The art of losing isn't hard to master;
so many things seem filled with the intent
to be lost that their loss is no disaster.

From "One Art" by Elizabeth Bishop


So, I had this toothache. It was in a tooth that I knew had a cavity. I knew there was a cavity because the last time I went to a dentist, which was about eight years ago, I had noticed a dark spot on my lower right molar. I noticed it because I am the type of person who compulsively looks in mirrors and inspects everything. Everything. I opened my mouth wide to check out the fillings in the back teeth, and I noticed a spot on one tooth, and I mentioned it to the dentist and he goes, “What, this?”* And at the time, it wasn’t even enough of a spot to call it a cavity, so he just said be sure you brush good, and it’ll be fine, and he suggested that perhaps I should tone down the self-inspections.

Which would’ve been fine, right? Except that this was my last dental checkup before going off to college, and though I’m ashamed to admit it, there were many nights when I drunkenly went to bed without brushing, and many mornings when I stumbled out of bed just barely in time to make it to class, and several other times when I mostly just failed to care because I was 18 or 19 and figured my teeth weren’t going anywhere. And for a while, they weren’t, until I was long past my college partying days, making a sincere effort to brush at least once a day, and getting regular medical checkups. The little spot on that back tooth had grown. I was still in the habit of checking out those back teeth. It had developed into the habit of looking mournfully in the mirror, knowing that eventually I’d have to make a dental appointment to get that filled, and wondering how complicated the insurance was going to be. Foolishly, I waited. It didn’t hurt. No need to go to a doctor for something that doesn’t hurt, right?

But then, one day it did hurt. Something was stuck in it. I gave it a good brushing, rinsed with salt water, and it stopped hurting for a couple days, but it started again. I went through this cycle for a few days until it became clear that I would need to see a dentist.

Appointment One:

After calling my insurance company to verify that I did indeed have dental coverage with a $5 copay for office visits, I had the company fax my insurance information over to the only dental office in town that (a) had openings and (b) accepted the particular insurance plan I had. Obviously, when everyone else in town is telling you they can’t get you an appointment until the end of next month and this office says, “Well, I have several openings this week,” you should consider whether you could stand to wait a month. But when there’s a crater in your molar and you find yourself compulsively picking things out of it with the aid of various improvised tools (tooth pick, paper clip, safety pin, earring hook), waiting a solid month just doesn’t feel like an option.

But when I arrived for my appointment, it wasn’t to get a filling or even have a tooth pulled. Since the tooth was not actively hurting at that moment (I had successfully rinsed all the food bits out of it for several days in a row), they gave me a cleaning. A good, 45 minute scrubbing, a painful scrubbing, too. And when I told the hygienist I hadn’t seen a dentist in eight years, she said she’d have to split my cleaning into two visits because there was “so much tartar build up that we won’t be able to get it all in one visit.” Oh, but your insurance will only pay for this type of visit once every six months, and we really can’t wait six months for this, so lets try and get you back in a couple weeks. That’ll be $75 today (you get the discounted rate), and you just pay your $5 copay next time. Oh, yes, I know it’s an unexpected expense and everyone is under pressure in this economy, but this is an investment in your health. You really need this, and you’ll be glad once you’re done. Granted, it’s completely your call. We could just do everything we can for now and then see you back for another regular cleaning in six months, but you will look sortof pathetic if you admit to being bothered by this unexpected yet entirely manageable expense. No pressure, of course.

All this was explained to me as I sat in the dentist’s chair, feet in the air, with what amounted to a small, sharp-edged, dual-action, vibrator-sprinkler jammed into the crevices between my teeth. This went on for 30 minutes before I found myself very briefly the object of attention of one Dr. B, who looked and sounded frighteningly like Ben Stein but with whiter hair and an eerily younger face. He glanced at me, then at my x-ray, made scraping noises with metal objects in my mouth, and told me I would need a root canal. Oh, and those wisdom teeth? They’ll probably need to come out (even though your dentist back home said to leave them alone as long as they’re not bothering you, and they aren’t). But we can talk about that later. After the root canal. For now, give her a treatment plan and schedule a root canal, and I’m out of here because I am a busy man, and it’s not my fault you didn’t brush your teeth enough in college, ya floozy.

Appointment Two:

My tooth started to hurt again, even when I brushed, and using my improvised cleaning tools didn’t help, either. I was rinsing with Listerine several times a day. When the small bottle I carried in my purse ran out, I stopped by Walgreens on the way home from work one day and couldn’t stop myself from taking a swig in the parking lot. Immediately I was confronted with the problem: Where to spit? I couldn’t just lean out the window in rush hour traffic and spit on a neighboring vehicle. I couldn’t open the door and spit on the ground and risk looking like a drunk or a tobacco chewer or both. So, I wedged the full Listerine bottle between my thighs, removed the cup/cap, and spit into it. I drove very carefully the rest of the way home, breaking gently, slowing to a crawl to go over the speed bumps, and merging ever-so-politely in order to avoid upsetting the shot glass of spit and mouthwash that was threatening to ruin my pride and the upholstery of my car.

