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his brain propped up in cotton and bloodied gauze, the surgeon slipped and nicked the nerve that regulates facial muscles on Vicente’s left side. He recovered 70 percent of his hearing, and maybe it’s even better now—we don’t see each other too much anymore. For one thing, there’s what he did to me with Helen. For another, it’s pretty off-putting talking to a guy who can’t move half his face. Doctors can go on all they like about odds, but just try telling the people who actually suffer that kind of weird illness. When it happens to you, it’s like you bet the farm on a single hand.

    The doctor called me in. He used a remote that looked like a toy to lower the lights and run through slides with graphics and drawings of the heart. While I appreciated the staging—a gold star for public health—I was still too scared to take in the details. The jargon whizzed by and I couldn’t arrange the words into any sort of order, until finally I grasped the secret motive of his spiel: the guy was reprimanding me. He explained that the heart is an organ that cannot store oxygen, which entails—aside from embarrassment for whoever designed the thing—a constant demand for blood to move through the tangled channels of vessels toward our hungry organs. The complexity of the capillary network made me feel a little better about our genetic legacy—hats off to DNA’s handiwork.
    My blood flow had been interrupted for half a minute, long enough to give a shock to my senses; a few more minutes and the tensed wall of my heart would have dried into dead tissue. Luckily (oh, so luckily) the flow had stabilized. It was hard to accept that I was actually seeing the inside of my artery, or to understand what it meant that it was only 30 percent clear. The rest was obstructed by a plaque of lipids and fat, cellular or molecular muck—I wasn’t sure which scale we were talking about, or what was really going on inside me, under the skin covering my hands and thighs and ribs.

    “It’s like the mixture of hair, soap, and dead skin that clogs up the shower drain.”
    This was the example that disgusting man gave me, and I smiled as if I had some familiarity with that filth. If my artery wall hadn’t held up, some member of his class would have sliced through the hairy layers and fat of my chest, then split my sternum with a surgical saw and conducted a life-or-death operation on my aging heart.
    “One might say you were lucky.”
    You know me, my appetites are basic but clear: I asked for something to eat.
    “That’s part of the problem.”
    I reacted like a child playing Parcheesi who sees the dice land on the combination that spells his defeat, but waits a few seconds to give reality the chance to backtrack. In the end I took it in, and the explanation was striking: from my myocardium to my pulmonary veins and optic nerves, my entire system was filthy and unstable with the toxic residue of forty years of extravagance.
    “We are what we eat. You have to be careful, and the best thing you can do is go on a diet.”
    To tell the truth, this doctor inspired confidence: he was around my age, but was the kind of guy who’s already given up on his appearance. With a hairless skull and slack skin over the flesh of his cheeks, his attractiveness was limited to the flashes of intelligence in his expression. But still, I wasn’t about to let him call me “diabetic” and be so pleased about it. That he was a doctor and I had no goddamn idea what I was talking about was neither here nor there—society is democratic now, and you can’t just go around imposing your point of view on people. I decided I’d investigate on my own: Wikipedia and the Discovery Channel. Because I couldn’t make head or tails of the diagnosis. In school we’d always had one or two diabetics: white as marble, shooting up insulin like junkies in training, useless at sports, and condemned to eat peas and cauliflower forever. I was never one of them—you