Читать книгу Joseph Levy Escapes Death - Rick Strassman - Страница 8

ONE

“WHAT’S NEXT?” David Morales asks. He swirls the ice in his glass keeping cold the last drops of scotch.

Joseph Levy shifts in his chair and looks over his neighbor’s shoulder, out the kitchen window toward the eastern sky. His distant stare doesn’t reflect back much. “There’s my tooth,” he says thoughtfully.

Levy’s desk is clear for the first time in decades. He’s mailed his publisher the final draft of a manuscript, the end of a 16-year project. What is next? His entire adult life has been one massive, multi-year project after another. He’s finally free, and he blinks his eyes in the glare of the present.

Levy says, “This might be a good time to take care of my pesky tooth.” Nothing that serious, but he doesn’t like that it’s gone on for several years. “Now that I’m back in Wheaton, I can see my old dentist in Phoenix.”

His previous dentist, in Willowville, recommended a new crown, but Levy wanted to wait. The secretary scolded him for delaying. “You’ll need a root canal if you don’t let him replace the crown right away.” The tooth settled down soon enough and he forgot about it.

“Sounds great,” Morales winces and chuckles. “Celebrating with dental work.”

“That crown’s been a pain,” Levy says as he pours more mid-quality single malt scotch into his own and his neighbor’s glasses. He sees his own ice is gone. “It fell off right before a two-month trip through Europe in the 90s. The glue didn’t hold, and it came off again while having lunch that first week away.” Not that it was a normal lunch; rather, a five-course wine-drenched feast at Sandoz Pharma in Basel. The home of LSD. “A dentist in France put it back on, but that only lasted a couple of days.”

“That is a bad tooth,” Morales agrees, frowning.

Levy laughs. “That was a bad tooth trip. Another one broke the next week. We were eating cold soggy veggie burgers in Scotland in the rain.”

Morales looks as if he’s remembering something, “It’s like one of those dreams where your teeth break and fall out.”

Dr. McPherson, Levy’s old dentist in Phoenix, hasn’t aged noticeably over the 20 years since their last visit. He remains youthful and energetic, with only touches of gray in his mustache. The office lights reflect off his mostly bald head, as Levy remembers they did back then. His office is different, though. Three times the size of his previous one, it’s busier, more pressured. Levy wonders how much is due to McPherson’s partner, Dr. Bigby. Maybe Dr. Bigby thinks bigger is better.

After Levy makes himself comfortable in the patient chair, Dr. McPherson takes a look at the tooth. He taps the top of the crown with a long-handled metal tool. “Does that hurt?”

No.

He squirts ice water, then hot water, onto it. Everything is fine. He takes a highly magnified photo of the crown and shows it to Levy.

“See. There is a tiny hole on top of the crown. There may be some seepage entering the tooth. That’s probably it. I recommend you get a new crown.” McPherson gets up from his stool.

As they begin talking, McPherson leaves Levy nearly horizontal in the chair. He stands off to his right, making Levy crane his neck to look up and over at him. McPherson notices and sits down in front of Levy, without however, raising the back of the chair. He’s still parallel to the ground. McPherson’s bedside manner seems to have suffered, Levy thinks.

“There is a really awesome new ceramic out there,” McPherson begins. “It’s called zirconia.”

Levy raises his eyebrows as much as he can from his prone position, indicating interest.

The dentist says, “It’s incredibly hard, never wears down, and nearly impossible to break. And we can match the color to your surrounding teeth.”

Levy says, “The color isn’t too important. How about the cost?”

“It’s a little less than gold.”

“Now my tooth hurts,” Levy grimaces. It’s reacting to all this attention. The harsh January desert sun floods the room, and he feels a headache coming on.

He says, “I’ve always had gold, and never had a problem with it. It’s pretty, too.”

“Zirconia should last longer. Besides the color advantage.”

Levy wonders if that’s the company’s selling point. He doesn’t care about the color.

“How long’s it been around?” he asks.

“A few years.”

“That’s not so long,” he says skeptically.

McPherson says, “People are raving about it. There’s even equipment for your office where you can make a zirconia crown the same day. No more temporary crowns.” He wants to sell Levy this product.