I called the dentist the next day.

“I have an appointment for a root canal, but I want to know if I can come in sooner. My tooth is really hurting.”

“You don’t have an appointment for a root canal. Your appointment is for a cleaning. You have to go to the other side of the office to make an appointment with the doctor.”

“No one told me that. I thought I was making an appointment for my root canal.”

“Nope. But I can get you in for a root canal … next week?”

“Well, no one told me that was an option. I really need to think about this, but let me make the appointment now, and I’ll at least get to talk to the doctor when I go in.”

I made a lunch time appointment because I don’t like to take time off work when I can avoid it, and they didn’t have any evening appointments available soon enough. In the interim, I sought advice from people I knew who’d had root canals. Everyone seemed to think it’s best to save the tooth if you can, I chose to proceed with the root canal rather than extract the tooth. I arrived early for my 11 a.m. appointment but sat in the waiting room until 11:15 anyway. By the time I reached the dentist’s chair,  I had made up my mind that I was there to have a root canal. I told Dr. B as much, he administered anesthesia, and began drilling away. The procedure was painless, Dr. B put a temporary filling in my tooth and told me to schedule the second half of the root canal at the front desk.

At the front desk, the receptionist told me I didn’t owe anything since the procedure wasn’t finished yet, however the total cost would be $580 at the end of the next appointment. What happened to the $5 copay? my inner voice screamed, but all I could say was, “They didn’t tell me that.” Then the tears began to flow. An old man who had been sitting the waiting room across from me earlier appeared to smirk at my tears as the receptionist said something about a treatment plan — the treatment plan, yes, that was supposed to explain what was involved in this root canal business. That was supposed to explain all the costs. What happened to the treatment plan? I never got a copy.

I put down $50 that day, left the office sobbing, and left my husband a voice mail in which I could only choke out the words, “Hey, it’s me. I need you to call me, okay?” He called me 30 minutes later, afraid I’d been too drugged to drive back to the office. I did drive, though. I stopped off at Smoothie King to get a liquid lunch, and as I sat in my car, in the rain, in the parking lot,  I struggled to get it together enough to go inside and order a medium Angel Food. I stopped crying and heaving hysterical sighs long enough to get inside, but before I could order, I realized my wallet was missing. I ran out to the car, got the wallet, and came back. The other customers applauded, but one woman looked at me and saw how distressed I was.

“You have too much going on,” she said. “You just need to slow down.” I took a deep breath, nodded, and tried not to cry.

“Are you ok?” She said.

I nodded.

“Do you want a hug?”

I nodded again.

She walked right up and hugged me.

“Ah jeeze,” I said. “I’m really going crazy. I’m hugging a complete stranger … but that’s OK.”

“I’m not a stranger. My name is Tanya.”

Tanya was amazing. She gave me hope. She told me to take care of myself. Don’t make myself sick. She had been a victim of sickness, she said. She was diagnosed with breast cancer just a few months before losing her job. She was living off savings, and she would have her last radiation treatment in a few more days.

“You’re amazing,” I sobbed. “I want you to get better.”

“I am better,” she said. “I have claimed my healing.”

I couldn’t believe I was crying over a root canal. I didn’t tell her. I thanked her profusely and went back to work with a sinus headache (the inevitable result of crying). I tried to tough it out through the day but ended up going home at 4 p.m., at which point I slept, whined, and apologized to my husband for being a burden. The only food I managed to stomach that evening was about four spoonfulls of some kind of mediocre soup and a slice of a baguette.

Appointments Three and Four:

At appointment three, I received the second half of my cleaning, which was far less painful than the first. It was unremarkable.

By appointment four, I had figured out that my extreme emotional reaction was more likely due to the anesthesia than being told the cost of the root canal. I knew I could afford the procedure, even though it was an unexpected an inconvenient expense, so it had to be the drugs. Not to mention that loss of appetite is not at all how I normally cope with bad news. I asked to be treated with a different type of anesthesia if possible. The doctor’s assistant explained that the usual anesthesia actually contains adrenaline, which causes some people to have nervous reactions. Only then did I realize exactly how bad for me that particular anesthesia had been — we’re talking about someone with an anxiety problem, panic attacks, and trouble spending extended periods in groups of people — even if those people are close friends and family. Giving me an extra dose of adrenaline before telling me I owe nearly $600 just doesn’t go over well.

As I sat in the chair pondering all this, the doctor and his assistant prepared and administered a different kind of anesthesia, one which they said was slightly less potent and might wear off more quickly (not a problem, I figured, since the last one had left me numb for much of the day). I few needles to the jaw later, I was numb and just waiting to get the drilling done. Perhaps they didn’t realize how quickly the drugs took effect because Dr. B walked away for a good ten minutes, and in the mean time, my face got droopy, and his assistant remembered something.

