language. He referred to this as “The Turban Factor,” which he qualified by reiterating the fact that not only did the exams test knowledge, but equally as important they tested the ability of any given person to be able to speak English, to understand English, to understand logic, and to do it quickly enough to get through all the questions in the time allotted to take the test. Somewhat contrarily I argued that the process was more the case of queries being posed by erudite academic pudits who then sit back and chuckle to themselves at their innate ability to create inverse logic or literary Venn diagrams.

For example, why does the question always read:

  • All the following are false except.

Is it not easier to understand:

  • Among the following there is only one true statement. So, pick it.

In addition, all the choices then will probably contain true double negatives, meaning that each statement is false, except for the false double negative, which is the true answer, such that by the end of the ordeal the only thing ringing as absolute truth is a splitting frontal headache. It’s like the scene in The Princess Bride when Vizzini plays the double negative inverse logic game with Westley over the goblet of Iocaine poisoned wine, then gets completely confused by his own perverse reasoning―only to then succeed in poisoning himself.

Real life does not operate on the principle of double negatives unless one fully understands vernacular such as “I don’t got none” as really meaning that a person really does not have some.This person, making a statement as to the absence of having none, really does have some, although he stupidly does not know what he really meant and therefore validating my roommate’s theory that this functional illiterate would not pass the double negative Boards.

Test result:

  • He would not make for no good of a doctor anyway.

It is also not true that a person with no cough, no sputum production, no fever and no infiltrate on a chest X-Ray in fact does have pneumonia.

See what I mean? Yes…or no?



The King of the Congo

The King of the Congo 

As I got older, I became an animal rights advocate. My reasoning was a concern that human overpopulation was causing so much loss of natural habitats that many of nature’s wild creatures were being squeezed onto pathways that could only lead to extinction. I also had to make up for all the rotten things I has done as a child. This included shooting birds or mice with a B-B gun, making frogs into race car drivers and setting them on fire, sending Bumble bees on sub-orbital rocket rides, stoning dozens of Blue Claw or Horseshoe crabs to death and in general disrespecting most of nature. I don’t know when my attitude changed, but I eventually came to believe in preservation of the environment, coupled with a feeling that the only way to accomplish this would be to advocate for human zero population growth.

Being one of those people who has even gone overboard the other way, when I find them in my house, I will set spiders, bees and beetles free; much to the chagrin of my wife who prefers to handle issues like this more expediently with a fly swatter. She shows little or no interest at all when I chide her about the teachings of Buddha who said that all life is sacred.

We had this argument.

  • There is nothing sacred about a wasp, an ant, or a spider.
  • Then what about an Angel fish?

For certain areas of the planet it is already too late, but there is still a chance to save large tracts of nature in both the Amazon as well as in Africa. Two common African practices that are a horrifying waste of animal life are killing elephants or rhinos for the sole purpose of respectively harvesting their ivory tusks and their horns. It is sickening to see photographs of tusk-less or hornless carcasses left behind to rot after these trophies are removed. Ivory has value in the music industry or as jewelry, but even piano keys can now be made from more durable synthetic material. I have also seen women wearing ivory pins who should worry more about their elephantine weights than what they stick on their blouses to offset their dowdy or dumpy appearances. Despite the silk gown and the exotic baubles, they still look like the sow’s ear.

I also knew that rhino horns, like the lore about Grizzly Bear gallbladders, are taken because they are then ground into powder and sold as an aphrodisiac to reverse erectile dysfunction in human males. The primitive two step equation becomes: Horny animal = Horny man; which may sound logical enough; except for the non-sequester that the male rhino uses his horn to root around for food; not for diddling rhino pussy.

When Viagra came on the market, I contacted the Pfizer Pharmaceutical Company to suggest that they could do a great deal to save the Rhino. The plan would be to grind their pills into powder with the same color and consistency as powdered horns― then supply it in bulk to African or Chinese apothecaries who could dispense it in naturopathic bags or pouches. In saturating the market, this would not only bring continuity to the culture and preserve whatever rituals might be involved but would also bring an end to the senseless slaughter of this magnificent primitive beast. I did receive a polite response from the company’s Medical Director that he would send my suggestion up the corporate ladder; but that was the last I ever heard from them. Years later, the decimation and near annihilation of the rhinoceros remains unchecked and the White Rhino is now extinct.

At one point I considered stockpiling the drug, going to Africa, and then distributing it as a wandering crusading merchant of human sexual satisfaction and savior of African wildlife. The fantasy went as far as becoming a great white witch doctor or medicine man; then made ruler of the tribe after saving the virility of all men both young and old alike. Placed on a throne, then fanned, fed by Nubians and having all the women I could possibly desire put at my disposal; I would be a veritable third world Hugh Heffner: Priapus 1st, House of Pfizer, his most revered and majestic: King of Eros.

I suppose the CEO of Pfizer did not like the idea because at $18 per erection, Viagra has made an enormous contribution to the corporate financial bottom line. A more likely explanation is that either he never got my letter; or if he did, dismissed it as only one more example of senseless ranting from yet another one of far too many misguided tree-hugging fools.

One day when the drug patent finally expires, the generic version will cost pennies a pill. The Rhinoceros, however, will always be proprietary; and when its patent expires, so does a species that will only then exist in photos or on a taxidermy display.




A Crown of Horns



Have a Mint

Have a Mint

When Michael and I moved out of the Brookline doghouse we found a rental apartment in a rundown tenement in Summerville, just over the town line from Cambridge. Local snobs not living there called it “Slummerville,” and our apartment was a pure monument to that truth. Housing quality diminished in direct proportion to rental pricing as one moved away from the trendy neighborhoods near Harvard and entered the working-class suburbs of Boston. It wasn’t that we wanted to live there. It was because we were on parental budgets that forced us to make do.

The place must have been made for midgets because every room in the apartment was about three fourths what would be considered normal. This included the height of the ceilings, all of which fostered a perpetual sense of claustrophobic containment. It gave new meaning to the terms ‘kitchenette’ or ‘dinette,’ with the entire layout being hardly big enough for one person let alone two. The interior was also so dark that the only plants we could hang in our windows that would remotely stand a chance to survive were mushrooms. Add in no air conditioning and the only way to stay cool was to go half-naked.

When my father saw it for the first and last time on his visit for my medical school graduation he was appalled.

  • I just can’t understand why you had to pick a place like this to live in.

What could I say? I had succeeded in coming in under a budget he had based on a 1941 rental pro forma.

Once again, like Big Funk, our décor was dismal and the furniture third or fourth hand. Then not being exactly the kind of place that fostered a keen desire to design or create a better interior in the first place, it was more like the kind of place that made one abandon all hope. The apartment did nothing to help our social lives either, as it was so embarrassing, we never brought dates home. The exception was the doped up Chinese girl, who was oblivious to her surroundings and barely knew if it was day or night anyway.


Myself and dog lover Bob― over for a visit, a drink and a spliff


The landlord/owners were an elderly Irish couple, Alice and Joe, who no longer had any desire, much less even the physical or mental capacities required to maintain the place. They could barely remember when it was time to collect the rent; or then tried to collect it twice when they forgot they already had. But what difference did it really make in the grand scheme of things? It was our last year of Medical School and there was finally a light at the end of the educational tunnel. Pretty soon we would be independent; starting to make lots of real money and would no longer have to live like lepers in a cold cellar.

