EIGHT

DAISY WAS STANDING NEXT TO MY PARKING SPOT when Harold and I arrived at school the next morning. Summer doesn’t last in Indianapolis, and even though it was still September, Daisy was underdressed for the weather in a short-sleeve top and skirt.

“I have a crisis,” she announced once I was out of the car. As we walked through the parking lot, she explained. “So last night, Mychal called to ask me out, and I could’ve handled myself via text but you know I get nervous on the phone, plus I remain unsure Mychal can handle all . . . this,” she said, gesturing vaguely at herself. “I am willing to give the giant baby a chance. But in a flustered moment, not wanting to commit to a full-on proper date, I may have suggested he and I go on a double date with you and Davis.”

“You did not,” I said.

“And then he was, like, ‘Aza said she wasn’t looking for a relationship,’ and I was, like, ‘Well, she already has a crush on this dude who goes to Aspen Hall,’ and then he was, like, ‘The billionaire’s kid,’ and I was, like, ‘Yeah,’ and then he was, like, ‘I can’t believe I got fake rejected by someone for a fake reason.’ But anyway, on Friday night, you and me and Davis and a man-size baby are having a picnic.”

“A picnic?”

“Yeah, it’ll be great.”

“I don’t like eating outside,” I said. “Why can’t we just go to Applebee’s and use two coupons instead of one?”

She stopped and turned to me. We were on the steps outside school, people all around us, and I worried we might get trampled, but Daisy had the ability to part seas. People made room for her. “Let me list my concerns here,” she said. “One: I don’t want to be alone with Mychal on our first and probably only date. Two: I have already told him you have a crush on a guy from Aspen Hall. I can’t unsay that. Three: I have not actually made out with a human being in months. Four: Therefore, I am nervous about the whole thing and want my best friend there. You will note that nowhere in my top four concerns is whether we picnic, so if you want to move this mofo to Applebee’s, that is A-OK by me.”

I thought about it for a second. “I’ll try,” I said. So I texted Davis while waiting for the second bell to ring and commence biology.

Couple friends are getting dinner at Applebee’s at 86th and Ditch on Friday. Are you free?

He wrote back immediately. I am. Pick you up or meet you there?

Meet us there. Does seven work?

Sure. See you then.

—

After school that day, I had an appointment with Dr. Singh in her windowless office in the immense Indiana University North Hospital up in Carmel. Mom offered to drive me, but I wanted some time alone with Harold.

The whole way up, I thought about what I’d say to Dr. Singh. I can’t properly think and listen to the radio at the same time, so it was quiet in the car, except for the thumping rumble of Harold’s mechanical heart. I wanted to tell her that I was getting better, because that was supposed to be the narrative of illness: It was a hurdle you jumped over, or a battle you won. Illness is a story told in the past tense.

“How are you?” she asked as I sat down. The walls in Dr. Singh’s office were bare except for this one small picture of a fisherman standing on a beach with a net slung over his shoulder. It looked like stock photography, like the picture that came free with the frame. She didn’t even have any diplomas up on the wall.

“I feel like I might not be driving the bus of my consciousness,” I said.

“Not in control,” she said.

“I guess.”

Her legs were crossed, and her left foot was tapping the ground like it was trying to send a Morse code SOS. Dr. Karen Singh was in constant motion, like a badly drawn cartoon, but she had the single greatest resting poker face I’d ever seen. She never betrayed disgust or surprise. I remember when I told her that I sometimes imagine ripping my middle finger off and stomping on it, she said, “Because your pain has a locus there,” and I said, “Maybe,” and she shrugged and said, “That’s not uncommon.”

“Has there been an uptick in your rumination or intrusive thoughts?”

“I don’t know. They continue to intrude.”

“When did you put that Band-Aid on?”

“I don’t know,” I lied. She stared at me, unblinking. “After lunch.”

“And with your fear of C. diff?”

“I don’t know. Sometimes it happens.”

“Do you feel that you’re able to resist the—”

“No,” I said. “I mean, I’m still crazy, if that’s what you’re asking. There has been no change on the being crazy front.”

“I’ve noticed you use that word a lot, crazy. And you sound angry when you say it, almost like you’re calling yourself a name.”

“Well, everyone’s crazy these days, Dr. Singh. Adolescent sanity is so twentieth century.”

“It sounds to me like you’re being cruel to yourself.”

After a moment, I said, “How can you be anything to your self? I mean, if you can be something to your self, then your self isn’t, like, singular.”

“You’re deflecting.” I just stared at her. “You’re right that self isn’t simple, Aza. Maybe it’s not even singular. Self is a plurality, but pluralities can also be integrated, right? Think of a rainbow. It’s one arc of light, but also seven differently colored arcs of light.”

“Okay, well, I feel more like seven things than one thing.”

“Do you feel like your thought patterns are impeding your daily life?”

“Uh, yeah,” I said.

“Can you give me an example?”

“I don’t know, like, I’ll be at the cafeteria and I’ll start thinking about how, like, there are all these things living inside of me that eat my food for me, and how I sort of am them, in a way—like, I’m not a human person so much as this disgusting, teeming blob of bacteria, and there’s not really any getting myself clean, you know, because the dirtiness goes all the way through me. Like, I can’t find the deep down part of me that’s pure or unsullied or whatever, the part of me where my soul is supposed to be. Which means that I have maybe, like, no more of a soul than the bacteria do.”

“That’s not uncommon,” she said. Her catchphrase. Dr. Singh then asked if I was willing to try exposure response therapy again, which I’d done back when I first started seeing her. Basically I had to do stuff like touch my callused finger against a dirty surface and then not clean it or put a Band-Aid on. It had sort of worked for a while, but now all I could remember was how scared it had made me, and I couldn’t bear the thought of being that scared again, so I just shook my head no at the mention of it. “Are you taking your Lexapro?” she asked.

“Yeah,” I said. She just stared at me. “It freaks me out some to take it, so not every day.”

“Freaks you out?”

“I don’t know.” She kept watching me, her foot tapping. The air felt dead in the room. “If taking a pill makes you different, like, if it changes the way-down you . . . that’s just a screwed-up idea, you know? Who’s deciding what me means—me or the employees of the factory that makes Lexapro? It’s like I have this demon inside of me, and I want it gone, but the idea of removing it via pill is . . . I don’t know . . . weird. But a lot of days I get over that, because I do really hate the demon.”

“You often try to understand your experience through metaphor, Aza: It’s like a demon inside of you; you’ll call your consciousness a bus, or a prison cell, or a spiral, or a whirlpool, or a loop, or a—I think you once called it a scribbled circle, which I found interesting.”

“Yeah,” I said.

“One of the challenges with pain—physical or psychic—is that we can really only approach it through metaphor. It can’t be represented the way a table or a body can. In some ways, pain is the opposite of language.”

She turned to her computer, shook her mouse to wake it up, and then clicked an image on her desktop. “I want to share something Virginia Woolf wrote: ‘English, which can express the thoughts of Hamlet and the tragedy of Lear, has no words for the shiver and the headache. . . . The merest schoolgirl, when she falls in love, has Shakespeare or Keats to speak her mind for her; but let a sufferer try to describe a pain in his head to a doctor and language at once runs dry.’ And we’re such language-based creatures that to some extent we cannot know what we cannot name. And so we assume it isn’t real. We refer to it with catch-all terms, like crazy or chronic pain, terms that both ostracize and minimize. The term chronic pain captures nothing of the grinding, constant, ceaseless, inescapable hurt. And the term crazy arrives at us with none of the terror and worry you live with. Nor do either of those terms connote the courage people in such pains exemplify, which is why I’d ask you to frame your mental health around a word other than crazy.”

“Yeah,” I said.

“Can you say that? Can you say that you’re courageous?”

I screwed up my face at her. “Don’t make me do that therapy stuff,” I said.

“That therapy stuff works.”

“I am a brave warrior in my internal Battle of Valhalla,” I deadpanned.

She almost smiled. “Let’s talk about a plan to take that medication every single day,” she said, and then proceeded to talk about mornings versus evenings, and how we could also try to get off the medication and try a different one, but that might be best attempted during a less stressful period, like summer vacation, and on and on.

Meanwhile, for some reason I felt a twinge in my stomach. Probably just nerves from listening to Dr. Singh talk about dosages. But that’s also how C. diff starts—your stomach hurts because a few bad bacteria have managed to take hold in your small intestine, and then your gut ruptures and seventy-two hours later you’re dead.

I needed to reread that case study of the woman who had no symptoms except a stomachache and turned out to have C. diff. Can’t get out my phone right now, though—she’ll get pissed off—but did that woman have some other symptom at least, or am I exactly like her? Another twinge. Did she have a fever? Couldn’t remember. Shit. It’s happening. You’re sweating now. She can tell. Should you tell her? She’s a doctor. Maybe you should tell her.

“My stomach hurts a little,” I said.

“You don’t have C. diff,” she answered.

I nodded and swallowed, then said in a small voice, “I mean, you don’t know that.”

“Aza, are you having diarrhea?”

“No.”

“Have you recently taken antibiotics?”

“No.”

“Have you been hospitalized recently?”

“No.”

“You don’t have C. diff.”

I nodded, but she wasn’t a gastroenterologist, and anyway, I literally knew more about C. diff than she did. Almost 30 percent of people who died of C. diff didn’t acquire it in a hospital, and over 20 percent didn’t have diarrhea. Dr. Singh returned to the medication conversation, and as I half listened, I started thinking I might throw up. My stomach really hurt now, like it was twisting in on itself, like the trillions of bacteria within me were making room for a new species in town, the one that would rip me apart from the inside out.

The sweat was pouring out of me. If I could just confirm that case study. Dr. Karen Singh saw what was happening.

“Should we try a breathing exercise?” And so we did, inhaling deeply and then exhaling as if to flicker the candle but not extinguish it.

She told me she wanted to see me in ten days. You can kind of measure how crazy you are based on how soon they want to see you back. Last year, for a while, I’d been at eight weeks. Now, less than two.

On the walk from her office to Harold, I looked up the case report. That woman, she did have a fever. I told myself to feel relieved, and maybe I did for a little while, but by the time I got home, I could hear the whisper starting up again, that something was definitely wrong with my stomach since the gnawing ache wouldn’t go away.

I think, You will never be free from this.

I think, You don’t pick your thoughts.

I think, You are dying, and there are bugs inside of you that will eat through your skin.

I think and I think and I think.