Learning to ride, falling down, getting back on
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After my little brother punched a kid on his first day of kindergarten, he was taken to a specialist and diagnosed with attention-deficit hyperactivity disorder. Suddenly there was a scientific reason why he was so loud and rambunctious and hard to live with. He started taking Ritalin to manage his behavior and help him focus in school.
I was nine, a good girl and a rule follower. I needed quiet and calm and cleanliness, but these were hard to find in our small house. My two siblings and I were still upset about our parents’ recent divorce, and my brother filled every space he was in with his reckless energy. When he was being particularly bothersome, I would call him a “freak” and shriek, “Go take your medicine!” I knew this hurt him, but it was the only thing that made me feel temporarily in control.
As my brother and I got older, we became closer, and we talked about our childhoods. He had deep-seated insecurities over having been medicated for so long. It had led him to think he was defective. I felt terrible that I had contributed to that belief.
Last year I was diagnosed with clinical depression and began to take antidepressants. Only then did I fully realize how frightening it is to feel dependent on medicine and to question your ability to function without it.
It was March in Korea, and the weather was still very cold. I had been there a month teaching English when I got sick. I couldn’t sleep at night because I couldn’t breathe. During the day I dragged myself up the hill to campus, taught my classes, and sat in my freezing office. My employers had given me some kind of medical insurance, but I didn’t understand what it covered, and I had no idea where to find a doctor. I knew perhaps twenty phrases in Korean.
I went to Professor Han, my mentor, who made me an appointment with a doctor in town, also named Han.
I went there alone in a taxi. The driver let me off before a door with a sign that read, HAN’S CLINIC. The place seemed ancient and drab, not at all like the shiny, pristine doctors’ offices I was used to. The walls were an industrial green, the lighting was dim, and the waiting room was crowded with sad-looking people. I went to the small window, gave the receptionist my name and Professor Han’s, and was let in right away. I hoped it wasn’t because I was an American.
In the examining room the doctor asked, “American?”
I said yes and began explaining my symptoms, using simple words and gestures.
He nodded. “Shirt up,” he said.
I looked at him.
“Check breasts,” he added.
I immediately felt my vulnerability, a woman alone in a foreign place. Then I realized he had said, “breath.” He wanted to listen to my lungs. Of course.
He sent me into a room in the back, where a nervous young man took an X-ray. The doctor then said they would give me an injection and some pills to take over the next few days. I was asked to lie on an examining table and pull down my pants. A nurse came in, spanked my buttock several times, and told me I was finished. It was the most painless shot I’ve ever had.
They sent me to the pharmacy across the street for my prescription: three baggies of three pills each and some brown powder. I went home and took the first dose on faith, having no idea at all what it was. I then slept for the entire afternoon and woke up feeling better. I continued to take this mysterious medicine until it was gone. I still don’t know what it is they gave me. I wish I did. It worked.
When I hear people defend our healthcare system, saying we have the best in the world, I think of Han’s Clinic in Hongsong, South Korea, and how quickly I got better, and how little I had to pay.
When I was a child, my favorite stories were about my great-grandmother and great-grandfather, who came to New Mexico in the 1950s in a covered wagon — or was it a Model A? My abuelita (grandma) didn’t always remember. I learned, with my cup of half coffee, half milk poised at my five-year-old lips, about how my great-grandmother, Grama, was the one women came to in the village for help with illness, pregnancy, and abusive spouses. And my great-grandfather, Grampo, was like the village chiropractor: he would crack men’s backs and rub some oil, or holy water and dirt, on aching legs and muscles to make them strong for the next day in the field or on the railroad. My abuelita told me that the medicine Grama and Grampo practiced was better than what the doctors have now. You could talk to them and tell them all your troubles, and they would fix you because they cared, not because they accepted your insurance.
I became interested in medicine in my second year of college. When I wrote to my abuelita about it, she said she would try to remember all the remedies her parents had used. Since then I’ve received many scribbled cards from her and sometimes a clipping from Woman’s Day with a note that says, “This is like what my mama did.” One headache remedy involves thinly sliced potatoes soaked in vinegar and tied around the forehead with a bandanna. Another, for the digestive system, is a porridge made of blue cornmeal, or atole. I make it occasionally when I feel homesick.
