Manifestation

This is how your pain manifests.

I am 13, standing in front of an x-ray machine and drinking a chalky liquid filled with Barium, a radioactive element. I’m doing this so the doctors can look for problems in my upper digestive tract. When the results come back, my family doctor tells us nothing is wrong with me, despite the pain I feel after nearly every meal.

Next comes a motility test a few months later, which involves putting a catheter the size of a spaghetti noodle up my nose, down my esophagus, and into my stomach while I take small sips of water.

Finally, after years of misdiagnoses, prescriptions that cause more pain, and tests that turn up nothing, I find myself undergoing an endoscopy, in which a massive tube is inserted down my throat, through my esophagus, and into my stomach and duodenum to ensure they are all functioning properly.

I remember lying on the examination bed in the sterile room, which makes me think of the sick bay in Star Trek, The Next Generation, with my mother nearby. Over the doctor’s shoulder is a screen that displays the insides of my digestive tract, what looks to be a wormy, pink mess. The whole time, the doctor smiles and says, “beautiful beautiful” as I gag away before him.

It has to be worth it. This doctor is the top of the mountain, the end of the road. If he can’t figure out what the matter is with me, no one can. And so I try not to react to the strange bedside manner, not to twitch uncomfortably, not to vomit bile on his table.

Photo by Martha Dominguez de Gouveia on Unsplash

In the consultation room after the exam, I sit as demurely as a I can, hoping to regain some dignity. “There’s nothing wrong,” he says. “Are you a people pleaser?” and I nod, flooded with shame, disappointed at one more thing I shouldn’t do or be.

“You put this stress on yourself. Try to do yoga. Or pray. You look like you pray.” And then he pauses for a moment before finishing with a flourish. “It’s all in your head”.

At the time, it feels like a cop-out, like the man with the many degrees not doing his job… but what do you tell someone who complains of constant pain and discomfort when you can’t find a physical reason for their suffering? How else do you explain these outward manifestations of inner agony?

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“Do you feel anxious?” my family doctor asks me years later. I’m sitting in her clinic, hands in my lap like a scolded child, trying to understand why my blood pressure is so high that she’s forbidden me from strenuous exercise. Just until we get to the bottom of things.

No! I don’t just say it. I declare it. I’m not anxious, I’m not anything that can be mistaken for a mental illness.

But over the next few weeks as I go to test after test, sit in brightly lit waiting rooms, extend my arm to draw the blood and take measurements and fill out forms, I remember.

My heart pounding in my chest as though a prisoner, trying to break out.

My stomach clenching and twisting in agony, melodramatic.

The inability to eat for days before a test, a presentation, a hard conversation with a friend or a sister or a parent.

Panic for 48 hours at the thought of my mother seeing an 8th grade math test I have to get signed - my grade 28 out of 31.

My whole body, vibrating against my bed when I should be asleep, a shiver that can’t be stilled with the piles of blankets I’ve burrowed beneath, the shaking so severe I think I might float off the bed and out the window.

Once I finally accept it, I wear my anxiety like a badge, if not of honour, than of recognition. It was neglected for so long, I feel like I owe it. I allow it to subsume me, become my entire being for all the years I forced it to a back corner of my self, deep in the shadows of my heart where no one would see it. I am Noha, and I am anxious. For a time, I introduce myself as this person, not realizing how I let the anxiety get comfortable, settle in, take the best seat on the couch, grab snacks, and get bigger and bigger until it is a balloon, choking me from the inside out. Still, I read post after post about stress and anxiety and the end of the world on Twitter as I doomscroll, pressing the little heart underneath, a declaration of my ardent agreement.

And then one day, I hear someone say the story you tell yourself about yourself is who you become. And I look back at my anxiety, at the fact that it’s grown instead of diminishing. Realize that the relief I felt at recognition has been replaced with a constant presence, heavy, hovering. For years I have said I am Noha, and I am anxious, and that is true, but I am also grateful, also happy and silly and loving and fun, and I haven’t said these things in so long that my soul hasn’t heard them.

I try it. I say I am grateful. I am blessed. I am loving and I am loved. I am open to growth. I can learn to be calm. At first, I hardly believe the words, but I repeat them. And repeat them. And repeat them again. With gaps of course, of forgetting and crying and breaking down and vibrating and getting flushed and vibrating and panicking. Afterwards, when the panic has passed, I say them again. I am grateful. I am blessed. I look up the names of God to do with gratitude, Shukr. God is Al-Shakur - The Appreciative. And I learn to appreciate. I uninstall the Twitter app on my phone, and notice my nervous vibrations diminishing. There can still be memes, but now they are schmoopy and saccharine, filled with hope and possibility. I consider the benefits of embracing the corny and the optimistic, counter to my hard, cynical outer shell though it is.

I come across a meme that says, you can eat the kale, drink the alkaline water, take the supplements, do pilates or hit the gym, but if you don’t deal with the the stuff going on in your heart and mind - you are still unhealthy.

I press the heart, a declaration of my ardent agreement.