“Oh, has anyone given you one of these yet? She said, handing me a form.”

“No, what’s this?”

“This is just a release form giving us permission to do the root canal.”

Should I have stopped her at this point? Should I have protested? Should I have said, “What the hell? You already started the root canal last time I was here. You didn’t give me a treatment plan, didn’t tell me what was involved, didn’t tell me how much it would cost, gave me drugs I wasn’t prepared to cope with, drilled the center out of my tooth and suckered me into a long, drawn-out, multi-visit process, and NOW you’re giving me a release form?” Yeah. I probably should’ve said that. But I didn’t. I signed the form and let them drill into my tooth again because realistically, what dentist would take a patient who was half way through a root canal someone else started? Then they strapped a humiliating device on my mouth. It involved a rubber sheet and something like an old-fashioned head-gear, and I couldn’t stop the mental images of disturbing pseudo-medical porn from flooding my brain. I stared into the blindingly bright light overhead, and decided I would need to see a different dentist as soon as humanly possible.

As the anesthesia wore off, I began to twitch and squirm, and eventually even to moan and jerk away from Dr. B, who administered more anesthesia and soldiered on. Still, he was unable to finish the root canal. I learned later that it was at least in part due to the fact that the root of my tooth formed a 90 degree angle at the bottom, which made it particularly hard to drill. Had I known this earlier, I might have chosen to save myself the pain and extract the tooth right off the bat. But there I was: tooth drilled, root canal nearly finished, thinking if I could just finish this mess, I would reward myself at the end by finding a better dentist. Knowing that at least another $700 in dental fees lay ahead, I paid what was left of my nearly $600 root canal bill although the procedure wasn’t finished. This would allow me to space out the payments and make the $700 seem slightly less painful when it came due.

Appointment Five:

I made my appointment to finish the root canal and to start to post-core and crown process, and in the mean time, I sought out recommendations of dentists. I explored every possible option, and I even considered flying home to Louisiana to see a dentist I trust so I could end this charade with the local dental office once and for all. But within a week, the tooth broke. I swear to God, I was following all the rules, but there you go. The side chipped right off while I was eating French fries, and I must’ve swallowed it by accident. It left the temporary filling exposed. I called the dental office, which was closed. The answering service woman explained that the dentist on call doesn’t respond to anything after 11 p.m., and as it was 11:15, I could choose to either go to the emergency room or just wait until the following morning. I wasn’t bleeding out, so I chose to wait. As I lay in bed that night, I coached myself on what to say the next day. I would tell them to pull the tooth. I would never go back. I would find a new dentist. And if anyone tried to make me feel bad about removing the tooth, I would tell them, “I’ve lost more important things than this tooth.” Silently, I enumerated the many things I’ve lost.

It was the Wednesday morning before Thanksgiving, and I got a 9:15 appointment with a Dr. M. I was expecting another Ben Stein look alike but was surprised to meet a young female dentist not much older than myself. She had a brunette bob with near-blond highlights. It was apparent that she put some effort into her make up that morning. She looked like someone my age who I wouldn’t be likely to be friends with because we had nothing in common even though she was, by all accounts, a really nice person. She didn’t look like a dentist. She didn’t look like Ben Stein. I had a brief feminist experience in which I came face-to-face with my own ingrained sexism as I realized I wasn’t 100% confident in this young, attractive, friendly and well made-up female dentist. I made a conscious decision to trust her because (a) at least she was nicer than Dr. B, (b) she was my only hope to get rid of this damned tooth, and (c) I needed to get over that sexist bullshit because I wouldn’t have let anyone else get away with saying the same things I was thinking. Be the change you want to see and all that.

Dr. M took a look at my tooth and noted that the break looked rather superficial and she could probably still cap it, and I’d be able to go ahead with the post-core and crown. She took an x ray to make sure the break wasn’t worse than it appeared. She offered to cap the tooth for me, but — and this was my moment of triumph, strange as it may seem — I looked her in the eye, willing my tears back into their ducts, and said, “I really just want to pull the tooth. I want to be done with this. I’ve been round and round with this tooth. I can’t keep taking time off work for this, and I honestly can’t afford it, and I just want you to pull it.” She patted my cheek and said she would do it. She conferred with another doctor about that 90 degree root. She numbed me up with my preferred anesthesia. She worked quickly with her assistant, who happened to be the same person who dealt with me sobbing embarrassingly at the receptionists’ desk a few weeks before. She warned me before doing things that might hurt, “You’re going to feel a lot of pressure here.” And she stopped when I raised my hand to ask for a break. he was everything I wished my first boyfriend would be. It crossed my mind to stay at that dental office as long as I could only make appointments with her. I was in love with Dr. M.