Money is tight as always. Or as it always seems. But it’s never really. Nevertheless, this smells faddish, a smell mixing with the more usual dental office odors. The word “harebrained” pops into Levy’s mind, and he remembers something McPherson suggested many years ago. Levy had consulted with his dentist about a night guard to help reduce the effects of his teeth grinding.

McPherson said, “Try going to sleep with your tongue pressing against the back of your top teeth.” It was something he had learned at a recent conference. Levy didn’t really try and got the night guard.

Why am I thinking harebrained now? Levy wonders.

When he tunes back in, McPherson is wrapping up. “Why don’t you try it?”

McPherson and that tooth went back a long way. He’d saved it from Levy’s previous errant dentist. Levy trusted him, but he’s not sure about this.

He decides too quickly, and hopes for the best, “Okay. If you’re so impressed.” He could’ve said, “Let me think about it,” and then done some research. Say, Google “gold versus zirconia crowns.”

Levy returns the next Friday. Bladder full, back hurting, and the grime of the city already clinging to him. He enters the suite full of dental sounds and smells. He stretches out on the dental chair, and Dr. McPherson comes in.

Examining the tooth again, he nods, reiterates, “Yep. There’s that little pin-hole on top of the old crown. That must be what is causing seepage and irritating the tooth.”

Levy doesn’t like the word “seepage.” It sounds like a fistula—things are connected which ought not be. Like an anal fistula where feces seeps out of a crack along the side of the anus rather than directly out the end. Or a toxic, maybe radioactive, sludge seeping through a failing barrier, contaminating the underlying groundwater. There’s lots of that around where Levy lives. Hundreds of poorly-managed and then abandoned uranium mines that metastasized throughout the county during the Cold War.

Shaking off the uranium and anal analogies, Levy chooses to say nothing. His priority is the tooth. But “seepage”? He can’t ignore it: insensitive, oblivious to his and his tooth’s feelings. Maybe he made a mistake not going with gold if McPherson is so out of touch.

The dentist injects what feels like an inordinately large volume of anesthesia around the tooth. In a few minutes, the entire left half of his face is numb and rubbery. McPherson returns, sits down, and takes up position. “Okaaay. Here we go.”

He tries lifting the old crown off with a probe. It doesn’t budge. He approaches it from a different angle. No luck. Putting that probe down on the nearby tray of instruments, he picks up a more substantial tool resembling a tiny crowbar. He and it lean into Levy’s mouth. The pressure is surprising and pulls his lower jaw upward. McPherson’s lost none of his strength, that’s for sure. His stocky arms, beefy fingers. There’s no sign of tremor; he’s rock-solid. He exhales with the success of his effort, then pauses as he looks at what he’s pulled out of Levy’s mouth. The crown and half the tooth with it.

“Man, that crown was really cemented on there. That happens sometimes. Well, it must have been a fracture line that the tooth separated along. No more fracture in that molar!”

He examines carefully the tiny gold and off-white object. “There aren’t any fragments and the tooth looks healthy otherwise. We’ll just fill in that space with the crown.”

Levy’s rattled, shaky, but tries to be lighthearted. “Give me that tooth, would you? Part of the oral history. Ha ha.”

McPherson and his assistant—Leanna?—look doubtful but hand the fragment to him. He slips it into his shirt pocket.

They take the impression and the assistant begins fitting a temporary crown. Levy’s mouth is still thoroughly numb, and she finishes quickly. McPherson doesn’t return. Levy schedules his return appointment for two weeks. As he’s leaving, the assistant says, “Now don’t eat any hard candies, nuts, pretzels. Those kinds of things.”

Levy’s mouth begins waking up on the drive home. The temporary crown feels awkward, oversized. It fits poorly and gives off a bitter sour taste. This must be the flavor of battery acid, he thinks. Pulling up to his house, he searches futilely for the tooth in his pocket. Damn, it must have dropped out. But where?

Sunday morning, chewing half-done toast on the opposite side of his mouth, sipping his first espresso, the temporary crown falls off. The tooth is tender, painful, feels ratty. He calls McPherson’s office the next morning and gets an appointment for that afternoon.

He takes his seat in a treatment room, and McPherson briefly appears and lightly anesthetizes the tooth. Levy’s left with the assistant, whose name he cannot remember. He’s not sure now if she ever told him, and somehow he is not especially interested in finding out.

I’m unsettled, Levy notes. Am I wrong being unsettled?

