When you have hardware installed in your flesh, you tend to forget about it.

One month into the New Year and already I'm striking out in the resolutions department: quit smoking; get a new battery installed in my pace-

maker -- a $20,000 proposition with no insurance (my fault there...another dropped ball); and land a book contract. Very little gets done in the publishing business over the holidays; and January is a catch-up festival, so I didn't expect much in that area so soon but the other two are bothersome enough. I tell myself that given the lead-time between writing a column and its publication, I haven't really shot the whole month. Not yet. Speaking of lead-time, I may well be having that Duracell installed around the end of the month. The thing started quietly beeping (exactly 16 times every 6 hours) around early November. Of course I had no idea what the sound was and kept looking around me for a tiny alarm clock I didn't know I owned. Apparently that's a signal, not unlike a smoke alarm, that the thing is going south and you have about 90 days to change the power supply. Because the thing stops does not mean that you do. It does mean that should your heart attempt some lunatic rumba, the attached defibrillator will not do its thing. Its "thing" has been described to me as having a mule kick you in the chest. This paints a graphic picture to everyone I've mentioned it to, as if we've all, at one time or another, been kicked in the chest by a mule.

When you have hardware installed in your flesh, you tend to forget about it. Why dwell on it? In effect, you live in a constant state of denial. I have found this continues even when your attention has been called to it in no uncertain terms.

My electrocardiologist sighed and told me he knew there would be a problem as soon as he heard that the thing sounded off, albeit very quietly. A little, let's see, ticked off would be the term, I corrected him and said, "You mean you knew there would be a problem once you learned I no longer had insurance."

His response was to ask me if I was still drinking.

"No, I quit," I told him, as if I were talking about donuts and not years of recovery, relapse, rehab, relapse again, and more moral, physical, and spiritual anguish than I have ever experienced over matters of the heart -- or cancer, for that matter.

That this is on my mind, just beneath the surface of denial like a submerged reef, may not be surprising. What is, is my naïveté regarding the attitudes of medical professionals toward the uninsured in this country and the greed-fired cost of what should be routine medical maintenance.

The phenomenon of MDs as social or conversational dunces (maybe bulls in china shops is more apt more often) has been well noted and is based on the presumption that they were studying while most of us were learning to "get along" or "get over" with our fellow man. We pay them for the schoolwork and suffer their personal ineptitude; that's the deal. What amazes me is that doctors, rigorous and brilliant enough to get through med school, display not even a low animal cunning, as far as I can see, when it comes to daily human intercourse.

I do not mean my main guy, my cardiologist, who saved my life at Mercy a few years back. It would be less than genius to cast aspersions here, but I wouldn't dream of it anyway. Doctor Friedman is not only smart, funny, and even charming, the guy is a diplomat. Once while watching me wheeze alarmingly while on a treadmill, I asked him desperately, "There's something wrong, isn't there?"

"Well," he nodded, "you are deconditioned." Had it been me with the clipboard, lab coat, and stethoscope, I would have said something like, "You're shot out," or "You're a flabby sack of ----." High diplomacy. Dr. F. has also not charged me for several visits, prescriptions, and various services. If you're reading this, Doctor, I know and thank you. I was not talking about you in the previous cracks.

So, the Reaper is clearing his throat in the wings, fanning himself with the program, and mixing metaphors like Enderby, the fictional, flatulent poet in Anthony Burgess's trilogy. Re-reading book II for a distracting laugh, I find one of the poet's (now bartender's) works-in-progress:

Unless to hope to hold off

The unavoidable happening

With that frail barricade

Of week, day or hour

Which melts as it is made,

For time himself will bring

You in his high-powered car,

Rushing on to it,

Whether you will or not.

High-powered car. Burgess must have had fun.

Well, I have to live. I may come in handy for my son. As for fear of death, it is largely a fear of that crushing chest pain when the heart is failing. Pressing as all of this is, getting my affairs in order begins this morning with a decision: how much to put down on my T-Mobile cell phone pay-as-you-go account. That figure, once arrived at, should give me a pretty fair reflection, a grade, as it were, on matters of faith.