Beth Deitchman

Reader, Writer, Knitter, Slayer

Category: Hypochondria

Assume the Worst

Last Tuesday at midnight, I woke up in the middle of a hot flash as Dave was getting up to go to the bathroom. Ralphie, ever alert to our movements, hopped from the bed to investigate the sudden change in status. He followed Dave to the bedroom door where he hovered, presumably because he had to know where The Man One went. After Dave returned and crawled back into bed, Ralphie needed a little coaxing to resume his spot. Instead of curling up and going back to sleep, however, he climbed up to the head of the bed. On hot nights he tends to avoid the top of the bed, but there he was, sniffing, next to my pillow. I hoped he’d cuddle, but he leapt off the bed and rushed to the other window, still sniffing. For the next several minutes, Ralphie chased something around the bedroom–head lifted toward the ceiling and shifting on a dime. It was pretty impressive, but whatever he was trying to catch had some mad flying skills.

“It’s probably the beetle I saw earlier,” I said, so confident. “Ralph, get back in bed; you’re not going to catch him.”

Ralphie ignored me. I sat up and watched as he continued to spin around the room. Then something black swooped over me–it was a little bigger than a Monarch butterfly. “That’s not a beetle!” I shrieked and pulled the covers over my head. “Make it go away!”

Dave, like the good husband he is, got out of bed and looked around.

I peeked from under my covers. “Turn the light on,” I suggested. He did. As I dove back under the covers, again shrieking, Dave said, “I think it’s a bird.”

“It’s not a bird.”

He took a beat.

“No, it’s not a bird.”

Underneath the blankets I shivered, so creeped out by the bat flying around our bedroom.

Meanwhile, Dave and Ralphie watched as it banked again and again around the room. “Wow!” Dave said. “It can really fly!”

I wasn’t interested in its prowess. “Open the door!” It wasn’t a suggestion. (We have to keep our bedroom door closed at night or Ralphie will go charging down the stairs–barking–at regular intervals.)

I heard the door open and a moment later close.

“Is it gone?” I pulled the covers off my head.

“I think so,” Dave said. “It flew around the hall for a minute, but I think it found its way out the door.” He turned off the light and climbed back into bed. Ralphie stood by the bedroom door for another minute before he, too, jumped on the bed, curled up, and went to sleep. Dave started to slip back to sleep.

I, on the other hand, was WIDE awake. A bat had just flown around my bedroom. That by itself isn’t such a big deal. It’s just a (creepy) little winged creature–most likely more afraid of me–that simply wanted to catch some bugs. I  was kept awake by something I remembered hearing while in graduate school: the fiancé of a friend telling a story about a bat flying around in a restaurant–how that had been considered dangerous because of the potential for rabies infection from a fly-by. He was a med student and spoke with authority. Wikipedia didn’t yet exist and instead of questioning him or looking it up in the library, I merely stored this terrifying little nugget of (mis)information in that vault in my mind where such things lurk and moved along.

Until Tuesday. I spent the early hours of that morning convinced that the bat had sprayed rabies ALL OVER my room. I know, rationally, that such a thing isn’t possible.* I’m not an idiot. But at 12:30 on Tuesday morning I wasn’t operating from rational thought. I was operating from fear and a super-charged imagination.

What’s the worst thing someone can do in such a situation? Yep, consult the Internet, whose slogan should be “Assume the Worst!” The next morning I looked stuff up on the Center for Disease Control website. According to the CDC, if you wake up to find a bat in your room, you have to assume the worst. That’s not how they phrase it, but that’s what they mean. I sat in my office wondering how long the bat had been in the room–had we been asleep? Had it entered not through the upstairs deck door as I thought, but through the window over the bed? Had it crawled through that window and hung over me while I slept? Had it landed on me? Had it bitten me or Dave or Ralphie? Stories began to spin themselves–fueled by a catastrophic imagination, an episode of House, and an episode of Scrubs. (Who knew such different tv shows could make use of a rabies death?) To stop the stories from spinning out of my control, I made several phone calls, starting with the Advice Nurse. The one for my doctor’s office had to call back later, so I tried the Anthem Blue Cross Advice Nurse. She was a lovely lady, based in Atlanta, I think, who had had to get a bat out of her house recently. Unfortunately, she couldn’t tell me much–she was searching the CDC website for information. She suggested that I call the CDC and helpfully gave me the number.