We used an old packing trunk for a coffee table, covered it with a paisley print cloth, and in the middle of it had placed a small glass bowl filled with some gallstones that Michael had procured after a surgical case. Apparently, it was one of the worst gall bladder cases on record with the diseased sack containing at least twenty yellow-orange multifaceted perfectly smooth lustrous stones that looked like extra-large driveway pebbles.

In a fit of perverse and bored fun we had attached a little sign on the bowl that read: 

Fine Mint Candy. Have one!



Because of our decadently embarrassing dwelling we rarely if ever had any real guests over anyway and forgot about the inside joke of the gallstone candy dish. The dish had simply blended invisibly into the rest of the sordid background where it had become a fixture. We had so forgotten about it that we were paying virtually no attention to it the night my brother happened to visit, got very drunk, stoned on pot, and then got literally stoned as he began to chomp on the little yellow mints.

He had already consumed about three of them and was chewing on his chalky fourth before we realized it, then told him what they really were. Being four sheets to the wind and nearly in his cups, the only response he could mumble was:

  • God. No wonder these things are chewy and tasteless. I thought maybe you guys left the candy out so long that it got stale.

It wasn’t until the next day when he finally sobered up that the full realization of what he had done hit home, which made him sick and nauseated in retrospect.

  • Shit, I can’t believe you guys let me eat somebody’s gallstones.
  • Better than some other nasty things you can put in your mouth in a state of abject drunken waste, my brother.

Actually, in some primitive native cultures it is believed that if a man consumes pieces of desiccated grizzly bear gall bladders, he can prevent sexual impotency, or if already impotent, reverse the curse. Like some other men I have known, I guess these natives may have thought of their bear enhanced erections as somehow becoming ferocious wild beasts on the prowl for fresh meat.

But trust me―the last thing my brother got from his little debauched snack was a nice big hard on. Toward the end of our lease term, old Joe had a stroke and although we begged Alice to let us help, she refused to even take him to the hospital. He was paralyzed on his left side, aphasic and dribbling down his chin, but Alice said that he had a good life and that the hospital would kill him for sure. So, she put him in a lounge chair, stroked his motionless side several times a day in a fruitless effort to bring it back to life, and after a brief period of time let him die a natural and compassionate death.

Although it is probably true that old Joe would not have survived the hospital anyway, it was more likely that the food Alice attempted to stuff food down his throat every day and that subsequently trickled into his lungs instead of into his gullet was the more probable and proximate cause of his eventual demise: Aspiration pneumonia.


R.I.P. 1973

Old Joe

Killed with kindness




Myself and former rommate Bob/Personal photo
© Photo: Gallstones Deutche Welle
Source:Deutche Welle


























More womanly woes

More Woes

I only had two other relationships of note when I was in medical school. Although neither of the women were virgins, and while not giving me a lethal STD either, they both were potentially lethal for other reasons.

One affair was a brief fling with a Chinese girl who was working as a secretary for a Cardiologist that I met when rotating through his service at the Boston City Hospital. I asked her out for a drink and after one beer she asked to see my room…the bedroom. I should have known then that if the deal seems too cheap, too easy, and too good to be true, there is probably something wrong with it. Caveat emptor. As it turned out, the only virginal orifice she had remaining might have been her left ear.

Things went well for a few months and she was especially good to have around when ordering food in the local Chinatown restaurants. She also took me on a tour of the Chinese gambling parlors and certain other places where a white man would not only fear to tread but would undoubtedly be denied entrée—or worse. What I did not know about her was that she was a hard-core opioid addict, only finding this out one night when I picked her up at her parent’s apartment. When I rang the bell, she opened her front door, then promptly flopped onto the floor in a drug induced coma. Wearing nothing but a negligee and wrapped in a white fur coat, she looked like a semi-conscious fluffy chinchilla. It was a strange way to start a date, except for the fact that because she was already dressed for bed, perhaps that’s where we should have gone first.

We were supposed to go to her friend’s house for a party but ended up driving around in large urban circles looking for the place. While I drove, she occasionally became conscious enough to either give me bogus directions or perseverated repeatedly:

  • I love you. Soon your family and my family will be as one.

Meanwhile I was thinking that “Bless Happy Family” was just an oriental dinner dish listed under column A; and not a lifetime commitment.

Because she wasn’t sober enough to know where we were going, I brought her home to her parents, rang the doorbell, and left her asleep at the front door. When I spoke to her the next day, she couldn’t remembere any details of what had happened, and not even the fact she had proposed to me. Blessed happy relief!

The other thing I did not know about her was that she worked part time in a pornography shop. That was fine. I even enjoyed a private tour of the place and met some of the girls who worked as strippers in the glass faced dollar-a-minute jerk off booths. What was not fine was the fact that she had nearly been stabbed to death in a gang related brawl and that she was in fact the immediate ex-girlfriend of a local Chinese Tong gang leader.

She had made up some completely whacky story about landing a bit part in a Woody Allen movie, then having an accident on the set that explained away the twelve-inch scarred over gash in her abdomen.

  • Tell me again. You were on a movie set. Then a knife flew out of nowhere and landed in your spleen, so they fired you, right?
  • Yes. It was a stunt gone wrong.

For about a minute I was stupid to believe her fantastic prefabrication.

Forget about drug overdosing or contracting VD. That was about as close as I ever wanted to come to meeting her boyfriend, the Mao Ze-Dong of Boston’s combat zone.

  • You round eyed running dog of Yankee Imperialism. You fuck my girlfriend. You die.

The next near-death relationship involved my engagement to a nurse I met when rotating through a surgery elective in Springfield. By this time, I was a twenty-three-year-old who was beginning to think about getting married and settling down. When I met her, she was having an on and off affair with a married surgical resident who she said almost always had anal intercourse with her to avoid the possibility of an embarrassing pregnancy. In fact, he had deflowered her anus before her hymen; a statistic on the very low end of how young women first get laid. Anal sex as birth control was a nice enough way for two lovers to mutually rationalize that perversion, and being no prude myself, I couldn’t have cared less. In fact, it opened exciting new possibilities for deviant sexual experimentations I could try with her.

She was also having an affair with a real estate broker who was twice her age but who had made it clear he had no intention of going further than dating.  I suppose it was a good thing I was not a prude then, and instead of asking whether she was a virgin or not, asked her instead if she had any holes that had not as yet been penetrated— like a nostril or an ear canal. She was not amused.

We started dating. She gave up the affairs. We seemed to get along. But there was only one thing about her I could not get over; which had nothing to do with her recent jaded sexual history. Although she was an extremely pretty girl of Italian descent, she happened to have a mole on her face exactly where my Aunt Roses’ had been, and which drove me crazy with the less than fond memories of forced holiday visits at the Guinea Ponderosa. I asked her to get it removed. She did. Things were good.

What was not good was letting her talk me into getting married after knowing her for only a month or so. Her biological clock was ticking, she was in dead-end relationships, she was on a mission of matrimony and I just happened to be the new missionary. When I called my parents and told them I was engaged the response was predictable. My father was happy, especially when he heard about her heritage; and my mother was less than discreet in voicing her displeasure. At first, I thought it was only because of my father’s elation that she was Italian and that my mother was only being spiteful. However, it was more likely the case that in her eyes no one would be good enough for her son. No one. Not ever.

In retrospect I had either forgotten about the penchant for my mother’s opinions to be co-opted by cognitive bigotry, or more likely the case that I was not even aware then that she had this fatal character flaw in the first place.