After much pushing, prodding and pulling, I heard and felt a crack somewhere beneath my gum line, and Dr. M produced a tooth.

“Cah ah heee?”

“Huh? Oh, sure, just let me get this cleaned up quick. Once we get the root tips out, you can get a look at this.”

There was more digging around in my mouth, then the application of a suction tube to remove the blood, then Dr. M and her assistant left my side briefly. They wanted to take an x ray to be sure all the bits of root had been removed. While they were gone, I lifted my head just enough to see the paper napkin on my chest. It was stained with blood. I felt a little sick and a little proud. Dr. M came back with good news. The x ray showed no pieces of the tooth remained. Dr. M put stitches in my gum; told me how well I’d done; gave me instructions for caring for the wound, 800 mg of Ibuprofen and a prescription for Percoset, which I ended up never taking. She sent me off with a firm warning to eat something before taking any medications. I didn’t get to look at the tooth. I really wanted to see that 90 degree root.

Through the next few days, I poured over the instructions for caring for the extraction site. I meticulously avoided acidic foods and beverages. I did not eat turkey or cranberry sauce at Thanksgiving but stuck to stuffing and other foods soft enough to be mashed with my tongue or chewed on one side. I texted a friend in a tizzy when I found a piece of noodle slouched in the hole where my tooth once was. The noodle did not respond to the “gentle rinsing” described by the dental assistant. My friend texted her mother, who was also a dental assistant. Word came back: I could rinse, but no spitting, sucking, or sneezing was allowed. The noodle was defeated. On Friday, I sneezed. By Saturday night, I allowed myself beer, the effects of which were heightened by several days of a mostly liquid diet. We had a party, and at 1 a.m., we went to the Double T Diner, where I had baklava.

Nearly a week after the extraction, I sat dully tonguing the stitches in my gums, trying not to interfere with the healing yet unable to resist my compulsion to fidget. I suckled my beer gently. The stitches were coming loose, and the thread dangled in the back of my mouth like the lose yarn on an of an old sweater. I ached to pull on that thread, to unravel it just to see what would happen. In two days, I would have an appointment to get the stitches removed, but I worried about the loose thread. I simply couldn’t cope with the prospect of complications — infection, abscess, dry socket, which I nearly had panic attacks avoiding — I had been cautious for a week, and I didn’t need a reason to spend even more time and money on my floozy teeth. But that night,  I pictured all the beer I’d had over the weekend, how I’d heard the effervescence from soda could dissolve or dislodge the blood clot and cause dry socket — how much worse could beer be? I lay in bed imagining my stitches coming undone and my precious blood clot washing away in rivers of beer until I fell asleep. In the morning, I worried that the final checkup would result in the doctor conjuring up some other issue for which I would require some other expensive treatment. I considered cutting the last remaining stitch with nail scissors and skipping bail.

Appointment Six:

On the day my stitches were to be removed, the husband and I had to carpool because his car was in the shop. Despite a frantic day at the office, I spent much of the day imagining finally being free of my unraveling stitches. I tried not to fidget, and while standing in line at the Indian buffet where I went to lunch with my coworkers, I had just enough self-control not to say, “Today,  I’m getting the stitches out of my gums from that tooth extraction I had last week.” After work, my husband dropped me off at the dentist’s office and went across the street to get himself a cup of coffee. I warned him: They always run at least 15 minutes late, so even if we get there on time, they won’t see me till 5:30. He planned to be back by six. I walked up stairs, signed in at the front desk, and by the time I finished hanging my jacket, a dental assistant was there to call me back. She sat me down, snipped the one remaining stitch from my gum, and rinsed the wound with salt water. It didn’t hurt at all. It felt instantly better, in fact, as the temptation to fidget was removed. When she went to get the dentist, she left the little wad of thread on the tray beside me. It looked like a small dead bug with a bit of mush (probably rice pudding) caked on the wings. Or like something you might find in the bathtub drain.

Then my Dr. M returned.

“How are you?” She said cheerfully.

“A thousand times better than I was last time!”

“How about the day of the extraction? That was one hell of an extraction, huh? Did you have a lot of pain?”

“Not really. I turned in the prescription you gave me but I never ended up taking it. I just took Ibuprofen for a couple days.”

She was enthusiastic about this news. I gazed into her green eyes (enhanced by colored contacts, but beautiful nonetheless) and noticed how much she resembled one of my heroes, Carlin Ross.

Dr. M leaned me back in the chair one last time. She swiped her finger along my gum line, looking for swelling and irritation, commenting that the healing seemed to be coming along fine. She said it would heal even faster now that the sutures were out of the way. Sutures, I thought. Yes. I had forgotten that word. She reviewed my chart, saw that I had no need to come in for any appointments any time soon, and encouraged me to take a break, rest up, and enjoy the holidays. And that was that. On the way out the door, I checked in with the receptionist about my refund for the root canal. In the car on the drive home, I took a photo for posterity. I wondered if I would ever see Dr. M again. Then we went out for hamburgers.