So I called the CDC. The sweet lady on the other end read me what was on their website. While I was answering a brief survey about customer service, my other line buzzed. The Advice Nurse from One Medical had returned my call. Another nice woman spoke to me–this one in San Francisco. She didn’t have very much experience with bats. We began to bandy about the terms “post exposure prophylaxis,” which I had learned from the CDC website. Apparently rabies shots have gotten less daunting than they were when we were kids. Now it’s just a series of four shots to the upper arm, not the gazillion shots to the belly we whispered about as children, wide-eyed and thrilled by the horror.

But as nice as she was, she couldn’t give me any advice beyond considering the shots or contacting the Marin Department of Public Health. I asked her what she would do, and she replied, “That’s a good question. It’s kind of a tough call in this case, because you don’t want to take any unnecessary medication, but rabies is fatal.” Yes, well. I took down the number of the public health department and thanked her. She wished me luck.

By now I had to get going–I had a Pilates private session to teach. Plus I was all phoned out. I asked Dave to call the health department while I was gone. As anyone who knows Dave can imagine, he was completely blithe about the whole thing. Maybe not completely, but he wasn’t really worried. He agreed to call them and to stop by the vet’s office. (I made the mistake of looking things up like cases of rabies in dogs with up-to-date vaccines. It can happen.)

Luckily my client that morning was the daughter of another client–a marvelous man and retired surgeon who knows about my health concerns. He happened to drop her off for her session, and naturally I told him–mocking myself as I do to hide my fear. He waved it off, laughing, and said I shouldn’t worry about it, which mollified me for an hour.

Meanwhile, Dave had called the public health department. He told me when I called him from the Good Earth parking lot that they suggested we take the prophylaxis. So he’d called the closest urgent care center that had the shots, and they said to come in as soon as possible. Cue freak-out. I kept myself pulled together to grocery shop, but visions of horrible things accompanied me home. No matter how much I pushed them aside, they kept storming back. Lunch was a tense affair–Dave insisted we eat because who knew how long we’d be at Urgent Care? But we finally made it out of the house and up to Terra Linda.

Dave and I have a lot of experience of emergency rooms together. We had only been dating a few months when I had an acute case of appendicitis that led to a morning at the UC Davis Student Healthcare Center and then the afternoon and night at Sutter Davis Hospital. We’ve also been to Sutter Davis for a couple of serious asthma attacks (mine). I find trips to the ER with Dave very entertaining. Something about medical facilities inspires his already great sense of humor and timing. So it was only fitting that we spent part of our thirteenth anniversary at Urgent Care.

By this point in the day we had come to a clearer sense of the timeline–determining that we were awake when the bat entered the premises–and we were also pretty sure that we hadn’t been bitten. But those damn websites I consulted made it sound as though a bat could swoop in, bite its victim, and swoop away completely undetected. And that it would leave the tiniest of marks, easy to overlook. (Who the fuck writes these websites anyway?). Since rabies is fatal, I was not taking any chances.

Urgent Care was not busy, so we were seen pretty quickly, starting with Dave. Just before my turn, I heard the doctor in the hallway saying, “He’s fine with not getting the shots.” Then he came into the room and calm descended. He told me about Dave’s decision but added that I don’t have to do the same thing. Then he said that he didn’t think I needed the shots, but it was up to me. Naturally I was torn. He inspected me for bites, found none, and reassured me that if it were he, he would not bother with them. I debated–thinking that I might spend the next ten days seeing rabies in a headache or a sore muscle. Finally, my nascent rationality, something I’ve been working on, took over. “Let’s skip it,” I said.

“I think that’s the right decision,” he replied. Then he got up to do my paperwork, sending me down the hall to sit with Dave. When the nurse came in to give us our paperwork, she said, “The nurses all think you made the right choice.” That statement provided the most comfort all day. We thanked the staff for their wonderful treatment and headed home to Ralphie, who had forgotten the whole incident and just wanted to play fetch.