I have received my undergraduate degree and am preparing to apply for medical school. In the meantime I work for an isolated research lab in Boston and pine for the indigenous remedies and stories that sparked my early interest in healing. I want to practice care-based medicine like my great-grandparents. My abuelita firmly believes that in just a few years I will be able to cure all her aches and pains. I hope she is right.
Christina N. Dragon
Jamaica Plain, Massachusetts
For most of our lives my siblings and I had weathered our mother’s withholding of affection. Even on her good days she doled out only crumbs of love.
After we left home, she showered kindness on strangers. “Just call me ‘Mom,’ ” she’d say to anyone who paid attention to her. “Annie is like a daughter to me,” she’d remark of someone from her church who drove her to the grocery store. But if any of us developed a friendship with an older woman, she became jealous: “Who does she think she is — your mother?”
Occasionally one of us would vow in anger to leave her be, but another (usually I) would say, “But she’s our mother. She needs us, and we need her.”
After having cancer surgery, my mother lay in the hospital bed with an IV line sending morphine into her vein. The doctors said they’d gotten it all: no lymph nodes involved or invasion to other tissues; no radiation or chemotherapy necessary.
My mother had been operated on once before, and after that first surgery the nurses had never found the right amount of pain medication for her. She’d always been hurting or agitated. This time I’d asked for better pain management, and her doctor had ordered a morphine dispenser.
I sat with my drugged-up mother and thanked God for the poppy flower that kept her comfortable and also made it possible for us to talk without bickering. Under the influence of the drug she became friendly and accommodating, even complimentary.
“Oh, what a lovely sock you crocheted,” she told me. “It’s all my favorite colors. You’re so talented and such a lovely girl.”
Her undrugged self would never have said this. We would never have been able to laugh or talk about life without negativity creeping in or a misunderstanding turning into an argument.
I hated my mother’s cancer. I hated what it took from her. But in those weeks after the surgery, the cancer made the morphine possible, and the morphine made her the mother of my dreams.
As a physician who delivers babies, I have sometimes found the birth plans of well-meaning parents to be unrealistic, an attempt to impose their wishes on the most unpredictable of events. But several years ago I had a patient whose unorthodox plan proved best.
A single parent of a two-year-old son, this woman had a prior history of drug and alcohol abuse and now was pregnant again. After several rounds of testing, the unborn child was diagnosed with trisomy 18, a life-threatening disorder. Most infants with trisomy 18 die before birth, and few survive for long after delivery.
This patient wanted her child to be born. She’d had a classical C-section at her first delivery, so another had to be scheduled. She asked to have the baby during the thirty-fourth week of her pregnancy, six weeks before her due date: late enough for fetal viability, but earlier than the intrauterine fetal demise that often occurs with trisomy-18 infants. When the baby was born, she wanted us to give him bag-mask ventilation if he wasn’t breathing, but no intubation. She wanted us to do CPR and give intravenous epinephrine to restore his heartbeat if necessary, but then perform no further interventions. She wanted her two-year-old with her in the recovery room as soon as possible after her surgery. And she wanted her newborn son to be given the utmost respect, as if he were the “center of the universe.”
To schedule a delivery that early would normally be unethical, but we went ahead with her plan. The day came, and everything happened exactly as she had requested. When her newborn son died in her arms forty-seven hours after his birth, she said, “I have held him his entire life.” It was true: she never let go.
I had come to a little hillside station in northern India seeking an audience with the Dalai Lama, bringing with me only what I could carry on my back — and a severe cough. There was nowhere to stay in the small town full of other Westerners courting enlightenment, so I decided to lodge in a Buddhist monastery a mile farther up the mountain. I had to share a room with a German Buddhist student named Klaus, a sweet young man so firmly focused on spiritual matters that I knew, as a woman, I wouldn’t have to worry about bunking with him.
Truth be told, it wouldn’t have mattered if Klaus had developed amorous intentions. I soon came down with a high fever and body aches. For the next few days I lay in bed staring at the ceiling through half-open eyes, almost unable to move. The monks suspected I had dengue fever and performed a “red feast” ritual in my room, inviting the demons of death to come and eat from my body. In the Tibetan Buddhist tradition such an offering is an act of compassion and relieves the sufferer of the fear of dying, which at this point I was feeling.
Klaus watched over me day and night. He walked into town to buy me medicine and supplies, and he even cooked for me over a tiny camping stove. When I had to go to the bathroom, he would bring me an empty coffee can to pee in.
