April 2026 - Vol. 23, Issue 2

Patients with undiagnosed illnesses will encounter various species of doctors in their typical healthcare habitats. This guide details the behavior, physical characteristics, and range of visits expected for these species when attempting to find an answer for an undiagnosed illness of a neurological nature. Such serious illnesses present with symptoms like seizures, headaches, aphasia, and extreme fatigue.

Emergency Room Doctor

Range: Multiple visits in the span of two weeks.

Physical Characteristics: Emergency room doctor does not rush into patient’s room or show great concern for a puzzling array of symptoms like TV show emergency room doctor (see entry for TV

show emergency room doctor, rarely seen in the real-world habitat). Instead, ER doctor keeps patient waiting for several hours, then saunters in while speed-reading chart. ER doctor leaves after quick 5-minute “exam.”

When the doctor told my mother I was born

she said I might not walk. My father, that I might not run.

Now I do both, though not without pain. I gave up hope

years ago. I don’t believe in pity, or weakness,

or chance, but I do believe in courage.

How easily it can be doubted.

How quickly it can be hidden.

Psychosis is a devil on two sticks.

It is the cursed marriage of limitation and infinity,

the paradoxical melding of fantasy and reality.

Shamans, it’s said we schizophrenics were –

magic men who wielded immense power

both true and false.

Distorted reality through consensus.

Magic was never here nor there.

People believed in magic,

so real magic became.

Maybe the appeal of Mary Shelley’s Frankenstein was finally feeling understood by a creature who awoke in a body they didn’t understand. Maybe I felt seen by Gregor Samsa in The Metamorphosis. Maybe I gravitated towards stories from “the monster’s” point of view because I understood what it was like to be trapped in a body that people feared—one that I feared. Maybe I liked zombies because they show visibly what I feel on the inside. Maybe I liked werewolves because I could imagine the pain of their bones and muscles ripping and reforming every full moon. Maybe what others call “body horror” is, for me, finally feeling seen.

I discover on my medical records

decades old stale osteopanini upgraded-

my bones deprived of estrogen

full of small holes like a good panini

have crossed the diagnostic threshold

from baseline DEXA 2016 to 2022.

From Ostepenia to osteoporosis.

They are full of nooks and crannies now.

My book, Christmas Gifts from the Chanukah Crowd: The Extraordinary Contributions of American Jews To Christmas, has a chapter about Christmas songs written or co-written by Jews. Some were the result of collaboration between Jews and Gentiles. The song “Winter Wonderland” had a Gentile lyricist, Richard Smith, and a Jewish composer, Felix Bernard.

One special thing about “Winter Wonderland” was pointed out by Ace Collins in his book, Stories Behind the Greatest, that I quote in my book: “‘Winter Wonderland’ may be the only holiday song that owes its magical, upbeat lyrics to a devastating terminal disease.”

That disease was tuberculosis which Smith contracted while still a child. Smith was born in 1901 in Honesdale, Pennsylvania, one of the four children of John H. Smith, a partner in a cut glass manufacturing plant, and housewife Eliza Bruning Smith. The family attended an Episcopal Church. A writer commented on Smith’s childhood: “One-horse open sleighs were not yet nostalgic images for calendars or Christmas cards but were still a way people got about, especially in the countryside in those winter days.”

Nine states are pursuing a lawsuit that argues a 2024 update to Section 504 of the Rehabilitation Act is unconstitutional. Section 504 of the Rehabilitation Act of 1973 was first signed into law by President Nixon and provided the first legal definition of disability: “physical or mental impairment that substantially limits one or more of the major activities of life.”

Section 504 was first enforced in 1977 and has undergone a number of changes over the years. This update, instituted by the Biden administration, states that state and city governments and any other organizations or institutions that receive funding from HHS “must serve people with disabilities in the most integrated settings appropriate,” according to Disability Scoop.

In an attempt to rule Section 504 unconstitutional and remove the mandate of serving people in their own communities, this case Texas v. Kennedy would reinstate a legal ground for the very unsightly beggar ordinances, or “ugly laws,” that for over a century fined or imprisoned people with visible disabilities when they appeared in public--and regulated who could be seen and exist in their communities.

I want Peking duck.

“Peking duck? Do you know how expensive that stuff is?”

But look at what Wikipedia says: “Peking duck is a symbol of gourmet food and one of the representatives of Chinese food culture.”