That night over dinner, Dave and I talked about death and fear and life and love. We toasted our thirteen years of marriage, made plans for the future, and reminded each other how lucky we are. We imagined the best.

 

*I have a theory about the bat spraying rabies: rabies is transmitted through saliva. A rabid bat can drip saliva from above, unlike a land-bound creature that has to bite to spread the disease. In the infinitesimal chance that a bit of infected bat saliva lands on a freshly opened wound or in your eye, you might contract rabies from a bat flying overhead. But that’s just my theory.

Maddie’s Purple Party

My niece Madison organized an eating disorders awareness event for her senior project. She invited me to speak (for reasons listed below), and because I knew that I would have a long day of travel before speaking, I wrote everything down. After I finished speaking a few people asked if I could send them my talk. So I’m posting it here–without the deviations that naturally occurred when in front of an audience because I can’t remember what I said:

When Maddie first invited me to speak at her Purple Party, I wasn’t sure what to say. I knew that she’d asked me in part because I have my own eating disorder stories to tell, and since the worst of my anorexia faded away a long time ago, perhaps I could shed light on the recovery process. But I didn’t really want to relive my anorexia story. It’s old, and, frankly, it’s not that different from anyone else’s. Yet I love my niece very much, and I want to support her, so I kept thinking about what I could say if I didn’t talk about anorexia.

The idea came to me, as so many of my ideas do, while I was getting ready for bed one night a few weeks ago. As I was brushing my teeth, a sentence began to form in my mind, so I rushed into my bedroom to write it down in the notebook I keep by my bed for that purpose. Finally I knew what I could talk about. Stories. Specifically the stories we tell ourselves about ourselves and about our relationship to the world.

I call them stories rather than thoughts or even beliefs for a few reasons. I’m a writer, so stories are what I work on every day. I also come from a family of women who LOVE to tell stories. Especially funny stories. I think that’s another reason Maddie invited me to speak—aside from my experience with anorexia, like the other women in my family, I am very entertaining. At any rate, lately I have become really interested in the power of our own stories—how they shape who we are, how they benefit us, and how they get in our way.

We all tell ourselves stories about ourselves—I’m a loser because…, I’m a winner because…, I’m lucky, I’m unlucky, the world owes me something, I’m not good enough…they go on and on. Some of our stories have been with us since we were very small, some develop as we grow older. Many of the stories we tell ourselves come from outside influences: for instance, there’s the old chestnut: ‘girls are bad at math,’ so there are hundreds of young women who don’t even bother with math. I was actually pretty good at math until I heard that I wasn’t supposed to be. Or until I took trigonometry—because it kicked my ass. And then there are the stories that advertising tells us that we absorb often without realizing it. Those stories are scary because they are so patently unreal, and yet we believe them as though they are proven facts. You can all think of at least one seductive advertising campaign that had you believing you needed x product to make your life complete, or stop aging (I’m not growing old gracefully, I’m going to fight it every step of the way), or have perfect hair. And you can all think of at least one little story you tell yourself about yourself.

Although some of the stories we tell ourselves can be comforting, many of them can be harmful. For example, when I was a teenager I began to tell myself the story that if I weighed above 100 pounds I was fundamentally unworthy of being loved. That’s a horrible story for anyone to tell herself—not least because it’s not true! But it stayed with me—perhaps not so clearly articulated—until my thirties—resulting in some really bad dating decisions. I am pretty sure that story came out of my anorexia (which I said I wasn’t going to talk about, but there you are). As you know eating disorders breed a whole host of horrible stories.

There’s a particularly insidious storyline in many eating disorder stories—the victim story. “I am a victim of ED,” it goes. “And that victimhood stems from something in my childhood, in my culture, in whatever it is I tell myself is true, whatever led me to embrace ED.” My problem with this story has two parts—first of all making the eating disorder into a character by naming it ED really bothers me. Giving a man’s name to a disease that largely affects young women seems fundamentally wrong. I know it’s a convenient nickname, but calling an eating disorder ED removes some of –if not all of—the power from the person who has the eating disorder. It becomes a separate entity entirely, not tied exclusively to the complexity of the individual, not allowing the individual full ownership of her—or his—disease. I also hate the victim story because it actually makes recovery—real recovery—impossible. As long as anyone believes she or he is ED’s victim, he or she cannot be free from ED. In taking away our responsibility for our behavior, we take away our power over the disease. As “victims of ED” we are forever linked to ED. I hate that.

