Last week, I visited an ENT to see about the constant ringing in my ears. I’ve had this tinnitus for years, but it either got worse recently or I’ve just started noticing it more.
From behind his otoscope, peering into my left ear, the doctor asked, “Have you been exposed to loud noises?”
I told him yes, sort of.
I used to go to loud concerts and clubs, but I didn’t think it was any more excessive than the next person.
“Well, we’ll see about that,” he said, as a nurse led me into the audio testing room, where she placed me in a black soundproof booth.
“Repeat the words I say until you can no longer hear me,” she said.
What a lilting experience to have words, disembodied and vaguely Americana, echoed into diminishment: Sidewalk… Hot Dog… Railroad… Baseball… Mushroom…
The nurse scanned my results into a computer and told me the doctor would be in shortly to review.
The door stayed open, and a moment later he walked in grinning, holding some papers to his chest like a kid with a new toy.
“Those concerts? Turns out they were louder than you thought.”
On the papers, he showed me a tiny notch in a graph that indicated that at a certain frequency, I have hearing loss consistent with someone who has been exposed to loud noise. He was still smiling. As he told me I’ve irreparably lost my hearing, he was smiling.
Garth Greenwell’s Small Rain is the book I wanted to write after bearing witness to my father’s cancer treatment last year at one of the largest hospitals in Dallas. Small Rain is about many things. But after losing my Dad the way I did, I could not read it any other way than as an indictment of the U.S. medical system.
The novel centers on a man who enters the ER at the height of the COVID pandemic with a tear in his aorta. (Spoilers ahead, if that matters to you.)
When the narrator enters the ICU, doctors immediately begin artificially lowering his blood pressure to prevent further damage to the artery, and for the next 200 pages or so, he’s subject to a relentless barrage of interventions, medications, and procedures—all increasingly violent to the body, and done in the name of “keeping him safe,” a phrase that recurs through the book like a mantra.
He’s relegated to bed rest, and in his room is a single window through which he occasionally sees a sparrow—his only connection to nature and the outside world, except for one visitor a day, at restricted hours, with strict sign-in protocols.
The poetics of the medical system are full of violence and war. Antibiotics and procedures are described by the medical staff as carpet bombing his system and burning through his veins.
At the end of the book, after nearly two weeks, the doctors find no cause for the tear. They simply release him, but can tell him nothing about what happened, if it will happen again, what caused it, or how to treat or cure it. He is back where he started, except now he’s physically debilitated. They send him home with a PICC line so he can continue taking drugs intravenously, and he can no longer stand, walk, dress, or bathe on his own.
To me, it seems reasonable to ask if his debilitation was a result of an artery tear or the trauma his body endured in the hospital. While he had a life-threatening condition when he walked in, it seems at least some of his new reality could be attributed to the days of constant drug cocktails, endless blood tests, isolation, psychological and emotional distress, and mini-surgeries he endured. This is sustained trauma.
But because he walks into an American hospital with a potentially life-threatening condition, the hospital feels justified in declaring war on his body, for we Americans see ourselves as heroes and illness as the villain. Everything we do in the US, the solution seems to be war.
When my father went into the hospital in January 2024, it was like stepping onto a conveyor belt. The hospital system is a train with a protocol and a schedule that consists of highly aggressive and painful procedures against the body while precluding the most basic elements of human care like water, food, movement, and sunlight.
In two weeks—about the same amount of time as the narrator in Small Rain—Dad’s arms became swollen and purple, his eyes sunken, his body ravaged. Yes, he had cancer, but he was also undergoing daily injury to his body from the doctors and nurses in the name of medicine.
And in the end, like Greenwell’s narrator, we were left only with a shoulder shrug from the system for its impotence, its inability to understand the human body, let alone heal it. And, of course, the bill.
Getting my diagnosis from the ENT, the doctor’s smile made sense in this context. He was smiling because his job is not to make me well. It is to relinquish his responsibility for my wellness. In telling me that I have a problem that can’t be solved, there is no more need for me to be in the system. And given the state of our medical system—one that doesn’t heal us, but drowns us in pharmaceuticals and spits us out weaker than we were when we came in—evading it, for now, is in fact good news for both of us.