The year is 1909. Suzanne Heath is a ticket-seller at Coney Island in New York City. She also has psychic abilities and is called in by the police to help find a murderer whose victims have been hideously mutilated. Suzanne feels compelled and obligated to offer her assistance even as doing so recalls memories of her childhood and youth when her psychic talents only brought about rejection, heartache, and pain. Suzanne's one true friend is Cittie Parker, a young man who ran away from the Colored Waifs' Asylum and now performs as a bloodthirsty Zulu drummer in Coney Island. He knows of her abilities and fears for her safety. As Suzanne digs deeper into the grisly Coney Island murders and her own past, she finds herself and Cittie caught up in a nightmare.

This dark historical fiction works very well on a number of levels. First, the story is complex. The author deftly handles flashbacks and plot structure with ease. You have different threads involving Suzanne, as a child with a deranged mother, as a teen in a girls’ boarding school, and then as a young adult working a dead end job on Coney Island. Intertwined these settings are paranormal incidents, a rash of serial murders, and an unidentifiable evil lurking ever present just out of view. The amusement park setting also adds a seedy creepiness with a sense of unpredictability. As a result, the novel was an absorbing and thrilling read.

I thought the characters were nicely drawn and believable. The early 20th century depiction of Coney Island and New York City seemed authentic. The time period, with its social mores and overt expression of racism, were well depicted.

The one issue that I have with the novel is the ending. I certainly did not see the ending coming. It certainly is a shocker, but part of the reason it is such a stunner is that the reader is tricked by a sleight of hand. I actually felt manipulated. I will not disclose anything more for fear of spoiling the work for potential readers. I really liked all aspects of the story except the conclusion. I would not hesitate to recommend Hell Gate. Just be prepared to be let down with the way the author tries to bring the story to a close.

Just a few quick updates. First, the book club discussion went very well. The group was very supportive and engaging. What more can you ask? Second, I have been delinquent in posting book reviews. I will follow with two shortly. Third, I will also resume with my "stroke" blog, as I have been calling it. That will probably occur on Sunday. 

I've been a member of a men's book club for about 25 years. This is quite an eclectic group in terms of reading tastes and occupations - although all members are professionals or retired professionals. Book discussions are animated and decidedly high-brow. The books that are selected tend to be well written and well regarded. So, when I announced to my group that (a) I've been (secretly) writing horror novels over the years and (b) I had one accepted for publication, I was more than a tad nervous. I shouldn't have worried about their reaction - they were hugely supportive and enthusiastic. So when it came time to select books (we select books every 6 months or so), I was pleased that my novel Birth Offering would be a selection - although I did not seek or recommend it. Not only that, but was was informed that I would read the discussion. Gulp. Well tomorrow night (Monday night) is the day we discuss Birth Offering. I am quite nervous. Of all the people I've worried most about in terms of reactions to the book, this is the group. I'm envisioning their expressions will look a lot like the picture of these two guys, whom you've all seen before.

So, tomorrow night is the night. I write about what happens in a few days. If I survive.

About two weeks after her surgeries for the removal of the adrenal gland and the renal cell cancer, my wife started vomiting. This wasn’t just an occasional “blast”, but a more or less constant barrage. Hour after hour. At first, everyone thought “she has the flu…” which made sense… it was late January or early February when it started.  But it wasn’t the flu… or a virus, or something related to the immune system, or some complication from the recent surgeries, or something related to the endocrine system, or bone cancer, or some strange gastro-intestinal disorder. All of these things (and more) were examined as potential causes. The vomiting continued, except for short respites, until June – nearly five months. The short respites (if you could call them that) occurred when she was hospitalized. Sometimes it would take a day or two in the hospital, other times it took a week or ten days to bring the vomiting under control. In June the vomiting just trailed off. The official diagnosis was “neuropathic” vomiting. Or, as one physician honestly told me, “a clinical way of saying we not sure what the hell was going on”. That wasn’t entirely true – the cause was the brain randomly setting the process in motion and the not being able to turn it off. Hence the “neuropathic” term. A small dose of an anti-depressant seemed to do the trick. She was prescribed it with the hopes that it would calm the system down. For whatever reason, that worked.

This was a brutal time for us. My wife felt absolutely miserable, which is easy to understand. For me it was a different story. I hate vomiting. I hate the sight of it, the sound of it, and the smell of it. I realize that no one loves it (although, somewhere out there, people probably exist who relish the sensation). However, there are people who can manage being around sick people and clean up vomit without blinking an eye. They are capable of wallowing in the stuff and barely flinch. These creepy bodily functions are just no big deal for them.  I could never understand how they did that. Not me though. Just hearing someone retch from afar can make me gag. So, I actually fear being around anyone who may be ill or is getting ill. Needless to say this was a huge challenge.