Then how might we break free from our eating disorder stories?? I have a deceptively simple suggestion: we tell different ones. The beauty of being a writer in the early 21st century is that technology makes my job SOOO much easier. On my computer I can change anything with just a few clicks. That never gets old for someone who learned how to type on a typewriter (you could probably find a picture of one on the Google). But many of you knew more about computers by the time you were five than I ever will, so you know exactly what I’m talking about. Because of this editorial ease, I see all narratives as amazingly flexible, erasable, rewritable.

That’s why when Maddie asked me if she could say in the program that I would speak about the power of our thoughts I said no. Thoughts are different from stories. Thoughts creep up on us; they surface sometimes almost without our noticing them and then they’re gone. Replaced by a song (Electric avenue has been running through my mind for weeks) or another thought or something else. We can also be lulled into believing that what we think is true and therefore immutable. But stories require effort—we bring several thoughts together into a narrative. Stories have form, plots, characters. We make our stories, so we can change them. We can revise them. Reshape them. Rewrite them.

And that’s a big deal because if you really want to change who you are, you have to change the stories you tell yourself about yourself. That’s where my healing began—and continues—for I am NOT a victim of an eating disorder. [That’s my toothbrushing sentence] I am not a victim of my childhood experiences. Not a victim of something my parents, teachers, culture did or didn’t do. Yes, all of these things inform who I am and how I manage to negotiate my way through the world. But I refuse to see myself as a victim. As seductive as that story can be—because it takes the responsibility for a lot of my behavior off of my shoulders—that isn’t my story anymore, and that doesn’t have to be anyone’s story anymore.

But what, you might ask, do I do with this idea, (aunt) Beth? How do I apply it to my life and to my recovery? I’d love to say it’s easy as I’m making it sound with my awesome computer analogy. But it requires a lot of work. You start by thinking, really thinking, about what you want your story to be. Who do you want to be? How do you want to see yourself? Then you listen to yourself to find those stories that get in the way of you being who you want to be. What are the repeating negative storylines? One of mine is that chaos is just around the corner at all times and if I’m not vigilant about everything, chaos will reign. The world will spin completely out of my control and all hell will break loose. I break free from this story in a couple of ways—first of all, I know that chaos always wins anyway—one of the laws of entropy tells us that nature tends toward chaos—and I remind myself that I’m actually okay with that. There’s something kind of exciting and relieving about chaos being inevitable. Then I remind myself that my actions and the universe have absolutely no relationship. None. The laws of physics operate no matter how much I worry about anything—whether it’s about traffic, my husband, my dog, my work, my time, my health, my dog’s health…I think you get the picture. The truth is, I have very little control over most things. But I can either let that fact drive me crazy, or I can change the story. I can tell myself I am the type of person who doesn’t worry about control. I am the type of person who does not worry. (breathe)

That’s only the first part, of course. Because if I’m really going to change the story, I actually have to behave like a person who doesn’t worry about things that she cannot control. I’m working on that. My first step has been to stop the crazy worry stories from gaining traction in my mind by repeating, aloud if necessary, “Just because I can imagine it does not make it true.” That simple, albeit grammatically dodgy, mantra has helped a lot. It stills my mind and calms my stomach. It’s a tiny action I can take to change how I behave.

And that’s where all this leads. Putting the new stories into action. When you figure out what stories you want to tell yourself—the old stories that still work and the new stories that help you heal—then you figure out how to act like the person you want to be. It’s a constant negotiation with yourself and with the world, but it’s a negotiation that puts the power back in your hands. Which is where it belongs.

