When I was 12 or 13, I convinced myself I had a brain tumor. A classmate had been diagnosed with cancer and his sepulchral appearance haunted me. The second I conjured it, my head filled with ash. A headache spread from my eyes down through my jaw and around the back of my neck. Language disappeared. I felt for lumps and found them. I was convinced the tumor was piercing my skull like weeds through concrete. I couldn't tell anyone. One Friday when I was home from school, my mother asked if I wanted to go with her to pick up my brother from school. Because it was the end of the week, she offered to stop at Roy Rogers. I stared at her, afflicted. Can I get fries? I asked, convinced I was dying. When we got in the car and pulled out of the driveway, the paranoia relented. I'd left its address.
Years later, as I sat with my classmates in the writing workshop room at Ohio State, the professor's voice darkened into double stops on a viola. I called my husband who lived two hours north in Cleveland. His voice sounded like he was in witness protection. Something is wrong with my hearing, I said. An audiologist closed me in a soundproof chamber and played various games through the headphones. I panicked when I couldn't hear anything and rejoiced when I could. A fussy student in my adult life, I worried about getting the right answers and passing the test. The audiogram showed sensorineural hearing loss in my right ear, with a drastic dip on the lower-frequency side.
My case was mild compared to others, said the ENT, a callous, yet respected man. Ruptured membranes, a frayed nerve that may or may not heal. I'm a musician, I said, even though that was a stretch. He said he'd treated members of the Cleveland Orchestra with worse problems. An MRI would rule out a brain tumor or multiple sclerosis. Brain tumor I'd already considered; it was one of the eventualities I'd paid into, like an annuity. But multiple sclerosis was fresh. Without knowing exactly what it was, I felt myself contracting it. How can you tell from an MRI? I asked. White patches, he said. Prednisone would treat the inflammation and intensify psychological disturbances, and a diuretic would shed the fluid in my ear and help me lose weight.
At night, psychosomatic parasthesias prickled my arms and hands. In the damaged space between 500 and 250 Hz, my brain placed a buzz. I clapped my head in pillows, but I was trapped with my mortal enemy, the buzz. I entered crowded rooms left ear first. My husband brought a fan into the bedroom and turned it on high. I'm going to quit school, I said. No you're not, he said.
***
Years later, in a remedial empathy class for doctors, I played the part of a woman in her thirties receiving a diagnosis of multiple sclerosis. I rocked in my chair and cried. When the simulation was over, and I'd blown my nose and wiped my eyes, the doctor looked down at me through his wire-rimmed glasses. He spoke with an elegant Austrian accent. Tears are manipulative, he said.
***
I don't think of my anxiety as anxiety. The word itself contains urgency and a whiff of longing, all true to what I feel. Splendid possibility is lost. Dire possibility is found. Right answers are wrong, and wrong answers are right. The imagination swells. But for some reason, the word seems distant to me. It's flat and clinical. It's treatable.
I am sitting at the piano for my senior recital in the dim sanctuary of a Unitarian church. I set my hands to begin Brahms' Rhapsody Opus 79 No. 2, the piece that contains everything I feel at age 17. I want to be Martha Argerich on the cover of her debut recital album, on which this piece appears. Her brow creased with brilliance, velvety dark hair, full lips I want for myself in every way. But my mind dries up. My mouth is sticky as a glue trap. I can't remember the opening notes that send the piece galloping from the bottom to the keyboard to the top. All I know is I'm setting two marmoreal hands on a new surface, a keyboard. The audience -- a handful of friends, a Catholic priest, my piano teacher, my parents and siblings -- awaits. The food I won't eat later sits on a long table in the back. Later, my father says, what the hell's the matter with you?
It's a disruption.
It's of the same quality as the rest of life, but sick instead of full. I
don't just check the stove. I check it to the tick of the second hand.
Memory vanishes, or becomes a finger probing my mouth. I can taste its powdered latex glove.
Anxiety feels like my body standing up for itself. Drugs have a paradoxical effect. The night I separated from my first husband, a friend gave me Xanax. I stayed awake all night, impaled by dread and exhilaration. When I lost my hearing, I was prescribed Ambien. I stayed awake all night, carrying on conversations I don't remember. I was prescribed Trazodone, which I was too scared to take. Lexapro made my hands shake so violently I couldn't type. I took a shot of whiskey before an audition and my heart thumped
erratically all the way through it, as if my cardiovascular and
respiratory systems were skittish dogs meeting each other for the first
time. I was too scared to go under general anesthesia, so an oral surgeon gave me Valium. The opposition of my body versus the surgeon's body was more than I could bear. We can't stop now, he said. I haven't listened to Sigur Ros since.
