I scheduled a doctor’s appointment during a school day afternoon since mornings could be tricky and the train ride was all the way uptown. Both mom and dad had obligations, so I was going by myself for the first time. Mom left me a blank check, my insurance card, and her notepad to write down what the doctor said. I took a sick day from school and slept in. I had a light breakfast of toast and a scrambled egg, then walked to the train station at Borough Hall.

To the hospital and back on the train combined with the waiting room could be a couple hours of reading time, so I brought along The Catcher in the Rye, for which Josh had called me a cliché when he saw me reading during free period. “Oh, feeling angsty? Gonna go rebel without a cause?” I swiped my MetroCard and ran to catch an uptown 4 train. All the seats taken, I stood in front of a seated mom with a baby harnessed to her chest and bouncing on her lap while she read from one of the new e-reader tablets, next to an older man reading from a folded Chinese newspaper. Print should survive in one form or another because it doesn’t need a battery charge, but rapidly technology updates and integrates as the division between human and device seems less, seamless. Maybe these are the early stages of our evolution into robohominids, which is inevitable if we want to survive after the sun burns out and the Earth is old and grey. If we don’t evolve, we’ll have to invent regenerative fuel so that we can travel for thousands of light years looking for a new habitable climate, Hanukkah oil not efficient enough, unless relativity at that speed reverses the aging process so that only one generation needs to cross from shore to shore in a spaceship. Who will be left behind, all the nobody people or just an old graveyard ghost?

Screeched to a stop at 86th street, walked with the crowd upstairs and transferred to the local 6 train for one stop to 96th, and then up out of the underground and west towards Mt. Sinai. Buds on the street trees, spring starting to green winter’s gray, warm rain had come and washed away the petrified dog turds and gross snow from winter’s end. Maybe we can save the earth when the sun burns out by creating synthetic sun or go underground and preserve the warmth of the earth’s core. First need to avoid nuclear omnicide, a second big bang, one burned black dot amid the universe, period at the end of our sentence.  

I walked into the Mt. Sinai office building and took the elevator to the 9th floor, signed in at the front desk, sat down, and opened my book:

“I live in New York, and I was thinking about the lagoon in Central Park, down near Central Park South. I was wondering if it would be frozen over when I got home, and if it was, where did the ducks go. I was wondering where the ducks went when the lagoon got all icy and frozen over. I wondered if some guy came in a truck and took them away to a zoo or something. Or if they just flew away.” If my stomach is okay after the appointment, I could go for a walk and see if they’re back in the park by early May.

The nurse called my name. I stood up. “Come with me please.” I walked to the examination room, sat down on the cricklecrackle paper bed, “Okay, I’m going to take your blood pressure so can you hold your arm out please?” Strap around my arm, squeezing tighter and tighter, veins bulge, until air release pshhhhh and she counted my pulse badum badum with her stethoscope. “Normal. Let’s check your weight.” I stood up and walked onto the scale. She moved the sliding metal until it balanced. “You’re about 143 now, I’ll tell the doctor. He’ll be with you shortly, and I’ll see you for blood work before you leave.” “Thanks.” Smiled and walked out. Usually gain weight during winter, burn it off in the summer. Door open, doctor.

“No parents today?” he asked as we shook hands.

“Nope, both working.”

He sat down and opened my file.

“So, looks like you’re losing weight again, how are your symptoms?”

“Not great, I’m slipping back to where I was before the steroids.”

“Alright, we’ve still got some tricks up our sleeves to get you healthy, can you lie down on the table and pull up your shirt? Let’s have a look at your stomach.”

He pushed gently with two fingers.

“Does any of this hurt?”

“No, it’s alright.”

“Okay. Well, our next course of action is the category of immunosuppressants, which are powerful and have very high success rates.”

I nodded, should be taking notes? Mom’s pad: immune suppressant 

“As you know, Colitis is an autoimmune disease, meaning your immune system is attacking your body. These drugs weaken your immune system so that it can’t cause inflammation, which does leave you more susceptible to viruses and infections, so you have to be careful, you know, wash your hands after the subway and during school, especially before meals.”

“Alright.” 

“I think the best one to try first is Adalimumab, market name Humira. It’s a self-injection, you can do it in your stomach or in your thigh. The first and second dose are higher to help introduce the drug to your system, so the first time you’ll take four syringes, next week you’ll take two, and then you can take one every other week.”

“I inject the syringe myself?” cringe.

“Or you can have someone else do it for you. It comes in two different forms, the syringe and the pen. Most of my patients say the pen is easier for self-administration. You just put it on your skin and press the button. Do you think you would prefer that?”

“Yeah, that sounds better. Are there any side effects?”

“Like I said, your immune system will be compromised. It is very rare, but some people have an allergic reaction, so if you develop a rash, swelling in your throat, or feel especially dizzy, call me immediately.”

What would mom and dad ask?

