Pleasure dome

I’m 24

Funny shaped tap drips without end,
birds no longer sing in this city

I tell myself, I cannot survive much longer

If my view is a saffron robed Pakistani man, hawking up phlegm at 8am, into his dying rhododendron

Despair like me, at these four walls and dirty pipes protruding from beneath singleton sink

Who ever made sinks this size? Sometimes you throw up in them. Other nights you heft your hiney and pee long and shameful

The golden shower of malcontent. I don’t like to share bathrooms with strangers or friends

Poverty and her gifts, laying each day another absence, a reminder, you are in the meat grinder of the city, she waxes her legs on your sharp disappointment

As a kid you thought you’d wrangle diamonds from street corners, the fizz and pop of bright lights luring you to the center, like a Christmas nectarine

Is always spoilt.

In the petting evening, wet lipped men come to the spindly girl upstairs

She has thin shoulders and jagged hips, her eyes are always transparent and high on pyramid crystals

These men grind their dirt into her pretend cries of ecstasy and she gets crisp and filthy notes left on her childhood dresser afterward

I fantasize about asking her, if it has to be men she admits into her sanctum

But I’ve never paid for it and I don’t want to step in their cooling semen

If she knocked on my door and offered a damson breast I may

Break that rule and risk, even in the AIDS era, even as a feminist, even if I can’t afford the powder, her hungry nostrils crave

Just to feel the rub of her emaciated hips and hard thighs against my parched skin

I’d fucking inject it if I could, to take away the feeling of savage loneliness in the big city

That sick feeling, you’re stuck, among landlords and low paying jobs, even at 24

Massaging an ancient electric meter with dirty coins, for a little light showing more dirt

The temptation to let it fade out and lie, door open, legs open, coins in your mouth until blood freezes in your veins.

Come in and pay for me then, what am I worth? What can you fill me with, I haven’t already drunk?

Strange people’s scarfs on universal banisters, the smudge of sex in screwed up foil and old bus tickets

Lift up my hips, ram it in, pay your due, switch poison for love and love for death, welcome to the pleasure dome.

The man in 4b puts his hands down his granddaughters dress but the abuse hotline just rings and rings and rings

There’s a gypsy in 5a, cries for his lost lover til dawn. There’s a 13 year old boy who turns tricks in the street, who asks for bus money and new socks

The flashing lights of the strip club opposite are flamenco pink and penetrate through my squalid curtains, wailing their synthetic dreams

How far will you travel to see the sky again? To touch sand and sea and gulp with fevered breath, the pollen of forgotten worlds, lost in your lust for noise

I think of the Pakistani man and his phlegm, growing flowers from spit

As the Eastern eyed girl sells her small fruit for a ransom and a cry

Breasts like pinches, thin ribs beneath wool, taut ride of her skirt showing little pursed mouths of bruises

Her feet are always bare andlacquered, mine are unwashed and leave imprints of desire outside her door in ring-a-rosies

She wears her tips without a bra, nipples hurting in their push, smoking cheap cigarettes before light, smell of burnt coffee and sex on her chewed neon fingernails

They pay her to keep them hard, I beg her to stay soft

The city is a searching arbor of need and want and ingratitude

At 3am people wander the street for drugs and pain and death in little sealed packets

She leans in the doorway, exhaustion a shroud, touching her bottom lip with a haloed question

I open my mouth and let her in.

To her, and all the men she brings, to 24 years and not a minute more, to the nialism and thready vibrant flowers growing from scorn

Her body is a violated temple, a bingo hall, an arcade game, with multiple slots for change

Her mouth tastes like ashtrays and night clubs and old men, skinny throat a pin cushion of bite marks

I make her sing

As light wakes the rest of the world, all the lost birds hear her call

The Pakistani man admires his flowers and thinks

How beautiful this little piece of color is, here in this metropolis where all are brushed beneath concrete

I brush my hands across her small deflated breasts

Seeing sunlight find its way in between crowded houses filled with sore tenants

Touch her violet tinged skin in patterns, warming her before she awakes.