*Please note that all dialogue in this piece is paraphrased. I wasn’t taking notes in the dentists’ chair as I was hoping all along that this would not be the type of medical experience that merited an essay, especially one of this length. If I had known it was going to be so dramatic, I would’ve brought a tape recorder.


I was 24 years old. It was 1989, and I had just moved from my hometown in Canada. I had come out to my Catholic family two years earlier, and since then our relationship had escalated from constant criticism to outright rejection. Isolated and confused, I sought professional help in the person of psychiatrist “Dr. Alfonzo.” In turmoil, I asked this doctor how I could best come to terms with my homosexuality as well as with the psychological effects of the sexual abuse I had endured as a child.

Alfonzo seemed to offer hope in a form of treatment based on Primal Therapy, the goal of which was to erase the mental imprints of my biological parents via intense, primal sessions, and then to replace these with the “healthy imprints” of surrogate parents.

Within the first few months, Alfonzo told me that I would never be happy as a homosexual, presented me with conflicting causation theories, and directed me to release my anger and to feel my pain in an effort to “unlearn the error” of my homosexuality. If I dared say that I really was gay, Alfonzo became enraged and threatened to throw me out of therapy. If I persisted in arguing with him, his loud, accented voice would overshadow my own. He would point his finger down at me in a menacing and condescending manner, cocking his head to one side. I would know enough to stop talking immediately—or else. No one had the last word when it came to Alfonzo. The end result was that my already low self-esteem plummeted.

Six months later, Alfonzo ordered me to move, along with four of his other patients, into a therapeutic house which he called The Styx. At his instruction, we built a makeshift 4’ x 6’ sound-insulated “screaming room” in the basement that we used for self-administered primal sessions. Alfonzo had us compose a written Charter, detailing his expectations about what foods we would eat (vegan), and what activities would not be tolerated (smoking, drinking, sex in the house). Nightly meditation was implemented. Members were discouraged from leaving the house during non-work hours except in the company of other members, and from having social contact with anyone outside the therapy. Visitors were forbidden, except for other patients sent by Alfonzo for three-week residential stays or “intensives.”

Alfonzo prescribed increasingly higher doses of medications, which he said were necessary if I was to benefit from his therapy. The medications included a combined or overlapping use of Rivotril, Surmontil, Elavil, Sinequan, and Anafranil. Weekly intra-muscular injections of Ketamine (a dissociative anesthetic, sometimes used in veterinary practice) soon followed. The drug was administered immediately prior to each re-parenting (“nurturing”) session, although he never received proper informed consent to administer this drug. Often he double-prescribed my monthly prescriptions, instructing me to bring the extra medication back to him for his personal use. Years later, I was to learn that he double-prescribed for many of his patients.

In private, he disclosed intimate details of his life to me, including facts about his own breakdown from which he claimed never to have fully recovered. Styx members were referred to as “family.” We were required to spend time with him at house meetings and during visits to his private home. We were given chores—to cook his meals, to clean his office and home, to care for his pets (one of which, a dog, he’d had us drug and steal from a nearby farm), to help him write his autobiography, and to renovate his retirement home on a remote island (where he said we’d all one day live communally). If any of us had “a feeling” about any of our many duties, Alfonzo told us to “work it in private,” and not in front of patients who weren’t “part of the family.”

Over the next two years, Alfonzo systematically denigrated my homosexuality, characterizing it as learned behavior and comparing it to a drug addiction. He told me that I needed to carry my “cross” with dignity (remain celibate), and not act on my “insanity.” In deep primal sessions, howling and beating a mattress in Alfonzo’s office, I began to accept—or, at least, not contradict—the doctor’s beliefs that I had self-identified as gay because of poor parental role modeling, the childhood sexual abuse I suffered at the hands of a stranger in a public washroom, and the consequent years I spent “acting out” of that abuse by training my body to respond only to men.

As my primal sessions deepened, Alfonzo prescribed ever higher doses of medications, and I became increasingly unable to function. By late 1992, the side effects I suffered included short-term memory loss, breathing difficulties, blurred vision, dry mouth, constipation, urinary retention, involuntary twitching, excessive sweating, weight gain of almost forty pounds, and visual hallucinations. Generally, I felt numb and “spaced out” all the time.

In 1993, I suffered a breakdown, brought on largely by extreme medication toxicity. Alfonzo added an anti-psychotic to my regime of daily medications and placed me on medical disability. He prescribed yet more medication to deaden my sex drive, saying that I would never be able to “flip to the other side” as long as I was obsessing about “the gay side.” In the most bizarre form of treatment yet, he ordered me to bottle my feces and sniff them whenever I was attracted to a man, in order to help remind me “where homosexual men stick their penis.” When none of that worked, the doctor threatened to hook my genitals up to electrodes. “Without my help,” he told me once, “you’ll probably just get AIDS and die.”

In 1994, Alfonzo placed me on what he described as a short therapeutic holiday, during which time my primal sessions were reduced and the medication dosages lowered. Consequently, as the fog of the medications waned, my sexual desires intensified. Despite five years of so-called therapy, I was still attracted to men. I began to spend longer hours away from the Styx, struggling to accept my homosexuality, all the while becoming ever angrier over what I’d been doing in an effort to kill that part of myself.

In early 1995, Alfonzo told all of us at the Styx that unless we corrected our life patterns by practicing more “tough love” on one another outside of our workroom, none of us would make it in the world “out there,” nor would we ever be allowed to live with him in his new home. We took his advice to heart. No longer did we work out our feelings in the basement; instead, we brought our primal rage upstairs into our living room, our kitchen and our bedrooms. We became like caged primates, and the house structure quickly disintegrated. Finally, in late 1995 we agreed to disband.

I returned for prescriptions regularly during the next year. During each of these visits, the doctor continued to make derogatory comments about gays. I said nothing, feeling numb inside when he spoke.

By the time I visited Alfonzo in mid-1996, I realized how many years I’d lost in a futile effort to change. I dreaded returning to his office, but knew that I had to be weaned off the medications. My best defense seemed to be to say as little about my life as possible, get my prescription, and leave. During our last visit, he told me he was concerned for all his former “children,” but in particular for me, since I had stepped back out into the world “with all those homosexuals.” His words sent a jolt through my body, as if I was hearing the hatred in his voice for the very first time.

“I’m one of those homosexuals,” I snapped back at him. “And nothing’s going to change that fact. I can’t hide from the world my whole life, and homosexuals are as much a part of the world as anyone.” I continued to look him in the eyes, not backing down. He said nothing; then, a moment later, turned back to his desk, wrote another prescription and made an appointment for the following month. I never kept it.

I spent much of the next two years in solitude, feeling shell-shocked, weaning myself off all the medications while struggling with memories of Alfonzo and “the family.” Despite the doctor’s ongoing attempts to revert my sexuality to its “base heterosexuality,” there had been no heterosexual in me waiting to emerge. The truth was, I felt more like a shell that had had its innards scooped out.

Gradually, I thawed out and deprogrammed from the therapy. The panic attacks I’d suffered through for years soon dissipated, despite Alfonzo’s constant warnings that they would necessitate a lifetime of medication. In other friendships and in work relationships, I was accepted as a gay man and this assisted in challenging my own homophobia. I continued to fluctuate between feelings of outrage over what had occurred and a great deal of loyalty toward Alfonzo. With the assistance of a new, healthier, counselor, I not only dealt with issues relating to my childhood sexual abuse, but also with Alfonzo’s systematic attempts to erase my gay identity.

In May 1997, I mailed a five-page letter of complaint to one of Canada’s colleges of physicians and surgeons. Essentially, the complaint stated that the doctor ran a cult in which I was excessively overmedicated, forced into providing free labor, subjected to his homophobic dogma, and treated in an effort to “cure” me of my homosexuality. Alfonzo was given fourteen days to respond. Seven months later the college received his 500-page rejoinder, in which he denied all inappropriate conduct. The college consulted an independent psychiatrist, who advised them that Alfonzo’s behavior was considered “acceptable within the framework of his therapeutic model.”

Following a twenty month investigation, Alfonzo was directed to attend a conduct review before the college’s Ethical Standards & Conduct Review Committee. Comprised of four senior physicians and two public representatives, the Ethical Conduct Review, I was told, was intended to be educational and remedial, and to provide advice, guidance, and criticism as warranted to the physician to avoid the recurrence of similar complaints at the college.

I was there for the review in March 1999. Alfonzo was asked first about his attitude toward homosexuality. He spoke at length, saying that he had no particular attitude: that twenty percent of his clientele were homosexual; that he did not know the causation of homosexuality because nothing was known; that he was aware of theories such as the way in which childhood damage can cause a person to be gay, but that he did not regard homosexuality as an illness, because homosexuality itself was no longer in the DSM. “How could I treat someone for a disease that no longer exists?” he asked.

The chair spent several minutes reviewing the Canadian Medical Association’s view on homosexuality. She said that homosexual orientation was considered neither a mental illness nor moral depravity. “In fact, homosexual orientation has been found to be in place very early in the life cycle,” she continued, “possibly even before birth; and research strongly suggests that efforts to repair homosexuals are nothing more than social prejudice and could result in severe psychological damage inflicted onto the individual.”

