Dissection

Skin, muscle, viscera, bone. Peel back the skin to reveal the fascia—first the superficial, then the deep. Retract the muscles. Uncover the viscera from their wrappings. Make note of the vasculature, of the nerves. Each layer is a whole, an armor, penetrable only by highways of vessels and circuits—supported by or encased in bone. Take a moment to consider the complexities of the body.

Integument

Sometimes my skin resists the needle. My entire body resists, in fact, and I tense as if by instinct, my skin becoming like leather—tough and unyielding. On other days I am relaxed, and my skin simply relents. I never know what to expect from this daily ritual.

I think of my father as I inject myself with blood thinners for the disorder I inherited from him, a condition that announced itself in the form of a massive clot in my veins following the birth of my son. I picture him gathering the soft flesh of his stomach between his fingers and injecting himself easily. His skin is cross hatched with surgical scars, pocked and pitted from unidentified infections in various stages of healing. It has learned not to resist.

 He may have acquired the syringes for some legitimate purpose after his last discharge from the hospital. He may have stolen them from the City Mission clinic where he sometimes volunteers. Every day as I pinch a fold of skin and brace for the momentary sting, I picture my father and his syringes, alone in his one-room apartment, injecting himself with his own feces.

Today, my skin resists. I have begun to predict the outcome of my day based on this measure, like the star ratings on the daily horoscopes. The needle nearly bounced off of me on my first attempt but the second one was smooth—a three-star day, I figure.

My father calls to check on me. He has been in the hospital for well over a year, failing to heal. The abscesses in his abdomen, he says, are from an infection he contracted in the hospital following his last surgery. A fistula the size of a salad plate opens to his insides, and I can’t help but picture school children gathering around to peer into his intestines, making a study of his body, dissecting the living.

The doctor’s account was different. My father’s stomach had healed many times. But there were the hidden razor blades, the stolen knife from his lunch tray, his fingernails—any instrument to tear open the wound and dig out the flesh, any reason to begin the months of healing all over again. Months of sympathy and surrender. Months of narcotics on demand. Munchausen Syndrome, she said, explaining the origin of the mysterious illness, the abscesses the result of the artificial introduction of bacteria. My father with his syringes.

Those words ricochet off of me as I think of them, off of my resisting skin. My father tells me that he plans to sue the hospital for giving him this infection, for failing to make him well. I am stuck in that awkward space between knowing the truth and abetting a lie. It is not an unfamiliar place.

The first time I was boxed into that space, he was sitting across from me on the living room couch staring at the ceiling, conjuring a memory. We were talking about Viet Nam. He had joined the Marine Corps just out of high school in 1969, filled with a young man’s bravado, lusting after that strangely intoxicating romanticism of war. I carried his boot camp photo in my wallet, thinking him handsome in his dress uniform, his determination evident in the square set of his jaw. Sometimes he’d sing jodie calls about Parris Island—the land that God forgot—songs stitched so firmly into my memory that I still hum them to myself on occasion. Being a Marine was his entire identity, his one source of true pride, but he never spoke of Viet Nam. His thoughts on the war had always been evasive, cliché—I’ve seen things I don’t want to talk about, so he never did. He had plenty of reason not to.

But that day, sitting on the couch, his body twitching in faint spasms as if deeply absorbed in a nightmare, his talk turned from history to memory. He told a gruesome tale of the blood on his hands—a gunshot through the forehead, throat slashed open in the form of a smile, the Vietnamese woman and her young son lying dead in his encampment.

This image haunted me, not because of the trauma or the gore, but because I knew that my father had never set foot in Viet Nam.

Fascia and supporting structures

The doctor explained that factitious disorders are co-morbid with depressive and personality disorders, and many patients exhibit problems with identity and impulse control. I could have saved the psychiatrist a lot of time, I think to myself, as her words bounce around in my head. Borderline personality seems ill fitting. Nothing about my father’s behavior has ever been borderline, the threshold to a sane life, a sober life, long since crossed. He has been spiraling toward this place, as if destined to make the same choices, spiraling down, this graveyard spin narrowing until it ends at this very spot—the hospital a return to the womb, an IV of morphine his lifeline.

If I look back on my life with my father now, it’s as if I’m watching a movie for the second time, a closer observer, picking up on all of the small signs planted in each scene to indicate that something with him was desperately wrong. Some of the clues, from an adult’s perspective, are not so subtle. Some images escape from my mind with a startling force, and I wonder where they have been all these years, simmering.