Hypochondria: How Easy is a Bush Supposed a Bear

My sister’s favorite story about me goes like this:

During the summer of 1999 I had an emergency(ish) appendectomy.  About a week later, still sore and slow moving, I went with Dave to have lunch with some friends in Davis.  After lunch I had to go to the bathroom.  While I was there doing my business I looked down and saw that my abdomen looked purple.  Naturally I freaked out because obviously I was bleeding internally.  I returned to the table and, in a panicked whisper, informed Dave that we had to go home because I WAS BLEEDING INTERNALLY.  After we walked home,  I showed Dave my lower abdomen and said, “See?  It’s purple!  I’m bleeding internally!!”  Dave said, very calmly and sweetly, “You’re wearing purple underwear and it’s reflecting off the skin of your stomach.”

Okay, maybe it’s not Stephanie’s favorite story, but it ranks pretty high on her list and after thirteen years still makes her laugh.  I like this story for a couple of reasons: a. the punchline never gets old and b. it’s a great example of how my hyperactive imagination colors everything, especially things related to my health.  Like anyone whose imagination encourages them to see things that aren’t really there, I see internal bleeding where there is only purple underwear, or a heart attack where there is only a sore left arm.  Or a stroke.  Or melanoma.  Or…

Before I paint myself as a complete lunatic, however, I have to say that my fears about my health are at least sort of grounded in reality.  I have a few actual chronic health conditions.  I was diagnosed with asthma when I was five(ish), and as a child and teenager I had a few pretty serious attacks requiring middle-of-the-night emergency room visits.  I have never experienced anything more terrifying than feeling like I can’t breathe.  And to experience that fear more than once as a child leaves a mark.  At least that’s how my therapist once helped me to rationalize my hyper vigilance about my health.

But as a child I didn’t make the kind of creative leaps from familiar symptoms to dreadful diseases that I do as an adult.  I knew that my wheezing and shortness of breath were caused by my asthma and allergies and that, for example,  if I went over to Jennifer Keeping’s house to play I would need to bring my inhaler because they had a cat.  The connection was clear, and though it was scary and sometimes the symptoms hit me when I didn’t expect them to, which was even scarier, at least I knew exactly what was wrong with me. (That didn’t stop me from worrying that I was going to die, but I think that’s a valid worry.  People DO die from asthma, even though my father assured me otherwise to keep me calm during attacks.)

I’m not really sure when I stopped making those clear connections between my symptoms and their causes.  I think my first “heart attacks” happened in my mid-twenties; I distinctly remember walking through the restaurant where I worked feeling really concerned about the tightness in my chest.  Looking back I can see that it was simply anxiety–I hated my job, so naturally I was tense and anxious while I was there.  But at the time it seemed so obvious that I was on the brink of cardiac arrest.

As I get older I seem to be getting worse at interpreting my symptoms rather than better at it.  And the Internet does not help.  Instead it facilitates those creative leaps from purple underwear to internal bleeding by providing me with more details than I need about every illness known to humankind.  More than one doctor has suggested to me that I should avoid websites like WebMD because they will only feed my obsessions and intensify the feeling that I am spiraling out of control.

Recently that spiraling feeling has gotten even worse, so I decided to write this post  because I am tired of being ruled by my unruly imagination and sick of assuming the worst, of seeing bears where there are only bushes.  But I’ve been wrestling with this post for a few weeks now because I’ve had a terrible time figuring out where it was going.  And then my friend Emily reminded me to keep it simple.  And with that reminder something important clicked for me.  I realized that I choose how I interpret my symptoms, and if I choose to keep it simple, then a sore neck does not have to mean I have meningitis, it more likely means I need a new pillow.  In the grip of my fear, I had forgotten that I have any choice.  Suddenly, with that realization, everything has snapped back into perspective, suddenly the heart attacks and strokes have stopped.  Or so I have chosen.

Post script:  In October my sister had a beautiful baby boy named Brayden.  He was pretty big for a little guy, so she ended up having a C-section.  When she was about to go home from the hospital, I sent her a text message telling her not to wear any purple underwear.  A few days later she sent me a text to tell me she had a purple stomach–she had a real hematoma and needed a medieval torture device called a wound-vac to help with the healing.  I spent a week at her house doing laundry and cooking while she was going through this, and it’s clear to me now that if I had actually been bleeding internally after my appendectomy, I would not have been able to walk home from the restaurant to show Dave my purple stomach.

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