The final time I did marijuana, I ingested pure terror. I receded from my skin and looked into the blank space between my person and my skin, an elevator closed and waiting inside a shaft. My chest turned to concrete, preparing to die. I peered out my eyeholes at what was called the world. I no longer knew its representations and meanings. My ears filled with a humming nothingness. I was a nothingness machine. I am not a person, I remember thinking. I am a thing in a sweatshirt and hat. Music is nothing to me. At the hospital, I was given Ativan to counteract the marijuana. I finally calmed down when warm blankets were heaped on me.
Now, the sun through the attic window feels good on my coiled form.
***
When I was a kid, I didn't think of my father as afraid. I thought of him as mean and strange. He had a lot of rules and baroque punishments for breaking them. He was afraid. He was afraid of dirt and germs and death. He was afraid of gay people and black people and women. He was afraid of the police. He was afraid of outside clothes inside. He was afraid of shoes. He was afraid we'd choke to death in our sleep. He was afraid we'd suffocate. He checked doors and windows. He watched the street from the front door, one hand gripping the front of his shirt. When I asked for fashionable clothes or listened to pop music, he said, why do you want to grow up to be like everyone else? He was afraid to the point of humiliation, his and ours.
Friday, February 21, 2020
Thursday, February 13, 2020
Exit Interview
Last year, I left my job at a major hospital system, where I worked as a research editor. I'd spent nearly nine years there, most of my thirties. The managing editor in the office, a veteran of the Federal Reserve research division at a time when they laid out pages on poster board and photographed them, taught me the art of editing. She shepherded me through projects that tested the limits of my stamina and patience---nights, weekends, early mornings with the sun blasting off the white and chrome favored by the campus architects. I became a professional. On breaks, we watched YouTubes of Monty Python and discussed our lives, mine anxious and matrimonial, hers filled with boomer intrigue. We laughed over the headers on random pages of the enormous American Heritage Dictionary she kept on her windowsill.
For as long as I knew him, my colleague's husband was either recovering from or experiencing heart ailments. In 2015, I watched his health decline, plateau, then decline again until he died in 2016. His chest was studded with implantable devices designed to pump, prop, pace, or shock, all of which failed at one point or another. He was alive in his bed in the intensive care unit, talking about home repair and answering my paranoid questions about asbestos removal, then he was dead in the middle of the night after a last meal of chicken wings, his heart galloping past the silent devices to the finish line.
His healthcare at the same institution that employed us was expensive, risky, and at times inexplicably cruel and misleading. Each week brought a new doctor, a new promise, hope buoyed, then another procedure and another failure. The sediment of this anguish settled in me. His gray hair parted down the middle and combed. His cough freighted with the fluid they took off him in gallons. The boat he bought when he knew he was going to die. A honeycomb of smells. A struggling body smells honest and human and unavoidable. It's a miasma of prescriptions and altered diet and interrupted sleep, of bed baths instead of showers. His skin grew mottled, but he was still tall and mighty. His commanding voice was burnished by years of cigars and Scotch. Take her out to dinner, he said one grim afternoon in his hospital room. He flashed his credit card around the room at his adult sons, at me.
He lived, then he died.
In that year, my colleague lived 60. She ricocheted from promise to promise. She had no choice but to rely on a system that quickly showed itself to be indifferent to the personal and captivated by money. She drove him to the emergency room in the middle of the night. In vain, she wondered what happened in care team meetings and procedure rooms. When she asked, she got half-answers, or contradictory answers, or no answers.
It's one thing to know academically that people get sick and die as a matter of course, as an imperative of nature or fate or otherworldly prerogative. It's another to watch it. It's another to watch a person mow his grass and grill vegetable sandwiches and drink Scotch, then walk out of a hospital freighted and hobbled, then wheel in and stay, again and again, all in a great mystery that everyone seemed prepared to prolong, but no one seemed prepared to solve.
It's another thing to watch a system work.
My colleague and I sat in adjoining offices and produced drafts, submissions, proofs, second proofs. The race was on to produce more papers than the hospitals that were ahead of our employer in national rankings. She taught me about column balance and bad breaks. We debated hyphen versus en. In a sweater set and scarf, black dress pants, silver jewelry he'd made, and fresh lipstick, she visited her husband. She brought him homemade meals in an insulated lunch bag. She brought him his war medals. When he was sedated, she sat with him.
