Everyone in this town is crazy. I am not weird enough to be here. I am a scoop of vanilla, relatively, that somehow got dropped into a bowl of rainbow sherbet topped with chocolate sauce and a vast--and I mean VAST--assortment of mixed nuts. I had to go to the doctor on Sunday. I had a sinus infection that I let get worse and worse until I had sinusitis and couldn't stop coughing. I felt like my head was going to pop off my neck from the pressure of constant unproductive coughing, and I didn't want to wait another few days to get into a family practice. I found an internist in Manhattan with urgent care hours. I left him a message and he called me back personally within an hour--that in itself freaked me out--since when does a doctor of any kind call you personally regarding appointment scheduling, especially on a Sunday? He had a blog on his website that was miles long, covering a variety of topics--that should have been my first clue--but it was good stuff, at least to me, the kind of things I want to hear as a patient--HMOs are bad, taking plenty of time with each patient is good, don't do drugs, stuff like that.

So we go to Manhattan--my husband goes with me, because I don't want to go alone. This doctor's office is in Midtown, the business heart of Manhattan, so I feel reasonably safe. We enter the building, a non-descript, smallish, newer office building with a doorman who does nothing, not even greet you--he just sits on a chair behind a podium at the front door. We take the elevator to the correct floor, step off, and realize that this building is residential as well as commercial. We both get a little uncomfortable--if this doctor's office is in his personal apartment, I am not not sure I like that--if he can afford to be an internist in Manhattan, he can afford separation of home and work place. We ring the doorbell on his door. It is 9:25 a.m., and the appointment is at 9:30 a.m. We hear him rustling around for a minute or two, and then he opens the door. He is nice, polite, but he is ODD. His office is strictly his office, so that's good, but it is actually really dirty, which is bad. I have never been in a doctor's office that is actually really gross--even busy family practices with 200 kids in the lobby--they have a few dings on the walls and the bathrooms aren't perfect because they see about a million people a day, but they aren't filthy. This place has hardwood floors, and everywhere you look under furniture are dust balls that are the size of hairballs--like you would have if you had multiple pets and went on a vacuum strike for a week. When no pets are involved, it takes weeks, even months, for dustballs to accumulate and reach that size. There is a blanket of dust on the counter in his exam room, which is also his office. His desk is piled with piles--paperwork, books, etc. I don't like clutter, but I especially don't like clutter that is actually physically dirty because it has been in specific positions for so long that it has been able to accumulate dust.

Dr. X chats up my husband while I fill out a form, talking about everything under the sun but what I am there for. In less than 15 minutes, this is what we learn about Dr. X: he has a house on Long Island, but his girlfriend prefers Manhattan, and it will take him awhile to sell his house because he has a ton of tools because he inherited equipment from his mother's construction companies, and he has boats, cars, motorcycles, and four Jeeps--are we interested in buying a Jeep? He's a Jeep expert, he tells us--he likes to fix them up and resell them. He also buys damaged model planes on e-bay, which he thinks is the coolest thing ever invented--he talks quite a bit about e-bay--then gets back to the planes, which he restores and resells on e-bay. He takes a phone call--he has one of those earpieces attached to his cell phone, which is clipped onto a pocket of his very clean and new black jeans. He makes an appointment to see another patient after me. I am finished filling out the form. He tells me to have a seat on his exam table, which is next to his dirty desk. He gets a mouth thermometer out from one of the dusty cabinets and puts one of those paper sanitary guards on it, but not all the way, and when he puts it into my mouth and tells me to bite down on it like a bone, the teeth on the left side of my mouth bite down on plastic instead of paper--icky.

Dr. X reads my form while my temperature is being gauged. He tells me he has a lot of patients who are hairstylists to celebrities, and who are celebrities themselves. I throw out some names after he takes the thermometer out of my mouth, but none seem to register with him. He sets the thermometer down on the dusty counter, and does not remove the paper guard or sanitize the machine, at least in front of me. He then launches into a story about how his dad died when he was a kid and his mother supported him and put him through medical school by running several construction companies--they were so poor when he was young that they were on welfare. I tell him he's come a long way, being polite and congratulatory because that's the way I am because I am a Midwesterner and we are a nice people, even when we are sitting there wondering if Doc Quack is ever going to ask us about stuff like our symptoms, etc. Then he listens to my chest and my back while I breath. I am looking down at the floor while he does this, and I can't help myself, it just comes out: " Dude, you need a maid." He finishes counting my heartbeats and smiles and says that not only does he need a maid, but also a secretary. His girlfriend was his secretary for awhile, but he also mentioned that she was a psychologist, so that probably got in the way of her practice. There is a nice watercolor on the wall next to the exam table, and he points to it and tells us that his girlfriend bought it for him. He says it is especially meaningful for him not only because it is a good water color, but because it reminds him of their first date together in Central Park, the details of which he goes so far into that I get scared I'm going to hear something I don't want to hear--they were in the park, and it started to rain "cats and dogs," and by the time they got back to her place they were "two little wet noodles, and ..." I thought for a second he was going to tell us they ripped their wet clothes off each other and had sex on her floor or something, because he seemed to be really building up to something, and had a big smile on his face, but mercifully, he didn't go any further.

He then asks Patrick what he does, and a whole diatribe springs from that--turns out this guy likes Thomas Kincade's work, of all people, which floors Patrick and I--we're the Midwesterners, the hillbillies in the room, and here is this Manhattan internist telling us how much he likes what Kincade paints and how he paints it. Patrick explains to him that Kincade's "paintings" are produced factory style on an assembly line, and often aren't real oil paintings at all--we are both outsnobbing a Manhattanite at this moment, and to be brutally honest, really enjoying it, because this guy is really on both our nerves by this time. I tell the doctor his girlfriend has good taste in art, meaning, indirectly, that he doesn't, just to be a passive aggressive little bitch, because by this point I am really tired of hearing all about Dr. Weirdo and nothing about what is wrong with me. We are about to get to the bill part, and I am wondering if this guy is going to charge me up the wazoo for the privilege of hearing his life story.

Doctor tells me I have sinusitis and a throat infection and writes a prescription for common antibiotics. He asks me if I take any medication or vitamins. I tell him I take vitamins, and then he tells me how he is writing a book on nutrition. He tells me this in a "you should buy my book" sort of way. I find this funny because, to look at him, he is hardly the picture of health--he is skinny rather than healthy, and has the face of a heavy drinker--think a young W.C. Fields--that reddish-purple, mass of broken capillaries skin. Maybe I should give the guy the benefit of the doubt and chalk it up to a serious cause of rosacea, but they have lasers for that now. So I'm guessing he likes his liquor. I like wine myself. Thing is, you have to drink it by the caseload every day to get a face that looks like Doctor Strangelove's.

So anyway, he prints a bill for $150.00--not too terrible for Manhattan, or for urgent care in Manhattan, so we are relieved. Somehow music comes up and doctor starts talking about all the famous musicians he sees--how they are really messed up and live very unhealthy lifestyles. "Courtney Love--she's in the practice," he says. Oh wow, we both say, because we have no idea what to say. I'm not sure exactly what in the practice means--does that mean Doctor Weirdo, who also makes house calls for an extra fee, saw her once during an overdose, or is he pulling our chains? I don't know, and I don't care--I just want to get the hell out of Doctor Dirty's office. We pay the bill, and thankfully, he gets a call on his cell, so we can scoot. The last thing he says to us: "Welcome to my practice ... anything you want to know about the city, you just call me--this is a really strange and complicated place, and it can be hard to adjust ... I'm happy to help in any way I can ..." then he starts talking to his caller while walking us to the door and waving us out. We leave the building, passing the apparently deaf/mute doorman, and it is all we can do to keep quiet--we are both looking at each other in the elevator like "Holy shit--what was that?" We don't speak until we hit the street, because for some reason we both feel like we shouldn't say anything out loud until we are out of the building--hidden cameras and all, you know. We laugh about it all the way home. Even the freakin' doctors here are weird.

As mental as I've always considered myself to be, I am just not mental enough for Manhattan. I need to develop a much more ridiculous personna if I'm going to fit in here. Even the aerobics instructors at my health club are characters. The last weight training class I took was from a tiny girl with Elvis black long hair that was hunter green in the front, and she had a huge nose ring with green beads on it that matched her highlights. She was almost completely tattooed, and I found it hard not to stare at the designs peaking out from all parts of her workout clothes. She was very nice and funny, and a bit wild that day, in her own words--"I'm on a roll today--I've had three Chais already!"

I don't run down the street talking to myself or screaming anything and everything at the top of my lungs, my hair has no food coloring in it, I have no tattoos, which might mean I will never be granted permanent residency in Brooklyn, my dogs and cats are not pure breeds of anything, I actually own regular plain old sweat pants, and I don't litter.

What am I going to do?