by Meghan Cadwallader
“I love the way my legs feel,” said Kristen. Our ski trip the previous day left her muscles tight, and she stood in our living room demonstrating proper form while sliding her hands over her thighs and hamstrings. “When can we go again?” I couldn’t believe I had convinced her to go, the two unsuccessful attempts of her youth lingering in her jokes about “the agony of defeat” as she was fitted to rentals. But after a few hours practicing how to stop and how to get up from a fall, we turned in the rentals and drove to a ski shop to buy Kristen her own pair.
On a ski trip soon thereafter, a man on a snowboard came from behind me and took out my legs. The sensation of sailing through the air, disconnected from my equipment and the snow, was new. I hadn’t fallen in years. When I came to a stop, I sat up, almost pleased with the collision. An inventory of my equipment proved less satisfying. My brakes were bent and would interfere with every turn I made. One pole sported a ninety-degree angle. As I stalked through the snow gathering my mangled equipment, I noticed that the back of my left arm stung. I shook as I popped my skis on and skidded down the rest of the hill, so weak and uncertain from the collision that I keeled over when I got to the bottom.
As we peeled off our layers at home, I heard Kristen gasp.
“Oh, honey—it’s blue already. It’s huge!”
I put my right hand up to where Kristen’s eyes were fixed, on the back of my left arm. It was hot and felt inflated like a balloon. I iced it that night and stared at the ceiling as Kristen slept, the throbs from my arm radiating up into my shoulder, through my left side, diminishing into little burning pulses in my knee.
In the morning, my left arm was double the size of my right. I found something to fit over it and went to work, sitting at my computer in such a way that I wouldn’t brush the back of my arm against the armrest. At home that night, I got out the digital camera I had received for Christmas, and while we sat on the couch watching TV, I asked Kristen to take a picture of the bruise. When I lifted my arm up under the light, she winced and sucked in her breath, turning her head to the side.
“What does it look like now?” I asked.
“More colors,” she said, lifting the camera to her eye. “More swollen.”
After the camera’s click, I made her show me the picture in the display, but it was disappointing. Shapeless blue-gray and purple were emerging under the pale flesh of my upper arm, but that was all. It didn’t look anything like it felt. There should have been lightning bolts and flames singeing my sleeve off, knives tearing ragged paths in my skin. I sat on the couch and watched TV, a baggie of ice tucked between my left arm and my torso.
Over the weeks that followed, the swelling decreased, but the bruise spread and produced an array of colors. We took pictures of it each day—cataloguing the purple, the gross greens and yellows, a dull rust that showed through the palest skin at my armpit. Two trails of blue wrapped around my elbow, and white, bone-hard lumps appeared in the middle of this rainbow. I ran my fingers over them, trying to figure out what they might be. But then I would shake my head and go clean out the car or fold laundry, frustrated at paying so much attention to something that would, like everything else, go away. Finally, Kristen called the doctor and made an appointment for me.
“Hematoma.” The doctor looked unimpressed as I sat on the examination table, my hand above my head. I gritted my teeth as she ran her hand along the back of my arm, poking a finger into the bruise every inch or so. “Did you do anything for this?”
“Some Aleve and a few nights of icing.”
“You should heat it now. It will break up the pooled blood faster. But it’s going to be around for a while.”
“What are those white spots?”
She peered at my arm and poked a finger into a knot of white. “I don’t know.” She shrugged. “Keep an eye on it.”
My parents visited us later that winter, and after dinner one night they both made close inspections of what remained of my bruise. My mom ran a hand over it, grimacing when her fingers met the hard white lumps. Turning to Kristen, she said, “I always knew with this one—when she finally told you something hurt her, it had passed the point where we could do anything about it and it was time for the emergency room.”
“Meghan’s tolerance for pain is so high,” said my father with exasperation.