Alfonzo was asked about the power difference between therapist and patient—the “slave and daddy role” within his therapy. He was reminded that his patients underwent regression, were therefore extremely vulnerable to suggestion, and could be easily damaged. He was asked about using abusive language on his patients; whether he kept his beliefs to himself; the fact that patients may have witnessed his own Ketamine-enhanced therapy, where he told us he was Christ, that he had been crucified in a past life and that this was the world’s last chance to hear his message.

One by one Alfonzo denied each of the allegations. He pretended to be particularly horrified at the idea that patients may have witnessed his own therapy. When asked why I would say that this had occurred if it had not, the doctor replied that I had the ability to blend fact and fiction and vice versa, which was characteristic of my sort of personality disorder. “For a patient to witness his therapist’s own treatment would not be therapeutic,” he said. “It would break all the rules. It would be traumatic for the patient, not to mention unethical and a violation of trust.”

Alfonzo was asked whether he was doing research with the Ketamine, and whether he’d had any peer review. He said that research in psychiatry was not the same as in other branches of medical science—a statement the chair quickly rebuked—and that he conducted “continuous research” on his patients, who in turn gave him feedback on their therapy. He was asked about his use of Ketamine and the general use of anesthesia. Alfonzo told them that he utilized very small doses of Ketamine in order to avoid the hallucinogenic effects, and that it had also been used thirty years ago in Russia to enhance psychotherapeutic processes. When asked why he did not use Benzodiazepines, Alfonzo said that he did not wish to use a medication with a sedating property; that he did not wish to “dampen the feelings and emotions” of his patients. Considering that I had been well beyond sedated for the majority of our time together, this comment, in particular, left me dumbstruck.

The chair noted that at one point I was prescribed up to 550 mg of Elavil every day, in addition to other medications, and that such dosages would normally be restricted to the most severe patients in hospitals or institutions. Alfonzo said that there were very few outpatients who required such high dosages, but that they were needed for me because I was “quite mentally ill.” There was a suspended moment where I looked at each committee member, and each of them looked back at me. I had worn my best suit that day, was freshly shaven, and my eyes, I knew, had the clarity and sparkle of a very sane human being.

“Are you trying to tell us, Dr. Alfonzo,” the chair responded, her inflection rising dramatically, “that this young man sitting before us here today, that this man is a very, very, very damaged human being who required 550 mg of medication per day just to function?”

For a moment every person in the room had turned and looked at me, and I, in turn, had looked at them. It was as if the entire moment was happening in slow motion: the chair’s question; the members’ glances at me; all of us waiting for Alfonzo’s response. Then Alfonzo turned to me as I turned to him, and we all turned back to the chair as he responded to her.

“Yes,” he replied. Some of the members shook their heads in what appeared to be bewilderment. I caught the eye of one Committee member, a doctor herself. She winked at me. “He looks great now,” Alfonzo added as an afterthought. “Obviously my therapy worked.”

The chair asked Alfonzo if he denied all of my allegations. The members seemed amazed when he said he did. “Dr. Alfonzo,” the chair asked, “tell me, please, what could possibly motivate any person to invent, and then spend years of their life pursuing a complaint of such magnitude, unless at least some part of it was true?”

“I currently have 65 patients,” the doctor responded. “None of them are complaining. Most of my referrals are self-referrals that have come to me from other patients.”

“Dr. Alfonzo,” the chair stressed, “complainants come to the college without any thought of gain for themselves but out of concern for the physician’s behavior: even one complaint is cause for concern.” She told Alfonzo that his was an unorthodox form of therapy. “It has never been properly investigated,” she advised, “and leaves much to be desired at the scientific level. The fact that an experimental program of this type of therapy was run almost thirty years ago in Russia is not sufficient, nor is the Committee even interested in such research. Scientific knowledge must be continuously evaluated and re-evaluated in order for advances to be made. Furthermore, we are concerned that you are isolated from the psychiatric community in that you’ve had no conversations with other psychiatrists in the previous two years. We are particularly concerned about your future group work with patients, and your individual therapy; your use of Ketamine.”

One Committee member spoke up and added that he was not at all comfortable with Alfonzo’s style of practice; that he personally found it very distressing. “Tell me, Dr. Alfonzo,” he said, “when exactly do you plan on retiring?”

“In ten years or so,” the doctor replied.

The conduct review concluded two hours after it had begun when the chair told Alfonzo that the college would arrange for his practice to be reviewed by two “independent psychiatrists.” Five months later I received a copy of that review. It amounted to a slap on the wrist, and concluded that Alfonzo was “clearly trying his best with a difficult patient mix,” and that he was “well intentioned and approached his work with diligence.” At no time was he asked to alter his practice.