More next blog...

The evening before her stroke, my wife received a call from her endocrinologist. Ann had broken her foot many months before and the bone was not healing. The investigative efforts were turning up nothing as the cause for this mystery. Then, one of the many physicians along the way wondered about an endocrine-related cause. Sure enough, the endocrinologist discovered that Ann had Cushing’s syndrome, caused by a tumor on either the pituitary gland or the adrenal gland. So, the endocrinologist was calling the night before her stroke giving her the news and beginning to discuss the next steps.

Cushing’s syndrome is an odd condition. As a result of this (usually) benign tumor, the body is exposed to prolonged exposure to massive amounts of the hormone cortisol. The result is a bizarre set of symptoms: rapid weight gain, insomnia, hypertension, thinning of the skin (results in frequent and easy bruising), moodiness and irritability, muscle and bone weakness (hence the inability of the broken foot to heal), and a whole host of other symptoms.

The thinning of the skin is critical for understanding the likely cause of her stroke. Nine days prior to this phone call from the endocrinologist, Ann was in a pretty severe automobile accident. Our relatively new car was totaled, but other than some soreness and being shaken Ann was okay. The next day she developed nasty looking bruises around her waist and a diagonal bruise from the left shoulder to her lower right side. If you can imagine the position of a seatbelt and shoulder harness, you have the idea of the shape of the bruise. The force of the crash created a bruise the entire length of the restraint. What we didn’t know was that the Cushing’s syndrome not only weakened the external skin, but also internal “skin”. Her right carotid artery dissected in the crash. The scar tissue took ten days to break off from the dissection in the carotid artery and worked its way to the brain and caused the stroke (at least this is my running hypothesis).

Ann was in the hospital for 35 days. The first task was stabilization, and then occupational, physical, and speech therapy to prepare her to come home. While in the hospital, the medical team thought they might as well check out exactly where this tumor was that was causing the Cushing’s syndrome. They already had plenty of head MRI and CT scans, so they knew it wasn’t on the pituitary gland. That left the adrenal glands to be checked out. We have two of them, one on top of each kidney. So, twenty days into the hospitalization, the pictures were taken. Sure enough, the benign tumor was found on one of the adrenals. But, unfortunately, so was something else on the other kidney. Renal cell carcinoma. Kidney cancer.

Needless to say, this was a stunner. Within a twenty-one day period, Ann had a massive stroke, and we learned she had Cushing’s syndrome and renal cell cancer. All of the specialists attending to Ann (and there were a lot of them) said that the cancer was the least of our problems. She first needed to go through the rehab from the stroke and recover to the point where she could manage the surgeries (one to remove the adrenal gland and one to get rid of the tumor). So, the surgeries were being scheduled for January. That would give her three-plus months of rehab time. 

The next three months were intense with frequent doctor visits and rehab therapies. We had (and continue to have) excellent CNAs who helped with home care. Ann was walking fairly well and gradually left the wheelchair behind and adopted a single point cane. By the time January rolled around, Ann was well enough for the surgeries. They were scheduled on the same day with two different surgical teams - one right after the other. The pre-surgical preparation, the procedures and post-surgery recovery took longer than expected. Some bleeding issues (possibly Cushing’s related) slowed things down, but everything went well.

We thought we were in the clear. But, no…

Strokes have an interesting impact on the brain and subsequently the body. Type of stroke, location, severity, and duration all intersect to have detrimental effects. In addition to the weakness and paralysis on her left side and all of the accompanying ramifications (e.g., foot drop, drooping face), my wife experienced some heretofore unknown side effects – at least they were unknown to me. For instance, she had “left side neglect”. When shown a picture and asked to describe what she sees, she would provide accurate detail of everything from the midline of the picture and to the right of the picture. It wasn’t that she was blind in her left eye, but seemed to not process the information. When asked, “what about the stuff on the left side?” she would reply, “oh sure, and then describe it.

Then there was the loss of emotional display within her speech. When we talk, our speech intonation rises and falls, and voice tone shifts with emotional content. For Ann, immediately after her stroke, this display of emotion within speech was gone. I found this one of the most devastating outcomes. He voice was robotic and flat. There was no liveliness, no sense of affect. It was like listening to an automated recording. The human part of her voice was missing. She would report being angry or frightened, but her voice would not display anything indicating this affect.

A final oddity for this discussion was the loss of her ability to do long division. The other mathematical operations remained intact.

