As a boy I was something of a wanderer. Our family home, broken and then repaired into a chimera of middle-class normalcy, existed in a state of perpetually coiling tension wound ever tighter by dysfunction and abuse. To escape it I often fled outright in long excursions around the neighborhood; at first on foot, and later through the greater range afforded by a bicycle. When I was about nine years old we moved into a house directly abutting a dry stretch of the San Diego River. I spent hours walking the arroyo with a wooden sword in hand and the family dog at my side, looking for ogres to slay.

Dear vermiform appendix,

It pains me to write this. But at least now I can write. For a while, there was too much pain to do anything besides curl up in a ball and drool like a sad walrus on an unloved beach. Now, with some space between us, I can finally share my side of the story, and with an obvious debt to Alanis Morissette, there are some things, dear appendix, that you oughta know.

You remember the night I made a meal entirely with ingredients from Trader Joe’s? What a delicious meal that was. Being that at the time I was relying on Trader Joe’s for about 70% of my caloric intake, it was also a somewhat ordinary meal, and it was a safe one; no meat, and no dairy. You probably remember that, although I’m not even a vegetarian, I sometimes have a unexplainable hankering for vegan food. You can thank my vegan ex-girlfriends and my friend Goldie.

So when I began vomiting a few hours later, followed by fever, chills, body aches, stomach cramps, dry heaves, and then a persistent dull pain in my lower right abdomen, I first felt angry at that suddenly cruel and treacherous monster named Trader Joe’s. This was the worst food poisoning I had since my experience with Mystery Lou down in Argentina, but on many levels it was more devastating. A breach of trust with Trader Joe’s would be, along with the waning of print media and the ceaseless conflicts overseas, the Sadness Of Our Generation.

It was time to see the best doctor in the world, Dr. Garcia, who told me the truth: it was you, vermiform appendix. How dare you make me throw that kind, caring, dependable Trader Joe’s under the bus like that, when all you had to offer me was your own vestigial confusion?

Now look, I understand that you’ve had it rough. A bit of an identity crisis and all that. Many of my other organs that knew you, that saw you around, they liked you – but they also knew that you were ultimately up to no good. Sometimes I wonder why I didn’t just listen to them sooner. I’ve since met people who’ve had their appendixes removed preemptively, say, before traveling overseas for a year, just to get the damn thing done with and get some closure.

You lived right under my nose for so long before I really got to know you, but once I really did—and it breaks my heart to say this—you quickly became impossible to live with. You were like that neighbor that I’d never met for years, who, right after we finally met, decided he could start blasting reggaeton at 6:30 in the morning. Only in your case, there was no landlord to call, and the reggaeton was potentially fatal.

Dr. Garcia immediately sent me to a CT scan and a few hours later it was confirmed: The pain in my life was from you, and you had to leave. Still, I fought this conclusion; I didn’t want to let you go. I asked right away if there wasn’t something I could do to make things go back to the way there were, maybe couples counseling, maybe a nice weekend getaway with just the two of us—someplace that’s not in the news, like Togo or the Pitcairn Islands—but no. That night I was to go to the hospital.

It was a bad night for sympathy. A couple friends of mine had dying or injured pets, one friend was having a final going-away party before a permanent move to New York, and it was raining in Los Angeles, which meant that no one wanted to drive, especially the people in their cars. However, my friends Jake and Dan came to the rescue and arranged for my safe transport to and from that place where I would finally kiss you goodbye.

Some good people helped me through our separation. I had a pretty wild anesthesiologist named Mikey who is apparently known for the “awesome music” (the nurse’s words) he plays during operations. Matthew, my laparoscopic surgeon, I found later, does not agree with said nurse’s assessment. Apparently the battle during my operation, between Mikey and Matthew, was whether to listen to Gloria Gaynor or Coldplay. You decide which, if either, is awesome.

If they let me choose, I would have requested reggaeton, specifically “Chacarron Macarron” by El Mudo, as loud as possible, but it didn’t matter, because whatever they did play, I didn’t hear at all. When I came to, I was in a dark room called RECOVERY with two people I had never seen before and would never knowingly see again. They seemed bored, so I knew that everything was swell.

