The Gray of Individual Worry

In my previous post, I wrote about how worry and pedantry can consume you after experiencing an extreme illness. I want to talk a little more about what that can look like.

In September of my senior year of high school, I developed a very sudden, progressive illness. Over three months I lost tolerance for any exertion, not to mention dropping a quarter of my weight, spiking fevers and night sweats, growing erythema nodosum that ate through my lower legs and made walking very painful, weathering near-constant abdominal cramps and frequent diarrhea, spitting into a cup every few seconds from waterbrash, and enduring vast personality changes with intense depression, anxiety, and weeping. In the month prior I had been quite healthy; cheerfully reading college guides, training with the cross country team, and researching alternative diets.

About a month pre-illness, charging up Steens Mountain.

In late November I had gotten so bad that I was finally hospitalized. In the hospital a surgeon consulted with me about having a colectomy, where my entire large intestine would be removed, as it was so diseased and ulcerated that it may have been beyond repair. Fortunately, a biologic drug rapidly reversed the inflammation. After I was discharged from the hospital in early December, colon intact and symptoms dramatically improved, my parents and I were still traumatized by how drastically our life circumstance had changed in a few short months. They had both had to cut their work hours significantly in order to care for me round the clock. We had been told that this was caused by a chronic condition that would require indefinite management.

It became our mission to somehow ensure that I would never suffer like this again. We wanted a complete cure of something that I had been told I would now deal with for the rest of my life.

And so, the heightened state of alert continued. I kept a symptom diary documenting every food I ate and every bowel movement, which my parents would read and review. I followed the strict Specific Carbohydrate Diet protocol that I had started in October, eating a handful of the allowed foods from the intro stage and only introducing a new food every four days. My mom spent the better portion of her days cooking for me, making homemade yogurt, and sourcing unconventional ingredients. I saw an array of alternative practitioners – an acupuncturist, a homeopath, a naturopath, a psychic healer, a BioSET expert. Any activities or outings with friends were computed well ahead of time in terms of food needs and parental support; I could do almost nothing truly spontaneously.

This is one book cover I’d be happy to never lay eyes on again.

As I slowly regained my stamina (which I’m not sure the practitioners or our fanaticism actually had much to do with), I drove myself mad with worry. During that time, I had a nagging belief that I had caused my illness somehow – perhaps through poor diet, exercising too strenuously, stress, or moral failing. This was my way of feeling in control; if I could cause an illness, I could also reverse it somehow. But this logic also meant that any minor slip-up could be the one that sent me into another 3-month horror show of severe infirmity. If I accidentally ate something not allowed on my strict diet, or if I failed to tell an important detail to my homeopath, or if I overexerted a wee bit and was tired the next day – that mistake, to me, meant a one-way ticket back to hospital.

Additionally, my time in online support groups for illness had overexposed me to New Age, mind-controls-the-body theories – think Rhonda Byrne, Bruce Lipton and Joe Dispenza. I took it all way too literally. I believed that worrying too much about illness would itself make me ill, which trapped me in a bizarre infinite loop. I remember the anxiety would particularly come on at night, and I would sit awake crying to my mom about how scared I was, and getting scared because I was scared. I think it came on at night because the day I had been hospitalized, I had gone to bed feeling stable and awoke screaming and feverish later in the night. The night was the unknown, the leap of faith; I thought I would go to bed normal and wake up with no intestines. And that it would have been my fault.

None of these fears quite ended up coming true. While I continued to weather great difficulties with my health over the next six years, I never once got as severely ill and dependent as I had during that first flare-up. I had to accept that maybe there was no real way I could have prevented this; that the cause was just not known. Or further – that even knowing the precipitating cause doesn’t always mean much as far as how to reverse the illness. (For example, many people who have mast cell activation disorder developed it after an infection like Lyme, but Lyme antibiotics are usually not sufficient to treat the disorder.)

Starting around April of 2012, I gradually returned to a normal diet (except for being gluten-free due to a diagnosis of early-stage celiac). I let myself exercise more, starting with just one lap around my block and building to 3-mile jogs. Although my body did not respond as well to the exercise as it used to (possibly due to anemia), it was clear that I wasn’t doing something harmful. Slowly but surely, the circuitry of fearing my every move broke.

July 2, 2012 after one and a half miles of walking. I was a bit deconditioned.

Yet something had shifted in me by this time that has never fully resolved. Perhaps it was the natural inversion of the “healthy” version of myself pre-illness who still had some very questionable beliefs about what allowed her to be happy, and why people get sick or unhappy. It’s often not the “illness itself” that we fear. It’s what we associate with it; perhaps a loss of identity, a loss of community or friends, a loss of self-expression, a loss of ability to provide for oneself or others. I will address this in a future writing if I am able.