On the fifth day of my illness a new couple arrived at the monastery: Rasheesh, an Indian musician, and Kaleigh, a cute blonde from Switzerland. They would entertain in their room, playing guitar and singing for anyone who stopped by. News of the sick American reached them, and one evening Kaleigh showed up at my door. Without asking permission, she and Klaus bundled me up and helped me to a room where a small group had gathered to hear Rasheesh play. In a corner a bed of blankets and pillows had been reserved for me.
As I lay there in the glow of candlelight, listening to the guitar, Kaleigh fed me red grapes. “It’s medicine,” she said, as she placed the fruits in my mouth. And they were. All of it was — the people, the music, the sweet grapes. Little by little I could feel my health returning. The demons had had their fill.
Maria Fabiana Arrastia
Pacific Palisades, California
Depression has shadowed me all my life, lurking in the corners of rooms even when I was a young girl, a loud voice in my head telling me I’d never amount to anything. The more depressed I got, the more self-loathing I felt.
When I finally received a formal diagnosis, I told no one. I felt ashamed: After all, what did I have to be sad about? Depression seemed self-indulgent, weak.
I wanted to avoid taking antidepressants because I was afraid they would numb me, and because I saw them as an admission that I was powerless against the disease. But I had been talking to a therapist for years, and it had been about as effective as a diabetic’s just wishing for insulin production.
Meanwhile, around that time, I fell and broke my wrist. I got it set in a cast. I didn’t feel ashamed or defeated; I just treated the problem.
I finally had to surrender to treatment for depression when I couldn’t drive a car anymore: the disease had taken over. The first few drugs my doctor prescribed didn’t work for me, which made me feel even more hopeless. But when I finally found the right drug and dosage, it was like when I was eight years old and went to the eye doctor for the first time and discovered the world didn’t have to be blurry. I had been depressed for so long, I’d forgotten another way of life existed.
I now believe in seeking help when you need it. I believe clinical depression is a disease, just as diabetes and lupus are, and requires treatment. I believe in medicine, because it saved my life.
Los Angeles, California
When I was diagnosed with irritable bowel syndrome, my doctor prescribed smooth-muscle relaxants. I took them but didn’t like the disruption in my digestive tract. Then my husband and I packed our tent and sleeping bags onto our motorcycle and headed across the country. Somewhere in Colorado my symptoms subsided, and I realized that the wind in my face and the lack of stress were better for me than the drugs.
When I went into menopause in my forties, my doctors all strongly recommended estrogen therapy to minimize night sweats and hot flashes and to protect my heart and bones. I respectfully declined. I told them I could take black cohosh for the flashes and sleep naked under a fan. I could consume more calcium-rich foods to stave off osteoporosis. I could increase my cardiovascular activities and reduce my fat intake to keep my heart healthy. But I would avoid taking added estrogen because I had read that it could increase my cancer risk, and that scared me. Several years later, when estrogen therapy was indeed linked to cancer, my doctors admitted that my choice had been wise.
When my life crumbled and I was having trouble sleeping, focusing, or wanting to live, a therapist insisted I needed antidepressants. Instead I went to the animal shelter and adopted a dog. She and I took to the hills every weekend. We floated downriver in a friend’s canoe and jumped into all the best swimming holes. At night I wrapped my arms around my dog until her breathing lulled me to sleep. Soon life was worth living again.
I believe in taking advantage of the miracles of modern medicine when necessary, but sometimes the best medicine isn’t medicine at all.
New Market, Maryland
While pregnant with me in the late 1960s my mother began bleeding lightly. It had taken her five years to conceive, and, fearing she might lose her baby, the doctor prescribed a drug called “DES” to decrease the risk of miscarriage. Later DES was found to cause defects in the reproductive systems of developing fetuses, and its use during pregnancy was discontinued.
On the eve of my first visit to the gynecologist, my mother explained to me that I had an increased risk of cervical cancer, miscarriage, and infertility and would have to monitor my health closely for the rest of my life. I was thirteen.
At the age of thirty-one I became pregnant. My obstetrician knew my history of DES exposure, and he prescribed a medication he said would decrease the incidence of contractions, thus lowering the likelihood of miscarriage. I took terbutaline pills daily from my twelfth week of pregnancy until I delivered my son by cesarean section at thirty-seven weeks.