Staying overnight in a hospital is like trying to sleep on a cross-country bus. I was awoken constantly all night by strangers, and for often logical but also disorienting reasons. I passed the time between intrusions by watching, (in order of quality, coincidentally) Rear Window (awesome), The Karate Kid (amusing), and Dinner For Schmucks (corrosively dumb). During my fitful sleep, I was somehow able to avoid having a nightmare about being pushed out of my window by Raymond Burr, though if that would’ve prevented me from watching Dinner With Schmucks, I’d have understood.

The Trader Joe’s dinner was on a Wednesday night, and after vomiting it up, I didn’t eat solid food again until Saturday afternoon, when a kind nurse brought me Salisbury steak, mashed potatoes, and a big brown bowl of the thickest, most savory soup I’d ever tasted. I decided to finish off the soup first, and then noticed they didn’t give me any gravy for the potatoes. I then realized what I’d just eaten an entire bowl of.

If you’re ever in a hospital again, try it some time. They’ll totally give you a free pass for that kind of thing.

After about seventeen hours, I was on my feet and out of the hospital, six pounds lighter than I’d been on Wednesday, and who knows how much of that was you, dear vermiform appendix. It was tough at first to get my old strength back, and to find myself again, but with the help of a number of friends, I made it through. The wounds are still healing, and for now I need my space, but I honestly wish you well.

Everyone asks if I saw you one last time, and sometimes I think it’s a shame I didn’t. I heard they sent you up to pathology, where you were a bit of a rock star. I know I would’ve been proud.


J. Ryan

Sentimental scars disregarded. Response
cuts; incisions you chose not to delve into. The black
residue of removed yesterdays – unrest. Settled
into harrowed, addled, a discomforted occupancy.
Morning, plied year-round. Live-in
cadaver: diligent; despondent. Dead

Wake. Never fully
rejuvenated. Stitched and stabilized. Released.
Soon after the sutures come out. Follow-up
steps are planned: “A Path to Recovery.” It gets better
until you are healed – like inferior tissue. You thrive,
learning to live again. Aware. Let the routine

I don’t like being out of my comfort zone. Not only does it make me uncomfortable, it makes me regress.

Carrying out my life in a foreign language has made me revert to the awkward, shy teenager that I try so hard to forget I was. Being a thirtysomething who is not guaranteed to put together an entire sentence, let alone an entire thought, gramatically correctly has made me self-conscious all over again. I speak minimally, do not expand upon thoughts in a profound way, and am constantly worried about my accent and whether people can understand it. Even if people compliment me on my French or assure me that my accent is charming, it is exhausting at times to be constantly reminded how I am different. Of course being unique is great but not every time I open my mouth.

When I first moved to France, I did anything I could to avoid vocal interactions with other Frenchmen. Thankfully, buying a baguette is formulaic, e-mail and texts have replaced phone calls, and more and more things have become automated, like buying movie and metro tickets.

However, since doctors are not machines I knew that I would eventually need to carry on a medical conversation in French, something I was not dying to do. But after seven years of chronic knee pain it was time to see if the French could cure what the Americans could not.

I liked my new primary care physician, Dr. Martin, from the start. He set aside a few hours each day for unscheduled appointments which allowed me to avoid phoning a secretary to make one. I was surprised to see upon my arrival, however, that a secretary was nowhere to be found. The door opened onto a waiting room with 10 other patients already inside.

There was nobody there to explain which doctor out of the three in this particular office I was there to see or why. There was no patient information form to fill out nor was there was a sign-in sheet. I took a seat and waited my turn, hoping it would be obvious when that turn would come.

I’m often scared of conversations I’m not convinced I can have, and get tongue-tied when around people of authority. In this case, I was not only worried about spitting out the right words and articulating clearly, but was anxious that I wouldn’t understand what the doctor had to say back. Sometimes doctors have relevant things to say concerning our health and I didn’t want to miss anything important.

