Issue Eleven

Winter came screaming to a halt this year
Here in northern latitudes by inland iceland sea.
Jonah Benjamin Bernstein’s head emerged,
Seed to fruition,
At the end of February.
The ground was still hard,
The Light had just faded,
But his cry promised the warmth of the sun,
Early eclipse home.
And after twenty-one inches
And seven pounds and some was out,
The cord was clamped and our hopes released
For many years and leaves to follow,
Our  branches to be many,
And now our roots are four.

    There are no marble monuments etched with the names of corporations or foundations announcing the Jonah Center at the Erie County Medical Center.  A modest green vinyl sign suspended from a drop ceiling suffices to demarcate this hospital corridor.  This is a medical clinic of last resort.  A few graciously donated pieces of artwork briefly distract the eye before one sets their sights on the utilitarian design of cancer diagnoses.
    Whatever privilege or wealth you may have accumulated, or prejudice and depravity that you might have suffered along the way, recedes now in this hallway under the prospect of confronting an oncologist with your diagnosis.  Here at the Jonah Center, the examination  rooms are filled with those attuned to the voice of such an oncologist.  This voice reverberates from the echo of a Brooklyn neighborhood no longer in existence, and belongs to Zale Bernstein.
    Bernstein, a fit man in his mid-fifties, appears through the clutter of patients and workers at the Jonah Center.  There is a certain hard earned leanness to his body, the by-product of intense daily workouts that began when he discovered his inner-athlete relatively late in his forties.
    Bernstein has always been in touch with his inner-comedian.
    “I used to be a parks worker,” he jokes as he wheels an elderly woman past a maze of hospital carts, “but with all the budget cuts the union reclassified me as an oncologist/hematologist.”
    Bernstein and the patient share a bag of potato chips.  Often, Bernstein uses food and humor to penetrate the trepidation that lies at the surface of the patient doctor interaction, and in his hands the chips become a diagnostic tool.
    “What is this?,” he asks Tanya Bellavia, the Jonah’s Center’s untiring physician assistant as she rushes to join him in the examination room.
    “A stethoscope,” she replies.
    “Oh, yes now I remember,” Bernstein exhales and thrusts the bag of chips in front of the patient again.  “Now dear, please tell me how are you doing?”
    Moments later Bernstein and Bellavia leave one room and head to another where a sixty year old man with second stage pancreatic cancer awaits them.  Again, Bernstein extends the bag of chips to the patient.  The man releases a boyish grin and the rigidity of his body slackens while listening to Bernstein’s latest prognosis.
    “Ah,” Bernstein says, “they thought you were going to die, but now you’re going to live and they don’t want you to have a heart attack.”
    Back in the corridor, Bernstein is ambushed by two pharmaceutical salesmen.  He grabs one of the men and puts him in a headlock, old-school style.  “Hold the patients,” Bernstein shouts.  “Hold the patients.  The pharmaceutical reps are here.  Everyone is going to be alright.”
    Bernstein bounds for another examination room while Bellavia struggles to keep pace.  There, two prison guards sit on an empty bed playing cards while the inmate they are guarding stares at the ceiling before Bernstein appears.
    “Here is how I want to describe what is going on inside of you,” Bernstein says, addressing the inmate.  “It’s raining inside of you.  I can mop up the water, but I can’t do anything about the rain.  You see it’s raining, do you understand?”
    “I think I do Doc,” the con replies.  “I need a new liver.”
    “Fast,” Bernstein says before bolting the room.
    Outside in the hallway, another elderly woman in an orange prisoner’s jumpsuit and leg cuffs stops and waits to say goodbye to Bernstein.  She blushes while Bernstein hugs her.
    “Darling,” he says.  “At least you’re walking out of here–in handcuffs–but you are walking out of here.”