My son appeared healthy at birth, but he was slow to crawl, walk, and talk. He also engaged in repetitive behaviors and appeared indifferent to other children. At twenty-one months my son was diagnosed with autism. By then I was eight months pregnant with my second child. This pregnancy was terbutaline-free and ended in a successful delivery.
Now with two children, I shuttled my older son to therapy sessions and nursed my infant in the waiting room. One evening, after a particularly difficult day, I Googled “terbutaline and autism.” The links included testimonials from parents, several attorneys’ websites, and abstracts linking terbutaline to autism and other neurological disorders. I learned that terbutaline was an asthma drug used to relax smooth muscle in the lungs, and that its use during pregnancy to prevent contractions was off label, not FDA approved, and of questionable efficacy.
My husband and I decided not to pursue a lawsuit against my doctor. I had already switched to a new obstetrician and did not want to deplete the energy needed to care for my son with what could be years of litigation.
I did seek out a new pediatrician, however, as the first had delayed my son’s autism diagnosis. The doctor I selected had a reputation for being sympathetic to the concerns of parents of children with special needs. He spoke with my son and observed him for several minutes, then called me into his office. “Does your son seem anxious?” he asked. “Because we can medicate him for that.”
We are now on our third pediatrician.
Los Angeles, California
During my rotation through the vascular-surgery service, we saw mainly diabetic patients with horrible feet and mean infections starting at their toes or heels and climbing up their calves. Their flesh was rotting. They were obese, depressed, and usually alone. We saw so many of them.
Each morning our white-coated tribe of medical authority would burst into a patient’s room, unwrap the pus-stained gauze, wince from the smell of decay, and shake our heads disapprovingly. When the necrosis got really bad, we had to amputate. Every day there were at least one or two amputations. The surgeons seemed to enjoy letting the young female medical students like me do the sawing. They all wore the same expression when they made the offer: one brow raised, with a grimace and a twinkle in the eye.
Day after day for a month I sawed off rotting feet. Sometimes, if it was really bad, we had to saw off a leg at the thigh. Amputating limbs took a certain amount of strength and concentration. I learned how much weight to throw into the saw when it hit the bone. I made sure to hold back a little as the blade made it all the way through, so as not to fall on the operating table. Aloofness set in as I successfully dissociated myself from the sad human beings to whom these diseased limbs were attached.
Now, only a few months into my pediatric practice, I cry all the time and often hold back tears in my patients’ rooms. Last week a teenage patient told me her father used to let other men have sex with her in exchange for crack. The evil and sadness in the world seem endless. I miss the days when I could chop off a rotten foot and be done with it.
San Francisco, California
When I was seventeen, I was in a motorcycle accident in Bogotá, Colombia, and wound up in the hospital with a mutilated leg: flesh open to the bone, raw nerves, and a foot going black from lack of blood. The surgeon put the leg back together as best he could, but the healing process was daunting. Every other day I’d hear the sound of a squeaky cart making its way down the hall, and my heart would begin to race. It was time for my curaciones — my dressing change. Despite the kindness and joviality of the nurses and resident doctor who cleaned and packed my wounds, each procedure was painful and traumatic.
One day the head nurse said, “Katherine, I must tell you something that I want you to understand: You cannot keep being afraid of your curaciones. The pain is what heals you. You must want the pain.”
For the last twenty-five years I have thought often about what she told me, but I’ve never been able to take her advice: not in that hospital; not when my heart was broken; not even when I was giving birth to my beautiful children. I have never been able to want the pain.
“Take your medicine.”
I couldn’t believe I was saying those words to my seven-year-old. I, who avoided taking even an aspirin, was feeding Ritalin to my little boy. I wasn’t even convinced it would do him any good.
My son took the pill well: popped it in his mouth and chased it down with a gulp of water, then showed me his tongue proudly. And I praised him for being such a brave boy.
When my son was nine, I divorced his father. By then he took two pills every morning: one to get rid of the “wiggles” and a little blue pill to make him “happy.” Neither of them made a difference that I could notice.
Now my son is sixteen. To him school is a waste of time, his stepdad is a pain, and I am the stupidest human ever to walk the planet. Getting him to take his medicine is a battle. I explain that the medicine will help him think in a straight line instead of endless loops and circles. He says being on Ritalin is like trying to function with a blanket over his head. He wants his thoughts free of the shackles that have bound them all these years.
I know he hides the pill and spits it out once he leaves the house. I pretend I don’t see and let him think he is getting away with something. Then the teacher calls me to ask, “Did he take his medicine?” because he is not sitting quietly at his desk like the other students.
We’ve tried counseling, play therapy, private tutoring. He’s been on Adderall, Wellbutrin, and vitamins. Perhaps sixteen is old enough for him to start making his own choices, I think, looking at myself in the mirror as I get ready for work. Then I take my medicine: two pills for high blood pressure, a multivitamin, fish oil for arthritis, calcium with vitamin D, potassium, and my very own little blue pill.
St. Louis, Missouri
For my third year of medical school I was assigned to a large university hospital in southern Israel. After two years of long days in the library and rote memorization, I was finally going to learn how to take care of patients.
The first two rotations passed in a blur. I barely had time to get through the histories and physical exams on all the patients. I spent more time with lab values and CT-scan images, gathering the data that would help me formulate a treatment plan.
Then I started my neurology rotation. I was mesmerized by the lead doctor, who could look at a CT scan or MRI of a brain and immediately pronounce a plan of care for a patient. He was famous for treating brain tumors, seizures, and strokes. His students looked on him as a god, and I wanted to emulate him.
On day three I met the person who would be “my” neurology patient. From her dusty robes and Arabic dialect I assumed she was a nomadic Bedouin and probably uneducated, so I spent even less time talking to her than usual. She had been having repeated, unexplained seizures in which she would lose consciousness, fall to the ground, and later have no recollection of the event. I obtained a CT scan, an MRI, and a full spectrum of blood tests, and I repeatedly monitored her brain waves. I could find nothing conclusive.
My neurology teacher dispassionately reviewed the data and said, “She has nothing real, just psychiatric problems perhaps.”
Early one morning, after drawing my patient’s blood for routine lab work, I dropped the sample off with the nurse.
“Not another poke,” she said. “Hasn’t she been through enough?”
The nurse told me my patient had come from Sudan, where she had lived in a rural village with her three sons and one daughter. They’d been attacked by the Janjaweed — armed partisans backed by the Sudanese government — and two of her sons had been killed in front of her. The third had escaped into the woods while her daughter had been raped and kidnapped. My patient had attempted to swim across the Red Sea to safety and been picked up by Israeli soldiers and brought to a refugee camp. Whenever she thought of what had happened to her children, she would feel overwhelmed, lose consciousness, and fall to the ground.
I was young and strong and healthy. I had been practicing Transcendental Meditation for thirteen years and lived a healthy lifestyle. I never took any drug, not even black tea or coffee. I chided my mother for paying my health-insurance premiums. I felt invincible, and invincible people did not need insurance.
Then the maddening cough started, and the deep ache in my lower back. Certain he would make everything better, I went to see my chiropractor brother, Walt. I was stunned when he said, “I cannot treat you. You have to see an MD.”
The lung doctor said I had to come into the hospital for some tests. The hospital? Me? I told her I’d look at my schedule. “You don’t understand,” she said. “Nothing is more important than this.”
That evening I was home alone and struggling to breathe. It felt as if I were drowning. To make matters worse, thick smoke from somewhere in the city was making it even harder to get air. I found out later the police had dropped explosives on the headquarters of the black-liberation group MOVE. The choking smoke was from the sixty-five homes destroyed in the ensuing conflagration.
I made it through the night, and the next day I went to the dreaded hospital filled with arrogant doctors in their stupid white coats with their toxic medicines. When I handed the nurse the required urine specimen, her eyes widened. “Does your piss always look like this?” she asked.
I gazed at the murky, cider-looking liquid and got an uneasy feeling: maybe this was not simple pneumonia.
For unfathomable reasons, my immune system was attacking the body it was supposed to protect. I was in the throes of rapid kidney failure.
The doctors brought out some big-gun medicines with big-gun side effects. I experienced euphoria, nausea, and violent nightmares. I hallucinated ghostly cockroaches dancing up the IV pole. For a month my dad slept in the hard orange chair by my bedside.
Thanks to the medicines — along with meditation and my vegetarian diet — my kidneys lasted for fourteen more years. In July 2000, after a year on dialysis, I received a kidney transplant. Now, whenever I pee and hear that melodious sound, I thank God, my transplanted kidney, my donor, my doctors and nurses, and medicine.
My papou — Greek for “grandfather” — believed that you go to the hospital to die. So he never went. Healthy almost every day of his hardworking life, Papou lived in his Chicago apartment until he died at age ninety-seven.