I had brought a book with me to help pass the time but I was too busy repeating medical vocabulary and formulating practice sentences in my head. MRI, physical therapist, cortisone, shot, pain, limp, anti-inflammatory…the translations for these words were all pirouetting through my head in a stressed-out frenzy.

When I finally made it into Dr. Martin’s office an hour later I did my best to explain that I had had pain in my right knee every day for at least seven years. An MRI (accompanied therewith) led an American doctor to determine that I had bursitis (in layman’s terms, an inflammation). Said doctor gave me a painful shot of cortisone and sent me to a physical therapist. The physical therapist showed me stretching exercises that should cure me and then sent me to a podiatrist because I walked funny and needed custom-made insoles for my shoes. [At 28, this walking funny business, and possible culprit, was news to me.]  Hundreds of dollars later, none of this worked.

Dr. Martin simply gave me the name of a specialist, wrote me a prescription for an anti-inflammatory, and sent me on my way. That wasn’t so hard. Then he asked me for the 22€ I owed him for the visit, which I would be reimbursed for later. Through my domestic partnership with Luc, I’m in the French health care system. Even if I wasn’t, I could afford a doctor’s appointment.

The bad news was that I now needed to go to the pharmacy. I don’t like pharmacies here because there’s no Advil, Tylenol or NyQuil — no recognizable comfort drugs that remind me of home. They also don’t sell chocolate candy, cigarettes, school supplies or lawn chairs.

Once there, I silently handed over the prescription for the anti-inflammatory, praying for a simple exchange. No such luck — the pharmacist asked for my government issued medical ID card. I obliged. Since I was new, I wasn’t yet entirely in the health system. Instead of not having to pay anything upfront, he explained that I would need to pay for the drugs myself and that I would get reimbursed later.

“Will that be possible for you?” he asked with sincere concern.

I quickly calculated how much money was left in my checking account and subtracted the amount I guessed the drugs would cost based on past experiences in the US.

“That should be ok. What will the medication cost…80, 100€?”


My leg specialist, while very kind and American-friendly, did not do much to cure my bursitis which he decided was tendonitis (in layman’s terms, an inflammation). After more drugs, cortisone shots, and useless months of physical therapy he sent me to a surgeon. Although I was scheduled to see the surgeon at 11am, I didn’t enter his office until 2. Not only was he behind schedule, he made me wait while he ate lunch.

Within 5 minutes, the well-fed surgeon with spinach stuck in his teeth determined that an operation would be too risky and advised against it. When he told me the cost of my consult, I thought he had said 120€. I was not shocked because I figured surgeons earn more than primary care physicians so I handed over my cash. Later, at home, I looked at the bill and saw that my consult actually cost only 80€. Not only did the good doctor waste my time, he ripped me off.

Could I dare go back and question this man, a prominent surgeon? I had no paper trail to prove anything; it would be my accented-word against his.

I was reminded of the time when I chewed on glass in a restaurant while dining with friends visiting from home. No, the menu did not mention anything about glass so I was quite startled when I bit down onto that shard. The waiter was very apologetic but I was dismayed when the bill arrived with the cost of my meal on it. I was foolishly too shy and too concerned about being the “obnoxious American” to demand that my meal be free. It’s one of those things I often think about with regret.

So I knew that this time I had to go back, defend myself and get my money. I practiced the hypothetical conversation while limping back to the doctor’s office. I nervously explained to the medical secretary that I misheard quatre-vingts (80) for cent vingt (120) and that the doctor must not have paid attention to the amount I gave him. The secretary spoke with the doctor and after a moment of very awkward tension he conceded his error. I was proud of myself for not letting my timidness cost me nearly $60, the equivalent of 5 minutes with a cheap hustler [shameless plug alert — see Hey].

I don’t believe in hocus pocus, but when friends raved about a miraculous “magnetiseur” who cost only 25€, I was intrigued. Since such a person is not recognized by the government as a legitimate health care practitioner I would not to be reimbursed. But for 25€, I figured that I had nothing to lose at that point.