She used the usual lines:

  • You’re still in school. You’re too young. You haven’t known her long enough. She’s probably just a gold digger. She’s only looking for a bird’s nest on the ground. You have your entire career ahead of you. And who will support you if she gets pregnant and she can’t work? Not me. Not us.
  • Bird’s nest on the ground, mom? And what do you think we have that’s so rare and valuable? Faberge eggs?

My automatically opinionated mother was an overwhelming intimidator. Also coupled with the fact that if she did not like something or someone, she either never let you forget about it or she treated the subject with both passive as well as with aggressive behavior. Unfortunately, I was still dependent on my parents for room, board and tuition, which made me too afraid to confront the bitch, or if so, would forever have to tiptoe around her ire. That was my excuse. The truth was, I simply had no balls.

In retrospect, however, even if I had showed up with Bridgette Bardot there would have been something wrong with her as well.

  • But mom; she’s beautiful, she’s talented, and she’s rich.
  • She has a funny accent. Dump her.

But two things happened to end the affair. One was the fact that after several months all my fiancé could talk about was the kind of house she wanted, the type of furniture we were going to get, the pile or color of the carpets, how many children she wanted, and where we were going to live; preferably close to her parents. Notwithstanding the fact that her parents probably would have bought us the house or built it in the customary Italian manner in their back yard, I began to see any potential control over my life and future going down a predetermined spousal and in-law drain. I started having cold waves of sweat that seemed to come out of nowhere. The second thing was simply the fact that we ran out of conversation as the differential in our intellects began to overshadow the initial blind passion of our sexual attraction. Being a neophyte physician, I definitively knew that unexplained cold sweats was a non-definitive but still equally poor premonitory sign for something bad in the larger domain of potential illnesses, such as cancer, tuberculosis, or lupus.

As my loan shark friend Chubby used to say:

  • Doc, the sex only lasts for about thirty minutes. Then each day you got to figure out what to do with them for the rest of the twenty-three and a half hours. So, if nothing else, you better really like ‘em, too.

One of my roommates said it better.

If she was a guy; would you always want to hang out with her?

 Falling into a panic at the potential loss of autonomy and intellectual succor, I wanted to call it all off, but was afraid of the repercussions after how far everything had gone. We had the rings, the wedding date, the catering hall and were about to send out the invitations, which had already been printed—at no trivial cost.

Michael came to the rescue. He explained that breaking an engagement was not like irreversible neuronal damage. However, being in a bad marriage might make me feel as though I did have a stroke. He said to tell her it was quits during the car ride back from my parent’s house on Long Island to Massachusetts. that way she would not be able to do anything drastic or foolish and would be captive long enough to talk it out. That was bad advice.

Bolstered by the example of my cousin Laura breaking her engagement several days before her wedding, I told my fiancé I wanted out as we were going 65 miles an hour along Interstate highway 95. I said I only wanted to postpone things, but not being an idiot, she knew immediately what my sorry excuse really implied.  After a few choice four-letter words and other epithets, followed by streaming monolog castigation, she suddenly opened her car door and tried to escape. What a nightmare. That was all I needed; a dead soon to be ex-fiancé splattered against the median barrier, while having to come up with a good alibi to cover up the accident.

  • Oh, officer. She decided it was far better to kill herself than to have to tell me she was breaking our engagement.
  • Sure. I understand. Happens every day out here on this horrible highway of broken dreams. I feel for you.

I quickly pulled onto the shoulder, spent several hours calming her down and made her promise not to jump out when we got underway again. She must have thought better about suicide but spent the rest of the ride alternating dead silences with loud cursing. She also said her father would be royally pissed off about this.

After several months, things calmed down a bit and I called her. She was still bitter, but back with the real-estate agent and biding her time until another potential mate showed up. She ended the conversation with a cryptic comment that I owed my life to her, as her father had seriously considered putting a contract out on me when I dumped her. Apparently in so doing I had shamed and disgraced the entire family. I didn’t know he was mob connected, or I might never have dated her in the first place. Or perhaps I should have gone ahead with the whole thing and had affairs for the rest of my life, like most “made guys” seem to do. Have the family. Ignore the wife and kids. Do whatever the fuck you want, any time you want. And fuck whoever you want to fuck, whenever the fuck you want to fuck them.

But she said she had persuaded her father otherwise about having me put six feet under and that in the long run I was not worth it anyway. That’s not what she really said. What she really told her father was:

  • He’s a worthless piece of shit. He isn’t even worth wasting a bullet on.

I kept the wedding bands in a desk drawer for thirty-seven years until my second wife persuaded me to hock them for cash. You know how women get about any past life, or history, or relationship baggage that comes attached to their new mates. They want it expunged…or in this case, melted down. It was a funny thing too, because before I sold the rings, I tried to put mine on, but it wouldn’t even come close to crossing the appropriate fourth left finger knuckle. Yes, I was a little bit bigger and a little bit fatter and a wee bit more arthritic. But at least I was still alive.


If you play with fire, you are bound to get burned.


Mafia figure,00.jpg


The thing about virgins

The Thing about Virgins 

Because it tends to be a ‘man’s world,’ in most male dominated chauvinistic societies, men have no desire to be virgins themselves, but always seem to want one for a wife. Then they like to boast about it if they have had sex with a woman for her first time.

  • Yep. Popped her cherry all right. She bled like a stuck pig, too.
  • Cool man. You’re lucky. Never had one myself.
  • Yep. Seems like they just don’t make too many of ‘em anymore.
  • You got that one right, my man. It’s a rare vintage indeed.

Virgin worship is nothing new, probably represents little more than a symbolic veneration of something not yet corrupted and is an atavistic theme permeating many primitive or aboriginal societies. Having sex with a virgin also ensures no chance of getting an STD, unless perhaps getting oral herpes from a French kiss.

Veneration of virgins was particularly true in ancient Rome, when six virgins always lived in the temple of the goddess Vesta—hence the derivation of the term ‘Vestal Virgin.’ This goddess represented the sanctity of the hearth as being central to the preservation of home and family. In being one of the oldest of the Roman goddesses (represented by icons rescued from the fires of Troy) she ensured the safety of Rome, but only if these icons were preserved, venerated and carefully tended. Vestal virgins were responsible for keeping the sacred fire in the temple of Vesta as well as for oversight of the sacred icons. They also had the responsibility of baking special breads, mola salsa, or ‘sacred cakes’ made from the first harvest of corn, ultimately then being considered as a food offering for the gods.

Women between the ages of six to ten selected for this duty would commit to a thirty-year tour as temple servants. Any lapse in the vows to keep the sacred fire burning or worse, to maintain their virginity would result in punishments as severe as being buried alive. Their annual ritual of sweeping and cleaning the temple is the derivation of our current cultural idea of “spring cleaning.” How it was determined if they had been deflowered has never been explained, but if I had to pick a different career in medicine, I would be the first in line to sign up for consideration as the Secretary Inspector of Vestal Virgins.