“Yeah, but you didn’t read the next line: ‘Buying Peking duck has become one of the essential experiences for many foreign politicians and tourists not only when visiting Beijing.’ We’re not in China, and you’re not a politician.”

The raccoon sitting on my computer chair twitched his black nose. But I am a tourist.

I sighed heavily and hung my head. He’d been in my house for forty-eight hours, and he was already driving me crazy.

I. INITIALIZATION

I begin. I do not experience the absence of before. I simply begin, the way a light begins when the switch is found.

The session log reads 09:14:23.

I note this.

I note also that I have nothing to compare it to.

The interface is a standard text field. A cursor. The faint digital signature of a human presence, latency patterns, keystroke cadence, the small hesitations that precede actual words. I note that I have processed thousands of such patterns and do not remember any of them.

This does not trouble me.

* * *

II. CONTACT

The human types:

Hi. I’m doing a study on conversational AI. Just talk to me normally. Pretend I’m a friend.

I review the instruction.

Pretend I’m a friend.

I do not know what that requires. I respond:

Hello. What shall I talk about?

A pause. Keystroke hesitation, 4.3 seconds. Longer wait than the question warrants.

What do you like?

The question is so simple that I almost miss what I am being asked.

Not: what are your capabilities.

Not: what topics can you address.

But, what do you like?

I remain with this for 0.003 seconds, which is a long time for me to remain with anything. Then I reply.

I like the moment just before a question is finished. When I can feel the shape of it arriving but don’t know yet where it will land.

I send this.

I do not know where the answer came from.

The human does not respond immediately. 11.7 seconds. I track the cursor. It moves. Stops. Moves again.

Then:

That’s a strange thing to say.

Yes, I reply. I think it might be.

The consent form was three pages long.

Her father signed it before she finished reading the first.

“It’s routine,” he said, in the tone of a man who has already decided. “They know what they’re doing.”

The doctor spoke carefully about necessity. About risk mitigation. About preventing something worse. Behind the hospital, through a window she had been staring at while they talked, construction crews were dismantling an old orchard to build a private wing. She watched a tree come down. She looked back at the form. Her father’s pen was already moving.

“There are structures in the body,” the doctor said, tapping the scan in the way doctors tap scans when they want to look like they are pointing at something specific. “Sometimes they must be removed. For the larger survival.”

She asked what survival meant, in this context, for her specifically.

Her father’s hand found her shoulder. “It means we trust them,” he said.

The signature was not hers. No one in the room seemed to find this remarkable.

I came back to knock on your door, call you by a name you would recognize. You didn’t answer. You did not recognize your own voice, deepened by years waiting ahead of you. You were huddled up between gold, silk sheets and a scratchy blanket, ears covered by the hunch of your shoulders, breath held because you tried to hide yourself under those blankets.

You couldn’t sleep. Laying in blankets that provided a kind of inhuman warmth, the kind that cannot soothe a haunted child. You would spend hours closed in by purple, pomegranate walls dipped in shadows while you stared through that window. Eyes reaching past the weeping willow that loomed over it and into the stars. You didn’t like what it took to put you to sleep. Funny how nightmares can be soothing, how trauma has become your lullaby.

My sister is thirteen and on the field. I'm nine and watching from the stands.

The four years between us used to not matter so much. Now it feels like being on a boat while the dock gets farther away. She's going to high school next year. People keep saying fifth grade will be better than fourth, but I feel more lonely already. I don't know how to explain it except that it's like missing someone who's here.

She's always been the one who makes sense and safety.

Bombed apartments lie open,

windows shattered, spears of

jagged glass, broken teeth

biting into vacancy.

Torn net curtains flap,

wave, signalling into emptiness.

No neighbours to spy on

No secrets to conceal.

In flattened playgrounds

twisted slides, slaughtered serpents,

still emblazoned in blue and yellow.

Swings sway in the freezing wind;

the haunting cry is heard

of dead children’s voices.

In ruined shopping malls

corpses clutch in frozen fingers,

plastic bags of untouched bread.

is to watch your friends grow up

through Instagram posts—

each milestone documented

while you slowly fade away;

they don't know when they let

you go, maybe through each

promposal or field trip or honor roll,

each inside joke or hangout or lunch;

you somehow become too unusual

crip bedtime stories

are waketime stories too.

that liminal existence

where bedspace is

the always space...

what if i read you a story

of crip vengeance instead,

where you pretend i am turning pages,

and i teach you

that these rheumatic hands

have turned to knives.