By James Seals


This morning I almost consumed the wrong medicine. In my pre-dawn drowsiness, my eyes failed to distinguish between bottles – ibuprofen, sleeping capsules, allergy pills – but luckily my hands remembered and recognized the incorrect bottle lids. I must take a 180 milligram dose of antihistamine twice a day to manage my inducible urticaria: pressure triggered hives.

During my master’s program, my skin became sensitive to everything: friction, sweating, cold, heat, sunlight, water. I had to visit a dermatologist, who explained to me that anxiety, pressure, strain (e.g., the stress of my MFA program) could trigger my symptoms, and I might have to live with hives for the rest of my life.

I sat there, taken aback at the prospect of having to spend at least $50 every two weeks on medicine, at the prospect of having to forgo participation in physical activities, and at the prospect of having to explain to my high school students, No, the rash on my neck is not a hickey, for the rest of my life.

 “As my mother aged, her anxiety became more of an issue. She developed this nervous habit of ingesting pills right along with her intended patient.”

I was saddened to be entwined in America's love affair of prescription drugs. In an August 3, 2017 Consumer Report article, Teresa Carr revealed that more than half of the population of the United States took prescription pills (four tablets of some sort) each day and that $200 billion per year was spent on unnecessary procedures and improper treatments. That declaration both alarmed me and made me laugh. It alarmed me because our healthcare industry is out of control. It made me laugh because this statement reminded me of my Filipino mother.

My mother might have caused the initial spike in the 1980s, which so alarmed those studying the increased use of prescriptions in the United States. My mother acted as family shaman, healer, witch doctor. She grew Johnny-jump-up, Feverfew, St. John's Wort, and other houseplants for medicinal purposes. Our poor Aloe Vera had been broken, scarred, and sliced as she attempted to repair her children’s rips, tears, and minor abrasions. She also believed in overmedicating her kids.

The very moment she heard a throat clear, my mother would be reaching for the purple stuff—dark berry-colored cough syrup she filled a clear-plastic measuring cup to the brim with, before hustling to the ailing person’s side. She made my siblings and me shoot multiple shots of this medicine even when none of us showed signs of illness. Because of her quick draw, my sisters and I often hid in our dark, musty closets the moment we heard our mother’s medicine cabinet click open. At Filipino parties, at the park, or in the car, Mother toted a white, plastic bag filled with multicolored liquids and chalky pills—just in case someone needed saving. My older sister and I called her bag the rainstick because every time it tumbled from a chair to the floor, the pills made the sound of a gathering thunderstorm.

It stormed a lot throughout my childhood.

As my mother aged, her anxiety became more of an issue. She developed this nervous habit of ingesting pills right along with her intended patient. She seemed to believe that the more she swallowed her elixir, the better her chances of thwarting any illness. So, instead of just watching me take shot after shot of the viscous, purple syrup, I would watch, wide-eyed and with an open mouth, as Mother threw back three or four shots herself before making me drink.

When we were young, my older sister and I began to take advantage of our mother’s growing obsession, especially when Benadryl became her lifesaving antidote. We began to fake illnesses on Friday mornings, in hopes of having another three-day weekend. Cindy coughed or I cleared my throat, and then we waited for the carpet-muffled footfalls of our mother dashing up the stairs, bottle already in hand. She would match us shot for shot, and it didn’t take but two or three to sedate my four-feet-eleven-inch Filipino mother, and after she fell asleep after 20 minutes or so, Cindy and I would just skip our bus—there being no one to force us to go.


In that same Consumer Report article describing America’s prescription love affair, Teresa Carr also quotes a doctor who stated, “many Americans—and their physicians—have come to think that every symptom, every hint of disease, requires a drug.” I disagreed with this because when time came for my mother to receive her much-needed treatment for an irritation that started in her foot then traveled to her brain, no doctor provided her with any purple syrup or chalky pills or some other form of help.

In early 2000, my mother had a tingling sensation at the bottom of her left foot. After suffering with it for two years, she  finally went in for an examination. The doctors told her that the tingling was nothing more than a invention of her imagination. And when it moved to her hip, then arm, they again told her she was making it up. My mother soon developed vertigo, could no longer drive, and lost the enthusiasm for the life that she had exhibited each day when my sisters and I were kids. Her inability to move meant she could no longer grow her remedies, conjure cures, which meant she felt useless to her children. Mother lost her status as shaman. She didn’t believe she would be healed. And she didn’t know which doctor to turn to. So, she had people pack her bags, sell her house, and fly her to the Philippines, where she chose to waste away—Parkinson’s disease.

I have considered purchasing a pill box to ensure I take the correct medications. Still, so far, I have avoided buying one. Those clear, little cases remind me of old people, reminds me that I am starting to age. But I think the real reason I haven’t bought one yet is because it cannot replace my mother—my mother the shaman, the healer, the witch doctor—the only person who knew the recipes to the old remedies, the ones I now miss taking every day.

La Isla Nena

By Melissa Alvarado Sierra


The amapolas fell whenever a strong breeze shook the trees, the scarlet blossoms dropping unhurried like feathers and dotting the vast green floor. My wooden house was nearby; I could see the shanty zinc roof and the white and pink facade through the trees. I lived in Barrio Pilon, a small neighborhood tucked away in the mountains of Vieques, also known as La Isla Nena, an island off the east coast of Puerto Rico. Life was painless and undemanding in what many would call the definition of paradise. Everyday, I took a nap in the jungle, on a bed of green grass sprinkled with amapolas. Pilon was unspoiled, quiet, and seductive. Eternally humid, this rural place was canopied by dense greenery in the form of bamboo, palm, and flamboyant trees. The jungle smelled of coconuts, mangoes, starfruit, and bananas. Pilon felt like a made up place, and I felt like a better person than before I moved there. A little lighter, a little bolder, a lot happier.

Melissa walking in the jungle of Vieques

Melissa walking in the jungle of Vieques

I remember sitting within the jungle with a woven basket next to me. The basket was full of fruit I had picked from the trees. I nibbled one end of a starfruit to make a small hole and then ate the pulp, seeds and all. Starfruit juice dripped from my mouth down to my clothes and I didn’t care. I was in Vieques, not in the busy city of San Juan, where I used to live. There was no right way of eating fruit in Vieques. I spent my days in the island like that—wildly eating nature’s sweets, my ears romanced by tropical sounds—mostly of the insistent coqui frogs. Ko-kee, ko-kee, went their song. Tradewinds blew from the east and the overreaching flora fanned everything below. Vieques, my sizzling Eden, was reachable by a faulty ferry or a teeny and decaying plane, which made for a slightly treacherous and vomit-inducing journey. Once there, though, all travel and life traumas faded away.

            Vieques’ beaches were tinted with cerulean and turquoise, and the sand was so white and bright it hurt my eyes. But the ocean floor on the east side was sticky with toxic phlegm and the sand of the southeast was covered in putrid radioactive waste. Undetonated bombs lied below the waters and within parts of the jungle. The air was sick and made locals sick—with cancer, immune disorders, neurological diseases. La Marina, the Navy, arrived in Vieques in 1941, settling to test bombs in La Isla Nena. It didn’t matter to them or to the local government when people in Vieques started to die because of it. They kept testing their bombs for more than sixty years.

A map of Vieques with the location of the bombs at El Fortín de Conde Mirasol Museum

A map of Vieques with the location of the bombs at El Fortín de Conde Mirasol Museum

In 2011, when I moved to Vieques, I knew little about the contamination. But neighbors told me to stop eating the fruits from the trees. They said the Navy had used depleted uranium, Agent Orange, arsenic, lead, mercury, cadmium, white phosphorus and napalm on Vieques. The traces were found by local scientists on the leaves, within the soil, floating in the water and in the hair of residents. I couldn’t digest something so atrocious. I searched for those allegations and found the Navy had conceded to using the heavy metals and toxic chemicals, but had denied any links to the elevated rates of disease and mortality on the island. Five million pounds of munitions were detonated between 1945 and 2003, and the Navy said it had no effect. Trying to prove otherwise is almost impossible. The Department of Interior owns the land the Navy used to bomb, consisting of two-thirds of Vieques. They restrict access, and so we are in the dark about the real state of the island’s health. They now call the bombed area a “natural reserve.”

Painting by Kayra, A local artist

Painting by Kayra, A local artist

When the doctor said I had a rare type of thyroid cancer a few years later, I immediately thought of Vieques. I had lived on the island for less than a year, but while I was there I grew increasingly sick. My neck grew bigger by the day, and a strange and dull pain became my normal. I remember the neighbors telling me to stop eating the starfruit. They said the soil was poisoned. But I was so enamored with the singular beauty of Vieques that I ignored what had happened years before. I kept eating the sweet fruits, kept bathing in the beaches, and kept breathing the salty air. Maybe I had been poisoned. Maybe I’m one more on a long list of people who claim the island’s toxicity is to blame for their health issues—that the Navy is to blame. It can’t be proven.

Viequenses believe the cleaning efforts by the Department of Interior have been inefficient. There’s also no serious interest in studying the unusually high cancer rates (27% higher than in mainland Puerto Rico). People are dying. When I flew to Vieques mere months after Hurricane Maria, I found the island to be in very bad shape, but the people were in even worse condition. Cancer patients like Laura, a bed-ridden woman in her sixties, couldn’t have access to chemotherapy and had given up on being cured. Others made the uncomfortable ferry trip to Puerto Rico to find help, but found the journey too arduous to repeat. An oncologist with a focus on natural medicine from the main island, Dr. Marcial Vega, told me he had been voluntarily traveling to Vieques for years to help cancer patients for free because no one else is doing it. There’s no support from municipal, national or federal government. People died after the hurricane, but many more had been dying from the lingering poison. Vieques and its people have been forgotten by all, even fellow Puerto Ricans. Vieques is now known as la isla enferma.

Photo of Protesters in Vieques, asking the Navy to leave the island. They left in 2003.

Photo of Protesters in Vieques, asking the Navy to leave the island. They left in 2003.

I’m still not officially cancer-free, though tests have been negative for the past three years. Being relatively healthy again is freeing, but I also have a strange mix of guilt and nostalgia when I think of Vieques. After the hurricane, I sailed to Vieques and drove to the jungle in Pilon, where I used to live. I sat on the ground, this time with no grass and no fruit trees around me. The hurricane took them. I thought about the amapolas from 2011 and how maybe paradise made me sick. I thought about the island as it is today, still sick by the man-made poison that is glued to every leaf and infused into every drop of ocean water. Hurricane Maria made sure this was not forgotten. The winds stirred the old toxins that were hiding within the soil and interred in the depths of the sea. There’s now more proof of contamination. The poison was agitated and released once again. The dirty secret just can’t stay away.

Melissa Alvarado Sierra is a current degree candidate at The Mountainview Low Residency MFA in Fiction and Nonfiction.

Create Destroy

by Danielle Service 


We boarded the USS Massachusetts at Battleship Cove in Fall River, Massachusetts, near the windy edge of the Atlantic Ocean on a late March morning. A hint of sun and one hundred and fifty-six seventh graders with a smattering of adults hit the deck. Twelve or thirteen year olds with ebullient and nervous and hyper bodies bounced on grid metal with overnight bags. I their teacher scanned, frantic to search for where could they get into trouble and the answer here, on this World War II destroyer that had traveled over the Atlantic through that war, was everywhere. It was a battleship, for Christ’s sake. 

When a teacher sees that everything in or out of sight has the potential to hurt the children the tendency is to relax. If you can’t control the situation, you realize you don’t have to. I stopped screaming for them to stay within bounds and let them explore, surrendering to the situation, letting go of the reigns.

It was loud and chaotic and I could not figure out where I was at any given time, crawling up and down the stairs and calling after kids, our voices echoing on the metal hull as we passed Nazi flags and makeshift mess halls decorated for tourists with the names of fallen soldiers. Later that night, the energy of the ship got to me. We’d finished with the storyteller and some enterprising schmuck had opened the snack bar at 8 p.m. to give the children coffee and candy before we could put a stop to it. By the time the movie went on in the downstairs hall, all was chaos, overexcited adrenal glands, wanton chip wrappers, and Nazi ghosts. We teachers gave up at around 9:30 and while the movie played we sat in the back choking back hysterical laughter at the absurdity of the situation until we had to tell a kid to pick up his stuff and he got attitude.  

Our voices echoed off the metal and my teacher friend turned and said “This is Hell. This is literally the definition of Hell.” I fell on the floor laughing and almost wet my pants so I went to the bathroom and the Nazi flag in the hallway stopped my giggles. 

We all spent the night on swinging platforms stacked by chains and I pretended I was a soldier at war. I got up sleepless, crept about the ship, prayed for peace, did some light yoga on the deck, honored the fallen. 

The next morning, we toured Battleship Cove. In the Torpedo Room of the USS Lionfish, a Navy submarine, I thought about humanity’s dual instincts: to create, to destroy. Creation makes sense; it’s natural and steeped in love, the most powerful force in the universe. Destruction doesn’t make sense due to its violence, and I’ve struggled to understand how the two coexist. But in the Torpedo Room it came to me: we are born and then we die. Life and death are the only two absolutes, so of course creation and destruction are equal forces. I sagged with relief, felt better than I had in a long time, and went to tell everyone who would listen. 

That epiphany fueled my faith in the universe for weeks. One Saturday night I told my friend Laura about it at a Mexican restaurant. “It reminds me of something Mr. Rogers once said,” she quipped. “He said that deep and simple was far more essential than shallow and complex.”  

“YES,” I hollered, waving a chip with cheese. “It’s like Occam’s Razor! The simplest explanation is the best one!” Our laughter echoed off the mosaic tiles. We’ve been friends for thirty years. It was April vacation and a beautiful night. Summer was six short weeks away. Anything could happen. 

The next day I drove my teacher friend – the one who’d said “this is literally the definition of hell” – to Massachusetts General Hospital to see our thirty-seven-year-old friend and colleague who had suddenly, inexplicably, been diagnosed with ovarian cancer. At the Mexican restaurant I had had no idea of the seriousness of ovarian cancer. Even on the drive to and from Mass General I had had no idea of the seriousness of ovarian cancer. It had been a month since Battleship Cove and I’d been riding the crest of my faith in the universe’s wisdom that whole time. Much like letting hundreds of teenagers loose on a battleship, I’d lost the idea that I could control anything – and I was fine with it.

It wasn’t until I saw our friend’s scar from low abdomen to chest and went home to google, that the potential truth of the situation hit me, a torpedo to my stomach. The cancer had, in a few short months, made its way from her ovaries to her ribs. Our friend and colleague has a four-year-old and a one-year-old and a husband who is a cop and was an officer in the Marines.  

The problem with having faith in the universe is that if you believe with all your heart in the absolute truth of love and creation you also have to accept when destruction rears its ugly head. We’re born and then we die – duh. But chemo is an atom bomb. The Allies defeated the Axis powers, their plan to take over the world. Surrender often trumps a fight, and honoring the duality of opposites is a skill: creation, destruction. I pray, still, for one over the other.  

Danielle Service is a graduate of The Mountainview Low-Residency MFA in Fiction and Nonfiction. She currently teaches seventh grade Language Arts and yoga in New Hampshire. 

Lighting Up

by Margaret McNellis

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When I see people light up a cigarette, I wonder if they really know where it will take them. Sure, everyone knows that cigarettes increase your risk of getting lung cancer, that they’re linked to 80-90% of lung cancers. But how many people who smoke really know what that looks like? When my father was diagnosed, he had Stage IV non-small cell lung cancer. Two and a half months before that, he felt great. He was working, traveling, and we have a picture of him at my sister’s birthday dinner looking happy and healthy. Two and a half months.

He didn’t have a single tumor. When one of his doctors showed my mother and I his CT scan, it looked more like static on a television, like a blizzard. All the white stuff floating around in his lungs was cancer.

The cancer would have been a quick death. Less than two weeks after his diagnosis, it would have killed him if he didn’t go on emergency chemotherapy. I remember walking through the ICU, I saw another patient whose face looked like it was skin stretched over his skull. His cheeks were hollow, his eyes sunken, and his lips pulled tight. He was having trouble breathing. As scary as it was having a parent in the ICU, at least my dad still looked healthy.

The monitors told a different story. His heart rate was hanging out in the 150s even though he was resting, because he couldn’t get enough oxygen. His heart was working overtime to feed his brain and other organs. We had the “get your family here” talk with his pulmonologist.

My father wanted chemotherapy. He wanted to live as long as he could, fight as long as he could, but I think he knew before he started that he was on borrowed time. The rest of us realized that over the next three months, but what none of us knew was how sick the chemotherapy would make him, how fast he’d drop eighty pounds and begin the starvation process that would rob him of the ability to move around, to think clearly, to live. The chemo made it painful to eat, so despite our attempts to find foods he could handle, he ate less and less.

A lack of oxygen made it difficult too, and the more his stomach shrunk, the more even the tiniest of appetizers made it harder for him to try to fill his lungs with air. He got skinnier and skinnier until his collarbone protruded so much that were it not for the absence of any bruising or complaint, I might have thought it was broken. I could see his ribs through his shirt. He started to look like that man I saw in the ICU, that man who wasn’t my father and I hoped my father would never become.

My father used to smoke cigarettes. I don’t blame him for it; he did so at a time when the population believed they were healthy. Hell, doctors used to prescribe smoking, after all. Just because someone is addicted to cigarettes doesn’t mean they deserve lung cancer or chemo. All the same, whenever I see someone light up, it takes every ounce of control for me to not rip the damn thing out of their mouth and stamp it out on the ground. It takes every ounce of control for me not to hop up on a soapbox and ask them if they want their children to watch them starve, for food, for air, for just one more month or week or day. I want to ask them if they know what it looks like and feels like when someone actually fights that fight until the bitter end.

I’ve never smoked a cigarette. The smell has always bothered me. I don’t know if they taste good or not, but after watching my father fight lung cancer—which eventually metastasized to his lymphatic system, bones, and maybe even his brain—I know this: the end is always bitter.

There’s never enough time at the end, no matter how much time the chemotherapy bought. I always wanted one more day, one more hour, even after my father slipped into a coma. The hospice nurse told us that was the final stage before death, evidence the body was finally shutting down. The morning that he died, on Friday, September 6, 2016, I told my father it was okay to go. I wasn’t okay with it, really, and I never will be. But I said those words, because he needed to hear them, because it was time.

Someone my age or younger once apologized for lighting up as we walked down a sidewalk. “It’s okay,” I said.