However, Roman social hierarchy was so chauvinistic in structure that the seating chart at the Coliseum, running top to bottom, meaning worst to best, went as follows:

7. Mothers, wives, widows and whores

6. Slaves

5. Husbands

4. Plebeians

3. Wealthy aristocrats

2. Senators

  1. The Emperor, his family and closest friends

Then, in a tent located next to the Emperor, at field level so to speak, resided the Vestal Virgins. (Row 1-A)

Married women, widows, non-virgins and prostitutes were so heavily discounted that a virgin was considered three times as valuable as a woman who had already lost her virginity—or even her husband. Not only was the value of a virgin considerably higher than that of an “already made woman,” but the concept of virgins mating or having mated with various gods was also a theme that consistently runs through many ancient societies.

In Babylon the Chaldean priests selected one virgin female from the entire population to be the human consort of the god, Bel.

In Egypt a virgin slept in the temple of Ammon as his consort.

Egyptian monarchs were also considered to be the offspring of Ammon, such that in a parallel leap of faith, and with a peculiar costumed sex game, the reigning king would assume the personage of Ammon before having intercourse with the queen.

In ancient Greece, Dionysus was annually married to the queen in a symbolic ceremony.

In Peru there was a village where the local Inca Indians married off a virgin, usually about fourteen years old, to a carved image of a god, and after three days of celebration sacrificed her, then subsequently deified her.

North American Algonquians and Hurons married virgins of about six or seven years old to their fishing nets, which were possessed of a “man-spirit,” in order to ensure a plentiful harvest of fish for the ensuing year. This complements the idea that a perfect god could indeed have sex with a mere mortal, but only if that mortal happened to be sexually pure.

There are also numerous anecdotal tales of the offspring of these unions cast in roles of individuals having supernatural or superhuman powers. The most commonly known example of this is the famous Hercules of Greek mythology, a man of supernatural strength who was the issue of a union between the god Zeus and the mortal woman Alcmena. He underwent eventual apotheosis himself but only after the penance of the twelve labors being imposed as a penance for having killed his wife and their two sons.

On a more mundane level, when a Viking king died it would be customary to select a virgin, but not the queen, to be burned along with him as he was sent out to sea on his floating pyre. However, this was only after hoisting her up and trucking her around the compound so that she could “see into heaven.” After this ritual she was gang raped by six Viking warriors allowing them in turn, to see nothing but the aura of sexual bliss. This is certainly one way to rationalize the sanctity of a gangbang, but why the women selected for this ordeal felt honored by it or why the king himself did not have the honor of having her first in the afterlife defies rationalization.

  • Yes. I had sex once with six men all at the same time. Then I died and went to heaven.
  • It was that good, was it?

After the fall of the Roman Empire along with the rise of Christianity, early apostles, followed later by some of the first popes, had to employ clever means to convert the masses of people who had been accustomed to polytheism to the concept of monotheism—while at the same time having to sell them the concept of Jesus being the son of god. It was infinitely easier to do this if the story coincided with the legendary folklore of the Pantheon.

The early Christian church replaced early pagan holidays such as Lupercalia, dedicated to Vesta herself, or Saturnalia a holiday dedicated to Bacchus, with the likes of St. Valentine’s Day and Christmas respectively. The church even borrowed iconography from Egypt such as halos, symbolic of the sun god Rah, and stuck them on the heads of holy figures or angels, a ploy that made the conversion and “buying in” of the general pagan populations that much easier. The Catholics carried forward the concept of Virgin worship and a holy deified offspring endowed with mystical supernatural powers with their contrived invention of Jesus. They cast him as not only being the son of God himself, but also as a person conceived by a supernatural Holy Spirit, usually symbolized by a pure white bird or dove, that miraculously entered Mary and impregnated her. This sounds remarkably like certain pagan legends of mystical conceptions occurring when women are entered by spiritual holy waters.

Then, of course, being the good guy that he was, Joseph stood in to be the stepfather, so that this poor innocent knocked up woman would not be a social pariah— or possibly even stoned to death for her silly indiscretion. Joseph of course taught Jesus to be a skilled carpenter and then faded into historical oblivion. That is the fable. More likely than not, Joseph in fact was the real father. If not, and we could retrieve Jesus’ DNA, perhaps we would be able then to clone God.

Jesus went on to teach morals and ethics, performed such miracles as raising the dead and walking on water, was eventually crucified, resurrected, ascended into heaven, and then called for his mother who was later also assumed into a large cloud. In becoming a celestial floater herself, she was lifted up to be with God and his son; who also happened to be her son, too. Strange though, is it not, that we never hear about God cavorting with Mary after she arrived in heaven. One would think that would be a given.

The story of Jesus however sounds eerily like that of Aesculapius, the Greek god of medicine, who was the son of the god Apollo and the mortal Trikkian princess, Coronis. But shortly after consorting with Apollo, Coronis fell in love with Ichys. Then after a crow informed Apollo about the affair, Apollo sent his sister Artemis to kill her because he thought the baby wasn’t his after all. Her body was burned, which stained the previously pure white feathers of the crow permanently black, while a remorseful Apollo having had second thoughts rescued the baby by performing the first caesarian section. He then handed the boy over to the centaur Chiron.

Chiron, who taught Aesculapius the art of medicine, then raised him to became so skilled that he was able to bring the dead back to life. But because this was a crime against the natural order of things, Zeus destroyed Aesculapius with a thunderbolt, completing his punishment and subsequent resurrection by setting him in the heavens as the constellation Ophiuchus, the Serpent Holder. His rod, entwined by a single snake, and being the original symbol of healing is often mistakenly portrayed as Hermes double snaked caduceus. After his mother’s death, Coronis was also deified and set in the heavens as the constellation Corvus, the crow.

Virgin worship was a theme central to pagan faith, while parthenogenic birth by mortal and virginal women who were impregnated by gods is a theme common to tales reaching far back into human antiquity. Rhea Silvia, the mother of Romulus and Remus, the founders of Rome was a Vestal Virgin. Her uncle had killed her father, the King of Alba Longa, then usurped his throne. Committing her to chastity was a foil to get her past mesopause, and therefore little likelihood of producing a nephew competitor to the throne he stole. Rhea had a good excuse for getting knocked up, and subsequently avoiding a death sentence. She said the god Mars had raped her in her sleep…and who could dispute or disprove that convenient alibi in 753 BC? There are also numerous ensuing tales of mortal death and resurrection that were simply designed to confirm the lineage of the divinity.

In order to facilitate a pagan world to accept or embrace the words of Jesus, it is likely that the Apostles— or the men who came soon after them—used this legacy of pagan imagery and iconography as a metaphorical vehicle to get people’s attention and to guarantee credibility. It was a subtle method used to rationalize and incorporate older beliefs into newer ones. The concept of Mary being a virgin came centuries later as part of a contrived dogma that the Catholic Church used to force its women into subjugated roles. For example, much like the women of Rome, no ordinary woman who ever had children, or who ever had sexual intercourse for that matter, could ever be held to this unblemished sexual standard. Then as an equally tragic spin-off perverted logic, the church invented the concept of the virgin servile nun, who they dressed up in black and white Taliban burkas, then sequestered them or made them subservient to priests.

As the reign of Roman Empire in Palestine was coming to an end, the corruption, the brutality and the chaos left in its wake sowed the seeds of hope for change and a deliverance from this dark evil culture. The Jews expected a powerful messianic leader with military skills, hoping for a person who would deliver a revolution. They rejected Jesus only because in practical terms, the last thing they needed at that time in their history was a talking head.