“So what’s the success rate on Humira?”

“There is some discrepancy between studies, but at a conservative estimate Humira controls symptoms for 60% of patients.”

“Sounds like it’s worth a shot. I want to talk it over with my parents first though, make sure they don’t have any objections. Do you have any other options?”

“There are always other options, but I think Humira is the most prudent next step. Talk it over with your parents, your mom can talk to her brother, and see what they say. If they have any questions, tell them to give me a call or shoot me an e-mail. I’ll write out the prescription for you anyways. The insurance company will have to approve it first because it’s a more expensive drug. So let me know if your parents are okay with it, and we’ll get the ball rolling. You’ll follow up with bloodwork one week after the initial dose to see if your white blood cell count lowers, which would mean it’s tempering your immune system.”

“Alright. Should I keep taking Asacol and 6-MP?” 

 “Yes, we’ll keep you on that for now, they can only help, and their side effects are benign. Do you have any other questions?”

“Uhm, not at the moment, but I’m sure my parents will have some. Do they have your e-mail?”

“If they don’t here’s my card, and here’s the prescription. Before you go, Monica will take blood samples so we can have updated numbers, sound good?”

 “Okay, thanks.”

“Stay positive, we’ll nip this thing soon.”

We shook hands and he left. Maybe this new drug could make me healthy for college, better than fifty percent chance. The nurse came in with vials and a needle and drew blood, squeeze swipe pinch prick… pressure, taped. Enough needles to not be nervy anymore. 

I left the austere office building and walked into the bright midday sun shining through the Central Park trees across the street. I crossed Fifth Avenue and entered the park just north of the Ninety-seventh street entrance, passing private school boys in blazers and khakis, rolling their backpacks home with their parents or nannies. Past the chest-high stone wall and between the boundary trees into the rectangular green oasis, East Meadow to my right with picnic blanket congregations. Along the bend towards the South, and up a hill to a giant reservoir and bird bath, flock sitting on the water along a shallow pipeline that runs from one stone building on the northeast to another on the southeast, don’t see any ducks though… Bump and bearings blundered for a moment as a group of joggers run by, the one who knocked me looks back with a half shrug and keeps running to stay with the pack, more joggers behind me, walk next to the railing as they pass, continuing west around the reservior, past a sign on the fence, “Jaqueline Kennedy Onassis Reservoir,” the national tragedy in her double surname, must have donated lots to the Parks Department, everyone needs an escape. John had colitis, how did he manage his stress? Past an old stone building, locked, “1864” at the top of the door, the year it was constructed? The year the North regained assurance in the Civil War and resumed leisure in the park? Approaching the west side towards art deco twin towers, need a closer look. The same building, attached in the middle by the ground floors with a terrace on top, must be grand apartments, 300 Central Park West. Turn back around to the reservoir and see Mount Sinai Hospital up to the north, an obsidian block looming larger than the adjacent apartment buildings. Continue along the path with joggers passing, stomach rumble, needing a bathroom soon, should be one somewhere. South through tortuous paths, rrrrrr I pass a group of a dozen or so with binoculars, cameras, and maps, what are they doing? “A warbler!” said one, pointing into the trees. Birders. I started to walk past them, but one stopped me, “don’t scare it off,” he said, but I had to find a restroom. He pointed, my eyes followed and found golden yellow, babycry from a passing stroller and it flew off into foliage, shutterclicks a moment late. “Did anyone get a picture?” Briskly to a boathouse straight ahead and found a bathroom well maintained.

Relieved, I walked with my head in the trees, cast of birds zipping about, what birds were they? A dark flash, a swerve, a flutter of wings. As I continued south, the tall towers of Central Park South’s skyline began to loom over the trees. I passed the abandoned skating rink to Holden’s lagoon, and sat on a stone wall with an overlook: there are the ducks, someone on a bench feeding a few, maybe JD himself. I took his book out of my pocket. There’s no way that some guy comes with a truck to take the ducks to a zoo at the beginning of winter, where would he take them? Florida? Reunite them with the retirees who made the same migration? Opening at Art Basel this winter: The Central Park Ducks Exhibit! See all your old friends! H&H bagels included! They probably fly south for the winter like most birds, not including the resilient rock dove. And what was Holden’s problem with school? That’s the best place to ruminate about meaningless questions laden with esoteric metaphor. For that matter, why was I gazing downwards from my perch at these waterfowl while listening to city sound convolve with nature, searching for augury… from who? Zeus? Ten decisions shape your life, migrate west to the quiet woods of Pennsylvania or stay safe in this city with support system? Ulcerative colitis is more common in industrialized urban environments, there is more carbon dioxide filtration in the mountains, and maybe leaving the bustle will reduce stress—hyper city stimulation skewing my sense of proportion. If these immune suppressants work, I will go away to college, if not, I will stay in the city until my doctor has found the solution, hopefully he’s not a quack.