I remember the weekend drives to my grandfather’s house in the country, how we would swerve wildly across the narrow two-lane road in the dark. I remember the feel of my fingernails digging into the soft flesh of my palm as I prayed that he wouldn’t kill us.

I remember the stink of my father’s skin after an all-night binge, the way his breath was tortured and erratic as he tried to sleep it off. I remember the smell of vomit, its sour smell curdled in the back of my throat as I cleaned him up while he slept.

There is nothing about my father’s substance abuse that isn’t textbook, which would trouble him were he to realize that he is not extraordinary in his suffering. Perhaps that is unkind of me. We all want to be extraordinary in some way. And he was not always beholden to this pain; some pain is a cancer—invasive and consuming.

Once, when my father was still a young man, he had promised his brother Craig that he would pick him up to spend the weekend with their parents. But he had been working on a job in Frederick, Maryland, and driving to Baltimore for his brother would have added two extra hours to his trip. He was tired. He was lonely. He wanted to get home to my mother. And to me.

 That evening, as Craig waited for my father to arrive, he took a handful of pills, maybe thinking that his brother would arrive soon to rescue him. Still alone at midnight, realizing no one was coming to save him, Craig put a shotgun in his mouth to call it a night.  

My grandmother may have blamed my father for Craig’s death, though silently, her cast-off attention simply hardening him until he sloughed off his old persona and adopted a new one. Shortly after this tragedy my father’s Viet Nam story emerged, the line between fantasy and reality beginning to blur, perhaps so that he could imagine a life in which he was a hero, saving his brothers in the Corps. Perhaps so that he could imagine a life in which he did not have to feel responsible for his own brother’s death.

Pathological lying. Pseudologia fantastica. This quirk of my father’s personality had the unintended consequence of making him a fantastic story teller. If I reach back far enough into my memory, I can hear his stories. I can hear him tell tales of Tatonka and his trusty sidekick Buffalo Chips, stories he’d invent effortlessly, entertaining me for hours. Harmless lies. Sweet fantasy. I did not know then that so much of his life was a fiction. But these stories, these fictions, are ones I care to remember. The memories are not all bad ones.

Vasculature

I am bruised. Not an inch of skin on my stomach has escaped an injection and the fat underneath has begun to harden into nodes like grapes—lipohypertrophy in the technical parlance. My skin is thickening in the most literal sense. For a time, I began to use my thighs for the injections but found that they bruised worse, making me look more like a victim of domestic violence than of faulty genes, genes that have given me bad blood, too eager to clot. Over the phone, my father apologizes for my inheritance.

“Of all the things I had to give you,” he says, trailing off.

He tells me to go to church, as if the holy water might heal my affliction. Every now and then my father finds a friend in Jesus. They are always tumultuous relationships, rising to the manic highs of a person in love only to plummet catastrophically into depression once that high fades and the real work of recovery should begin. Instead, he mines the depths of a shallow theology, a summation of those highly intoxicating first steps of AA: Surrender to God and you will be well. As if it were just so easy.

My father has traded drugs and alcohol for AA and Jesus many times, each addiction merely supplanting the last. The high ends when it becomes obvious that surrender is just the beginning. My father has never found reason to take his personal moral inventory. And if not for the morphine drip, he wouldn’t talk of God at all. 

Viscera

 “I’m here if you need me,” he says before hanging up.

The words evoke an impossible memory, one that rushes back to punch me in the gut. I am propped up in a crib staring hard into the dark. I can see the outline of a person sitting in the room nearby.

“It’s ok, Joey. I’m here.”

My father’s voice.

I lie down again when I hear him, the memory fading to black. When did he leave the room, I wonder now?

I’m here for you. The enduring lie.

I’ve given up telling him I’m here. I’ve given up indulging his fantasies of living independently, of salvation through Christ. I’ve given up my own fantasy that I might be enough to save him.

But those words pierce me. More than the memories that have resurfaced with every pinprick and remain to be examined with every bruise, more than the lies and drugs and failed love affairs with Jesus, I am torn apart by his desire to be present and his failure to do so. I still believe, in this exquisitely painful way, that those words still mean something to him. I don’t know the truth, but I am willing to abet this lie.

His doctor calls again and congratulates me on the birth of my son.

We’re all hoping that a grandchild will be the thing that saves him.

At once I am stripped, all raw nerve and bone, old wounds sliced open to be healed yet again. I am thin-skinned after all. Permeable, open—her words slide through me, through fissures just too deep for mending.

This essay was a finalist for the Bellingham Review’s Annie Dillard Prize in 2007. Creative Colloquy first printed it in 2020.