At some hour or another in the night I was awoken by a severe pain in my abdomen. For the better part of the next two days, I kept trying to find my way into the story where that pain was nothing. Eventually, there was a CT scan to discredit all the theories I'd devised. I met my surgeon as I was being wheeled into emergency surgery. It was the middle of the night again when he asked if I knew about appendicitis and I said yes and he said that there appeared to have already been a slight rupture. I thought of the name I'd just given to my new writing outlet. He told me about how long it would take to remove the appendix and clean up whatever contaminants might have already leaked into my abdominal cavity. I kept moving on the transport stretcher over the various surfaces and bumps of grout line under the hospital lights and through what appeared to be a construction zone. Somewhere along the way the surgeon fell from view but I caught a glimpse of him talking to my wife and even though they share a language that is largely alien to my own I understood that he was telling her what he’d just told me. I was wheeled into the operating room and moved to the operating table. I was discovered to be a werewolf and shaved into operating form. The anesthesiologist introduced herself and her contraption. I inhaled its passageways to nowhere, and then I went away. When I came back there was a new pain and a great thirst. “Naam,” I said in the nurses’ language. Water. “NPO,” they said in both of our languages. NPO. I had no idea what that meant but I knew it meant no water. And for maybe the thousandth time that week, I thought of No Country for Old Men.

In the inpatient room a day or two later, I looked it up and learned that NPO means “nil per os,” or “nothing by mouth.” This is to prevent aspiration, which occurs when food or liquids or stomach contents enter into the lungs, which could lead to all manner of complications and potentially death. I was struck by the word aspiration and thought of the ones that we humans carry around in us, and what we risk when we let them grow and burn unfettered. It is true that I was working from a surfeit of time and immobility by that point, though, and admittedly, I might have been seeing ghosts where there weren’t any. Never mind the demons that kept coming to me in my sleep. They came one at a time. Said nothing. Did nothing. Just sat in front of me, calmly, like Buddhist monks but with jet-black skin and dark garments and horns like Asian water buffaloes. They were beautifully lit in this oversized dark-red space, a sort of Lynchian planetarium. Somehow or another, their presence was a comfort to me. How that could have been I do not know, but it’s how it was, and I suppose it could have been the codeine. On his first visit to my room the surgeon showed me a picture of my appendix. The appendix. It resembled my dreams in hue and tone, but I didn’t tell him that. The appendix was enlarged in length and diameter and gangrenous, he explained, but it had not, as it turned out, ruptured.

I was released from the hospital on a Tuesday morning. By the afternoon, I found myself looking over an essay I'd finished a few days prior to the surgery, which suddenly read like a cipher. By the evening, I lay in suspended animation with the thought that both immaterial and material reality as we experience them exist as things that constantly pull each other into themselves. Viewed another way, they exist as things that constantly pull themselves into each other. There is nothing in my physical world that does not also contain my mind or arrive to me already wrapped in it. Likewise, there is nothing in my mind that does not refer in some way to my physical world or cross its borders to reach me. If these are constituent parts, constituent realities, could one of them be dominant? If so, which one would you suppose it is? The material or the immaterial? I think it would have to be the immaterial. Without question. Unless of course it’s the material. Dominion aside, if reality can be described—reductively—as something like a material hemisphere and an immaterial hemisphere that function in a kind of cannibalistic symbiosis, then at what point does that circle of input and output begin operating of its own accord? At what point do we become ersatz lever-pullers in an automated system?

I'd all but moved on from this thought by Friday afternoon, when my house began to sway. It was like being in a parked car that invisible hands rocked back and forth, and it went on for some time, the effect of a large earthquake that had struck nearly 1,000 kilometers away, in another country with another language and a long-running civil war that I have for reasons unjust and unknown been given the option to ignore. As the day went on and I followed the news out of both countries and the gravity of the situation set in, I was overcome with gratitude and guilt, the former for all the life I've been afforded to experience and endure and emerge slightly different from, the latter for the same.