I do recall one time when he wasn’t hospitalized but he did go to the emergency room. It was the night of my younger sister’s wedding rehearsal, and Papou, then ninety-five, fell on some marble stairs at the church. Nothing was broken, but he had a bleeding gash above his right eye. My dad and my husband drove him to the hospital while the family went on with the rehearsal. After it was over, we all continued to the Greek restaurant for dinner. What else was there to do — crowd the ER?
Halfway through the meal Papou came in with a big bandage on his forehead, more embarrassed than injured. He sat down at the table and slowly ate a big meal and drank two glasses of wine — finishing to the applause of the whole party.
Later my husband told me what had happened at the ER: First Papou had refused stitches. Then, when the attending physician asked him what medications he was on, Papou told him, “Nothing.” The doctor blinked and asked again. He ended up giving Papou aspirin, which worked wonders for the pain because he had taken it only a few times in his life. As my grandfather waited to be released, a small stream of doctors and nurses made their way over to chat with the ancient five-foot-three man with an iron grip and no prescriptions.
Angela Karras McAlister
When my mother became pregnant with me, she was already worn out from caring for my three-week-old sister, so her doctor prescribed a little “energy pill” that pepped her right up and got her through each day. By the time I came along, she had a sizable dependency. My brother arrived a few years later, and by then she needed depressants in the evening to take the edge off her daytime amphetamines. Sometimes she didn’t take a pill to come down, and I’d hear the sewing machine racing late into the night. I always thought she was the perfect mother. She did so much for all of us.
Home from college one summer, I asked her about all the vials of pills in her medicine cabinet.
“I don’t really know what they’re for,” she admitted.
“You stay out of this,” my father told me. “Her doctor and I know exactly what it all is.”
Santa Barbara, California
As the on-call physician at a small local hospital, I admitted an elderly man with widespread cancer. He had made it clear to his family that he wished for comfort measures only. I was doing my best, but he appeared in distress. The family mentioned that for years he had lived alone except for his old dog. I suggested they bring the dog to the hospital. It was late at night, and I figured we could sneak him in without being discovered. (This was before hospitals allowed pets to visit.)
I met the family members with the dog at a rear entrance and led them up a back stairway that bypassed the nurses’ station. The dog seemed to sense the need for quiet until he was carried into the room. Then he leapt onto the bed, curled up close to his old master, and let out a high-pitched, mournful cry.
The dog remained in the bed for three hours, and the old man appeared quiet and comfortable even after his pet had left. He died peacefully later that day.
My bursitis was killing me. It had been four months since I’d painted my house in Olympia, Washington, and the pain in my shoulders still had not eased. My treatment regimen of patience and aspirin was having no effect. To complicate matters, I had since moved to Beijing, China, and couldn’t consult my regular doctor.
I made an appointment with Dr. Hu, an acupuncturist. A middle-aged man with a weary, slumped appearance, Dr. Hu looked like the headmaster of a school of unrepentant delinquents. His fleshy face bore a serious expression behind Coke-bottle glasses, and his thick black hair and huge eyebrows needed trimming. A heady aroma of cigarette smoke preceded him into the room. I liked him instantly.
Dr. Hu’s manner was professional and intense. Through his young receptionist (he spoke no English), he asked about my diet, my bowel movements, and my sex life. Then he smelled my breath and examined my scalp, my teeth, my fingernails, and my tongue. I asked the receptionist if the doctor knew I was there for my shoulder. She replied, “Oh, yes. Dr. Hu sees . . . all over for you.”
My course of treatment lasted more than ten days. Each one-hour session consisted of a bout with the needles, a “cupping” — heated glass cups applied to the back, which made delightful sucking sounds when removed — a heat lamp, and a vigorous massage. As Dr. Hu worked, he and I would chat through the receptionist.
During my seventh visit, while Dr. Hu was cupping my back, I told him an old joke: A doctor gives his patient only six months to live. When the patient remarks that he’ll die before he can pay his bill, the doctor gives him another six months.
After a long translation I heard nothing but silence. I was a complete failure as a Chinese comedian. Then the doctor began laughing. He laughed so hard he had to sit down.
My bursitis, by the way, had been completely resolved by session number five, but I attended all ten because the treatment felt so good.