Recovery from a stroke is a long, frustrating and grueling process. Physical therapy, occupational therapy, and speech therapy are crucial. Medical and rehabilitative advances are being made all the time. My wife gradually relearned how to walk, and now walks on her own with a brace and uses a cane. Sadly, her left arm and hand never regained much in the way of functioning, although she is able to bend her arm and slightly move her fingers. On a very positive note for me, her voice regained its ability to express emotional inflections.

At the time of her stroke, my wife was one of the country’s leading early childhood exceptional education experts. She was truly a rock star within this domain. One thing that surprised all of Ann’s physicians and therapists was her spontaneous ability to begin using special education strategies normally taught to kids with cognitive and language delays or learning disabilities. She would routinely implement certain interventions when faced with the relearning of certain perceptual and cognitive tasks. For instance, once Ann became aware of her left neglect, she prompted herself to examine all aspects of her environment in trying to perform a task. The result was a significant improvement in this area and a virtual elimination of this problem. In a similar manner, she was able to address her long division issue – at least to some extent. Truth be known, however, math was never her strong suite. So, I am not exactly sure what role the stroke played in this disability.

My wife loved being a researcher, a professor, and an administrator. It soon became clear to both of us, however, that the rigors and demands of being an academic would be too much for her to resume. So, after much weighing of options, she decided to retire.

Unfortunately, the horrors weren’t over.

The rest of that day was unfathomable. She was transferred to the second hospital. I met with one neurosurgeon who described the next step - inserting some device in a blood vessel at her groin and threading this thing up to her brain to, I don’t know, dig its way through the clot (it was a clot, not a bleed). The way “the device” was described was a wire with a rotor-router type thing at the end - and mounted with a camera.

The doctor was able to thread this thing towards her brain and watch on a monitor. Turns out there were two clots. He got through one but not the second one. Then there was a research study involving some experimental medication. My wife tolerated that for a while, but began vomiting three hours into the administration of the medication – which meant it had to be discontinued. Oddly enough, that was devastating to me. I was hoping for some miracle-type outcome.

In between all of this activity were the phone calls. Her family. My family. Friends. Colleagues. I gave permission to people to spread the word. I couldn’t call everyone. Besides, retelling the story and providing updates was exhausting. By 8:00 PM she was resting comfortably (as comfortably as you can in an intensive care unit). The stroke was in the right hemisphere of the brain, meaning her left side was impacted. Language expressiveness is located on the left side of the brain, so she could still talk, which was a blessing. Her left side was paralyzed though. Ann could only wiggle her left toe. That was it.

I left the hospital at 8:30 and crashed in bed when I got home…only to be awakened by a phone call at 3:00 AM. What was this? You know what you start thinking when calls come at odd times of night. Who died? This time, though, I would know the answer. When I grabbed the phone, Ann was on the other line. I couldn’t believe it.

“Tony, bring in the paper and a cup of coffee when you come in.”

“What, Ann, it’s 3:00 in the morning.”

“That’s okay. Just remember the paper and stop for coffee.”

This conversation was making no sense.

We hung up and I was still confused. How did she get access to a phone? Is she better? What was going on? Were mocha lattes from Starbucks on the approved list for patients recovering from a massive stroke?

I called the nurse on duty in the ICU. She was very apologetic.

“I’m sorry, I heard her on the phone and tried to get in there and stop the call. She was disoriented. She was talking about going downstairs and making coffee. This type of confusion is really common in people admitted to the ICU”

So, there was a phone in the patient rooms in the ICU. I hadn’t noticed. She was stable, but this wasn’t evidence she was dramatically improving. And, to my surprise, mocha lattes were okay.

The next day, September 2, started the most difficult journey for Ann and for me. There was physical therapy, occupational therapy, and speech therapy. There were additional shattering illnesses and conditions that developed and demoralizing complications. The impact on family life was substantial. Our daughter started high school on September 5, and this huge milestone went by unnoticed. Issues related to careers, money, and insurance. Then came the multiple invasive surgeries for unrelated conditions. How we got through it is unclear. We did, though.

I don’t want to dwell on this too much, but I will mention a few points in future posts. Suffice it to say, the living horror story took a long time to work itself out.

I started talking in my previous blog about September 1, 2006 as being the scariest day of my life. On this day, in response to a call from my wife’s program assistant, I found her in the midst of a massive stroke in her office.

We were both university professors at the University of Wisconsin-Milwaukee, and our offices were in the same building one floor apart. Even retrospect, the memory of her appearance sends a jolt through my system.

Campus police and the paramedics were called, and I had some immediate help from a secretary and a couple of Ann’s colleagues. This was the Friday before Labor Day weekend, and classes weren’t due to begin until the following Tuesday, so many people weren’t around. I was fortunate that even these folks were there.