It’s medically and personally unsettling. Why does McPherson delegate? Doesn’t their two decade-history count? Levy feels not-special and that quickly turns into “neglected” and “unsafe.” He wonders again about his decision to pass on the gold. Maybe I’m being oversensitive, he thinks. I wonder who benefits from the zirconia? Does McPherson get a kickback?

“Were you eating something hard that you weren’t supposed to?” she accuses. Jokingly. Funny.

Defensively, “Some soggy toast.” It’s only a slight misrepresentation. It’s your fault, he wants to say. It was a lousy temporary. It fit terrible.

She mock-rolls her eyes.

Levy can’t tell what she’s doing in his mouth. At first, it’s as if she’s applying grout, reshaping the sawed-off top of the tooth with it. It’s an odd feeling, as if she’s replacing the temporary with putty. That makes no sense. Finally, she turns back to the tray, picks up the aluminum temporary between her thumb and forefinger, and rests it on the tooth. She covers it with gauze.

“Bite down hard on the gauze.”

It’s loose, too big, and digs into the surrounding gum.

“There,” she says. “That should do it. Be careful what you eat.”

“I was.”

Levy limps on the tooth for the next 10 days. It hurts constantly. He limits his diet to smoothies—vegetable or fruit—and Tylenol to 4-6 a day. He could easily take 10-12 but doesn’t want to damage his liver. One evening, Morales comes by for a beer.

Levy says, “It’s just a stupid tooth. I feel like a pussy.”

Morales is sympathetic. “It’s your tooth, man. A painful tooth hurts.”

That’s enough to make Levy feel a little better. Someone who shares his reality. Because of the beer, he skips his normal bedtime Tylenol. No point in giving himself hepatitis.

Even his body worker, Ingrid, senses the disturbance during their next appointment. She lays her hands on his left lower jaw, radiating warmth into it. She adjusts his neck and massages his skull, for nearly 2 hours. He rises from the table. His tooth pulsates.

She says, “I see the swelling in your jaw.”

It’s time to get the zirconia crown. Levy’s jaw throbs as he enters the office. The dental assistant sits him down. He gazes unsteadily through the window toward the little fenced-in lawn east of the office. She takes a probe and with no effort the crown pops off. Ten thousand volts of rotten electricity shoot through the tooth. He screams and almost falls off the chair.

She hurries out to get Dr. McPherson, who arrives quickly. His endogenous cheer barely tempers his own anxiety.

“So, that tooth is pretty tender?”

“Mm hm.”

He numbs it, then returns in a few minutes proudly displaying the lifelike zirconia crown.

“A real beauty, isn’t it?”

It looks like a normal tooth.

He glues it on, takes his tiny hammer and blunt-edged tamper, and taps a few times ceremoniously. He painstakingly smooths off any rough edges. He makes certain it fits perfectly by having Levy bite down on colored foil that shows points of abnormal contact.

“That should settle everything down. Call us if you have any problems.”

“How long do you think it will take before the swelling and pain go away?”

“Three to four days, seven maybe. A week at the most.”

Levy’s nearly ecstatic with hope. Finally, weeks of tooth agony gone in a week! Or less.

It’s a wish, though, and not really an expectation. He knows there’s a problem in his mouth. Driving home, as the anesthesia wears off, the tooth begins to pound. Not surprising, he tells himself. After all, it’s been over two weeks of misery. But those days are over! Be patient.

The zirconia feels like a rock in his mouth. Buyer’s regret immediately sets in. I’m just anxious, he thinks, as he breaks through the palpable yet invisible bubble marking Wheaton’s city limits. “Welcome to the friendliest small town in America” the billboard announces.

A week passes, another 30 Tylenol. Pain interferes with his sleep. He can’t chew on the left side of his mouth. He returns to Phoenix.

The dental assistant sighs as Levy sits down.

“The tough cases always live far away,” she says, as much to herself as to him. As if it were her mouth.

Dr. McPherson enters, his cheer wearing thin.

“Is it throbbing?”

That, being code for “bad.”

Levy nods.

An x-ray is unremarkable; that is, normal.

The crown fits properly, and McPherson files down a fraction of its surface, “just in case.”

Levy asks, “Do you think this has anything to do with the zirconia rather than gold?”

“I don’t think so.”

“What should I do if it doesn’t get better?”