Everything Changes

I took the Mayo Clinic art tour yesterday. Yes, you’ve read that right. It turns out that in addition to their renowned coordinated medical care, the Rochester, MN clinic’s buildings are home to an impressive collection of paintings, sculptures, and glasswork rivaling many museums. According to the pamphlet accompanying the tour, “Mayo Clinic has always believed that restoring the mind and spirit is an important part of making the body well ­­— and that art and science together play a role in the healing process.” Over the years, benefactors have supplied a collection that includes the Auguste Rodin piece Jean d’Aire, a Flowers series by Andy Warhol, a massive glass sculpture collection spread throughout the Gonda Building featuring works by Dale Chihuly, and many more artists who I would name-drop if I were cultured enough to know which ones to name-drop. Some of the contributing artists or benefactors were treated at Mayo or have family members who were.

 

The Plummer Building, Mayo’s oldest building still in use today (dedicated 1928), is basically a work of art itself (I thought that was just my original thought but the pamphlet says “the Romanesque-style building is a work of art in itself, both inside and out”). It’s fifteen stories high, topped with a bell tower complete with a fully functional carillon and surrounding balcony. The exterior of this tower is adorned by stone gargoyles, griffins and, as I learned on the tour, busts of women meant to honor the nursing staff. The interior of the Plummer Building just screams, “We have no idea the global economy is going to crash next year.” Take a look:

Mayo Clinic
Actual doctors work here.

Image from mayoclinic.org

But the piece that gave me and most tour-goers pause was a kinetic piece by Israeli sculptor Yaacov Agam, simply called Welcome. Agam’s son was treated for a heart condition at Mayo in 1975. The tour guide quoted Agam on the tour, and I later found the quote here: Agam meant for the piece to help patients and their families “rise out of the gray of individual worry and respond to life’s ever-changing rainbow of possibility.” A YouTube posting of the sculpture is unfortunately way sped up; I encourage you to watch my 2-minute real-time video of the slowly rotating solid below for the intended effect. My comments will come after so you can form your impressions first.

If a picture is worth a thousand words, then there’s a thousand words for each of the infinitely many iterations this piece begets. So let us talk about the change itself, a process through which Agam makes us sure we’re seeing one thing, then nudges us through the medium of time until we are definitely seeing something completely different, but can’t quite recall how we got from A to B. The timing is gentle enough to give the illusion that we can somehow comprehend the mystery, track it clinically and incrementally; and yet the sum of these small changes creeps up on us, and forces us to reevaluate. We must adjust to a new paradigm that – despite being the result of every small change previous to it – makes itself appear sudden. And yet every attempt at adjusting will again be slowly swept away as the picture changes. Sometimes the picture is incoherent, too busy, too many moving parts. And sometimes the coherent picture can only be seen on a panel that is fading from view.

Watching the piece in person, I felt something awaken in me at the cellular level. My medical problems have of late taken on the labile, ever-changing quality of Welcome. The diagnosis I received at Mayo this week – mast cell activation disorder (MCAD or MCAS) – describes one of the more chaotic and bizarre conditions a doctor might see in his practice. Dr. Lawrence Afrin, one of the pioneering researchers of the condition, writes in his diagnostic guide that “the general presenting motif of MCAS is chronic multisystem polymorbidity, generally of an inflammatory theme and with assorted elements waxing and waning over time, sometimes in synchronization with one another but more often cycling with different periods and amplitudes.” Or in English – the symptoms can happen in any body system – eyes, ears, mouth, lymphatic, pulmonary, cardiovascular, gastrointestinal, genitourinary, musculoskeletal, neurologic, psychiatric, metabolic, hematologic, or immunologic – and they all can wax and wane, independently or not, with no discernible pattern.

 

I have known the “gray of individual worry” of which Agam speaks. Long-term illness drills some fear-driven habits into you that are sometimes necessary when you are very ill, but become maladaptive as soon as the situation changes. Illness trains you to label and analyze everything your body does, to become a bloodhound for potential upset or danger. No longer can you let a stomachache just be a stomachache; it’s a sign, or a data point, or a harbinger – something requiring action and documentation. But with something like MCAS, where symptoms can not only appear seemingly at random but also go away just as quickly, how much use is it for my life to get bogged down in the details?

 

At the same time, it feels hollow to say that when my careful documentation of these symptoms is what allowed me to obtain a diagnosis in the first place. But what I need to work on more is my stifling habit of judging and labeling these symptoms, the now-reflexive projection into the future of “Because I have a headache now, I can’t go to the party that is in four hours,” or “Because I’ve had severe mood swings for two days [something that happened earlier this week], I will feel this terrible forever and won’t be able to write a blog.” This tendency is a relic of a time when my health required so much management that it was often safer and smarter to preemptively say no to everything. But at this time in my life, the answer to change is not immediate judgment but observation and adaptation to rapidly shifting realities. It is time to shed the “gray of individual worry” and step into that “ever-changing rainbow of possibility.” What exactly that will mean remains to be seen. I leave you with the double rainbow that touched down over my AirBnB when I got to Rochester: