Wednesday, December 17, 2014

Ham on Rye

            Every morning, my commute to work is a strategic one. I rush to the very edge of the platform, shoving aside tourists who aimlessly congregate in the center. They’re too busy relishing in the newfound joys of foreign public transportation to realize that the platform is middle-heavy. The person-to-cart ratio is like a parabola—the two opposite ends have less exasperated humans competing for empty seats in their section—it’s quite mathematic. If I’m getting on a subway car, I’m getting a goddamn seat. This is partially because I thoroughly enjoy my subway-reading ritual, and I cannot fully become engrossed in a book if a stranger’s armpit looms five inches away from my face. It is also because I am astoundingly lazy.
           
            On this particular morning, as I’m embarking on a new novel-journey with Charles Bukowski’s Ham on Rye*, some brilliant fellow passenger decides it would be acceptable to engage in small talk with me. Am I the only one who thinks that reading a book is the visual equivalent of having headphones in your ears and listening to music? Don’t speak to me. You are being rude while pretending to be nice, which makes you even more ill mannered. The exemption to this rule is if you are a young, good-looking male, asking me pointed questions about the book I’m reading. Or if you are Jake Gyllenhaal and you happen to be sitting next to me, in which case you can do whatever you please. ~Jake Gyllenhaal and the subway~*

            Thankfully, the monster got off on the next stop and I was allowed to begin this beautiful book. I personally prefer pastrami on rye, but to each his own—Bukowski was never one to follow the crowd, after all. His extensive list of literary publications ranges from short poems to full-blown novels, and his semi-autobiographical pieces often portray him in a loner light. This novel is no exception. Using the pseudonym Henry Chinaski, it is an unapologetic account of his blighted path from childhood to young adulthood, growing up in Los Angeles during the Great Depression. Fun times! Often the brunt of physical fights and the poster-boy for athletic disappointment, Chinaski is denounced by the majority of his peers as a renegade from the “mainstream”. In fact, he enjoys being alone; when boys do latch themselves on to him, their company is unwelcome and he feels that they embody a weakness that he does not wish to be associated with.  For instance, in response to an English class assignment on “The Value of Friendship”, he writes an essay titled “The Value of No Friendship At All”, which triumphantly receives a “D” (Bukowski, 161). He simply prefers to operate independently, and this brutally honest predilection contributes to the misconstrual of his character.

            The novel centers on violence and bitterness, directed towards both his classmates and family. His father is a truly awful man who mercilessly beats him with a razor strop for things as trivial as missing a blade of grass while mowing. I honestly thought—and actually hoped—that at some point Chinaski would murder his soulless dad. I love noting whom the author dedicates his/her book to and pondering why they are the chosen one(s). In this case, Bukowski says his novel is “for all the fathers”… as in, this book is a how-to for dads who strive to be dicks.

As he ages, Chinaski’s antisocial tendencies amplify and he is consistently hostile in his interactions with others. He has an obsession with possessing a “badness” related to being a man, which results in a douchey, goon-like overcompensation. For example, he tries to get the most demerits at school, drinks himself to oblivion on a regular basis, and arbitrarily picks fights with boys who can clearly beat his ass. God, I am so thankful that I am a woman. Still, the range of the novel is intentional—while he is not the most likeable guy, readers are sympathetic to his rocky past and joyless upbringing.

To cope with life, Chinaski finds solace in reading and writing…and that’s pretty much it. He claims, “Words were things that could make your mind hum. If you read them and let yourself feel the magic, you could live without pain, with hope, no matter what happened to you” (Bukowski, 152). Not only were his novels a form of much-needed therapy, he could also look up to the authors for guidance, reassurance, and relatability. He states, “To me, these men who had come into my life from nowhere were my only chance. They were the only voices that spoke to me” (Bukowski, 152). He appreciates books that don’t bullshit (and then he turns around and writes some non-bullshitting books himself).

            Speaking of bullshit, Chinaski thinks people are full of it. Ham on Rye is a coming-of-age novel set in a hardship-ridden time when you wouldn’t want to be any age at all, much less have to navigate potential career-paths and figure out women. Of course he’s angst-y! Chinaski is basically a less annoying version of Holden Caulfield from The Catcher in the Rye, mainly in that he communicates his cynicism in a more focused way. He believes that finding a job is essentially a forced choosing between the lesser of multiple evils. Ruminating on this dilemma, he admits, “I had no interest in anything. I had no idea how I was going to escape… But there was no place to go. Suicide? Jesus Christ, just more work. I felt like sleeping for five years but they wouldn’t let me” (Bukowski, 175). Yet as he delves deeper into this desire for nothingness in a meaningless world, he discovers an obscure sense of superiority. “The life of the sane, average man was dull, worse than death” and he’d rather reason realistically than pretend that everything is fine (Bukowski, 274). Life is not always Chili’s and rainbows, unfortunately, but better to face the facts than act like one of Caulfield’s “phonies”.