I file a medical malpractice suit against the doctor in 1999, four years after I left the Styx. Particulars of the doctor’s claimed negligence included that he failed to act in accordance with general and approved practices in the field of psychiatry; prescribed psychiatric medication (Ketamine) no longer in use in medical practice; prescribed medication in inappropriate dosages; double-prescribed medication for his own personal use; failed to explain or warn his patients of the side effects of prescribed medication; treated homosexuality as an illness or disease; allowed the plaintiff to care for his pets, provide editorial services for his book, domestic services for himself and his other patients, landscaping services and household renovations to his personal property—all without remuneration; intentionally inflicted mental suffering upon the plaintiff contrary to his duty not to inflict harm; and committed battery by injecting the plaintiff with the drug Ketamine without his knowledge or informed consent.

In their response to my statement, defense denied every allegation of fact contained in my claim. The court scheduled a four-week trial. Months later, two independent psychiatrists (one hired by my lawyer, the other by defense) interviewed me for over twenty hours. In December 2001, I attended the defense’s Examination of Discovery, where I was asked about everything from my childhood sexual abuse to my active sexual history, my coming out process, and my deteriorating relationship with my family—all of which, I was well aware, had nothing to do with the facts of my claim. When asked about my “visiting bars frequented by male homosexuals,” suddenly it struck me just how homophobic the context of the suit truly was: would anyone ever be asked if they visited bars “frequented by female heterosexuals”?

Defense spent several hours having me review numerous consent forms—all signed by me, although I had no memory of having signed any of them. I explained that this must have been due to the excessive amount of medication I was taking, and that most days I could hardly remember what I’d eaten for lunch, let alone the details of a contract. I had also trusted Alfonzo like a father: I would have signed anything he put in front of me.

I was shown multiple self-rated progress reports, all written while I was under Alfonzo’s care, and asked if I was truthful in the many positive comments I made with respect to the therapy, and, if not, why. I answered: “I was lying to myself about who I was. Based on that, I could not have been truthful in a lot of aspects of my life. … I also wasn’t honest about how scared I was of the doctor. I never mentioned the way he screamed at me, how humiliated I felt when he told me I was ‘crazy’ for saying that I was gay, that I was ‘insane’ for desiring to have an intimate relationship with a man.”

For over six hours, I answered every one of defense’s questions, and with each passing minute I felt myself being opened up and ground down: I felt exposed and exhausted, had trouble focusing, remembering, understanding what could possibly have motivated me to stay with this doctor, to have said that he was helping me, that I felt safe with him, that I was better off with his therapy. I wanted to say that I did not understand or remember any of it; that I was drugged and regressed and that self-hatred can make a sane person do and say just about anything: that I cannot be held entirely responsible for the internalized homophobia that was now being used against me. But most importantly, that none of that meant that Alfonzo had not been unconscionable in his treatment of me—that he had not been abusive and unethical. When defense asked what harm or ill effects the doctor had caused, I felt as if I were being asked to articulate how my rapist had damaged me—what ill effects had been caused by being raped. I tried to tell them something of the emotional harm his therapy caused, but after so many years and all that had happened, my words felt stilted, inadequate, pointless.

The first half of 2002 was spent waiting for the phone to ring. In July, my lawyer, Mackenzie called me down to his office. I had hardly sat down when he announced that there was no incentive for his firm to take my case to trial: we would have to settle out of court. I was in shock—considering that Mackenzie had told me, when I first sought his firm’s advice, that medical malpractice suits are rarely settled out of court.

With respect to my case creating legal precedent, Mackenzie explained that the Canadian Medical Protective Association—the mutual defense organization responsible for providing indemnification to all licensed doctors in the country—sent out details of all malpractice suits to all their members, including causes of action and information about settlements, excluding amounts. In that way, he assured me, physicians would be dissuaded from practicing similar types of therapy in the future. Based on everything Mackenzie told me, especially that my case’s outcome would be documented in one of the Association’s bulletins, I agreed to settle. After months of offers and rejections, in December 2002, I received a settlement of $30,000.

Thirteen months later, in January 2004, I called Mackenzie to ask for more information on any bulletin distributed by the Association that might have detailed my case’s outcome. Mackenzie would not take my call but relayed through his secretary that if the Association chose not to document my case, there was nothing he could do about it “after the fact.” On top of that, ever since my first complaint against Dr. Alfonzo in 1999, I had been reading through every bulletin from the college of physicians and surgeons—bulletins sent out to every medical practitioner in the province containing decisions of complaints brought before the same Committee that reviewed my complaint. The details of my complaint to the college were never outlined, not once.

So I am left to wonder, who other than me has learned from my experience? What has changed? How many more men and women will have to suffer the manipulation of their sexuality because of someone else’s intolerance combined with faulty science? The American Psychiatric Association may have ceased classifying homosexuality as a mental illness over thirty years ago, but this has not stopped some of its practitioners from treating it as one. My hope now is that one day soon there will be laws prohibiting this kind of “therapy,” and that those who do practice it, unlike Dr. Alfonzo, will be held accountable for their actions.