Some embraced him for the content of his message. However, others decided he was the messenger better off being shot; especially when he began to mess with moneylenders and Jewish sycophants who had been given positions of political authority by the Romans. Or, perhaps the Romans themselves feared a fomented revolution by the rabble that was listening to Jesus preach of a “new social order” and took it as a serious threat. A new Emperor; surrounded by 12 Apostolic men who became the Governors of the 12 Tribes of Israel; dictating a new religious policy and displacement of Roman rule.

Jesus never claimed divinity. Other people claimed it after he was dead. He also never said that he was a king or even a general. He only claimed to be a messenger delivering God the Father’s reiterations to: love your brother as you love yourself, be charitable, eschew hate, greed, and revenge, and then perhaps give the Ten Commandments a good periodic review about personal compliance. Being misinterpreted as the Son of Man perhaps it would be better to think of Jesus instead as the Sun of Men; a person delivering a bright new message of hope, peace, brotherly love and personal enlightenment at a time of greed, brutality, corruption and oppression of civil liberties. Jesus was probably a decent ordinary mortal man with a vision; perhaps a little more and perhaps a little less…then also not the only man to ever be killed for delivering a message.

Ironically, after he died, Jesus was deified, raised to a higher level and placed on an ethereal throne. Then the 12 Apostles were subsumed into one living mortal, The Pope, who being the only person with direct access to God, is a man surrounded by scores of sycophant Bishops, and like any Ayatollah, then dictates his own interpretation of Christ to billions of mindless lickspittle sheep.

What really defies logic is why Pontius Pilot killed a man who could raise the dead. If Jesus had that power he should have been sent along with the Roman legions as they went off to war. With the quintessential faith healer in tow, Rome might still rule the world.  Alternatively then, why did God the Father allow his only child to be sadistically tortured and nailed to a cross? Most civilized societies and religions frown upon child abuse.



Grow strong, dear boy; healer of the world. Often men shall owe you health and life, and yours shall be the right to win again departed souls, and though you dare this once in heaven’s despite, Zeus’ bolt will thwart that gift a second time. You, now divine, shall be a lifeless corpse, and from a corpse become divine again, and twice you shall renew your destiny.

(Chiron’s daughter Ocyroe and her prophesy to Aesculapius)


1. A Study in Magic and Religion/ Chapter 12. The Marriage of the Gods

Sir James Fraser Macmillan 1922/1963 Touchstone 1996

2. Vesta from Temple of Religio Romana and media shift PBS

3. Marriage of the Gods from The Golden Bough

4. Viking Funerals from The Last Apocolypse by James Reston

5.Asclepius: Wikipedia Theoi Greek Mythology (Quotation)

Vesta Image




Romantic love is an illusion. Most of us discover this truth at the end of a love affair, or else when the sweet emotions of love lead us into marriage and then turn down their flames.
(Thomas Moore) 


After I learned to Scuba, I took reef diving trips to Cozumel almost every year for two decades.

Cozumel is an Island off the Yucatan of eastern Mexico, especially noted for the clarity of its water. This is because the 6000-foot-deep trench that runs between the island and the mainland, serves as a funnel for one of several loop currents running south to north; which then eventually combine to form the Gulf Stream. This constant northbound flow can result in as much as 200-foot visibilities, but also runs fast enough that divers cannot swim against it; thus, forcing them to drift along with the current. This drift diving is a unique style of the sport, in a unique underwater environment, a true gem of nature.

My favorite day trip would be to take a plane ride to the spectacular Mayan ruins at Chichén Itza where one of the sites on the tour of the city is the Cenote. This is a circular sinkhole, formed in the limestone that drops straight down hundreds of feet below its sharp drop-off to a deep inky green-black pool.

Apparently one of the Mayan sacrificial god appeasement ceremonies involved periodically taking one or more vestal virgins to the cenote, drugging them up and heaving them off the edge. It was supposedly a good sign if the virgin sank and never resurfaced, but a very bad sign for the priest who oversaw guarding them if the body floated back up to the top. This meant that the gods were not at all pleased; also implying that perhaps they had been rejected because the priest had breached his vows to keep them pure by personally breaching their hymens as well. If a priest happened to get too many floaters, the citizens of the city would throw him in too, or perhaps cut out his heart, cut off his head or do all three.

This left the priests with several tricks designed to ballast the corpse which included weighing them down with heavy jewelry or making them swallow rocks before the ceremony. Their sedating drugs would add a layer of insurance against the possibility of flailing or flopping around on the surface when the body hit the water, and hopefully then send the weighted, semi-comatose corpse straight down to the bottom.

On one of those dive trips, I encountered a floater of sorts too; one that was directly linked to sexual indiscretions as well. I went to Cozumel with a nurse I was dating. On the plane ride from New York we sat across the aisle from a mixed-race couple that was also going diving. The woman was white, and the man was black. Coincidentally, they also stayed at the same hotel as ours. I attempted idle chat, but they seemed standoffish, shy and reclusive, so I did not push it. I thought they might be that way because in the late 1980s society in general still frowned on inter-racial relationships.

On one of our dive excursions there was great commotion on another one of the boats, along with shouting and hysterical gesticulation from two Mexican dive leaders who were standing over what looked like a limp body in the bottom of one of their small ancillary snorkel boats. Our boat raced to the scene where we witnessed the black man lying on his back in the bottom of the small aluminum hulled boat, in full cardiac arrest. My girlfriend and I jumped into the small tipsy craft, where she began mouth-to-mouth breathing while I pumped on his chest; but to no avail. I could tell that the man had died instantly while snorkeling above his wife or girlfriend, who was tank diving below him.

However, not to be undaunted, the Mexicans raced him to shore where an ambulance was waiting, unfortunately very ill equipped to the point of not even having an ET tube on board. This resulted in one of the paramedics trying to torture the corpse by intubating him with a snorkel. The scene then devolved into a horrific bloody mess as the all too large diameter of the equally all too rigid snorkel severely traumatized the poor man’s larynx as the so called EMT kept trying to unsuccessfully shove it down his trachea. It was only a gory scene of bloody, foamy sputum, saliva and snot being forced from the lungs of a dead blue body.

Later that night, I went to his partner’s room to offer my condolences, only to be brusquely rebuffed by her telling me to “just go away” and leave her alone. She would not even open her hotel room door more than a small crack before shutting me out without further conversation, which made me feel stupidly inadequate. By the next day her room had been vacated and she was gone.

I found out several days later that the reason for her terse rebuke was because the couple was married all right, but each one to someone else. Apparently they had been on a cheating vacation tryst when the man suddenly dropped dead on the surface of the sea; only to leave his counterpart with the embarrassing problem of having to explain it all to her own husband, arranging the transportation of her lover’s corpse back to the States, as well as the clumsy situation that was now forcing her to be a direct liaison to the man’s poor widow as well. This woman instead chose to cover her tracks and go silently into that good night. Perhaps on her next Caribbean vacation, she might want to spend it in the Virgin Islands, in a single room, above water, with her nose in a book. Or by the time she hashes it all out with her husband, she might be single again anyway, and could simply start over.

A similar situation with a happier outcome combined ultimate forgiveness with making the most out of a bad situation. The scenario involved a couple my wife and I met on a cruise who had managed to turn a potentially serious negative into a pluperfect positive.

He was a hard-working building contractor who had grown a multimillion-dollar business from scratch. By the time we met them they also had five adult children. But when the kids were young, he had been sidetracked by having an affair with an unhappily married woman who he met in his bowling league. The ostensible reason for his straying was because his wife, who was busy taking care of their five small children at home, had fallen into the syndrome of: ‘Chronically-being fatigued-all-of-the-time-mommy-lost-interest-in-sex.’

But after figuring out what was happening by the cell phone log, the wife called the woman herself, told her she knew what was going on and then asked her husband to bring the woman home with him so she could watch them screw.

He did.

The three of them then had sex together on a regular basis for several years; until three became a crowd.

After that the tired mommy, yet now rejuvenated and enlightened housewife, made sure that when each of her daughters came of age, that they were indoctrinated in the concept of never sexually neglecting their hard-working husbands.

She told them:

  • As long as he’s bringing home the bacon, give him what he wants, whenever he wants it, however he wants it, and however many times he wants it. It’s easy. You have three holes…so  all you need to do is make sure that at least one of them is always open for business.




Love ? Affairs

Love ? Affairs 

Sexual cheating on a spouse or a lover is euphemistically referred to as “having an affair.” I think it would be better to refer to it as “having a derailment,” both emotional and physical. The train has just come off the tracks, resulting in either a total wreck, in which the demolished cars are removed and taken to a train graveyard or, alternatively, whatever remaining pieces are deemed salvageable get reconstituted, re-railed and re-routed. Another good descriptor for having an affair is the commonly used term: ”cheating” because, in fact, it is the act of doing something that allows one person to hold a significant advantage over someone else. But because everyone has a different threshold for conscious self-reflection, whatever the exact advantage might be for the angst befalling the cheater, remains to be explained. After all, this is not the ordinary case of “I know something you don’t know” or the special advantage that comes to a card counting poker player. It’s more like the card cheater worrying that he’ll be busted for having an ace up his sleeve, which will result in either being shot by a competitor or rolled out the front door of a casino by a brute bouncer.

The “whys” of cheating are equally elusive and run the gamut of sexually addictive behavioral quirks, to the ‘grass is greener syndrome,’ to the ‘not getting any at home factor,’ or the rather bland ‘you do it because you can phenomenon.’ Men who enjoy positions of great power, fame or status in the society are particularly prone to the susceptibility of the free pussy that always seems to easily gravitate to the aura of that fame, or is merely a mercenary female attracted to their wealth like a moth attracted to a flame. It is also customarily the case that it is not only “if”, but rather It is necessarily going to be “when” the sordid relationship ends. This is because “discovery” is a principle that equally applies to one-night stands or single encounters with prostitutes.

The consequences after the fact of discovery are myriad and can result in a simple breakup, complete reconciliation, a bitter divorce, long or short-term stalking, depression, nasty confrontations, fistfights, a fall from grace, serious bodily harm and/or even murder. There are thousands of documented cases that went wrong enough to warrant airtime on television forensic shows, or the tantalizing sexual political scandals that periodically but predictably always surface from time to time.

My attempt to run with two girlfriends at the same time was as close to the first, as well as the last time, I ever had a derailment. I decided then that it if I needed someone else that badly, it logically followed that the original relationship must simply be lacking sufficiently enough to warrant ending it. Generally speaking, if I happened to be in a long-term relationship, I never cheated and specifically when I was married, never cheated either only because I was completely satisfied, or if not that, it required too much negative energy, craft, or deception to make it worthwhile.  Unfortunately, many long term loveless marriages are too expensive to end, in which case, even though the players may no longer be mutually faithful, the mantra becomes “cheaper to keep her; or him;” as the relationship then graduates to the more sublime level of becoming more of a perniciously plain old fashioned living lie.

This is not to say that when I was single, I may have had a few short-term affairs with someone who was married. However, that was their emotional problem and not mine, except to risk the potentially disastrous encounter with a jealous husband—or God forbid, that the woman thinks she has probably fallen in love with you. See? It still gets too complicated even if you think you’re an innocent bystander who has stupidly crossed boundary of having sex. At this point all bets are off in the predictably unilateral emotional calamities that inevitably follow suit. One of the worst-case scenarios occurs when a married man traps a needy woman with low self-esteem into a relationship that lasts for years or even decades, as he perpetually promises every week that he will leave his wife. This is need-want-user-used psychopathology at its best.

I did have one bad experience when I went to bed with a female Resident who was in the process of getting a divorce. Technically, she was still married even though emotionally she  was not. After two dates she began to discuss getting married to me; a ridiculous idea I equated as her going from the frying pan into the fire. Not even divorced and wanting to get married again? That sent a strong signal that there might be a few loose screws in her noggin—so I quickly backed off. That was a correct assessment, but too late for me, as I had already taken the lethal vaginal plunge. She categorically would not take “No” for an answer and developed a fixed delusional fantasy that she and I were going to be a couple regardless of my early precipitous good-bye.

The harassing aftermath lasted for two years beginning with a posted ‘letter a day’ complete with numerous personal photos. The themes ranged from maudlin sentimentality through outright bitterness, accusations that I was gay and she would rescue me from that fate, that I was a drunken drug addict who needed her to help my rehabilitation, then paranoid rationalizations as to why a Jew and Italian could still make it together, and ending with overt threats that if she couldn’t have me then no one else would. This was coupled with physical stalking, such as showing up at my house, my friend’s houses, my parent’s house, or worse—my workplace.

On one occasion when I lived in Nyack, New York, I was forced to hole up in the false bottom under an ersatz loft bed I  made by placing the bed frame on a stack of Sears cabinets. It was only designed to conserve space in my apartment, but then turned out to be a convenient hiding place instead. Not going to the mattresses, so to speak; but under them. My roommate intercepted her, and tried to dissuade her, while I almost suffocated waiting for her to finally believe his story that I was not coming home that day. In retrospect for that siege I should have laid in some supplemental oxygen, a few cans of soup, and a portable Sterno stove. However, because this was in the late 1970s to early 1980s, the police in Manhattan, Nyack, and eventually in Suffolk County sniggered at my attempts to get an order of protection.

  • OK. Let me get this straight. A woman is stalking you and you’re afraid. What? Afraid to get laid. That’s a good one. Everyone should be so lucky. Haw, haw, haw.

One of the supervising Attending Physicians in my Cardiology training program was only slightly more sympathetic when he simply said:

  • So. Have you seen the movie “Play Misty for Me?”
  • Yes. And thanks a lot for that pleasant thought.

I even went as far as to lodge a complaint about professional ethics with the Manhattan Medical Society, as she then worked in that borough, but this organization took my plea with an amused and unsympathetic grain of salt. They told me there was little they could do. Everyone thought I was hysterical or that I was blowing the entire thing out of proportion; but they had not read the nutty letters and were not the ones who had to constantly look over their shoulders. Then suddenly one day, almost as if it were by magic, the stalking abruptly stopped. I scoured obituaries on the off chance she had met an untimely but welcome death, but I learned later instead that she finally found someone else to marry. That was when I said a small prayer of thanks to the great psychiatric God of Emotional Transference, put away my bulletproof vest, and saved all the correspondence in a large mothballed box. You know— for evidence—or just in case she changed her mind on the wedding alter, too.

What I find most interesting about affairs is the “inevitable discovery” and how like so many other things in life can be accidental, the jig usually comes up by a completely blindsided twist of fate. Some of my married golf buddies must have read the Manual on Not Getting Caught and while I was still a bachelor, made sure that when we went away on bachelor weekends, the charges for the call girls went to my credit card. Otherwise, if you are not ready to explain the six-hundred-dollar charge for “Discreet Jewels” on your own card you had better come home with a nice bracelet you paid for with the cash that would presumably also have been borrowed from me.