            This novel is a good book to throw open when you feel bad about yourself and you don’t want a fake, hearty slap on the back and a bogus encouragement that things will get better. Instead, you want someone to sit down next to you at the bar, hand you a drink, and agree that things suck. Furthermore, Bukoswki keeps things interesting with his acerbic wit. Like when he discusses the draft, saying, “as for me, I had no desire to go to war to protect the life I had or what future I might have…with Hitler around, maybe I’d even get a piece of ass now and then and more than a week allowance” (Bukowski, 236). Nothing like a Hitler joke to really confirm your lack of national pride. Overall, Ham on Rye receives 4 out of 5 camel humps. The content is entertaining and hauntingly genuine, but there are moments when Bukowski’s unrestrained vulgarity is a tad bit overboard for my taste. Every book needs a little boorishness to spice it up, but it burns my mouth a little too much to earn the full five humps.

*Bukowski, Charles. Ham on Rye. New York: HarperCollins Publishers, 1982. Print.


*Yakas, Ben. “Photo: Everyone in NYC Has Sat Next To Jake Gyllenhaal On The Subway.” Gothamist: Arts & Entertainment., 21 Nov. 2014. Web. 17 Dec. 2014.

Wednesday, December 10, 2014

Brain on Fire: My Month of Madness


Anti-NMDA receptor encephalitis. Now that’s not something you hear every day. Healthcare gurus can move on, but listen up laymen! Humans have something called a blood-brain barrier, which selectively determines what is allowed to pass from our blood to our brain juice. Picture Gandalf wielding a staff and yelling, “YOU CAN NOT PASS” at unsuspecting molecules. Or Gretchen Wieners from Mean Girls snapping, “You can’t sit with us!” Just substitute “sit” with “swim in extracellular fluid”. 


          
         For the most part, the lymphocytes that comprise our immune system do not have their names on the bouncer’s list and are not allowed into the brain juice; however, on days when the barrier is feeling especially cheerful, he lets a few B-cells and T-cells mosey inside for a routine checkup. For reasons unclear to people more medically competent than me, Susannah Cahalan’s lymphocytes decided to squeeze past the blood-brain barrier without permission and stage a coup d’├ętat. Her immune system handled the situation like an evil dictator who decides that if he’s going to be destroyed, everything else might as well go down in flames alongside him. It created an army of pathologic autoantibodies—proteins which assault the body’s healthy cells. In Susannah’s case, these autoantibodies started to attack her NMDA receptors, which are responsible for overseeing important operations like memory and neuroplasticity. Justifiably angry, her brain became enormously inflamed, and formerly functioning synaptic connections went completely haywire. Her lymphocytes had crashed her brain’s party, lit a bunch of candles to set the mood, and then knocked them all over the place, leaving her brain on fire. Symptoms of this disease include, but are not limited to: paranoia, psychosis, catatonia, violent episodes, seizures, speech difficulties, and a myriad of cognitive impairments. Susannah Cahalan, the author of Brain on Fire*, and survivor of this debilitating disease, exhibited all of the above. Casual.

The autobiography is split into three, equally mesmerizing sections. The first, “Crazy”, details her out-of-the-blue physical and mental deterioration. At one moment, she is an ambitious extrovert, working as a successful reporter for the New York Post. The next, she is plagued by paranoid delusions and holds a tenuous grasp on reality. Multiple feeble diagnoses are thrown at her in an attempt to explain her sudden capriciousness, none of which fit the bill. Her case is extraordinarily inexact and, in her twisted state of mind, she is not the most accommodating patient. She repeatedly tries to escape from the hospital, convinced that the medical personnel are trying to hurt her rather than help. At one point, she punches a nurse in her fury; at another, she randomly rips her IV out of her arm mid-insertion.

The second chapter, “The Clock”, introduces a new doctor—a highly esteemed neurologist who makes her life-saving diagnosis. As Susannah’s mother says, Dr. Najjar is “a real-life Dr. House” (Cahalan, 136). Note: he is not nearly as sexy as Hugh Laurie. While having a name for her disease and being able to react in accordance is certainly a positive thing, it does not eliminate her suffering. To confirm the diagnosis, she has two spinal taps and a brain biopsy (a brain biopsy?!?). To combat the sickness—throw some water on the flames, if you will—she is put on an aggressive treatment regimen involving steroids (with numerous side effects), lengthy infusions to correct her immune deficiencies, and plasmapheresis (a fancy way of saying that her bad plasma is replaced with good plasma). Furthermore, the implications of her illness are largely unclear. Though there is finally a face to her diabolical disease, the journey afterward is quite uncertain. After all, in the spring of 2009, she was only the 217th person to ever be diagnosed with anti-NMDA receptor encephalitis (Cahalan, 226). There was not even a Wikipedia page for her disease at the time (Cahalan, 207)! How the hell did anyone learn about it? Dr. Najjar estimates that “90 percent of people suffering from this disease during the time when [she] was treated in 2009 went undiagnosed” (Cahalan, 223). How many thousands of people were incorrectly labeled with a mental illness when the underlying problem was immunological and potentially reversible? She had the luxury of financial resources, familial support, access to exceptional practitioners, and a stroke of timely luck. Just a few years prior to the onset of her symptoms, developments at a lab at the University of Pennsylvania made her definitive diagnosis possible.

The final portion, “In Search of Lost Time”, follows her discharge and subsequent maneuvering of post-hospitalization obstacles. Her cognitive deficits proved especially tough to overcome and she repeatedly scored in the “borderline impaired range” on multiple tests (Cahalan, 191). Susannah was deeply aware of the fact that her previously sharp mental skills were no longer up to par, which exacerbated the humiliation she already felt in social situations due to her altered appearance. You don’t waltz out of the hospital after such a traumatic event looking like a Victoria’s Secret model. For months, her self-worth was shattered. Her disease had been mildly publicized, but few people knew the details of her illness or appreciated the intricacies of her sufferings.

Throughout it all, in spite of the madness, spurts of the old Susannah would sporadically surface, giving her family and boyfriend hope that the real her was shoved down in there somewhere, capable of reemerging. When she was admitted to the hospital following a slew of seizures, her loved ones had no idea what the outcome would be. Yet, they remained incredibly loyal to her in her time of need. Her boyfriend, Stephen, is the man. I mean, they had only been dating for four months before her psychotic breakdown erupted.  During the recovery process, Susannah questioned why he had so solidly stood by her side. His response? “Because I love you, and I wanted to, and I knew you were in there” (Cahalan, 184). Someone get Ryan Gosling in here and let’s make a Nicholas Spark film…this is too good (I later discovered that a theatrical adaptation is in fact underway, produced by Charlize Theron and starring Dakota Fanning)*. Honorable mention to her mom and dad, who were also awesome at coping with the situation at hand.

Susannah recuperated from her tragic, and nearly deadly, circumstance like a total rockstar. It is unfathomable to me how she managed to move from: mysterious psychotic affliction >>> similarly cryptic diagnosis that completely wrecked her cognitive abilities >>> best-selling author. My first year of college, I was in and out of the university hospital for a couple of months with a kidney problem that left doctors puzzled. At one point, I was told I had lupus; at another, I was informed that I would need to be put on dialysis. Thankfully, I ended up healthily strutting out of there with a dual middle finger to my kidneys for succumbing to some rando virus. It was terrifying at the time, but it has become the brunt of many kidney donation jokes and I like having those in my comedic arsenal. Sure, I was upset at the prospect of lupus ruining my ability to tan, but I was not losing my goddamn mind. Susannah was on the verge of being institutionalized. Everything was falling apart for her! “The mind is like a circuit of Christmas tree lights. When the brain works well, all of the lights twinkle brilliantly, and it’s adaptable enough that, often, even if one bulb goes out, the rest will still shine on. But depending on where the damage is, sometimes that one blown bulb can make the whole strand go dark” (Cahalan, 83).

She also happens to be a phenomenal writer. Not entirely surprising coming from an accomplished journalist, but still. I was beyond impressed with her harrowing recollection; she articulated her emotional rollercoaster in a manner that made me feel like I had experienced it with her. Furthermore, she is stunningly adept at translating complex neurological processes in digestible terms. You can tell she did her research. She is the poster-girl for advocating an idea that I have argued for for quite some time—the necessity of cooperation among psychological, neurological, and immunological sciences (Cahalan, 225). You can have all sorts of capable doctors assisting with your case, but the real profundity occurs when different fields are working in unison.

Between her riveting story and her captivating writing, I give this autobiography 5 out of 5 camel humps. Tell me you don’t like this book and I will tell you that you don’t have a heart. Her struggle is incredibly moving, the response to her aberrant brain is humbling, and her ability to rise above such a helpless situation brings me joy. The book was so spellbinding that I finished all 250 pages of it in less than 29 hours. This is a testament to the author’s allure as well as the fact that I clearly have no life. I gobbled this book up like I did with Gone Girl, except this time I was actually learning about something valuable rather than eagerly reading about a malevolent bitch. I recommend this to anyone and everyone who has a soul and wants to learn a little bit about how your brain can screw you over.

*Cahalan, Susannah. Brain on Fire. New York: Free Press, 2012. Print.

*“Brain on Fire.” The Internet Movie Database. IMDb.com, Inc, n.d. Web. 10 Dec. 2014. < http://www.imdb.com/title/tt3704700/>.