“Give it another few weeks.”

What’s the alternative? Pull it off and replace it with gold? Another two weeks with another poorly-fitting painful temporary? It’s relatively easy to push that prospect out of his mind.

There are good days and bad. Levy’s tooth becomes a spiritual illness as much as a physical one. Maybe he’s being punished. Some kind of karmic retribution.

During his Zen years, Levy studied the works of Dogen. Eihei Dogen (1200-1253) was a Japanese Buddhist monk dissatisfied with his own country’s understanding and practice of Buddhism. He relocated to China where he for many years studied Chan Buddhism with the highest-level teachers he could find. Returning home, he introduced Chan teachings and practice, what later became Japanese Zen.

Dogen described three time-frames for karma—cause and effect, actions and their consequences. There is immediate karma, at the next moment—say, stubbing your toe right after indulging in revenge fantasies. Intermediate karma, days to months later. And long-term, much later, perhaps extending into future lives. Levy always liked this way of thinking about cause and effect. He wonders, now, what have I done that has led to this? Maybe it’s that book review I wrote. The one on Amazon a couple of months ago. If so, it’s intermediate karma.

Levy had written an especially uncharitable critique of a recently-published Bible commentary, of all things. The book was an English annotated translation of Abravanel’s (1437-1508) Genesis commentary. Don Isaac Abravanel was a Spanish royal advisor, rabbi, and philosopher. In his capacity as a financier in King Philip and Queen Isabella’s court, he arranged funding for Columbus’ first expedition to the New World. In his capacity as a Jewish exegete, he composed biblical commentaries that were staunch defenses of traditionalism. His enemies were the “modernists,” those who used traditionalist arguments to promote their iconoclastic agenda. Faced with such opposition, Abravanel laid out formal and meticulous arguments, making tightly-reasoned point after point in his Hebrew writings.

The author of the translation took liberties with Abravanel’s text, removed this or that section which he believed might not hold readers’ attention. Going even further to not to overtax contemporary Bible students, he used a breezy style and modern jargon, both of which detracted from and overpowered Abravanel’s message. Most Amazon reviewers shared Levy’s dim view of the new project.

For Levy, however, the truth was more complex. He resented the book because it revealed his own deficiency in Hebrew. He’s got a 150-year-old Russian edition of Abravanel’s Torah commentary in Hebrew on his bookshelf. It’s one of his library’s treasures. But he can’t read medieval Hebrew, not even modern. One day, he used to think, I’ll write just such an annotated translation of this beautiful book. But, he’s too late. He lost that race.

In Levy’s review, he wrote that the book’s style made him “grit my teeth.”

Aha! That’s it! Levy realizes. It’s “measure for measure.” Punishment reflects the misdeed. It’s like sexual indiscretions leading to diseases of the sexual organs, one of Levy’s favorite examples. Condemning the review with his teeth, Levy suffers through a tooth.

He revises his review and expresses remorse for the tone of the original. He tracks down and apologizes to the author, who is gracious. He agrees that some of Levy’s points are well-taken, while admitting to discomfort at the harsh tone. They exchange several respectful collegial emails and Levy feels forgiven. He’s repented according to the tradition and feels closure. He’s admitted his offense, expressed regret, made amends to the object of his hostility, and asked for forgiveness. The author had forgiven him. Would God? Now, will his tooth feel better?

In the shower that evening, he turns his face into the stream of water. He lays his hands over his eyes and face, looks upward, heavenward as the hot water pours over him. He feels a healing angel touch the tooth.

“Oh, God. Thank you for sending me a healing angel. Finally. My God. You really put me through it this time.” Tears mix with the water. Ground down tooth, gritting his teeth, apologizing. Karma. Reward and punishment.

The next morning, the tooth feels as bad as ever. He returns to McPherson’s office that afternoon. Another 300-mile round trip.

The x-ray shows no sign of infection, no abscess, but the tooth is swollen.

“I think you’ve got pulpitis,” the dentist opines.

Pulpitis. Levy’s never heard of it, but it sounds reasonable. The tooth’s pulp is inflamed and swollen, pressing on nerve fibers supplying the tooth, causing pain.

McPherson says, “I’d like to prescribe a short course of steroids. They’ll reduce the swelling and give the tooth a chance to heal. As long as it’s swollen, the blood supply is restricted.”

