I: Exposition.“What do you want me to tell you?”
III: Recapitulation: “Created sick, commanded to be sound”
My own confluence of contradictions, my peculiar blend of craving for and aversion to diagnosis, expresses itself in avoidance of doctors. I perk up every time public health bodies come out against a screening test for causing too many false positives and saving too few lives. Thanks to fortunate genetics, still more fortunate life circumstances, and a Brute Squad-grade immune system, I never worry about health. I am not speaking hyperbolically, still less prescriptively – it’s merely how I am. “This seems minor, but what if it’s a sign of something much worse?” simply never crosses my mind.
This means, however, that I do not seek diagnosis except when I also seek relief. This is a setup for agitation and disappointment. I am averse to diagnostic testing, not because of what I fear it will show, but because of what it won’t. Negative test results do not improve my peace of mind. They only mean “your trouble cannot and need not be fixed.”
These observations were primarily developed within the horrifying underworld of female complaints – poorly studied, still more poorly understood, and, it seems, generally disregarded unless encountered within the context of fertility. But what complaints aren’t disregarded, unless they affect how long the sufferer lives or whether the sufferer can reproduce? I heard a doctor discussing a study on IBS out of Japan which noted that negative diagnoses failed to reassure the sufferers – that, far from being pleased at being told they did not have the disorder, they would look for another doctor who would tell them they did. I wonder if anyone on earth is surprised by that.
Month by month, symptom by symptom, my google searches map a precise, even methodical attempt to find out whether this suffering is normal and should be accepted, or abnormal and should be addressed. But if there was one thing I learned in my reading, it is the appalling range of things that are considered normal in the female reproductive system. Will this kill you? Will this sterilize you? If not, then what do you have to worry about?
The stories piled up. These women missed work, they lost consciousness, they crawled and vomited and were sent to the emergency room, then were sent home again. There is nothing about you that needs to be fixed. Diagnosis: human.
If this is health, then what, good God, is sickness?
Perhaps, like the distinction between the individual and society, the distinction between sickness and health is not nearly so clear as we would like to believe it is. But whether there are options available to address the sickness-that-is-not-sickness seems to depend largely on the goals.
“Follow up with them,” my friend told me, (a friend to whom I voiced my complaints in far more detail than to any doctor; perhaps that should tell me something about what I was really looking for.) “This is persistent and worsening. This is interfering with your life.”
It was hard to know what exactly to follow up on. If I were trying to reproduce, I could demand knowledge or at least the quest for it. But otherwise? What was I asking the doctor for? Relief? Certainty? The opposite of certainty, which is hope?
“Yeah, that seems consistent,” said the doctor when I told her that I suspected endometriosis, that ghastly parody of the old notion of wandering womb, where the type of tissue that lines the uterus escapes the confines of the womb, growing over and into organs and flesh. I didn’t get as far as “that ghastly parody” before she went on. “It would take surgery to know for sure, and the treatment’s the same anyway, so.”
It’s not like I have any reason to be discontented with “Yeah, that seems consistent” in lieu of knowledge, when knowledge wouldn’t actually change anything I do. And yet I feel discontent. I left that appointment as I have left others, thinking “I need to find a good quack. Someone who can persuade me I have something wrong with me, and then persuade me that it has been cured.”