By the time the EMTs arrived, she could not remain upright in her chair and slipped to the floor. They took her to Columbia Hospital which was right across the street from the UWM campus. Ann was unsure when her symptoms began, which knocked her out of the running for that stroke medication that can only be taken within the first 3 hours of symptoms (which has now been expanded to a 5-hour window). When the films came back, the neurologist brought me into the ER office for a look. I was stunned, as it looked like a large chunk of the right side of her brain had been hit hard. The physician said to me, “this could be incompatible with life”.

I swear to God that is what she said. This could be incompatible with life. Your reaction might be wtf? Mine was. Imagine being under that distress and trying to decipher that phrase. I had to clarify in plain English.

“Are you saying this could kill her?”

The answer was an affirmative nod.

We had a 14 year old at home. We had a mortgage. We had expenses. We had a life with dreams and hopes and expectations. Now, I couldn’t think more than a few minutes ahead.

Ann needed more specialized treatment and she couldn’t receive it at this hospital. She was going to be transferred to Froedtert Hospital which is affiliated with the Medical College of Wisconsin. There they had neurologists and neurosurgeons who experts at some different procedures.

I was living my own horror story.

My life changed forever on September 1, 2006. As I go back and look at this sentence, I realize I am making it all about me.

Not true.

This day changed the lives of our entire family.

At around 10 that morning, I received a call from my wife’s program assistant saying that she as not feeling well. Could I come downstairs?

My wife and I were both professors at the University of Wisconsin-Milwaukee. We had the envious setup of not only having faculty positions in the same institution, but our offices were in the same building, one floor away. Ironically, we still took two cars to work – mostly due to the fact that we had to take turns with parenting tasks and home tasks. Our courses were often late afternoons and early evenings, and someone had to be home to handle after school duties, drive to practices, prepare dinner, etc. Again, most people juggle the same thing.

Anyway, on that September 1, I went straight to her office, and it was clear that she looked terrible. My wife rarely gets sick, and her “look” was something that I have never seen before. She wanted to go home right away, and the bulk of our 60 second discussion was about how to get both cars home. Could she drive in her state? She thought “yes”, but that was truly questionable. Something was alarmingly wrong and getting worse by the moment.

Then it hit me.

Her voice was garbled like she had cotton balls in her mouth. The left side of her face was sagging, and she was slowly but surely leaning to her left.

She was having a stroke, and she was only 48 years old. 

When I said, “you’re having a stroke”, her look was something I’ll never forget. Fourteen years earlier her mother had a stroke and had died about two years previously. The impact of the stroke on her mother was tremendous – and quite negative in terms of disability. I knew this was going through her mind.

Her expression was one of devastation, and we both knew life would never be the same.

More next time.

Life has a funny way of unfolding.

With the publication of Birth Offering, I have had a couple of people ask me if I believe in the supernatural. The question makes sense since I have such a fondness for the genre. A fair number of these questioners are puzzled when my response is “no”. I explain that I am a natural skeptic when it comes to these matters. As a psychologist and a researcher I look for data and evidence. And, the evidence for things supernatural is sorely lacking, as far as I can tell. I don’t need to believe in order to enjoy being scared or unnerved by novels and movies. I don’t see this as any different from those people who like superhero movies or outer space science fiction movies. You don’t need to believe in those things in order to enjoy those films.

This is not to say that I am a skeptic in all things “otherworldly”. I do have a spiritual life. I am a Catholic who struggles with faith issues like any other person who has a faith life. I lean rather strongly towards the progressive or liberal end of the spectrum, which means of course that I feel frustrated with the church hierarchy and their actions and pronouncements over the last few decades. But, culturally I am firmly entrenched into a community of people who are important to me and who quite frankly are more spiritually supportive than the hierarchical types.

I digress, however. All by way of saying, I do have a spiritual life and have a fondness for horror novels. However, I am not a believer in the supernatural entities and events that make the genre so thrilling. For some, this may make no sense whatsoever. In fact, they may think these are conflicting states of mind. I suppose that could be true. I am very comfortable with it though. Living with this level of ambiguity is just fine.

There are realities that do scare or unnerve me, however. Much of them are internal – I am a natural at roller coaster states of anxiety. Adolescent OCD and life-long generalized anxiety make up part of my history. More importantly, external sources of distress also have played a big role in my life. Specifically, family medical crises (in the form of a series of critical health conditions striking my wife) have rocked my very life foundation to the core. The re-establishment of my own emotional equilibrium may be a lost cause. While the latter point sounds unsettling, it really isn’t. I have had to recalibrate my expectations and outlook – which is not a bad thing. Many people do it all the time. Why not me?

I will talk more about these topics in upcoming blogs.