I’m 24 and she’s 22 and an entire life time, of fag butts and misery, washed down on lines of coke and old men groping for their last fuck

Later on I’ll take her to the coffee shop with the little bell above the door, and we’ll clasp hands beneath the sticky table cloth

Blue rinse ladies in the adjacent seat will remark, on our bright eyes and shining hair

As if we too were born

From the cracks of despair

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Anger

The therapist

she doesn’t look her age, though it wouldn’t matter

she is wise in years and that’s what counts

her skin reminds me of a Swiss lady I knew, she has the color of travel

and I trust her which is all that is needed

she asks me, why I don’t get angry

I think about where my anger has gone

after all I was an angry child

only the other day a friend’s parent reminded me

‘you were a naughty little girl, but I know it was because you were mad’

it feels like she’s talking about someone else

because I have lost my ire

that’s not a good feeling

if I had it back, I imagine

I’d rage through the streets, decrying the bad deeds of an indifferent world

but I sit quietly reading a book and the clock is ticking down the hours I am not

angry

for anger …

can be a severance, a sword, a spike

and we know that

so we tuck it, tightly to sleep

there it lays, sometimes for decades

burning a hole in our placid smile

I know someone who is angry, and they

are a short rocket full of sparks, able to go off at slightest provocation

whilst I, am measured and sensible, like a bad calculation

it gets me nowhere

because I am hurt

deeply by the injustice of little and great things

whoever told me not to be angry, that I didn’t have a right, that it was selfish or

low-brow or just plain bad manners and SHAMEFUL

isn’t here now

and I am, stuck on the wheel of sickness where they like to say

‘isn’t she calm and well adjusted to her own personal brand of hell?’

I thought strength was not letting anger get the upper hand

but i’ve been in a war without any weapons

sometimes anger is better than turning inward or, staying still

it fuels the urge to live

it leaves bruises you remember

I am angry

behind this painted mask and ironed clothes

I am a raging angry woman, with still unbrushed parts

who wants to throw the phone when it rings, out of the window, deliberately breaking glass

I am fury and it is a desire of mine

to scream until my throat is sore and beseech the skies

I am quivering with rage and if I could, I would, throttle the fates

for there is anger inside and though it is buried deep

it has a voice and that voice says

why me? why me?

(Not meant self pityingly, rather, a hard truth.)

A room with a view

ERSignWhen I was finally hospitalized, the nurse apologized profusely to me; “I’m sorry Ms. Daquin, but none of our rooms have a view.” I laughed as much as anyone who has been throwing up for 24 hours can laugh and when asked what was so funny, replied; “As long as it’s in the hospital you could put me in the broom closet and I’d be content.” The nurse must have thought it was a quaint European joke and she didn’t ask for me to clarify what I meant. Had she asked I would have told her; “When you are starving you’ll eat anything.” And this would have been the perfect explanation for my immense relief at being hospitalized AT LONG LAST. A few months previously I would never have imagined I could have wished to be put in hospital, let alone beg to be. This is the story of how that came to be.

Before I rampage against American healthcare systems, let me preface by saying having lived in other countries, it’s not a singular flaw but a worldwide flaw. There is one reason for this and it is this. PROFIT over COMPASSION.

It is true, we cannot go back to the ‘village days’ of doctors who work out of the goodness of their hearts and do not expect to become rich. That ship has sailed. Doctor’s today go through years of expensive training and expect adequate compensation, perhaps without this they would not be motivated to endure those years of rigor. This is one reason costs go up, quality of care down, and patients are often kicked to the curb in terms of continuous and good care, few people have it in them to become doctors and with a growing population, those who do, are tempted to compensate for arduous training by charging high fees. The other huge elephant in the room, the real problem, is the insurance industry, which has ruined the system so thoroughly there may never be a fix, irrespective of whether doctors over-charge.

Okay enough with the negatives … problem being are there any positives in healthcare today?

Certainly not where mental health is concerned. Anyone who has had a mental health crisis can attest to the stigma, lack of care, and inadequate diagnosis, not to mention penchant for over-medicating (or under-medicating) and error.

Unfortunately the same may often apply when you go through the healthcare system for physical illnesses, especially via the ER. I preface this by saying I am infinitely grateful that I had ‘some’ healthcare insurance at all, for surely having none unless you are on public assistance, can be even more terrifying (and I had 14 years of that).

My ordeal began a little over three months ago. A violently ill day out of the blue. You think to yourself; “It will be okay I’m just sick, maybe food poisoning. IT WILL PASS.”

Famous last words ….

The illness did not pass. Days of throwing up and all the rest, led to my first ever ER visit, then my second, then my third  and so it went on. One thing marked these experiences aside a dizzying variety of ‘opinions’ based upon no evidence and seemingly at whim. The thing marking those ER visits was the current healthcare’s notion that most diagnosis and treatments should be out-patient.

Until just recently I would not have even considered this. Is it right to make most healthcare on an out-patient basis? I may even have said; “Yes, because of diseases the more you can avoid hospital the better, it’s a modern approach of out-sourcing and enabling you to get diagnosed without having to spend days in a hospital bed.”

Made sense to me. Until, throwing up for weeks on end, nausea 24/7 and we’re talking “Super Nausea” the kind you couldn’t even describe accurately if you tried, I realized that I might actually end up dying at home.

It isn’t as hard as you think to get REALLY sick, REALLY fast. And in my humble estimate, when you get that sick if you are anything like me, you don’t want to be at home. You are scared, unsure of what is going on, violently unwell and you want to be in hospital. Yet every time I would go to ER, shaking, unsteady, sick and scared, I would be given basic treatment and told to follow-up with my specialist.

And sent home. Where not long after the medication wore off, I would get sick again and soon enough, end right back in ER.

During this time I thought of my grandparents, visiting them when they were in hospital, maybe for appendicitis, something like that, bringing grapes and flowers. It felt so comforting. I envied them the ABILITY to be in hospital. Apparently it was a modern-day luxury to be admitted these days.

There are times, continuity of care in the ER system needs see the bigger picture. If a patient repeatedly comes into the ER (at great expense I may add) it makes more sense to hospitalize that patient and DO THE TESTS THEN AND THERE than ask that they continue to follow-up with their specialist. Whilst having the specialist in the loop, the critical nature of such experiences requires for the patients sanity that their symptoms be addressed in a more direct manner as used to be the case before hospitalization fell out of vogue.

Seeing a specialist may sound wonderful, but what if they can’t see you for a month? Or you have to wait in a waiting room for 3 hours? And you’re throwing up? Or you can’t even make your appointment because you can’t ride in a car without vomiting every three seconds? There are times that out-patient services FAIL very sick patients and only exacerbate the STRESS for everyone involved. If a patient is very sick and cannot drive themselves or obtain a ride? If a patient has gone to the ER and misses that appointment?

I longed for someone to say; “You are VERY ill we’ll admit you and find out what is going on” but instead, I was released, released, released, paid a fortune in ER visits, got the basics done lots of times without any progression, and waited for days to see specialists who then tested me, and released me to await the results. Days, weeks passed, the sickness continued, my weight fell off me, doctors asked if I was anorexic, appointments were made, and I felt I was part of a nightmare.

Eventually EVENTUALLY when I was so sick it was impossible to turn me away, I was admitted. And in that admission I was tested and given a diagnosis and some kind of ANSWER for what ailed me. But this did not in any way appease the weeks (by this time, months) of extreme anxiety and feeling that I had absolutely nowhere to turn.

If you cannot turn to a hospital by way of an ER during your darkest moments of health then something is VERY wrong. It is absolutely terrifying to feel that you are incredibly sick and nobody is willing to say; “I will help you.” Instead, you are at the whim of the system which profits each specialist and mires progress to a crawl, causing an illness to become a trauma from which it is very hard to recover.

In essence I say this. Bring back hospitals. The kind we recall from childhood, where if you were really sick they would take you into a ward or room and doctors would come and examine you and answers would be given, and even if that didn’t happen over-night, you were not left being sent home desperately sick without answers, and without the succor of the medical world.

When you are very sick, sometimes the only thing you can cling onto is the reassurance that someone in the medical field will be able to help you, that you will not die alone on your bathroom floor, that you are safe. The anxiety of a serious illness cannot be underestimated, until you have experienced it, you may know logically that it is unsettling but not really comprehend the terror you can feel when something is very wrong and doesn’t stop. Be it pain, throwing-up or nausea, we are not trained to cope well with either the unknown or the unstoppable. It is the purpose of medicine as much to support as to ‘cure’ and this should include better options of hospitalization for those who do not fit the ‘recently amputated limb’ category of emergency.

I fully appreciate that with our burgeoning population, what was possible in 1950, or 1970 is not possible today. There are simply too many people. But if you look at the sheer waste of resources of repeat ‘visits’ to the ER, as well as unnecessary repeat tests, and the danger of some of those tests being repeated, it become apparent that it is ineffective to triage very sick patients without an option for hospitalization. In a sense a ‘one shop’ approach rather than our current plethora of experts, all in swish offices with highly expensive over-heads.

Most hospitals today in the US are quite grand by my European standards and yet, I would give anything for an antiquated ward if it meant receiving constant care in crisis, over pretty looking ER’s that offer little by way of comfort.

I admire anyone who works in the healthcare industry and this is no indictment of their tireless efforts, nor underappreciating the reality of modern-day-medicine, and the ‘frequent flyer’ type of ER patient who comes in regularly and to some extent, cries wolf. Maybe there is no fix, or way of discerning the patient who simply wants in, versus the patient who really needs to be, but something has to change.

Faced with mounting debt because of the number of cries for help which in effect a visit to the ER represents, I look back on the early part of this crisis with dismay, wondering what I could have done differently. Maybe if I panicked less? If I were braver? If I had been able to do more research? (Perhaps in between throwing up constantly and not having any energy). And yet, I must also hold the system accountable, because I feel both grateful and yet, that it failed me.

How did it fail me? One ER hospitalization relatively early on, based upon serious, ongoing symptomatology, and tests done during this hospitalization, may not only have gotten answers two months earlier, but avoided the trauma that I now unwillingly associate with this illness, exacerbated not only by the actual illness, but the experience of feeling completely helpless, without anyone to turn to.

A word to the wise, if I learned anything, I learned the value and importance of a VERY proactive PCP. I did not have one. Mine was kind, friendly and completely unprepared for helping her patient navigate quickly through the system. A proactive PCP can go a long way to cutting through some of the things you will not be familiar with, they can have you hospitalized if they know how to circumvent some of the bureaucratic red-tape insurance companies put up.

Additionally, have an advocate, someone who can speak for you, because when you are severely sick it is less likely you will convey all that you wish to convey effectively. An advocate may be the difference between ensuring doctors understand the severity of your illness and not. It takes some of the stress off you during a very stressful time and can avoid being at the whim of unresponsive doctors who are coming off a long shift.

I’m hopefully on the path to healing. At least that is what I have chosen to believe and much of getting well is attitude and focus. Just as I was traumatized by not having any support during the hardest time of my life, I am reminded that so much of ‘wellness’ is our will to be well. We cannot control very much in our lives, and nevermore is this true than when we are sick, but we can try our hardest to overcome burdens when they strike, and stay positive, because without that the journey is too hard.

The medical world should encourage this positive faith and hope, rather than strike it down with incompetency and bad protocols. Sometimes a sick person really does need, more than anything else, a room with a view.