This is an interaction I’ve seen play out numerous times and I always say nothing, thinking of the moments when Kristen is in pain, too tender to stand my touch. I feel as though my father’s line is unearned praise because I’m really a stranger to my own body. I have everything—all my organs, all my silent functions—but know nothing of them. I am empty of myself at the same time that I am full.
When Kristen and I get ready for the day, I watch her, happy for the glimpses of her midriff as she changes. I am always sidetracked by these snapshots. Following her from her dresser to the bathroom, I graze my hand across her stomach, making sure to brush at least two of the scars that spot her abdomen.
“Don’t touch them,” she says.
“These are still sensitive?” I stare at them, unfamiliar glyphs surrounded by skin and pores that seem to make sense.
“Yes.” She pulls away and itches where my hand just was.
“I’m sorry. But how many years ago was that? And they’re still sensitive?” I receive only silence as a response while she walks into the bedroom. I follow. “What was it like afterward? How long did you wear bandages?”
“Mmm. I don’t remember. Have you seen my black socks?”
“Were you scared? Did you feel different after the surgery? Did it feel like something was missing inside?”
“I don’t think so.” She has moved back to the bathroom and I trail after, looking at her scars in the mirror over the sink. If I stare long enough, I hope that I’ll see or understand what’s under the skin, but I can only imagine a moist, echoing cavern where a glistening, pink organ once was. There are parts of Kristen I will never know, the same organs and processes she would never have known either; parts that would have gone on secreting, processing, living her life right along with her if they hadn’t been shut down by a renegade lymph system. So I observe her outsides, watch her expressions and her body language, read her skin with my hands, but still I know more about what she’s lost than what she’s kept and this is what scares me.
Kristen has Chronic Fatigue Immune Dysfunction Syndrome. During high school, she spent months at home, unable to rise from bed. Her joints hurt, and she lost her appetite for weeks at a time, her weight fluctuating. Her organs threatened to shut down. Finally, her doctors discovered that her immune system was running at maximum capacity, as though she had a full-blown infection and the energy it took to live and function was being consumed by this false state of disease. Running at this intense level, her body damaged certain organs. It induced appendicitis, and cancelled out her gall bladder, forcing their removal. Then there was waiting to see if the spleen or a kidney was next.
After the surgery Kristen made a slow but full recovery. When she tells me about it now, she says the years of pain and exhaustion before a diagnosis made her feel lucky that she graduated from high school. There are minor complaints to be managed now—achy joints, a heightened need for sleep. And there’s always the possibility that it will come back full force, canceling out more organs, crumpling her to the point where she can’t move, where she cannot stand to be in contact with anything—the weight of my hand on her hand, the weight of the sheets against her skin.
This comprehension she has of organs and aches and pains and what they might mean for her, it’s a sensitivity I don’t understand. Unlike Kristen, I have never had an illness more serious than chickenpox, croup or mononucleosis. I have never had surgery. I have had a skin cyst removed here and there, and my wisdom teeth extracted, but I have my tonsils, my appendix, my gall bladder. I have spent time in the hospital, yes, but the only things my body has lost are teeth and fluids. To be rent by the blade, to awake without parts of me is a knowledge I can’t access.
Over a year after my skiing mishap there is still a notch in my arm, a depressed band across my tricep that hurts to touch. I use a cold as an excuse to take this to the doctor. She says the trauma of the collision must have killed that band of nerves in my arm. This sounds extreme, so extreme that I feel the deadness should be visible—like a chipped plate, this odd flaw it seems I will have for the rest of my life should be delineated by some rough edge or a glimpse into the insides of my arm.
“What did the doctor say?” asks my mother over the phone, not knowing why I had really gone.
“That I have a cold. Like I didn’t know that.”
“Did she give you anything for it?”
“I don’t know. I didn’t ask her. Oh, but when she was probing the glands in my neck, she said, ‘What is THIS?’ That’s exactly how she said it—can you imagine?”
“Wait—what did she say?”