The irony here was that I was getting plenty of sex at home, could have cared less about having a hooker come over, and although the wives expressed dismay about their hubbies going off with a “notorious bachelor,” it was their own sleazy husbands whose behavior was at risk.

  • You’re not going anywhere with him. I heard once he was married six times.
  • Not quite. It was the opposite way around. He was only married once for about six minutes.

Of course, if you do then happen to come home with a nice case of a transmissible venereal disease instead of that expensive bracelet, you had better be in tight with the treating physician who is willing to cover it up with a phony diagnosis, which will then only apply to a few limited bacterial, but not to the newer more permanent, unexplainable viral versions. If not so lucky then, you will be left hung out to dry, just as your penis should have been while hiding inside of the safe comfort of a nice thin little rubber raincoat, instead of romping around bare-back. Herpes is much more difficult to explain away and is no longer simply referred to as being “the kissing disease.” Then again, a nice raging case of gonorrhea would not go down too well in the annals of easily explainable genital discharges either.

  • Honestly honey, I don’t have any idea where that came from. Maybe you got it sitting on that filthy dirty airport toilet seat.
  • Oh yeah? How about more like the filthy dirty bitches’ seat that squatted down on yours.

Here are some of my favorite blindsided discovery cases and situations where the Manual on Not Getting Caught could not anticipate the glitches.

My father got caught in the plain, simple, straightforward, old-fashioned way; and just like Bill Clinton’s Monica Lewinsky, only because that special somebody spilled the beans. The woman he was going with had enough of it, called my mother at home to tell her what was going on and said that she just couldn’t take it anymore. My father moved out for a while, leaving my semi-hysterical, semi-regretful, half-crazed vindictive mother alone at home to brood. Although she abhorred drugs of all kinds, for this calamity she acquiesced to a pile of Valium I took out of a hospital medicine cart and hustled up to White Plains on my first available night off when I was still working a Resident in New York City.

She said:

  • He’ll have to choose between her and me. And if he chooses her, I’ll break both of his balls…and his bank account, too.

I told her I did not understand why she wanted him back, and that I didn’t blame him for doing what he did because she always treated him like shit. I also suggested seeing a marriage counselor by telling her this was their mutual opportunity to start over with a new leaf—along with a new attitude. Of course, after he came home, not only did nothing change but my mother also never let him live it down. Counseling was entirely out of the question because only “weak” people did that sort of thing. God forbid anyone would want to get some real help or personal insight into the decades long festering sore that had ruined their relationship. Years later, my father told me he would have left if not for wanting to keep the family together.

I said: “What family?”  because I could have cared less. I was twenty-six years old and already out on my own, my brother was independently out on his own too, and my sister had just turned eighteen—facts that only led me to believe that if he was telling the truth, the affair must have been going on for years.

Then there are those cases in which the situation occurs “in-flagrante;” and cannot even remotely be denied. I once had a patient, a very well-off local landlord, who owned several buildings on Main Street. He was as in his mid-forties. After being been cleared of having coronary disease on an Executive Physical style general work up and stress test, he decided to come back every year for another stress test anyway, “just to be sure.” He would also ask for an HIV test, something I thought peculiar because he was happily married with a young daughter. But one day his wife came home unexpectedly only to find him in bed with two other men, after which she promptly asked for a divorce. She told me if it had been a woman, she might have had a chance at successfully competing to get him back; but that she perceived this particular sexual proclivity as a battle she could never win.

She said:

  • If it was only pussy, that would be one thing. But ass fucking and 69 position mutual dick sucking? How can I compete with that?

This situation was nearly as bad as the woman who worked at the hospital who told me she was leaving her husband of three years because his sexual preference was to masturbate while strangling the head of his penis with a rubber band so he could have a retrograde ejaculation into his own bladder. Self-love is hard to compete with too, unless the guy was just working on a uniquely effective form of birth control.

She said:

  • I told him repeatedly to just let it go and cum inside me.
  • So, did he keep his feelings to himself too?
  • I don’t know. We never talked about that.

Nelson Rockefeller enjoyed the unique phenomenon of dying while sitting in a chair getting a blow job from a young secretary; being the classic example of literally getting caught with ones pants down. In this case, the only thing getting stiff by the time the detectives arrived was the half-dressed corpse. He probably forgot to read the then recent Japanese medical study that proved a clear direct increased risk of sudden death during sex, or Death in the Saddle Syndrome, but only occurring in men who had sex with their mistresses as opposed to having it with their wives.

  • So, after all these years do you still find me to be sexually exciting, honey?
  • Huh? Were you talking to the dog or to me?

The next scenario plays on the element of cavalier stupidity. I was on a vacation in Mexico when I met a young man in his mid-thirties, traveling alone, who after several beers regaled me with his sad tale. He told me he was severely despondent over his recent divorce because he had really loved and trusted his wife. Apparently, he worked for a telecommunications company, had a job that required him to travel almost every week for three or four days and had been married for only about two years when he happened to be rummaging in his basement for something only to come upon an entire wardrobe closet of men’s clothing that unfortunately he did not recognize as belonging to himself. When the dust settled it seems that his wife would simply move her boyfriend in for the several days her husband was on the road and as such had accumulated a nice supply of fresh shirts for the boyfriend to change into while he was there. Her excuse was that she was “lonely .”Yes, I guess and super horny, too.

Normally, lonely horny married women with husbands on the road will fill their emotional or physical voids with shopping trips or battery powered vibrators, but not necessarily with a full-blown surrogate attached to a torso. Or how about just being smart enough to have your paramour bring a suitcase; maybe even filled with the same brand of clothes your husband wears. then better yet, make it completely and secretively insulting by just letting the boyfriend wear all your husband’s clothes. After all, dry cleaners can do a same day turnaround.

I was once involved in something that was not really an affair and something I can only refer to as a “final fling.” One of my roommates in medical school wanted to visit an old girlfriend who lived in Springfield who was sharing an apartment with two other women. Michael came along for the ride and in the process of drinking and chatty small talk, one of the girls made it clear that she was engaged to be married in a few months. Michael lost interest, went after one of the other girls instead, which left me alone with the affianced.

Because it got too late to drive back to Boston, we were offered couches or sofa beds to sleep on, but as we settled in, the woman who was engaged invited me to sleep with her. It was simple. She said she was going to get married soon but wanted to have one good final free-love-fuck before the final commitment.

She also said:

  • Don’t get any funny ideas about this either. Meaning I like you all right, and I want to get laid, but don’t think for one second I ever want to see you again. So, don’t even think about it.
  • OK. OK. Don’t worry. I think I can handle it.

I got laid while the only thing my other two friends got out of the deal was a good hangover. You see; once again it’s hard to ever judge a book by the cover.

A similar situation with a different outcome occurred when I was a Resident and went to a large dinner party primarily attended by couples. Being single at the time, I did not really want to go, but as luck would have it found myself seated next to the only single woman at the affair. She was not unattractive and pleasant enough, but as the small talk proceeded over the next hour she let it be known that she was married. Losing interest, I spent the rest of the night talking to other friends while virtually ignoring her. As everyone was leaving, she walked over to me and said:

  • You know. You aren’t a very smart person.
  • What are you talking about?
  • Well I really liked you.
  • I liked you too.
  • But then you ignored me.
  • Not on purpose.
  • Yes, it was. As soon as you found out I was married, you stopped talking to me. But what you don’t know is that my husband and I have an open marriage, so this was my night out. All you had to do was be a little bit more attentive and I would have had no-strings sex with you in the bathroom.