© Paul Rozycki
In college you start to have unpredictable panic attacks: sweating, dizziness, stomach cramping, feelings of impending doom, the need to return to the safety of your home immediately. The doctor prescribes Zoloft (an antidepressant) daily and Xanax (an antianxiety drug) as needed.
Now the panic attacks are less frequent, but you feel a pervasive sense of numbness and gloom. Then come the headaches and insomnia. Maybe a different antidepressant will work better, the doctor says. Try Paxil. That’s good for anxiety, too. But you can barely tolerate the disorientation and double vision. Let’s see how you do on Remeron. At first your mood improves. You still get the occasional panic attack, but you don’t feel as weighed down. The headaches continue, though, and you still can’t sleep without nightmares. Try some antipsychotics for the nightmares and some Neurontin (an antiseizure medication) for the headaches. You gain thirty pounds in a few months. Maybe some amphetamines will help you lose that weight. Phentermine slims you down, but you start having diarrhea every day. Getting through college is proving to be much more difficult than you thought.
The antiseizure medication makes you feel like a zombie. You’re always tired, but you can’t sleep. Valium, Sonata, Ambien — none of them helps. Instead they make you hallucinate. You try to kill your sister’s dog with a cane because you see him for the malevolent alien he really is. Topamax (for the headaches and depression) allows you to see through the phony surface reality to the matrix underneath. You can’t study because when you try to read, the words are screaming inside your brain. Your head still hurts, you still have constant diarrhea, and you still can’t sleep. On top of that, your thyroid has become imbalanced, and you need to take hormones for it. Your mood spirals downward. You can’t retain information long enough to pass tests. Maybe you have an undiagnosed case of ADD. Try some Adderall. You chip a few teeth from clenching them so hard.
You begin contemplating suicide, so you switch antidepressants again. On Wellbutrin you are an emotional powder keg that no one can stand to be around. Celexa makes you a walking corpse. Somewhere along the way, you have developed bleeding stomach ulcers and kidney stones.
You drop out of college and gain forty pounds from Seroquel, the only drug that lets you sleep. You can’t control your thoughts and think obsessively about doing yourself physical harm. You start to believe that you aren’t really real.
But, hey, at least you no longer suffer from panic attacks.
“It’s polio,” the doctor said as he repacked his medical kit at the conclusion of the house call. In the sweltering summer of 1945 I was ten years old and had a fever, a blinding headache, and a stiff neck. It also hurt to move my legs.
The doctor explained to my mother that there was one thing that could prevent paralysis and keep the muscles from being deformed. He described it as a “hot-pack treatment” developed by Sister Kenny, an Australian nurse who had observed aborigines using the technique to relax muscle spasms. It meant a round-the-clock regimen of massaging my legs and applying hot packs.
The heat in our flat was almost unbearable. I don’t remember how many days and nights my mother simmered pots of water on the stove, soaked the towels, wrung them out, and put them on my legs, but I do remember wishing it were winter instead of summer. It must have been miserable, too, for my mother, who got little or no sleep.
When the doctor returned a few days later, he was pleased to see improvement and said the danger of paralysis had passed. Sister Kenny’s treatment had worked. Something as simple as hot water and towels had kept me able to walk.
As a child I was sick a lot with bronchitis and a persistent, rattling cough. The doctor prescribed a medication that came in large pills — “horse pills,” Mother called them. They stuck to the roof of my mouth and made me gag and choke. Taking my medicine became a battle between Mother and me.
One night I fought off the pills, and the next morning at breakfast Mother left the kitchen and returned carrying a small suitcase. Tight-lipped, she pointed at me and said, “You won’t take your medicine, so I’ve packed your clothes, and I’m driving you to the hospital and leaving you there. They’ll make you take it.”
When I cried and begged her not to, she popped the lid off the prescription bottle and handed me a pill and a glass of water. I gagged as usual, but I swallowed it. Then Mother sat back down at the table with my father and brother and me. I’d lost my appetite. My scrambled eggs, bacon, and toast got cold.
After Dad left for work and my brother for school, Mother tucked me back into bed. “You’re so dramatic,” she said.
San Luis Obispo, California
Normally I work as a postpartum nurse, but tonight my assignment is to take care of Sarah, a full-term baby girl who was born addicted to methadone. Her mother was in a methadone program and was advised to continue taking the drug even after she’d found out she was pregnant, as it was safer for her and the baby than the heroin she would otherwise have injected.