I'd never thought about my jobs in any moral or political way. As someone who'd lived on her own since age 18, and had worked since age 14, I had no qualms and no shame about earning money and receiving benefits, no matter the job or what it asked of me. Jobs resulted in money and the ability to live. Once I had one, I tended to stay for years. I'd thought all a job ever asked of me was the work itself, contained at a desk or restaurant table. It certainly didn't ask me for anything insidious, such as belief or endorsement. I applied to myself the capitalist corrective that I was producing something or contributing something, even when the something was difficult to define.
I was 32, 34, then 39. I clung to a salary 5K less than I asked for and 20K less than my peers. My employer, which was also my health insurer and provider, sent me letters informing me that I was obese and needed to lose weight to receive a reasonable rate on my health insurance. A surgeon groped me in a stairwell. It was suggested the grope was something a father would do to a daughter. Any disciplinary action would have to be initiated by me.
The MeToo movement, which hasn't yet reached high-profile medicine, reintroduced to a national audience the concept of the whisper network. But women in the workplace know about the whisper network. My former department's whisper network was broad and deep. We talked about the surgeon who threw a scalpel across an operating room. We talked about the secretary who was hounded for a date by a surgeon until she complained and was transferred across campus. We talked salary, which is the most important conversation one can have with colleagues. It is also the most verboten, violating an honor code enforced by people whose job it is to figure out how to pay the least and extract the most.
We talked about the right-sizers who arrived in our department ready to make cuts, whose cluelessness was matched only by their eagerness. We talked about how the department head, one of the most famous and respected researchers in the world, refused to participate in the ill-conceived takeover. When the dust settled and the middle managers were hired, he was removed from the organizational chart and stripped of important responsibilities. We talked about the cheap pens that broke off in our hands and the cheap forks that broke off in our food and the cheap sutures that broke off in surgical wounds. Every Friday, we carried our office trashcans to the hallway and emptied them into an overflowing main can. Women colleagues cleaned the office kitchen and vacuumed the office floors. They also brought in their own tools and tried to fix the bathroom sink so the department wouldn't be charged for a service call. One afternoon, we wrote on the kitchen cleaning sign-up sheet, "Waiting for a man to sign up!"
Revenues lifted into the billions. Patient volume was high, with plans to double it in five years. Traffic snarled around the main entrance. Elevators were full. People clutched sacks of pill bottles. They trailed catheters and cannulae, and smelled of cigarettes and alcohol and sickness and death. It's one thing to know, academically, about sickness and death. It's another to experience it and smell its brutal odor.
Experience erodes naivete and ignorance. It can make us radical, if radical means facing the fact that sacred systems are perversely incentivized and corrupt, and in need of overhaul. It shows us the pressure of systems on people. Experience shows us how years of conventions and niceties and compliance accumulate into a plaque. It casts a long, cold shadow over the thousands of private cowardices we've indulged and the bargains we've made. It gives us the gifts of doubt and skepticism. It may show us the way out.
First, we talk. By talking, we divest from shame and other conspiracies. We become acquainted with others like us, so we don't feel so atomized and powerless. We also become acquainted with the kinds of people for whom the talking, not the wrong itself, is the wrong. The kinds who privilege allegiance or non-disclosure, which are ultimately about power. By talking, we glimpse real and subversive freedom.
Last March, I came back from California and turned in my resignation. My new boss reacted with alarm, speculating that I'd been recruited to a rival hospital system. On my last day, I came home to a gift basket from him and a note thanking me and wishing me the best. I wrote him back, but I didn't say what I wanted to say.
For as long as I knew him, my colleague's husband was either recovering from or experiencing heart ailments. In 2015, I watched his health decline, plateau, then decline again until he died in 2016. His chest was studded with implantable devices designed to pump, prop, pace, or shock, all of which failed at one point or another. He was alive in his bed in the intensive care unit, talking about home repair and answering my paranoid questions about asbestos removal, then he was dead in the middle of the night after a last meal of chicken wings, his heart galloping past the silent devices to the finish line.
His healthcare at the same institution that employed us was expensive, risky, and at times inexplicably cruel and misleading. Each week brought a new doctor, a new promise, hope buoyed, then another procedure and another failure. The sediment of this anguish settled in me. His gray hair parted down the middle and combed. His cough freighted with the fluid they took off him in gallons. The boat he bought when he knew he was going to die. A honeycomb of smells. A struggling body smells honest and human and unavoidable. It's a miasma of prescriptions and altered diet and interrupted sleep, of bed baths instead of showers. His skin grew mottled, but he was still tall and mighty. His commanding voice was burnished by years of cigars and Scotch. Take her out to dinner, he said one grim afternoon in his hospital room. He flashed his credit card around the room at his adult sons, at me.
He lived, then he died.
In that year, my colleague lived 60. She ricocheted from promise to promise. She had no choice but to rely on a system that quickly showed itself to be indifferent to the personal and captivated by money. She drove him to the emergency room in the middle of the night. In vain, she wondered what happened in care team meetings and procedure rooms. When she asked, she got half-answers, or contradictory answers, or no answers.
It's one thing to know academically that people get sick and die as a matter of course, as an imperative of nature or fate or otherworldly prerogative. It's another to watch it. It's another to watch a person mow his grass and grill vegetable sandwiches and drink Scotch, then walk out of a hospital freighted and hobbled, then wheel in and stay, again and again, all in a great mystery that everyone seemed prepared to prolong, but no one seemed prepared to solve.
It's another thing to watch a system work.
My colleague and I sat in adjoining offices and produced drafts, submissions, proofs, second proofs. The race was on to produce more papers than the hospitals that were ahead of our employer in national rankings. She taught me about column balance and bad breaks. We debated hyphen versus en. In a sweater set and scarf, black dress pants, silver jewelry he'd made, and fresh lipstick, she visited her husband. She brought him homemade meals in an insulated lunch bag. She brought him his war medals. When he was sedated, she sat with him.
I'd never thought about my jobs in any moral or political way. As someone who'd lived on her own since age 18, and had worked since age 14, I had no qualms and no shame about earning money and receiving benefits, no matter the job or what it asked of me. Jobs resulted in money and the ability to live. Once I had one, I tended to stay for years. I'd thought all a job ever asked of me was the work itself, contained at a desk or restaurant table. It certainly didn't ask me for anything insidious, such as belief or endorsement. I applied to myself the capitalist corrective that I was producing something or contributing something, even when the something was difficult to define.
I was 32, 34, then 39. I clung to a salary 5K less than I asked for and 20K less than my peers. My employer, which was also my health insurer and provider, sent me letters informing me that I was obese and needed to lose weight to receive a reasonable rate on my health insurance. A surgeon groped me in a stairwell. It was suggested the grope was something a father would do to a daughter. Any disciplinary action would have to be initiated by me.
The MeToo movement, which hasn't yet reached high-profile medicine, reintroduced to a national audience the concept of the whisper network. But women in the workplace know about the whisper network. My former department's whisper network was broad and deep. We talked about the surgeon who threw a scalpel across an operating room. We talked about the secretary who was hounded for a date by a surgeon until she complained and was transferred across campus. We talked salary, which is the most important conversation one can have with colleagues. It is also the most verboten, violating an honor code enforced by people whose job it is to figure out how to pay the least and extract the most.
We talked about the right-sizers who arrived in our department ready to make cuts, whose cluelessness was matched only by their eagerness. We talked about how the department head, one of the most famous and respected researchers in the world, refused to participate in the ill-conceived takeover. When the dust settled and the middle managers were hired, he was removed from the organizational chart and stripped of important responsibilities. We talked about the cheap pens that broke off in our hands and the cheap forks that broke off in our food and the cheap sutures that broke off in surgical wounds. Every Friday, we carried our office trashcans to the hallway and emptied them into an overflowing main can. Women colleagues cleaned the office kitchen and vacuumed the office floors. They also brought in their own tools and tried to fix the bathroom sink so the department wouldn't be charged for a service call. One afternoon, we wrote on the kitchen cleaning sign-up sheet, "Waiting for a man to sign up!"
Revenues lifted into the billions. Patient volume was high, with plans to double it in five years. Traffic snarled around the main entrance. Elevators were full. People clutched sacks of pill bottles. They trailed catheters and cannulae, and smelled of cigarettes and alcohol and sickness and death. It's one thing to know, academically, about sickness and death. It's another to experience it and smell its brutal odor.
Experience erodes naivete and ignorance. It can make us radical, if radical means facing the fact that sacred systems are perversely incentivized and corrupt, and in need of overhaul. It shows us the pressure of systems on people. Experience shows us how years of conventions and niceties and compliance accumulate into a plaque. It casts a long, cold shadow over the thousands of private cowardices we've indulged and the bargains we've made. It gives us the gifts of doubt and skepticism. It may show us the way out.
First, we talk. By talking, we divest from shame and other conspiracies. We become acquainted with others like us, so we don't feel so atomized and powerless. We also become acquainted with the kinds of people for whom the talking, not the wrong itself, is the wrong. The kinds who privilege allegiance or non-disclosure, which are ultimately about power. By talking, we glimpse real and subversive freedom.
Last March, I came back from California and turned in my resignation. My new boss reacted with alarm, speculating that I'd been recruited to a rival hospital system. On my last day, I came home to a gift basket from him and a note thanking me and wishing me the best. I wrote him back, but I didn't say what I wanted to say.
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