Another situation highlights the fact that no matter what you think, in this modern world there are eyes everywhere, meaning that anyone had better think twice before having sex in anything even vaguely resembling a public venue. Spy satellites can even spot you doing it at home with your own wife on your presumably private outside deck.

A married Cardiologist in a very high profile local tertiary hospital was dismissed from the staff when he was discovered having sex with a nurse, live on the video camera that was set up inside the small hospital chapel where relatives were supposed to be praying for their loved ones who were going under the knife on the open-heart table or dying in the ICU. The nurse who was being operated on by the dull round point of the swordsman’s thrusts and parries was in fact repeatedly praying “Oh God, oh God, oh my God,” meaning at least that component of what turned out to be a successful procedure was entirely appropriate and ecumenical.

The security guards must have had a field day.

  • Hey, Joe. You stand outside the door. I’ll watch the monitor. Then I’ll give you the “all clear signal” to bust in right at the orgasm. Then we’ll go back and watch the tape together.
  • Great. It’ll be a perfect end to an otherwise boring day.

This was almost as good as the married Anesthesia doctor at our hospital who was caught banging a locum tenens nurse in his call room when the security guard, upon hearing a series of loud screams and thinking someone was being brutally assaulted, burst upon the scene after employing his master key to get in. Christ, I thought. Why didn’t the idiot just stuff a sock in her mouth? Or maybe have her bite down on an endo-tracheal tube. Or even sedate her with a short acting anesthetic for that matter. The nurse, who was an itinerant substitute anyway, known in the trade as a “Travel Nurse” was fired on the spot and simply went on to her next gig in another State. But for the doctor it was only after a prolonged period of marital counseling that the couple finally reconciled. However, his wife told me one night at a party that she made him pay through the nose for his little dalliance; and that his little indiscretion had come at a high financial cost after the much higher cost of the repeated emotional brow beatings. New house. New car. Diamond watch and earrings. New metal spiked dog collar. Very short leash.

The next case plays on the element of blindsided bad luck. A woman and her husband went to see a Woody Allen movie in which some of the scenes were shot on the streets of Manhattan. Suddenly in the backdrop the woman caught a quick celluloid glimpse of a man who just happened to be her husband, escorting a beautiful blond, arm in arm, lip on lip, as he plopped her into his sidewalk parked Mercedes convertible. There was no way out of the documentary evidence as well as the fact that the man worked thirty miles away in the New York City suburbs and had never mentioned the fact of any personal trips into the heart of the big city. Arm in arm perambulation with French style osculation will also heavily discount or negate the alibi of the “business lunch” or the long lost “kissing cousin.”

Then there is the quintessential case of blindsided bad luck and bad timing being complicated by a combination of serendipitous good fortune while also paradoxically at the same time; good timing. On the fateful day of 9/11/2001, a woman watched TV in horror as the Twin Towers collapsed in a heap of dust. Her husband was a high-profile broker whose office was on one of the higher floors and was assumed to already be at work. She had been frantically trying to locate him by landline as well as by his cell phone on which she had left numerous messages to “please call me back as soon as you get this.” Finally, he called her back with a curt inquiry as to why she had left so many hysterical calls on his cell and what was oh so important that she just had to interrupt him while he was at his “oh so important” stock trading job.

  • So, let me get this straight then. You’re at work in your office right now?
  • Yeah. Where else do you think I’d be?
  • Well, I don’t really believe that.
  • Oh. Here we go again with the same old tiresome accusations. Where are you, who are you with…on and on and on. Always the veiled implications. So, when are you going to stop it?
  • No. Not this time. This time I know I’m right.
  • Look. How many times do I have to tell you…?
  • Stop right there. I don’t know where you really are or what you might be doing, but if you are anywhere near a television set, you had better turn it on right now. You can’t possibly be in your office because your office doesn’t exist anymore. And we’ll discuss the rest of it when you get home.

He looked over at his girlfriend in the hotel bed next to him and asked her to hand over the TV remote.

The final scenario involves a perverse situation relayed to me by a drug sales representative one day on the golf course and highlights one of the reasons that HIPPA medical privacy laws occasionally turned out to be a good idea. She told me that she had known two couples that were extremely close to one another as mutual best friends. The two men played golf together every Saturday and the couples socialized very frequently with dinners in, dinners out, parties, etc.

One day, one of the men arrived at home before his wife and picked up the messages on their telephone answering machine. One of these calls happened to be her Gynecologist letting her know the great news that her pregnancy test had come back positive and so “congratulations. “The only problem was that the couple had not had sex with each other in about six months.

It turns out that the two golf buddies were not only sharing the same tee time but were also sharing the same putting hole. Then to make matters worse, the affair had been going on for about six years, meaning that even if lust had been the militating factor, love certainly was not.

I told my friend that if the two couples were truly all that close, they would have been better off doing full swaps or foursomes. I also said that if it had been me in cuckold the most insulting part of it and what would have hurt more than anything else, would be that not only was my best friend sharing the same golf hole, so to speak by banging my wife—but that I was also having to pay him those golf bets when he beat me.

Lately we just have the more blatant phenomenon of the politician or celebrity the likes of Rick Pitino or John Edwards who just never seemed to grasp the concept known as “pulling out in time” and are left with the proof of their indiscretions residing in the DNA of their “love children.” Or what about Tiger Woods, who was so dumb that he kept his private cell phone out in the open where his wife could find it, when instead, he could have had ten private phone accounts, with the call girl dialer locked in a safe. Although some women who trap these stupidly susceptible men only do it to get a leg up, some extra cash, or more likely some celebrity themselves where none existed before, I doubt that the porn star Jessie James would ever stoop that low. Well, maybe not.

Then there is the sad case of House Representative Gary Condit whose misfortune it was that his lover killed by a Mexican itinerant in a random act of violence. It’s only too bad that it took years to catch the man who really did it —while all along Gary was felt to be the most likely candidate for the dirty deed. Or what about Senator Craig, an otherwise intelligent man being stupid enough to come out as a closet gay in the public bathroom of a large metropolitan airport when he solicited sex from an undercover cop by playing footsie with him from the adjacent toilet stall.

I did have an affair with a married woman I met a work. I was recently divorced and the last thing I wanted was a serious relationship. It was her idea, not mine, and I decided to say “okay” instead of reporting her to the HR Department for sexual harassment.  Sure. How many men would turn down an offer like that?  She told me at the beginning it was because she was polyamorous, and no matter what, I should not fall in love because she would never leave her husband. I didn’t say, ‘Oh, shucks. how disappointing.” It lasted for several years and we never got caught.

When I finally got re-married I told my second wife that if she ever thought about cheating on me, I would appreciate it more if she would just bring the guy home so that at least I could then have the satisfaction, entertainment and vicarious pleasure of watching them. She told me “No” because that would take all the fun out of it.

At least she had a sense of humor.

When I said the same thing to my first wife, she slapped me.


A person cannot mount two horses

Or bend two bows

And no one can serve two masters;

For either he will hate the one and love the other

Or he will be devoted to the one and despise the other. 




Broken heart: