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Above: Jay McInerney in the Malibu Colony, CA, 2023.
I was alone in my apartment in the city on the night of December 20, 2023, so there are no witnesses. What I do know is that I woke up in the morning to blood all over the bedroom, bathroom, and hallway. The bed and pillows were scarlet. I have suffered from orthostatic hypotension for a decade: When I stand up abruptly in the middle of the night, to stroll to the bathroom, say, I sometimes faint. It took me several days to consult my doctor, Peter Halper. I can’t explain the lapse. Perhaps it was embarrassment. (When I finally called him a few days later, he said my failure to react right away is pretty typical post-concussion behavior.)
On the morning of December 21, though, I was driven back to the Hamptons, where my wife Anne and I have a second home. While I typically split my time between New York and Long Island, since the pandemic Anne has been happy to stay in the country most weeks, in the company of her dogs, cats, chickens, geese, emus, donkeys, sheep, goats, and alpacas. Her grandfather William Randolph Hearst likewise had a large collection of animals, at one point the largest private zoo in the world, so maybe it’s a genetic proclivity.
This particular return to Long Island was notable because it was move-in day. The house we had lived in since 2005, which I had moved into shortly after Anne completed building it (using some of the heirloom mantels, fireplaces, and paneling that her grandfather had collected in Europe back in the 1920s and intended for San Simeon), was consumed by fire on Boxing Day 2019. The fire began in our bedroom in a massive limestone mantelpiece carved with the initials and likenesses of a medieval French couple and the year of their marriage, 1574. Friends from London, the writer Julian Barnes and his then girlfriend, Rachel, were arriving a few days after we moved back in, and I was excited to have them christen the new house with us.
I remember little of Julian’s visit. At my request he recently filled in some blanks for me: “Your doctor said you weren’t allowed to drive or go to the cinema, but on January 1 you drove us into Sag Harbor and we had lunch at the American Hotel. You showed us some recently arrived documents for your collection. Hemingway and Fitzgerald, I think—perhaps the latter’s school reports? You had warned us of the accident before we arrived, and we did debate whether or not we should come. But you were, shall I say, hospitably woozy, or woozily hospitable.”
I remember parts of my 69th birthday celebration with 13 friends at Restaurant Daniel a couple of weeks later. Mostly I remember the end, when I realized that I would have trouble walking out. It had to do not so much with the large quantity of wine I’d consumed as with the fact that I had fallen five or six times since that initial big tumble and, feeling dizzy, was pretty sure I wouldn’t make it to the car.
I’d been getting weekly CAT scans at this point, and the results were not encouraging. Dr. Halper had connected me with a top neurosurgeon at New York Hospital, Theodore Schwartz. He immediately ordered up another CAT scan. I was grilled, weighed, and measured by a resident, then taken up to Schwartz’s office. A trim, fit, good-looking man in his fifties, he had that air of confidence bordering on arrogance that tends to be an occupational hazard of surgeons. I liked him. No one wants a wimpy surgeon.
“You have a subdural hematoma,” he told me. “Actually, two of them, but the one on the left side of your brain is somewhat worrisome.” A hematoma is a nasty localized collection of clotted or partially clotted blood outside the blood vessels, typically caused by injuries to the vessels from impact or surgery.
“Do you have any symptoms?” he asked.
“I’ve been falling down now and again,” I said. This was about three weeks since the bloody night of December 20. “And my typing has deteriorated. As has my short-term memory.”
“We’re going to monitor you and see if the hematomas shrink,” he said. “With luck they will. But if not, we may have to intervene.”
I wasn’t sure what that meant, and I wasn’t sure I wanted to know. My typing continued to be wonky, and I fell again. First on the asphalt outside a gas station in Manorville. A week later I collapsed at the front door of Sushi Noz, on the Upper East Side, landing on the sidewalk and breaking the fall with my hands. In my defense, there were two steps down to the sidewalk, which someone should have warned me about. On the other hand, I’d exited this place twice before without incident.
I found out what “intervention” meant on my second visit to Dr. Schwartz. “The subdural hematoma on the right side has gotten bigger. We’re going to have to do an endovascular embolization.” Which, he explained, was a minimally invasive procedure. A catheter would be inserted in my wrist or my groin and worked up to the hematoma in my brain. The surgeon would then occlude the blood vessels and stop the bleeding. Or so he hoped. The procedure, he said, was usually successful.
On the upside, the catheter was inserted into my wrist rather than my groin. On the downside, I had to be awake for the entire thing and utterly motionless, my body strapped into a gurney and my forehead taped to it. I had been given a local anesthetic comprised of Xanax and fentanyl and so was only slightly freaked out as I imagined the catheter snaking its way up my artery into my brain. It took an hour and a half. Still, catheterization seemed a much better option than craniotomy: drilling holes in the skull, the last resort.
My next CAT scan showed that the catheterization had not reduced the size of the hematoma. In fact, it must have shown the opposite, because at 6 p.m., a few hours after the scan, Schwartz’s nurse called and demanded I report to the emergency room immediately. I argued strenuously. “I have a reservation for dinner at Roscioli.” Roscioli is a tough ticket.
“Do you want to die at dinner?” she asked.
My craniotomy took place not on the following morning but the one after. I think Schwartz came in to see me beforehand, but I don’t really remember. I do remember that Anne and my daughter Maisie, who had flown in from Nashville, seemed distraught. I was strangely calm. I felt it was my duty to reassure them. I remember being wheeled into the operating theater and noting what seemed like a dozen doctors, residents, and nurses. I had a brief shiver of fear about losing consciousness, and then I recall counting backward as the anesthesiologist held a plastic mask against my face.
I stayed in intensive care for five days, a drain funneling pinkish fluid from my skull. On the Saturday, with two small depressions where the bore holes had been drilled (and which were eventually covered over by a kind of epoxy), I returned home to Long Island.
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My thinking started to clear up, and my typing improved. After a week I was suddenly seized with the inspiration to finish the novel I had been working on for several years,See You on the Other Side, but which I’d stopped writing after my fall. I started going down to my desk at seven or eight in the morning and working for seven or eight hours a day, quite a bit longer than my usual workday. I felt inspired in a way I hadn’t in a long time and knew all at once how the novel should end.
But my terrible, horrible, very bad year wasn’t over. Six weeks after the craniotomy, I flew to Charleston to celebrate my sister-in-law’s birthday. From there I would go to Nashville to visit Maisie and her twin brother Barrett and have dinner with their mother, my ex-wife Helen Bransford, with whom I get along very well. Charleston is a city I have always enjoyed. Not this time. I couldn’t sleep my first night at the hotel, and I grew increasingly anxious, then frantic as the hours ticked by. By morning I realized I was in the grip of a full-blown depression. It had plagued both my mother’s and father’s sides of the family, and I had experienced it twice before myself—in the 1990s, when I was doing a lot of coke, and during the first year of the pandemic. Always it was a debilitating cocktail of anxiety attacks and extreme insomnia, and an inability to soothe myself even with things I normally love—dining out, drinking wine, surfing.
Dr. Richard Friedman had become my sometime psychiatrist in 2020, and I managed to reach him from Charleston. “What you’re describing,” he said, after grilling me, “sounds like what you had before—depression, and also anhedonia.” Liketrepanation, the old school word for craniotomy, which I came across in a dictionary when I was a kid, the wordanhedoniahas long fascinated and scared the hell out of me. It means the inability to feel pleasure. It’s a terrible diagnosis for anyone but especially terrifying for a man like myself, who revels—positively wallows—in his pleasures (and whose nickname among his wine and foodie friends is “the hedonist”). But here I was.
I was still anxious when I flew to Nashville. I had to duck out of a very decent restaurant where I was eating with Helen and Maisie because I felt the walls were closing in and I couldn’t fall back on alcohol—forbidden by Dr. Friedman—to get through the evening. But after a few days more of clonazepam and Lexapro, courtesy of Dr. Friedman, I was myself again.
Well, almost.
I found myself gasping for air whenever I walked up the stairs in our house; the stairs from the subway to the street were worse. It was six weeks after my brain surgery. I had been cleared to resume physical exercise and had just started working out again with Ed Cashin, my trainer of 12 years. I did it every other day unfailingly, under Ed’s long-distance Facetime guidance. We did a combination of strength and conditioning: kettle bells, TRX, BOSU ball. I found myself panting during the aerobic parts. My heart monitor was barely registering; I replaced it three times, thinking it was defective, but even in high aerobic mode I was getting up to only about 60 beats a minute. At rest it was closer to 40, which suggested either that I was the world’s fittest human or something closer to the opposite.
Dr. Halper once again connected me to a specialist, a cardiologist named Eddie Fisher. Dr. Fisher was extremely thorough and sympathetic—my first visit lasted almost two hours, during which he quizzed me as thoroughly as my shrink had. The stress test, performed on a treadmill with an abundance of electrodes attached to my body, indicated that I had arterial blockage. How much would be determined by a Dr. Sharma, from Mount Sinai, who would insert one or more stents into my arteries to facilitate blood flow. Fisher was also worried by my heartbeat. Basically, my heart was skipping every other beat.
More blood tests, another EKG, and then a two-hour procedure followed. An hour later Dr. Sharma emerged from the OR to tell me that my blockage was too severe—up to 85 percent—for stents. I would need open heart surgery and a bypass on several arteries. Dr. Fisher called to say he’d heard the news and suggested that I make my way back to New York Hospital to be operated on by Leonard Girardi, a med school buddy of his who he said was the best cardiothoracic surgeon in the biz. He had already called ahead and gotten the go-ahead from Dr. Girardi. The only problem was escaping Mount Sinai, which didn’t seem to want to release me. I ended up slinking to the bathroom with my overnight bag, getting dressed in there, and slipping away in a cab to New York Hospital.
Dr. Girardi, when I finally met him early the next morning, proved to be either very intense or very distracted; he seemed to have a hard time looking me directly in the eye. But the nurses and the other doctors clearly revered him. He was fiftyish, with reddish blond hair, and he was trailed by a retinue of 10 or 12 residents and doctors, ducklings following their mother. They filled the little space that I occupied, curtained off from another patient who was mostly unconscious. Dr. Girardi asked me a few questions, and then as suddenly as the mob had appeared it was gone.
I wasn’t wheeled into the OR until midafternoon on the next day, when Dr. Girardi performed a quadruple bypass, replacing pieces of the arteries around my heart with pieces from my arm, leg, and chest in five and a half hours of surgery.
For the next few days I dozed on and off with the help of oral OxyContin and intravenous Dilaudid. Although I was never a fan of opiates, the Dilaudid was wonderful, filling my being with a warm glow as it flowed up my arm. I requested it every six hours, as was my prerogative. I felt nothing from the oxy, which I could get in the intervals. I must not have been very drugged when the physical therapy team visited two days after the operation. They insisted I sit up and tried to get me to stand with the help of a walker. The pain was excruciating, and Maisie had to beg them to stop. They left me alone for a couple of days, though eventually I was shuffling around with a walker, making the circuit of the ICU and noticing how sick everyone looked. Judging by Anne’s reaction when she first saw me, I didn’t look all that great myself.
There was still the problem of my subpar heartbeat, which was so low I kept setting off the alarm. A pacemaker was needed. Because of my low blood oxygen and low heart rate, I was advised that anesthesia was not an option and had the procedure done with just some topical Novocain. The pain was no joke.
My recovery was slower than I would have wished it. Exercise was off the table for six weeks, and driving for at least a month. I was encouraged to walk as much as possible and to eat whatever I wished. Since alcohol wasn’t mentioned, I didn’t bring it up. I started drinking wine with my dinner—a couple of glasses a week after returning home—and felt better for it. I resumed strength training after six weeks, gradually rebuilding my muscles. Loss of muscle mass is one of the leading indicators of aging, and I intend to fight it till the end. I have largely cut out many of the foods proscribed by cardiologists, like bacon and A5 Wagyu. And I am taking about eight pills a day to stay relatively healthy.
Unlike the protagonist of the novel I finished after my brain surgery, I have not had a religious conversion following my annus horribilis. I was fervently Catholic until adolescence, an altar boy and a chastiser of blasphemous utterances until my increasingly inescapable sexual fantasies came up against the Catholic doctrine that impure thoughts, as well as deeds, were sinful. The logical contradiction of a God condemning the thoughts that he allowed to colonize my brain was painfully obvious. Add in a priest who was pruriently interested in my thoughts and deeds in the confessional, and you get an ex–altar boy who was saddened but not surprised by the subsequent epidemic of Catholic sexual abuse scandals.
Since my serial brushes with mortality, I haven’t changed my life radically. Incrementally, rather. I am more patient than before, and more grateful for small blessings. I no longer walk to the bathroom in the middle of the night, availing myself instead of the plastic hospital urinal I keep by my bedside. I used to be extremely profligate with my time and energy. Although I was a skinny nerd with Dumbo ears and always younger than my classmates, I identified with the bold and the brash—with the literary bad boys especially: Marlowe and Byron, Hemingway and Kerouac and Mailer. The hard-drinking ones who made writing seem daring and even dangerous. I lived recklessly, befriended Mailer, consumed large quantities of cocaine and alcohol and nicotine. I ran through friends and romantic partners and wives. I staked my future on the unlikely hope that I could be a successful novelist, a fairly foolish aspiration when you think about it. One that takes a certain amount of hubris and balls. And when I achieved success with my first novel,Bright Lights, Big City, I took it as an endorsement of my ambition and a license to indulge my whims. I don’t think my prefrontal cortex, the part of the brain that instills adult judgment in the brain of a youngster, ever fully developed.
If I’d been a cautious and sober young man, a responsible adult, a solid member of the community, I seriously doubt I could have had the life that I have.Bright Lights, Big Citytook me around the world and opened doors that I could hardly have imagined stepping through. But when I think of all the wonderful women in my life—culminating with Anne, my fourth wife, with whom I have been happy for almost 20 years—I realize how lucky I have been. As I write this, I’m sitting on the back porch of our house in the Hamptons looking out over the back pastures, where goats, donkeys, and alpacas graze, shooing away two miniature goats who are trying to step on my keyboard.
Prior to my very bad year, I always had the sense that I would travel widely—to Egypt, Iceland, Bali, to all the other places I haven’t yet seen. But I’m now acutely aware that my time is limited. And it saddens me to think that I will have to leave the people and places and things that I love. Thoughts of mortality often encroach since my brush with death. I wonder if I will remain connected, somehow. I observed my mother’s end-of-life experience, her minutes of contentment and communion with her parents, and possibly some luminous being, at the end of a hideous battle with cancer. Something is waiting for us at the end. Perhaps if I were stronger and braver I would look forward to it. Instead I see it as a dark cloud in front of me, inevitable and unimpeded. More than ever I don’t want to say goodbye. Instead, I call my kids. I pet my dogs. I chop vegetables for a Bolognese sauce. I open a bottle of wine and pour a glass. I hug my wife. And I write, trying to make sense of the world around me, trying to preserve my memories, even as they fade.
Knopf See You on the Other Side: A Novel
This story appears in the May 2026 issue ofTown & Country.SUBSCRIBE NOW
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