Dual Diagnosis

Dual Diagnosis
Dual Diagnosis

Dual Diagnosis

The men met
At the corner of Cherry Street and Terry Ave.
The one with the dog
Was dapper, groomed, face washed,
Warm in his Sherpa jacket
A dog in tow on a retractable leash.

The one with the deeply lined face,
Puffy eyes, 3 day old scruff on his jaw,
Missing several teeth, others in dire need of repair,
With no coat, wrapped in a 12th Man flag,
Spoke with the strong odor of ethanol and decay
Emanating from that disheveled gob.

“That’s a fine-looking dog.
I’d love to have a dog like that,
But I’m not responsible enough
To have one.
What’s his name?”
“Felon,” the other man answered.

The man with the dog noticed a puzzled look on the questioning man’s face.
This happened ALL the time.
The man with the dog noticed it, expectantly.
Must be his pronunciation.
“Felon…like a criminal,” said the dog handling man.
That man saw the light go on in the other man’s face and eyes.

“What a COOL name!” said the snaggeltooth.
“He’s a fine animal.
You see, I’m an alcoholic,
And bipolar.”
No news flash.
“I have a dual diagnosis. May I pet him? I always ask.”

“Sure! Fel…come here and meet…ummm…”
“…Gary. Come here, boy”
The drunk reached out a trembling, weathered hand,
And gently stroked the dog’s wide,smooth head.
The dog’s tail wagged as it always did when shown such affection.

“He’s a fine dog,” he murmured breathing out fumes.
“Maybe someday I can have a dog like him.”
“Well, I hope so,” said the dog’s owner.
“I wonder what you’d have to do in order for that to happen?” he asked respectfully.
“Well…stop drinking, get a job, and a place of my own.
But that’s really hard.”

“Yes, Gary, it is.
It can be done tho.”
The dog’s chaperon thought back,
Twenty five-odd years earlier,
His own drinking and cocaine use brought him to his knees.
Couch surfing after a hospitalization, faced with the same dual diagnosis.

So bewildering…the dog walker had made it through
The maze of the strong pull for release promised by substances,
The seemingly endless maze of one set of meds
After another, and another, and another.
And yet, here he was
Just doing the next best right thing after the next best right thing.

How would Gary do it?
Without even a couch to surf from?
Burned bridges strewn in his past.
Burnt out friendships and relationships.
No job, no anchoring to any semblance of reality
That the man with the dog had found, after much searching.

“Well, I’ve gotta go,” said Gary.
“You have a good day, Gary”
“Thanks!” And Gary shuffled off, body lurching from impending DT’s.
Right down the street, Straight to the convenience store
To get that “magic potion”
That would set him aright for a few more hours until he required another dose.

So bewildering.
“I guess not today, Gary,” the dog’s owner thought,
As he headed home.
Still puzzling.
“Why me?
And not him?”



© Richard A. Martin, Jr., MD, CPC, 2016

Five Trees

Five Trees Five Trees

Five Trees

Five trees with dying leaves. The center tree and the one to its left ablaze with the dying rays of the sun. A beach house stands at the end of the row. Abandoned. The marshy tufts of grass swept by a wind from off the beach, which slopes gently away from the grassy turf where the trees stand, erect against the sea breeze.

The dark outline of the beach house is captured stark against the evening sky with wisps of clouds blurring the outline of the golden sun.

It’s 3 PM and there’s a chill in the air as I walk toward the beach house, almost a silhouette at the end of the plateau close to where erosion has claimed and continues its claim on the plot of land where the arbor stands. Eventually they’ll either need to control the erosion or let the sea take the beach house. Even the trees flirt with the edge. I’m coming up the berm and climbing up the edge that spills into the flat space where the lonely trees wave gently against the sea breeze that drives the waves I can hear to my back. When I finally get to the flat grass where the beach house sits, I need to make a sharp right to walk along the edge of the plot of land to move toward the cabin.

I enter the cabin. I’m not alone. The tinkling sound of another man standing at the trough that serves as a urinal. I step up to the line on the floor delineating where one needs to pee over to hit the intended mark. The warm organics flow toward a central drain where we both hear our work flowing into the sewer.


Five trees. Two golden in the sunset. A sea breeze.

Stark against the evening sky.

A chill in the air. The eroding of the shoreline.

I walk to the cabin.

I am not alone. A dimly lit figure beside me works in the same way as I.

© Richard A. Martin, Jr. MD, CPC, 2016

Medical Geology

Medical Geology
Medical Geology


Medical Geology

So, we have this task, see
To create a piece based on words
Selected by another
Based on their expertise.
Their work.

This is tough for me.
I’m a one-trick pony.
It’s a pretty slick trick…
I can cut a person open
and then put them all back together again with ease.

That’s about it.
So, I picked these geological terms.
A subject I know nothing about.
Medical geology?

Medial moraine
…any glacially formed accumulation of unconsolidated glacial debris that occurs in both currently and formerly glaciated regions on Earth
I’m thinking about how, embryologically,
The human spine is formed…
Backbone a synonym for moraine.

Granitic intrusion
…like Devil’s Tower
In that Spielberg movie
I went to nightly while ill
During training.

…a glacial island
I’m reminded of this woman,
Her cancerous flesh
Jutting out from her pale breast skin.

…a mountain lake or pool, formed in a cirque excavated by a glacier.
Like Crater Lake
Where I and my son’s mother abused one another
For the sake of Shakespeare.

…(from the German for mountain cleft)
German, like mittleschmerz,
The “middle pain”…
Free blood in the peritoneal cavity after ovulation.

Then things got easier…

…what I am –
Or at least had been –
On the day before the anniversary
of Kristallnacht.

There it is!
…an ice hockey player whose primary function is to check opponents,
Like Coburn, or Sustr.
I knew one!!
Hockey, being another skill I’d forgotten about.

All this for the craft of poetry,
Which I’m hoping will be
A way for me to say
Things unsay-able.
About grief, and loss, and dis-ease.

Unsay-able because
IF I said them
I’d cry.
And Boys Don’t Cry
And I’m a boy.


© Richard A. Martin, Jr., MD, CPC, 2016

We Went On The Boat (a sonnet for David)

We Went On The Boat

We Went On The Boat (a Sonnet for David)

It was our pride and joy, that boat…our prize.
We’d go to Key West every year in fall,
After summer downpours left the noon.
We made our pact there as we both had suffered
from the plague ungluing all our lives.
Now I’m here next to David’s pallid body –
pale blue masque on, jaw a slack, grotesque.
He made the leap; he had escaped, was gone
Upon a journey I could not attend.
He left me all alone to sail solo,
Yet, He was captain and I his lowly mate.
Who would pull the spinnaker to catch the breeze?
Or talk with me as a person, unaffected?
Now, I was all alone just cast upon the water…

I sold that boat…

© Richard A. Martin, Jr., MD, CPC, 2016