I’m still not sure what a magnetiseur is exactly, but Judith is some sort of healer who transfers her energy to her patients in order to cure whatever ailment they have. After listening to my medical history, which I had gotten quite good at recounting by then, she asked me to roll up my pants leg before she placed her hands strategically onto the inflamed portion of my knee. For her, the tendonitis v. bursitis debate was of little importance.

Judith seemed to be deep in concentration which I was quite uncomfortable with. I always feel the need to make small talk (even in French) with anyone providing me with a corporal service. I did not know if she could transfer energy and speak at the same time. I hesitantly asked her if I could talk; she replied “yes” while laughing [at me?].

“Did you study medicine to do this kind of work?”

She laughed, again. “No,” she replied with dignity. “It’s a gift.”

Whatever you want to call it, it worked. After 3 sessions, some weird plant extracts and shark cartilage imported from Luxembourg, Judith did what 5 doctors, 3 physical therapists and a whole lot of drugs and shots could not. Nowadays my tendonitis only flares up when it rains, like an arthritic 80 year old.

I’ve come to worry that Dr. Martin thinks I’m a hypochondriac. When I recently found out that there is lead in our tap water at home, I went straight to him insisting on blood tests. According to a very reliable source, the Internet, any amount of lead can be dangerous. When I explained why I was there, I could see his eyes rolling in his mind.

“Are you sick?” he asked me. “Any digestive or respiratory problems. Problems with your motor skills?”

“No. It’s not that I’m sick now, I just worry that lead will make me sick later.”

He took my blood pressure and checked my breathing. I must not have said what I thought I just said. He told me that I was fine.

My blood tests showed that I do indeed have lead in my blood, but not enough to warrant medical attention. I’m only halfway there; I always was an underachiever.

Then there was the time I found a lump. I was convinced I had cancer even if lumps don’t form where this one was. A few days later Dr. Martin took me down from the ledge of hysteria. I had a hernia, he explained — essentially, a whole in my stomach muscle’s lining which required surgery. Gulp.

My surgery was scheduled for a Monday morning, so I had to check-in to the hospital late Sunday afternoon. I’m not sure why. Once I was shown to my room, I had nothing but free time until my 5am wake-up call. Luc and I took a tour of the grounds since there is nothing more depressing than being a healthy patient in a hospital bed.

Although it felt like a prison, or boarding school, there was no kind of “lights out” policy in effect. I was warned that I may miss dinner if I returned to my room too late but I was willing to take that risk. In fact, Luc and I decided to have drinks and dinner in a small bistro nearby. Coincidentally, my surgeon [not the knee one] chose the same place. I was not sure if she recognized me from our one previous encounter but I wasn’t about to go over and say hello. But I did keep my nervous eye on the bottle of wine in front of her.

It’s not that I have a fear of hospitals, I just don’t care for them very much. In my experiences, nobody comes out of a hospital cured, they’re just temporarily fixed until a health issue becomes unmanageable again.

Sure, mine was a minor surgery, but surgery nonetheless which required general anesthesia. Not everyone wakes up from that. So, I’ll admit it — I was scared. Which was unfortunate for the unassuming woman tasked with wheeling me from my room to surgery. I was alone, in a foreign country, and about to go under…I needed reassurance.

“I’m scared.”

“I’m sure that everything will be fine.”

If the surgery didn’t kill me, the cliché would.

In the operating room I was greeted by the anesthesiologist. I’ve seen every medical show created for television since “Trapper John M.D.” so that gas mask was no surprise, the suffocating sensation was. No instructions were given, at least none that I understood. I was breathing, and then with the mask on, I was not. I panicked and gesticulated for them to remove it. They confirmed that I was meant to breathe normally, even with the mask on. They replaced the mask, I breathed in twice, and then woke up what felt like one second later in recovery. That was cool.

It’s worth mentioning that I had absolutely no out of pocket cost for this entire process which included a consult with the surgeon , two nights in the hospital, one surgery and two weeks of much needed pain killers.


Then there was the time I went to the proctologist…