I am a cancer consultant
        at a county hospital
    for the disaffected
        and the disenfranchised
I enter their rooms
        and tell them the news
I describe the light
        at the end
            of the tunnel
    the struggle
        with this particular phase
    of existence
        is nearing its
            terminus
I try to describe
        the track
    the journey
        the scenery
    the locomotive
        I  cannot however
    tell them
        ultimately
            where they are going

    Later, Bernstein slouches against a wall like a chef who has just experienced the first rush of a very busy night.  His menu is an ambitious one–Medical Director for Cancer Care and Immuno Blood Conditions, Director of Center for HIV-Related Malignancies, Director of Immunodeficiency Program, Director of Hematology/Oncology, Blood banking, Immunohematology and Histocompatibility, Associate Professor of Clinical Medicine.
    The exam rooms fill up again.  The waiting area, hopelessly undersized, bulges under the weight of unspoken expectations.  Bernstein’s glasses momentarily descend the bridge of his nose revealing an impossibly youthful face, the face of a bit of a wise-ass.  His day has just begun.

    When  I cried
        with the parents of my patients
    I would leave
        always wondering
    how they carry on
        now I
        will have to learn
    teaching to believe
        and believing are
        always separate
    helping someone grieve
        and grieving are
        always separate
    observing death
        and dying
        will always be separate
    and that separation
        is beyond
            any imagination

    Zale Bernstein’s life began in 1948, the youngest of two, and he was raised in the rapidly transitioning neighborhood of Brownsville, Brooklyn.  His father died of melanoma when Bernstein was barely a year old, thus necessitating a move to his grandmother’s house where there was no hot water and live fish were kept in the bathtub for Friday night meals.  The Bernsteins remained the last Jewish family in what had become a predominately black neighborhood.
    As adolescence approached, Bernstein’s world changed when his mother remarried and the family moved again from Brownsville to Borough Park where he experienced his first taste of intellectual freedom known formally as the New York City Public School System.  Bernstein looks upon his entrance into public education as a momentous event in his development.  By the age of sixteen, he was accelerated through high school and sent to City College of Manhattan.  Though intellectually capable of handling a collegiate course load, Bernstein admits to being totally unprepared psychologically for such a precocious advancement.
    Bernstein also had to face the death of his mother, Leah, during his teenage years.  Shortly after remarrying, Leah Bernstein discovered a mass in her breast and gradually succumbed to the insidious lack of treatment options for the disease.  One of Bernstein’s most prescient memories of his mother’s death revolves around a particular discussion he held with his older brother, Ira.
    “I asked my brother what the doctor said,” Bernstein recounted.
    Ira replied: “The doctor said not to call him anymore because there is nothing he can do.”
    “ What’s wrong with her?” I asked.
    “She has cancer of the body,” Ira said.
    “I know you’re lying Ira,” I said, “ because you can’t just have cancer of the body.  It has to start somewhere in the body.”

    Saturday
        came and went, for me
     I answered his questions
         it is always the same
             how much time do I have?
        as if knowing
            The precise number of days
        gives comfort
            to the calculus
                of cancer
            and verifies the truth
                of someone else’s
                    verdict

    Bernstein’s path toward the practice of medicine has been unconventional.  He languished in his early twenties and experienced the sort of contretemps one might expect after losing both parents at a young age.  In college, he met an unconventional therapist who unshackled some of his anxiety, allowing Bernstein to build a sense of  hope and direction in his life.
    Structure and gainful employment came from a most unexpected source–the United States Postal Service–where he rose to the rank of letter carrier number 409.  Then, midway through his twenties, Bernstein developed a seizure disorder and was able to take advantage of a disability program that afforded him the opportunity to attend pre-med at Columbia University.
    After a tenuous start, Bernstein aced his studies at Columbia and was accepted by George Washington University medical school.  There, he disabused himself of the notion of pursuing psychiatry, and more importantly found a wife, Barbara, a pediatrician in training.  They moved to Buffalo, New York where opportunity awaited them in abundance.  Bernstein trained as a hematologist and oncologist, joining the staffs of Erie County Medical Center and Roswell Park Cancer Institute. 
    Timing, especially in infectious disease, is everything.  Soon Bernstein found himself at the fulcrum of a then strange outbreak of infection within the local prisoner population.  He was seeing the very first HIV cases in Western New York.  As the years progressed, he treated those same cases for HIV related malignancies.  Bernstein gained national prominence as a leading oncologist/hematologist in the treatment of AIDs.  His novel use of combinational drug therapy to arrest this incurable disease was noted and imitated by many of his colleagues in the field.
    Bernstein became prolific in his work, publishing countless journal works and participating in cutting edge research on AIDs treatment.  The practice and structure of medicine agreed with him and presented a vast and comforting challenge where he could finally channel his enormous talent.  The Bernsteins had three children–Rachel, Jonah and Ezra who filled their old North Buffalo home with a frenetic domestic energy.  Life and work were good.
    In the spring of 1998, however, Bernstein became embroiled in a public investigation into allegations regarding his employment.  It was alleged that Bernstein had, among other things, diverted research money from Roswell in a dispute regarding his employment outside the then New York State-run cancer facility.  The story had all the incendiary ingredients to excite the local readership of the daily newspaper–a disgruntled departing staff member from Roswell petitions the State for an investigation; a State Attorney General poised on losing a re-election vows to prosecute; a respected and revered local institution runs for cover, and soon enough Bernstein was left twisting in the wind of a thirteen count felony indictment.
    Bernstein was acquitted on all felony charges a year later.  It was proven that he had never profited from any alleged diversion of research funds, nor was his employment outside of Roswell illegal.  Bernstein had been put on unpaid leave long before the trial began and had to bear the exorbitant cost of legal defense.  The strain and turmoil that the ordeal placed on his entire family was great.  The surrounding publicity carried the sting of an untenable public insult.  But it was not the worst thing that could happen.

    Cancer Researcher
        spared jail time
    read the headline
        so the judge allowed me
    to serve
        my life sentence
    in my own prison space
        but the bars
        are in the sunlight   
        in the sky
            under  which
                I walk
                    each day
 
    Bernstein’s career in medicine has focused on the study of the roadmap of death and disease.  He writes about the inexplicable, and the predictable, reasons why cells mutate and become cancerous.  He does so in scientific journals and in his own collection of poetry.  His voice is steady and unwavering in what he sees in his daily work, but it is in another body of poetry where Bernstein tells of a completely different event.
    His Jonah Poems present an unrelenting portraiture of the catastrophic nature of the grief of losing one’s child.  Verse upon verse, Bernstein brings us back to the roadside of his son Jonah’s death in an automobile accident–in the midst of Bernstein’s indictment in 1998–and then pilots us away to the incomprehensible repercussions the death has enacted upon his family.  He even turns a clinical eye to the mortal trauma Jonah suffered at the moment of impact and the resultant physical injuries.  Nothing of the event is left unexamined.  Bernstein’s only acquiescence is to the irony of losing his son in an unforeseen and unpredictable manner.
    The Jonah Poems exist in two forms: written (unpublished) and spoken (condensed and narrated by Bernstein on CD).  It is in the spoken version where something truly extraordinary happens.  Bernstein’s voice arcs in the totality of human suffering until we understand, beyond words,  that the pain of losing one’s child  becomes in some strange way the validation of that child’s life for the grieving parent.

Perhaps when I am
    fully
torn asunder
    and squandered
at the side of that road
    I can
finally leave this stage
    the moans
and the pool of blood
    and the repetitive
what ifs
    the alternate takes
of each moment
    will play out
no more
    because
there will be no one
    to play to
then and only then
    will I finally
arrive
    at my end
not to begin
    anew
but again

    Here we are now, as Bernstein admits, at the dawn of a revolutionary approach to the treatment of cancer, where self directed nanotechnology will deliver targeted treatment to the origins of the disease  The most optimistic believe that we are on course toward the very self-engineering of our species in which somehow we will merge with our nano creations to ensure our evolutionary survivability.  What then will the result, or should we say, the outcome be, a human one?
    We know for certain that the Jonah Center is a real place.  That the modest green sign stands for Jonah Bernstein, a fourteen year old boy who was once alive and vibrant amongst us.  We also recognize the father of this boy.  Here, Zale Bernstein has toiled to heal and to cure those in a condition that bespeaks of our great human vulnerability.  And when nothing else can be done, he has sat by their bedside, waited and waited, for whom nothing can be done, even those who have no one else to witness their passage.

    –Poetry inserts from The Jonah Poems, copyright 1998
Zale P. Bernstein, All rights reserved.