by JIM KNIPFEL
April 9, 2017
I’ll Grind Your Bones to Make Me Bread
This past fall, I went to see my neurologist for the first time in a decade, as I seemed to be having a little niggling problem with neuropathy. Among other things while I was there, I asked him offhandedly if there were any known long-term side effects associated with taking Tegretol. I’d been taking massive daily doses of the anti-convulsive for over twenty-five years to keep my seizures at bay. Worked like a charm, gotta say, but given the way things generally operate in the pharmaceutical industry, I figured it was best to ask.
“The only thing I can think of,” he said, “is that when taken regularly over a long period of time, Tegretol can tend to leach Vitamin D out of the system, leaving the bones brittle and prone to breakage.”
“I see. Why am I not shocked by this?” My dad died in 2013 because the drug he was taking to control heart arrhythmia—and cardiologists know this is standard—turned his lungs to leather.
Given the number of falls, collisions and general mishaps I undertake on a weekly basis with no broken bones yet, I figured I was in the clear. Still, he insisted on some blood tests which revealed, sure enough, some shockingly low levels of Vitamin D and calcium. Along with ordering me to start taking vitamin tablets, he asked me to get a bone density scan.
I ignored that last directive thinking it a waste of everyone’s time, but at the follow-up appointment a few weeks later he again reminded me I really, really needed to get that done. He seemed pretty insistent about it, so one soggy and cold afternoon I found my way to a desolate wing of the hospital and underwent the test, thinking little of it.
A week later, and I’ve never known such a thing to happen before, I received a frantic handwritten note from the Russian woman who’d conducted the test, insisting, even pleading that I go see my doctor immediately, as my bones apparently had the texture and resilience of Nilla wafers.
Okay, so she didn’t mention any specific cookie or cracker in the note, but she did seem unduly concerned, which you could tell from the number of exclamation points and all the underlining.
Unfortunately, thanks to a number of technical and bureaucratic issues within the hospital itself, I wasn’t able to get an appointment until five months later. Amazingly, in the interim I did not crumble into a fleshy sack of soggy dust on my way to the grocery store one morning.
Early on a sunny Thursday morning, I climbed aboard a train in the heart of rush hour and headed for a neighborhood I despise to see my neurologist again. A middle-aged woman of indiscernible ethnicity sat across from me. As we rumbled slowly along, she punctuated the quiet hum inside the car with a loud “Ree-dickless!” Every few minutes she just spouted “Ree-dickless!” with no further explanation. Finally, after we’d paused a shade too long at one stop, she clarified: “Ree-dickless! People must get to work!”
An hour and a half later, the neurologist stepped into the examination room where I’d been waiting patiently. First time I saw him some fifteen years earlier, he struck me as brusque, nervous, and quite possibly incompetent, but his office was a block away, so I let it slide. When I complained of some creeping cognitive problems and he arranged a test consisting of purely visual games, I decided maybe I could do without neurologists for awhile. When the neuropathy began making its presence known last year I decided to go back to him because, incompetent or not, it was simply easier than trying to find a new neurologist.
In the decade since I’d last seen him, he’d undergone a remarkable and unlikely—even counterintuitive—transformation. Now he was friendly, personable, thorough, and curious about all sorts of things. I’d ask questions (“How fast do nerve impulses travel?”) and if he didn’t know the answer he’d get very excited and do some quick calculations or look something up. The problem in question at this particular appointment, though, was the supposedly crumbling state of my infrastructure.
“This is imperative!” he kept saying, having clearly received the same frantic handwritten note from that Russian tech. It seemed my lower spine and femurs were in particularly bad shape, all porous and thin and floppy, and if I sneezed too hard I could, in a blink, start my new sideshow career as the Jolly Boneless Boy. “There are drugs out there that can start rebuilding the bone mass,” he told me. “But they take years to work and I can’t prescribe them. You’ve got to see your GP as soon as possible and see if he’ll prescribe them for you. Otherwise you run the serious risk of a fracture.”
“He’s a kook.”
“My GP. He’s a kook. And a kook who yells at me a lot.”
“A kook? Well, if you’d like I could recommend—“
“Oh, I didn’t say he was a bad doctor. He’s actually a very good doctor who knows what he’s talking about. He’s just an ancient Italian kook who yells a lot. I’ll see him again in a second.”
He then went on to detail everything else that needed doing to spare me that sideshow career, from blood tests and adjusting my Vitamin D intake, to seeing an epilepsy specialist to determine if I might be better off switching out the Tegretol that was dissolving my skeleton for a similar drug that, well, wouldn’t.
“And now back to that neuropathy,” he said, after mapping out my next six appointments. “We decided that it’s likely caused by your alcohol consumption. So have you stopped drinking alcohol yet?”
But you understand the condition will likely only get worse if you continue.”
He sighed. “Okay, I’ve told you. But as an old professor of mine once said, I’m not your parent. I’m just your doctor and you’re my patient.”
“I understand and appreciate that,” I said. “And I don’t mean to be a pain in the ass, but let me explain. I’ve been a writer and journalist for thirty years now. This is how I make my living. Worse still, I prefer to pretend I’m living in 1947. See, in that world, smoking and drinking, and I mean smoking and drinking hard, are simply part of the job description. Right up there at the top, even. If I stopped either, I’d be drummed out of the union.”
There was a pause. “Wait,” he said. “You smoke?”
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