Levy has never taken steroids, drugs like prednisone. But his mother had. Many times, for recurrent pneumonia. High doses in the hospital for a few days to reduce lung swelling and inflammation. After returning home, she’d stay on a lower dose for several more months. Prednisone made her happy and easier to relate to. Levy could tell by her tone of voice over the phone what dose she was taking. More than 5 mg and she was chatty, slightly elated, and optimistic. Lower than 2.5 mg and she sounded dull, lethargic, and slightly depressed.

Levy says to McPherson, “Okay,” and adds, “Besides, I could use the mood elevation.”

The only complication is an upcoming trip to Santa Barbara. In 10 days, he’s flying to the West Coast to meet Karen, a woman he’s met on Match.com. A Chinese immigrant who teaches English for the government. They’ve been emailing and Skyping for several months and it was time to meet.

Dr. McPherson and Levy do the math.

McPherson concludes, “You’ll be off steroids for a couple of days before flying.”

If all goes well, the tooth will be good, his mood better than good, and a romantic rendezvous on track. The less optimistic scenario is beclouded. He simultaneously represses and denies any but a rosy outcome.

Levy picks up the “Medrol Dose-pak” at the Wheaton CVS. He recognizes “Medrol.” In solution form, it’s Solu-Medrol, a drug whose name he remembers from medical school. Neurosurgeons used it to reduce brain swelling after strokes or in brain cancer. Everyone—medical students, residents, and attendings—regarded it with fear and awe. It was the nuclear option, leading to bleeding stomach ulcers, psychosis, and malignant hypertension. And don’t forget otherworldly infections due to the drug’s devastating effects on immune function. As Levy recalls, only senior level medical staff could administer it. A chill runs up his spine.

He looks at the package. The initial days’ doses are massive. Then, they taper precipitously over the next week. Giving big doses quickly and getting out just as fast reduces the risk of shutting down your own adrenal production of steroids—another potential catastrophe.

Levy’s tired of the bad tooth, now into its second month. It’s time to feel normal, happy, and healthy again. Within a few days!

Feeling sickly, he takes the first dose. In a few hours, his mood rises; or rather, his mood accelerates and amplifies. It’s not happiness or euphoria, per se. More like a heavy coat of shiny paint over rusty metal.

For the next three days, his tooth hurts less. He eats more easily, but maybe not, as the drug suppresses his appetite. He feels strange, half in and half out of his body. He lowers his Tylenol intake but can’t stop it. The trip to Santa Barbara is approaching. As the steroid dose descends rapidly, Levy’s anxiety rises in equal proportion. Is it because of the steroid or because of its withdrawal? Or is it anticipation of flying to California to meet an internet date? There’s no way to tell.

The night before his planned departure, he meditates on his cushion for an hour, hoping to broaden and deepen his perspective. Instead, terror descends. How can he possibly travel in this condition? Should I cancel the trip? he wonders. I have an excuse, two excuses, maybe three. He writes in his journal, “Don’t go.” I’ll sleep on it, he finally decides.

He dreams. A horror cat sinks its claws into him, all four paws. It attaches itself to one of his hands, the right one. The cat isn’t moving nor letting go, just attached. It hurts, but not more than he thinks it should. After he awakens, he considers how he would have dislodged it. He’d smash it against a rock, as simply pulling it off would be too painful.

He gets up and makes coffee, eats breakfast, and finishes packing his suitcase. He’s scheduled to see McPherson that morning before going to the airport.

On the road, Levy thinks, I’m crazy. What am I doing? Is this right? I must be suffering from some kind of mental disorder. I’m jeopardizing my welfare in full awareness. First the zirconia, which I agreed to too quickly, and now this, a trip to California in a demented and disabled state. I’ve lost my common sense. Maybe I’m dissociating, separating from my own life, my own experience. Apparently I am. Because my welfare isn’t a priority, something else is, something I’m completely unaware of. Besides, Karen would be angry if I canceled.

McPherson says, “I want to save the tooth. If it’s not better before too long, we can do a root canal. That, before an extraction.” Somehow Levy feels reassured. Not by what McPherson says, but how he says it.

As Levy dons his coat and hat, the dentist adds, “By the way, I’ve seen cases where the zirconia is so hard that it traumatizes the underlying tooth.”