“The doctor said, ‘What is THIS?’ Apparently she found a lump in my neck. She thinks it’s on my thyroid.”
“What is she going to have you do for that?” my mother asks. I can hear her voice tighten; she expects the worst.
“She’s ordered an ultrasound of my neck and referred me to an ear, nose and throat specialist.”
“When’s your appointment with the ENT?”
“Do you want me to come down?”
“No.” There is silence on her end. “But that’s not going to stop you, is it?”
I have always marveled at Kristen’s body. Of course it is something I desire, but I want more than to hold her or caress her, more than to bring her pleasure. I would like to live in her body—to feel what it is to be her. I want to feel the skin’s stretch over the protruding bones of her wrists, to brush the carpet, the wood floor, the grass with the soles of her feet—feel the high arches of those same feet. What does it feel like to scrawl her pretty cursive on an envelope, to muscle the shovel through the snow? What is it to be at rest within her shape, to bend into acute angles, or to stretch wide her long arms and legs during yoga? I am at such a distance. I can only smooth my hand over the jeans’ perfect fit on the tight backs of her thighs as she stands at the sink, or run a finger under her collar as it falls away from her pale, thin, graceful neck.
So I ask questions.
“What is it like to be so tall?” At five-ten, Kristen is no Amazon, but to my five-three self, there are many times when I could use that height—to see better at concerts or to spread out the extra pounds packed on my short frame. My cheek lays flat against her sternum when we embrace; she may as well be the space shuttle.
“It’s a lot of responsibility,” she says.
“It must be.” After all, she serves as my step-stool-with-arms in the kitchen. Other times it’s simply, “What’s it like to be you?” Usually at these moments, I am touching her—my arms thrown around her, hugging tightly, or my hand resting lightly on the small of her back as she stands working at a kitchen counter.
“Itchy,” is all she says, scooting around me, her fingers feverishly clawing at the site where my hand has just been. How can her attractive body be so fraught with dangers and perils, with unwanted feeling and sensation? I wonder. I want to be in her and of her because I want to understand what she feels, to experience her body as she experiences it. But I also want this because I don’t believe her when she says she’s in pain or claims to need a certain accommodation. I want proof that her bad mood is the result of a missed meal, her fatigue possible even though she’s stayed nearly static all day, her abdominal pain the exact organ she claims it is. But even if I were her—were in her as her—I don’t think it’s possible to know, to be as certain as she is. With all the things I can create in my head—the ridiculous fraught scenarios of getting fired at work or coming home to our house ablaze—that loop through my imagination every day, I cannot understand how this woman who manages blindness to laundry piles and dust bunnies knows that a glass of wine the night before is the sole cause of a dull ache in her kidneys.
The ENT’s office is in a building that looks like it was meant for a real estate agency. Inside, the receptionist’s desk is surrounded entirely by glass. I wonder for a moment if the glass is bulletproof and then consider why the receptionist would need such protection. Perhaps the sticker on the door that says, “No narcotics on premises” is a clue? I fill out forms and am taken to a tiny examining room. My mother and I joke about the cross-sections of the body that line the walls until Dr. Bruce comes in. He is ancient. He seems to have fooled my mother with his swift gait and his charming Southern accent, but I notice that he’s stooped and tilts his head back to squint at me through Coke bottle glasses, his mouth alternately gathering together like he’s sucked a lemon, or slacking open like he’s about to drool in the middle of a deep sleep. His breath is questionable and he has a bumper crop of nose hair. At the very least, I’m grossed out, and at the worst, I’m skeptical of letting him practice medicine on me.
From a deep pocket of his white coat he pulls out calipers and shoves them into my neck, taking what must be extraordinarily accurate measurements of the lump. I would like to name it, but no moniker suggests itself. When I was in my early teens I used to name the very largest of my pimples so that I could acknowledge and make fun of the bulges that others saw on my face. Phillipe, Jacques, Didier—they were all male and French, perhaps because they seemed better able to be objectified and because I liked to say French names. Still, the naming made the painful and unattractive mountains on my face funny, and in turn that made me funny. That’s not going to work with the presence in my neck.
