All in all, my experience going to the doctor and with Taiwan's National Health Insurance was pretty harmless. Helpful even, in meaningful ways that my experience with the health care profession in the U.S., including family, never was. For starters, it was effective for what it did. My hearing's not perfect, but I think that's a matter of course; physicians aren't magicians.

Each of my two visits cost me NT$200 out of pocket. Six bucks U.S., including prescriptions. I don't know how different it is at larger hospitals or for serious conditions, but with neighborhood clinics, I just presented my national health card, they immediately asked for NT$200, they gave me a number, I waited, I saw the doctor, I picked up my prescription with no further cost. Nifty.

My first six dollar visit got me a diagnosis and ear drops for the impacted wax. The second six dollar visit three days later confirmed that my ear was clean, but since my hearing was still wonky I got a 3-day regimen of antibiotics for the infection. After three more days my hearing still wasn't perfect, but had improved enough for me to delay going for a third visit. I had impacted wax and an infection and they gave me treatment for those. They hinted that the next step would be giving me a referral to a hospital for more sophisticated hearing tests. They had done all they could. 

My general belief is that the human body, given time, will for most part heal itself from most non-life threatening maladies. So the doctors having treated my direct and identifiable symptoms to the best of their knowledge and abilities was the limit of what I was willing to pursue medically, and now is the time to give it time; to convalesce.

I figure the residual tinnitus I still have – a bearable, unobtrusive mid-range tone and occasional hearing drop-off – may be the result of deformities in my ear structure caused by swelling from the infection, and that's not anything a doctor can do anything about. I just need whatever ear parts to settle into where they belong to stop the ringing. I can physically manipulate my ear gently and carefully and get clarity in my hearing, and that's evidence that I'm not suffering from any major hearing loss requiring sophisticated hospital equipment to identify.

Not drinking for three days was easy and a bit interesting as I'd have quick pangs that I should be drinking by now, but then remember I'm not supposed to. I also didn't drink for 24 hours after the last course of antibiotics, so yay me. Also interesting was my body wasn't all that happy with the re-start of alcohol intake. But a fine alcoholic I'd be if I didn't drink, so my body just has to deal with not being happy. My brain and body don't have the best means or mode of communication.

I went to the doctor on Sunday and found I have impacted wax and an ear infection. He vacuumed out a big honkin' chunk o' wax the size of a grapefruit (just kidding, more like a desiccated pea) with a tiny bit of fungus growing on it (just a strand) and gave me a course of ear drops to take three times a day and to come back in three days. I went again today and it looks pretty well cleaned out, but since my hearing isn't back to normal he (actually a different doctor, who thought I was Korean so it took a while to break out his English) gave me antibiotics to work on the infection and to come back in three days. Don't drink alcohol or coffee, he says.

Coffee's no problem, I've descended into being satisfied with powdered Maxwell House coffee so that's easy to avoid. It's barely coffee. As for alcohol, I wasn't about to make any promises but then decided a web search was in order. In general, antibiotics and alcohol don't mix but I wanted to know what I was risking. I found a list of antibiotics that are particularly bad with alcohol and then checked if any of mine were on the list. The last tablet I checked includes two on the list and since the side-effects of mixing with alcohol are basically many of the gut problems I've had over the years and went away when I cut back on drinking, I decided to crawl on the wagon for a few days. I don't need to invite those symptoms back.

So now I get to test what I said about mindfulness practice and alcoholism. Great!🥴 Well, it's only three days, how hard can it be? If it's at all hard, I should consider myself full of crap in regard to that aspect of mindfulness practice. *sigh* I'm hungry. Hunger at this time usually goes away when I start drinking. And do I really drink that much? It doesn't feel like I do, but I guess that's what an alcoholic would say. Is a third of a bottle (and a beer appetizer) a lot? A little more than that is what I drink in a 24-hour period. Who am I talking to?

After all I've boasted and bragged (not really) about never going to the doctor, I'm planning on going this evening. Excruciating abdominal pain didn't do it. The possibility of glaucoma and future blindness didn't do it. A plethora of niggling seemingly-health-related-oddities-that-make-me-wonder-what-the-hell-is-going-on didn't do it. Nevertheless, it should come as no surprise that what's doing it are symptoms suggesting possible "pulsatile tinnitus", according to a cursory DuckDuckGo search (trying to avoid using China-friendly, "evil is swell", internet-monopolistic Google). 

Something's messed up in my right ear and I can hear my pulse, accompanied by tinnitus which I chronically get having supposedly been a rock musician, as well as occasional pain and hearing loss, which I don't chronically get. It was something I expected to go away, but after a few days it persists and although some websites say it should go away in a few weeks, others warn not to ignore it and get a real diagnosis. In this case, I'm gonna err on the side of caution and not wait "a few weeks" for it to sort itself out before getting it checked out.

Deciding to plan to go see a doctor is no minor source of anxiety, mind you; the least of which is just the idea of seeing a doctor. If something seems serious enough to see a doctor, I'm good with that; it's just something I have to do. Anything seemingly less serious, I just wouldn't even go. The anxiety is more about navigating the national health insurance system which I've never done before on my own, and dealing with the language issue in case the office or the doctors themselves don't speak English. Now, most Taiwanese doctors have some facility in English, it's just part of higher education. I think all hospitals in Taipei can accommodate English to some degree.

But I'm not going to a hospital. Much of Taiwan's national health insurance also supports specialized local clinics; step-in places for spot treatment, I think. These clinics can be found on every business street in Taipei, easily spotted by a distinct national health insurance logo, and knowledge of written Chinese will tell what the specialty is. In my case, I can recognize characters for nose-ear-throat (鼻-耳-喉) and I'll go to one of those I've located in my neighborhood which doesn't open until 6:30 p.m. on Sundays. I'm just a little less confident about English-ability in these neighborhood clinics, but I may be able to get by with my cursory Mandarin if no one speaks English *anxiety, anxiety, anxiety*. Also in these situations, there's a distinct possibility there will be an English-speaking good Samaritan who will step in to help translate. That's actually not uncommon in Taiwan; I've observed people will help people in seeming need. 

I'll probably have to fill out forms, so along with my national health card, Taiwan ID and (expired) passport for good measure, I'll also take along my written address if I have to provide that in Chinese *anxiety, anxiety, anxiety*. I've re-memorized my old 2G phone number in case I have to provide a phone number. It doesn't work, but it's easier to give a defunct number than trying to explain that I don't have a phone, which nowadays is akin to having to explain how I'm breathing or that I'm here at all. 

Now, me being me, I have to blow this up to the wider issue of 'what if my hearing is going?'. Is hearing loss an end-game? Indications of oncoming blindness is probably end-game. If I went completely blind, suicide is no longer an option so I would need to do it while I can. Cancer I've already entertained is end-game. Other non-health-related circumstances that would force me into situations that I can't imagine adjusting to (like having to move) might possibly be end-game. 

Hearing loss? All other circumstances that I identify as end-game involve other people and my relationship with the world. Hearing loss is just me and doesn't effect anyone else. But as listening to music is among my last few enjoyments of being alive, hearing loss would reduce quality of living to under, let's say, 10%.

Still, if it doesn't effect anything else but me, it isn't the endgame of an untenable circumstance that I have no control of, but rather becomes part of mindfulness practice of not being attached and letting go. Being able to listen and enjoy music is very important, but that's what makes it an attachment. Being forced to give it up is a mindfulness challenge to that attachment. Mindfulness practice is more important than enjoying music. If the two can co-exist, there's no problem. But if they conflict, mindfulness practice prevails, even if it means a further step towards my ultimate goal of suicide, which is something I both want and am resistant to. 

I've continued to listen to music per habit these past few days. Sometimes the tinnitus is unnoticeable with earbuds and sometimes it's noticeable (can't hear the right channel). I've turned down the volume to prevent further damage and discomfort of high volumes (not that I blast music in earbuds anyway). But if forced to realize that continuing listening to music here on in would mean degraded quality, I think I'd consider it not worth it and giving up that enjoyment and adjusting. It might just be a great relief. If it's in furtherance of a next suicide attempt, then praise the lord it be so. To be clear, it's not an excuse or reason for suicide. It's just removing a lame excuse and strong attachment to keep living.

I take it as my loss that my whole life Patti Smith has remained off my radar. I knew her as a one-hit wonder with "Because the Night" co-written (but primarily written by) with Bruce Springsteen. But she's released a starving baking student's dozen of albums and has enjoyed a long career as a highly respected artist, musician and writer.

When I was plumbing local public libraries for rock biographies, I did see her Just Kids (2010) and picked it up, but put it back down despite seeing it was highly lauded. It just didn't read like the usual rock biography. Recently I saw her M Train (2015) in the library for the first time and judging it by its cover decided to give it a spin. I was transfixed. Something about her writing style sucked me in and tainted the way I moved about the rest of my day, like every little thing was just hoping to become memory. Kindred mentions of Wings of Desire (one of my favorite movies from college) and The Master and Margarita (one of my favorite books from high school) tugged; although I should mention that I didn't get the vast majority of allusions and references she dropped from her copious knowledge of arts and culture.

M Train put me in meditative, hyper-observant moods that had me thinking and seeing in her voice. Mind you, that happened with Catch-22, too, and after reading that I'd go about making quirky observations and absurd interpretations of things around me. M Train also had me go back to Just Kids (at another library) and I ended up loving that, too. The tone of the two works are quite different despite being published only five years apart. Both can be considered memoirs. Just Kids is about her early life and relationship with artist/photographer Robert Mapplethorpe, whose name was familiar to me since his death from AIDS in the late 80s was well-reported in the news because of the "controversial" nature of his work. I didn't know there was a connection between them. She wrote the book to fulfill a promise she made to him when he was dying to tell their story.

M Train covers personal aspects of her adult life apart from Mapplethorpe, and is a bit cagey about her music career which was a little off-putting at first but I came to understand. Like she never mentions "Because the Night", but instead says that she "came across a bit of money". She also casually mentions touring to earn enough money to buy or invest in something that was important to her, but touring is a big thing! It means she's a big deal in some way; she has backing, an audience and a way to pay musicians. But that's not the emphasis of the book, so she rightfully downplays it. M Train is in a completely different mental state from Just Kids. The important men in her life have all gone and I got the sense of her moving on with her life in a certain amount of personal isolation and grief. Batty, even. Mental. But artistic, because she's an artist.

I don't know if I would have been a fan of her music if I had been exposed to her long ago (like I would have with Sonic Youth), but unfortunately I only heard that one radio hit and no one I knew had any of her albums or didn't push them on me. She's also a photographer, and it may have been her pictures that prompted me to wonder about my iPhone as a camera and dig up what cameras I had left.

Speaking of reads, I also recently read a book about "The Simpsons" called Springfield Confidential by Mike Reiss, which is a no-brainer, (library) must-read for anyone even vaguely entertained by the show. The thing is a lot of what he writes are actually jokes rather than anecdotes. But it's a simple formula to figure out what is which: if it has a punchline, it's a joke. And a lot of his "anecdotes" have punchlines. He does write about the internationalization of "The Simpsons" and how there are fans all over the world who take sudden interest in him once he tells them his job. What I don't know if he knows is that in the Taiwan market, (I'm told) the show isn't directly or loosely translated but has a completely re-written script in Chinese to something that still matches the visuals but has nothing to do with the original plot in English! That's some mind-blowing, extra-level creativity going on there!