the healing muse

Volume 12, 2012

It's All in My Head

Kevin Bray

      I think I am a hypochondriac, although I will seek a second or third opinion until my fear is assuaged. My self-diagnosis is confirmed by the holy grail of online medical knowledge and the one place that I stop before going to my doctors to confirm the malady: the Mayo Clinic Symptom Checker.

      The suspicions started some twenty years ago when I was turning thirty and newly aware of my waning years (the Death Clock has never wavered from its prediction that I will die on May 19, 2035; I hope the weather is nice), diminished vigor, and the first crease at the corner of my right eye. I woke up on a Monday with vertigo, something quite unlike the vodka spins that I endured ten years earlier at a stag when I was twenty and too young—I naively thought—for a brain tumor. This was pre-Internet and although I owned a comprehensive guide to common illnesses and a companion guide to prescription drugs, I couldn’t read either while my brain compelled me to imagine I was spinning in a whirlpool.

      “Worrying that minor symptoms or bodily sensations mean you have a serious illness.” This item from the Mayo checklist for hypochondria trivializes my worries; indeed, wouldn’t my doctor be considered a hypochondriac if he orders a test when the body sensations (spinning, blurred vision, ringing in ears) I experience lead him to worry that I might have a serious illness and he wants to preclude the possibility? And if the first doctor I see doesn’t worry, or worries in insufficient measure, then I’m sure the second doctor will share my concern and an MRI will be ordered with expediency.

      “Frequently switching doctors—if one doctor tells you that you aren’t sick, you may not believe it and seek out other opinions.” I’m supposed to do this, right? Every movie or television show or self-help book says get a second opinion! Yes, if I generate an iterative process and head off to see the nth doctor for the nth opinion (where n is greater than six), then maybe I am a hypochondriac, but maybe I am also just lonely or having the bad luck of garnering medical opinions from doctors who are out of their depth and constantly refer me to another specialist until I see a doctor whose degree of specialty is so intense that they know more-and-more about less-and-less until they know everything about nothing.

      Thinking you might have a disease and actually faking the thing are quite different problems. I know this from the Mayo Clinic. My good friend’s ex-wife faked cancer. This takes some effort, but some cancers don’t show outward symptoms and you can look healthy while dying, at least in the incipient phase of the disease. Every Thursday he picked her up from radiation treatments until one day he phoned the hospital to let them know he’d be late to arrive and could they let his wife know? Dots were connected to reveal that radiation treatments for her form of cancer took place on Wednesdays and they had no record of her. Her lie was so big, so much an impressive outlier in the scatter plot of human behavior that the marriage failed soon after. Her disease (you can confirm this at the Clinic) is Munchausen Syndrome, which sounds like something only a Muppet can get.

      I have suffered. In no order, my confirmed and real illnesses have included psoriasis (correlates beautifully with marital discord and general familial strife), vertigo (non-vodka related), Reynaud’s Syndrome (fingers turn white in cold weather and when the blood slowly returns they look like mottled shrimp), mild tinnitus (the ringing sounds like a distant burglar alarm), H1N1, four flesh separations that required many stitches, removal of wisdom teeth, painful eczema (spent ten days in hospital with cracked feet, which the doctors soaked in oatmeal and then salad dressing and it ended my juvenile judo career) and hemorrhoids (this ended well).

      There are other illnesses that are probably just as real, but still waiting for a fifth opinion. For some an opinion is not yet possible since they are yet bulbs that haven’t burst, seeds that must germinate, and flowers that will soon blossom. I suspect that I have a cancer, skin being the most likely one. I spent most of the seventies in the sun and a good part of the eighties and nineties. I used tanning beds for a little while, about two years, but never enough to go beyond a subtle hue. Blotches are appearing near the corner of my eyes where sun baked the high ground of my cheekbones, and I noticed a single Madagascar-shaped spot on my shoulder. Inside my lungs is buried fine and combustible sawdust, inhaled in my teens, and layered over this are asbestos fibers that wafted through the air when I removed floor tiles from our swinging-sixties bungalow three years ago. Can lung cancer be far off?

      There is a clicking noise in my head, very similar to the repetitive sound of a retractable pen being fiddled with by a nervous student. This comes and goes but recently caught my attention at my fiftieth birthday dinner. The syncopation seemed to coincide with my heartbeat, a sound that I wish to hear continue, but at night when the distant burglar alarm is ringing in my ear I dread the loud beating of this heart and try to associate it with imagined heavy footsteps on the second floor of the house. Better to think a real burglar is in the house than to accept impending cardiac arrest.

      I lived in a windy city while attending university. I’m sure I remember this correctly: people living in windy places are more likely to suffer brain tumors. A brain tumor is insidious and tricky. Signs might include headaches or fuzzy vision, but this is pretty much the same as declining visual acuity and you have to go to the optometrist before you get inside the MRI machine, just to rule out the need for glasses. Changes in personality can also signal brain cancer, and if you are irritable or confused or maybe just not able to follow MapQuest driving directions and you can’t blame bad finances or your wife for this inattentiveness or anger, then you should ask the doctor for an MRI. I told him that I once lived in a windy city, and he said that would be bad for my hair but not for my brain.

      My hair is thinning. I see the early stages of male pattern baldness, and to fight this I have applied minoxidil for years. Now I wonder about the long-term effects of twice-daily sprays of hair-growth treatment. There is no conclusive evidence of harm, but this is what they said about DDT while they sprayed Japanese civilians with it during the American occupation after WWII. Everything is eventually found to be cancerous and the minoxidil will make me a canary in the coal mine for any of the one hundred and twenty types of brain tumors. indicates that one of the disturbing side-effects (and they even reference the Mayo Clinic on this one) is “a decrease in sexual desire or ability” but I figure that I can counteract that with a little Viagra.

      I accept death. It will come and I hope I am asleep when it does. I should take sleeping pills every night just to make sure that I am unconscious when a massive coronary or critical stroke fells me. The problem is that even though the Mayo Clinic symptom checker confirms many of the diseases I suspect I have, the possibility of an accident is significant and I can’t take sleeping pills while driving, swimming, or using chainsaws. This is my greater fear: I will be pushed across the River Styx by some cataclysmic force for which I had no warning. Using my background in mathematics, I compile statistics and create guesstimates from to determine if I will be shot, t-boned at an intersection, fall from a motorcycle or drown in a quarry.

      “Certain antidepressant medications may be helpful in treating hypochondria.” See, even if the other diseases that I have aren’t real, then this one is because a treatment is available. The drug and the disease are complimentary. I used to worry that I might be a hypochondriac and that by relentlessly pursuing a diagnosis I would subject myself to harmful medical tests, but now I fret that I suffer from hypochondria and serotonin reuptake inhibitors. I hear these can cause suicidal thoughts or actions and I’m not prepared to confront self-destruction. Maybe I should stop worrying and just accept the inevitable. Is there a disease called “plausible denial?”

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