“Well, May-gen, you’ve got quite a growth in there,” he says. “Several centimeters.” Nearly every statement he makes is followed by a breathed “hmm” as though he’s gently exclaiming with the effort it takes to be a doctor and interact with patients, telling them what it is he knows. Or maybe it’s just the effort it takes to be, and he breathes this way after everything he does and says. “The ultrasound isn’t really conclusive, but I’d like to see what’s in there, hmm.” Wouldn’t we all, I think.
“So, I’m going to do a biopsy and see if there’s any fluid in there while I’m at it. It looks like it might be filled with fluid.” Out of a drawer, Dr. Bruce pulls what appears to be a medieval instrument of torture—a gun-shaped piece of surgical steel complete with a trigger. The barrel is almost completely open and there’s a round cookie-cutter shape at the end where a bullet would come out. In the very center of the round cookie cutter is a huge, thick needle that punches forward when the trigger is pulled. Dr. Bruce snaps the trigger a few times and the needle leaps out.
Attaching a huge syringe to the back of the gun, Dr. Bruce places the cookie cutter against my neck. “Just a little pinch,” he says. “Hold still.”
I freeze. This old man is going to shoot a needle into my neck. A little to his left and he’s shooting a hole in my trachea; a little to the right and he’s tangling the needle in my vocal chords. If he experiences a tremor, I’m screwed.
And then: a small, sharp punch in my neck, as from the fist of a gnome.
“Oh, yeah,” he says, “that’s full of fluid.” I feel the warm, papery fingers of one hand pressing the cookie cutter into my skin as the other draws back the plunger on the huge syringe. We sit for a few seconds and then he draws the gun back from my neck, pops the syringe off and snaps on another.
Before he has the chance to sight and shoot I ask, “You’re going to do this again?”
“Oh, yes—there may be a lot more fluid in there. And we want as complete a sample as we can get.” He starts to put the gun to my neck again, but stops and leans in close to me, his eyes just inches from mine, our noses nearly touching. “And guess what else we’re getting?” His eyes twinkle. “Samples of your thyroid!” He rocks back and slaps his thigh with his gun-less hand as though this is the best joke he’s heard in a while. Then suddenly he’s serious again, leaning in and peering at my neck. “Yup,” he says, “got to get us some meat.”
He adjusts the device against my neck, and I look at my mother. She just smiles and shifts in her seat.
After two more punches from the needle gun, Dr. Bruce sends a nurse away with the syringes and turns back to my mother and me. “Probably just a cyst in your thyroid. It’s also called ‘goiter.’”
“Goiter,” I say, looking at my mother.
“Oh, God,” she says, rolling her eyes to the ceiling.
“Why? What’s this about?” asks Dr. Bruce.
“The word ‘goiter,’” I say. “It’s hilarious.”
“Oh,” he says, shrugging and raising his eyebrows. “I guess so. Well, either way, goiter’s no big deal. Nothing to worry about.”
“Now I can tell people I have goiter,” I say, leaning back in the examining chair, satisfied.
My mother draws in a huge breath and leans forward, shifting in her seat yet again.
“What, Mom?” says Dr. Bruce. “I can tell you’ve got something on your mind.”
“She may have something on her mind,” I break in, “but I don’t. This is my doctor’s visit. My health.” I pause. “My goiter,” I say, the words erupting into a laugh.
My mother glares at me and turns to Dr. Bruce. “It’s just that you haven’t done any tests on that sample yet.”
“Well, no. And of course we’ll test the sample.” He sits with his hands on his knees and appraises her with his squint. “But in my experience this is nothing.”
“But we should wait to see the results of the biopsy.” Although a question, it comes out as a statement.
“Mom, please,” I say.
Dr. Bruce looks from my mother to me and back again. “If you like I can call you with the results, Mom.”
I gasp. “Are you serious?” Goiter isn’t hilarious anymore. “Isn’t that illegal?”
Dr. Bruce just laughs and continues to look at my mother, who looks at me. I can tell she’s weighing his offer. Whatever the results, in my mother’s hands they would be missiles of fear, flares of terror to send up and light the dark night of the future she can’t see. It was a doorway into my life and my care that she hadn’t had since I was dependent upon her and I didn’t want to usher her back through it now.
“I’m serious,” I say. “You are not calling her. Those are my results, this is mine to know.” He looks at me. “Don’t you get it?” I ask him.
“I don’t want to get in the middle of anything,” he says, looking down at the floor between my mother and me.
“So you offered to break the law by calling my mother with my test results? Way to extract yourself,” I say.
“I appreciate your offer,” says my mother to Dr. Bruce, “but that won’t be necessary.”
“How about another opinion?” he asks. “Would that make you feel better, Mom?”
“Yes, yes it would,” she says quickly before I have time to object. I slump back in the examination chair. Even if I did object, Dr. Bruce is too deep into his grandfather routine. Nothing I say will stop him from writing the referral or making the appointment.
“Okay, then,” he says, “we’ll send you to Dr. DeLeon in Williamsport for another opinion.”
Two weeks later, we’re in Dr. DeLeon’s office, my mother having made another five-hour trip from upstate NY to central PA to be with me once again. Dr. DeLeon is a tiny Filipina who seems very grave. “I would recommend that you have your thyroid removed,” she says.
“Great,” I say.
“Why?” she asks. “What’s wrong?”
“Did you have to say that in front of my mother?”
A smile flickers at the corners of her lips and she stares at me intently.
“It’s just that Dr. Bruce said there was no reason to take it out,” I continue. “All my thyroid levels are where they should be; it’s obviously functioning fine. Why should I take it out? I’m not even thirty.”
She says nothing and pops a CD loaded with pictures from my thyroid ultrasound into her computer, enlarging one image on the screen. With her pen she points to a smattering of white dots in the otherwise gray and grainy image. “Do you see these?”
“Yes,” I say.
“That’s calcification. Where there’s calcification, cancer is almost certain to follow.”
I stare at the picture, trying to understand what it is, trying to see my thyroid. There’s no real shape to it, just a shadowy outline that surfaces here and there. I cock my head to the left and right, thinking a different angle might help me see inside my neck. Calcification, calcium—I think of milk, good for your teeth, good for your bones. Not good in nodules in your thyroid. But the white dots of calcification are the only things in the whole image that draw my eye to them, the only light in this murky mass of organ. “Are we talking right now?” I ask. “Cancer when? In a year? In twenty years?”
“Well, there’s not enough calcification for me to assume that cancer will follow in the immediate future, but there’s no way to make an accurate prediction of the timeline this could follow.”
I look at the white spots again. My mother speaks for the first time. “So you think she should have it removed.” She seems to ask a lot of questions in the form of statements when in doctor’s offices.
Dr. DeLeon sighs and stares at the image on the screen, nodding. “Let me put it this way,” she says, turning to look at me. “If I were you, I’d have it taken out. Now.”
“And if I don’t?”
She shakes her head and doesn’t answer.
My mother and I don’t say much on the car ride home. In the silence, I can tell she’s tending to the worry growing in her mind, and I picture her bending over flats of plants in a greenhouse, little white sticks in the pots all labeled with different problems—“Cancer,” “Unemployment,” “Dog Hair.” She thinks that if she opens her mouth, her fears will take shape, the thoughts and ideas solidifying into physical objects, as real as deposits of calcium in my thyroid. I know my mother thinks that if I get cancer it is somehow her fault. She has had it and been treated for it—uterine and far from one’s thyroid, but still—she went bald, spent days nauseated, empty of food and words, full of terror at what she couldn’t control.
But I think about the years I have spent walking around whole and ignorant. I think of the years my mother has been without disease, her full head of dark brown, ungraying, perfectly coifed hair, how I’ve only seen or heard her throw up once. It seems to me that a body moves forward, growing and changing in service to its own life. I strain to hear something from my body, to understand it—is my skin silent because it has no messages to transmit from my bones and organs, nothing there to hear but the whisper of my pulse as blood beats through my veins? How can I not trust the very near and local mystery of the only thing that’s mine?
Yet Kristen’s overactive lymph system—I can actually feel it. I can feel it. When we lie in bed at night, she burns next to me. I have dozens of pounds on her and still she’s hot to the touch, my hands blocks of ice to her volcanic body. She shrinks from my cold skin, shivers even when swaddled in layers of blankets. From September to May, she wears a T-shirt under a long-sleeved T-shirt and tops that with a fleece and a wool sweater. She gets giddy when I switch out our light cotton comforter of summer for the down-filled duvet we use in fall, winter and spring. It took me years to connect the two—her radiation of heat and the CFIDS that creates it. Perpetual fever.
And this burning takes fuel. Kristen can eat and eat without seeing a pound added to her tally on the scale. When she tried on the dress she was to wear as the maid of honor in her sister’s wedding, it gapped around the bust; there was an extra inch or so poofing out around her stomach. With a little less than a month to go before the wedding and a dearth of decent tailors where we live, we had no choice but to feed her into it. Pizza a few times a week, pints of ice cream in the evenings, sweetened, hand-whipped cream on warm scones for breakfast, individual slices of cake whenever I came home from grocery shopping. Even after four weeks of this, the bust still needed to come in a half-inch on each side—her mother took care of this the day before the wedding.
But there are other times I don’t know about her symptoms, times I can’t believe what she claims she feels—I can’t see them in a loose dress or the hues of a bruise. She says she can’t go hours without eating, that even on a three-hour car ride between our home in Central PA and her parents’ house in the suburbs of Philadelphia she needs to stop and “grab something quick.” If her body is busy burning all its fuel to keep her warm and to keep her lymph nodes and glands running at top velocity, it stands to reason she needs food to keep this process going. But what does she feel—hunger? The stomach rumbling, the shaky hands, the drowsy slump of low sugar? I know what those are, too; I have felt them many times before. And I can withstand hunger. Why can’t she?
Still, no matter what I think should be endurable, I cannot take Kristen’s body for granted because she has something, a disease or disorder with a name. Any complaint might mean trouble ahead, a red buoy bobbing in the channel of our life. It can be convenient—this knowledge she has of herself makes her some sort of holy ark to study and preserve; it gives credence to my continued wonder at her perfect butt, her working yet graceful feet. But just as I can’t imagine my way into her skin, her aches, her organs, I can’t imagine what life would be if my body demanded that much attention.
Yet I am likely to lose this thing—the thyroid with its constellation of calcium—in the future. There is a part of me that is excited at being ushered into this group that Kristen belongs to; sometimes I can make myself believe it will bring something into focus, give me some understanding of what she already knows. I will fall asleep whole within the scratchy folds of hospital sheets, my bare neck cold with antiseptic swabbing. But after waking, I will know nothing more than the name of what I’m missing and the name of what was inside of that. In that first moment when I remove the gauze from the sutures, a raised line marks my skin—under my fingers, I comprehend only a score of loss. But there is no diagnosis to understand, no symptoms to observe, no disease to keep me in check—nothing to keep me from careening along my lifeline.
Meghan Cadwallader is a recent transplant from Central Pennsylvania to Boston, where she lives with her Scottish Terrier, Friday, and works as the Director of Admissions at The Boston Conservatory. Her work has appeared in The Fourth River, Bloodroot and Floorboard Review, among others, and she is currently at work on both a memoir and a collection of poetry.