Sarah started withdrawing within twenty-four hours of her birth. She was prescribed morphine to alleviate the pain of living without the methadone. She suffered explosive diarrhea, tremors, sleeplessness, jitteriness, and who knows what other symptoms she couldn’t tell us about.
Sarah is now a month old. Her mother loves her and wants what’s best for her, but she is poor and has a two-year-old son and no car, so she doesn’t come to visit for days at a time. Sarah’s father is in jail. In a way she seems to the other nurses and me like “our” little girl.
Every couple of days Sarah’s morphine dose is lowered, and each time, she goes through another withdrawal. Tonight she is fussy and wakes every hour, howling for food. I give her a bottle, and she sucks wildly, then stops, letting the formula run out of her mouth. She is hungry for something besides food. I wonder if, when she is older, drugs and alcohol will make her feel at peace with herself, like coming home.
In the meantime Sarah and I sit together in a rocking chair. She has had her morphine, and her small body finally relaxes on my chest, her head almost under my chin, her ear over my heart. I sing her the simple songs she would be hearing if she had a normal life.
My grandfather distrusted doctors and relied on old Italian folk remedies. He wore a copper bracelet to aid his circulation and drank a daily jigger of extra-virgin olive oil to keep his joints and digestive system in good working order. And, of course, he had a few glasses of red wine a day. All these measures must have had some positive effect, because he lived into his nineties.
My father, being a second-generation American, held a slightly more modern view. He wanted his children to take advantage of medical advances — polio immunization, measles vaccines, regular dental checkups — but when it came to his own health, he followed his father’s philosophy.
Today, as old age brings a slow physical decline, my father is resigned to taking his cholesterol and heart meds, but that’s it. His real medicine — what keeps him going — is his three o’clock martini: heavy on the vodka, light on the vermouth, no olive.
My father and I have been through some tough times and years of no communication, but I went to see him a while back with no agenda, no finger pointing, no blame. We just sat and sipped our martinis, happy to be in the same room with one another. It was good medicine for me, too.
In my family any illness that required medicine was my father’s domain. When I had what he called a “bellyache” (my mother called it “diarrhea”), Daddy went to the kitchen, brought back a brown bottle, and poured the liquid inside into a silver spoon. “It tastes just like Coca-Cola,” he said.
Thanks to the power of suggestion, that’s exactly the taste I remember.
We rarely went to the doctor. My father preferred home and over-the-counter remedies: chewed-up tobacco on bee stings; raw bacon tied to the foot to extract splinters; Vicks on the chest for congestion. If a home remedy didn’t solve the problem, he would drive down to the drugstore, and the pharmacist would fill a bottle with penicillin, no prescription needed. At home my father would crush those pills into peanut butter and sugar, then spread his concoction on white bread, crusts cut off, and sit with me while I ate it.
Years later, in the months preceding my divorce, I was in emotional anguish and had a hacking cough, insomnia, and terrible dreams. To feel better I’d get in the car at three in the morning and drive to the all-night convenience store to buy myself an icy Coke and two miniature Reese’s Peanut Butter Cups. After this treat I’d go back to the house where my thirty-year marriage had unraveled, and I’d sleep soundly for the rest of the night.
Even now, fifteen years later, my morning ritual is to put two Reese’s cups in my pocket and go to McDonald’s and order a Diet Coke at the drive-through. Sitting in the car, I indulge in Coke and peanut butter and the memory of my father, my original medicine man, who did everything in his power to make me better.
San Antonio, Texas
As I read for the second time Jenny B.’s Readers Write on “Medicine” [January 2011], my own experiences with inappropriately prescribed drugs came flooding back to me: I was diagnosed with bipolar disorder in 1995 and had a psychiatrist who changed my medication every three weeks. Like Jenny, I was on an endless series of meds — Tegretol, Seroquel, Geodon, Zoloft, Ativan, Topomax, lithium, Depakote — many of which made my symptoms worse. I was veering from depression so severe I could not shower, work, or take care of my child, to a state of agitation and aggression in which I accused my family of terrible imagined slights and erupted into violent anger.
Finally, after eight years, my mother made me an appointment with a psychiatrist who weaned me off the damaging drugs. Step by step, he found a regimen of medications that helped me return to my old self. He even accepted me, once I was stabilized, as a partner in treating my own illness. I will always be bitter about my first inept psychiatrist, and eternally grateful to the one I have now.