A node can be a turning point. A node can also be a vertex, a place where lines in a network cross or meet. It can be a knot, a bond, a small lump or mass of tissue in your body, a pathological swelling or enlargement, an entangling complication (as in a drama): a predicament.
I really shouldn’t be here. On the one hand, I shouldn’t be here in this operating room because this tonsillectomy should have been done a long time ago, back when I was a young child. Back then, I should have been taken care of by the people whose job it was to fix these things (doctors, my parents)—but it was becoming out of fashion to perform them. Doctors were wary of seeming trigger-happy with the scalpel. Parents didn’t want the hassle of recovery, or simply didn’t want to subject their children to the knife.
On the other hand, I shouldn’t really be here at all—as in, alive—because I should have probably died several times over by now in my lifetime were it not for relatively recent gains in modern medicine like antibiotics and intravenous fluids. I might have died of dehydration from days of uncontrollable, sustained vomiting related to repeated infections of strep throat. I might have died (eventually) from complications associated with multiple bouts of scarlet fever as a young child. I most certainly would have died of dehydration that time when I was twenty and infected with strep while studying field ecology for a semester in the Kenyan bush. My tonsils swelled up inexplicably overnight to the size of golf balls and I awoke no longer able to swallow my own saliva, let alone water (or the horse-pill antibiotics that I’d brought with me from my university’s travel clinic—even if I’d crushed them I wouldn’t have been able to get them down). There, in a thatched-roof hut in the scorching wilderness at the equator—hours on perilous dirt roads to the nearest town—I’d have died in only a day or two without medical intervention.
This is all just to say that my tonsils and I have been through the ringer together, and I (and those around me) allowed it to continue. This is a cautionary tale, of how trying to be a tough girl can almost destroy you.
A place where lines in a network cross or meet.
To say that my ENT’s office is dated would be a gross understatement. The waiting room is outfitted with 19th century wooden dining chairs and an antique end table that squeaks and almost buckles when I pick up a magazine. The front wall is original brick, inside and out, and boasts several built-in sconces, which presumably once held candles, but which now brandish medical pamphlets. I am too strung out after sleeping less than two hours total over the last three days and in too much pain to laugh out loud at the setting, or really, I would. For some inexplicable (perhaps sleep-deprived) reason, I find the aesthetic endearing.
The exam room itself is probably ninety years old. There is a sort of gothic, old-fashioned dentist-style chair in cracked black vinyl bolted to the center of the floor with a metal head restraint at the top for extra-creepy flair. The tile is reminiscent of mental institutions circa 1920 and sports that particular horror-flick shade of toothpaste green. The lighting consists of diffuse, cloudy daylight from the window (there is a small, naked floor lamp with a single, bare, incandescent bulb, but it isn’t turned on). The door is—there is no door (on closer inspection, I see there is an ancient pocket door flush with the frame, but either it doesn’t close or no one bothers to close it). I snicker despite the agony in my throat, or perhaps precisely because it all feels so apropos. This is exactly what a lifetime of periodic tonsil-related misery should lead up to: a veritable torture chamber. I love it.
The doctor enters the room and barks, “So what’s the problem?” He resembles Bernie Sanders except that he is wearing a plaid dress shirt tucked into khakis instead of a baggy suit and has a close-cropped beard. In this way, he looks like Bernie Sanders on vacation.
I explain my health history (or rather, my history of un-health), and open my mouth. He looks for half a second then puts down his light tool, because my problem is obvious from across the room.
“Why the heck didn’t you have these taken out when you were a kid?”
“It was out of fashion,” I remind him, because he was almost certainly in the business back then as well. A degree certificate hanging in the room that bears his name dates to 1966, fifty years ago and fifteen years before I was born. “And I didn’t really have a say at the time.”
An entangling complication.
Before I go any further, I want to address that even writing about this feels problematic. I have deeply entrenched personal taboos against writing about illness or physical suffering. I’m aware that it’s the kind of subject where you don’t read the comments. I anticipate labels of wallowing, of self-pity. I admit to having once been the kind of woman who winced at this sort of thing, who boasted about never crying when I broke bones.
In her 2014 essay “Grand Unified Theory of Female Pain” for Virginia Quarterly Review, Leslie Jamison expresses similar ambivalence to writing about her own pain: “I find myself in a bind,” she writes. “I’m tired of female pain and also tired of people who are tired of it.” Sounds about right. She chronicles the prevalence of tragically wounded female figures throughout literature from Anna Karenina to Sylvia Plath and suggests that “[t]he moment we start talking about wounded women, we risk transforming their suffering from an aspect of the female experience into an element of the female constitution—perhaps its finest, frailest consummation.” I acknowledge this to be true, and yet I also feel compelled to write about it anyway, as Jamison does. I feel compelled to change the way I approach female suffering in my writing, and the way I experience and perform pain in front of my children, my family—the world.
It’s different, of course, for men, but I would argue that the disparities in how the genders are expected to suffer do men a disservice as well. They’re so often compelled to “suck it up” and “be a man” and endure pain at all costs, which is shitty for men, but it also means that, ironically, when a man does admit to some kind of severe ailment or pain we tend to inherently believe him, for we assume that he’d be unwilling to risk a possible downgrade in his manliness rating for anything less than something truly debilitating. Jamison refers in her essay to a study from 2001 examining why men are more likely to be given pain medication by their doctors, which concludes that women “are more likely to have their pain reports discounted as ‘emotional’ or ‘psychogenic’ and, therefore, ‘not real.’” An uneasy hush would fall over our house whenever my naval aviator father was injured or ill. He would admit to it so rarely, dismiss symptoms as minor unless they were outrageous, that we knew something must be terribly wrong when he was sick in bed.
My mother, in contrast, suffered from extreme, debilitating chronic allergies throughout her adult life. She would alternately beg, chide, and yell to try to get my father to remember to close all the windows before he mowed the lawn, but he’d respond with indifference; he never closed them. He treated her retreats to their bedroom to recover from her allergy attacks as temper tantrums. He sighed heavily. He rolled his eyes.
It got to the point where I didn’t even believe that she had allergies; his reaction seemed to suggest that they were in her head. It wasn’t until I was an adult and—1) I developed grass allergies of my own that were verified through testing, and 2) she got comprehensive testing later in life herself and shared the results—that I began to review my memories of how all of that went down with a degree of skepticism. The doctor who performed the testing supposedly told her, “It will be easier for me to tell you what you’re not allergic to than to list the things to which you are.” And yet, she had been ignored—mocked—for complaining about these allergies. For decades.
But it wasn’t just at home. As a woman, over time I have absorbed this sense—because women are so often depicted fictionally as relatively whiney, frail creatures who complain and fuss over small discomforts, like “cramps” or headaches or indigestion (think of all the fainting girls and women you’ve seen onscreen)—that I should endure even great, unbearable levels of physical suffering because I am (or rather, my pain is) not to be taken seriously. You can see this especially (though not exclusively) in our culture’s portrayals of childbirth, where the woman’s howls of pain are universally played for laughs. A cursory Google search of fictional on-screen births returned such absurd clips from TV shows ranging from Murphy Brown to Friends to a more recent film called What to Expect When You’re Expecting—in which a character quaintly, gently sneezes out twins in one room while Cameron Diaz clownishly yells her baby out in another. This is a process so traumatic to the human body that millions of women around the world die from it every year, and yet every time you see a woman giving birth on television or in the movies it’s supposed to be not heroic, but hilarious.
I would never go to the hospital for extreme pain alone, only for measurable, visible, objectively bad symptoms. I fear more than anything the dreaded label of hypochondria. I apologize to my husband daily whenever I am sick, as if I had any control over it, and he is enlightened enough to be baffled by my apologies. I ask if he wants to see my throat because I fear he won’t believe me. He declines; he doesn’t need proof. I want him to look anyway.
A small lump or mass of tissue in your body.
Tonsils are a kind of node. Mine certainly have proven their propensity for “swelling pathologically.” I wouldn’t exactly have characterized myself as a sickly child, though. In between terrible, regular stints of strep throat, tonsillitis, and eventually quite awful mononucleosis, I was robust and spry. But now that I think about it, I view a large portion of my life through the lens of illness and convalescence.
For instance, some of my most intimate ties with my father growing up developed over our toilet bowl. He was the lighter sleeper of my two parents and when I’d come into their bedroom feeling unwell, he would be the one to leap up and don a robe to come hold my hair back as I threw up into the toilet, often several times in a single night. As I was somewhat of a vomit-phobe, the process generally took quite awhile. I’d rest my teary, feverish cheek on the cold seat and moan at how awful and cruel it all was, as if I alone in the universe suffered so terribly, and he would pat me on the back sweetly and say how sorry he was, and sound like he truly meant it. I marvel to this day at the man’s levels of patience and empathy, but I wonder simultaneously how this same level of compassion had been denied to his wife. I never once saw him dote on my mother in this way, and at the time, from within the myopia of childhood, I assumed she must not have deserved it. It never occurred to me that I might someday be in her position, although in my case, the compassion would ultimately be denied not by my husband, but by myself. Or really, by proxy, by my father from the past. By my experiences out in the world.
My mother is allergic to grass, trees, every kind of flower, weeds, cats (dander and saliva), dogs, cockroach dung, dust mites, fragrances, smoke, and detergents. And that’s only the things I can remember. But we (my sister, father, and I) all “knew” she was making it up. She was so vocal about it. She seemed to be after attention. At least, that’s how we perceived things through our father’s eyes.
Wouldn’t you want to try to modify your environment and the behavior of those around you who brought you in contact with these things? Wouldn’t you complain if this was your lot in life? Would you really, though? Because I wouldn’t. I wouldn’t dare. I mowed lawns and did grassland restoration work in my twenties—grass allergy be damned. My legs would be covered in hives afterward, my eyes and nasal passages swollen shut for the remainder of the day. I would eventually give myself asthmatic hay fever and need inhaled steroids to breathe, but I didn’t stop mowing grass.
My first severe throat infection of this past year began Christmas afternoon. I was going to make a pie for dessert and then I got up to make one but couldn’t. I was very suddenly in massive pain, became quite irritable, yelled at the children for fighting over their presents and felt terrible, for both reasons. By dawn, I had thrown up all of Christmas dinner several times over (and then some) and had a fever of a hundred and three. My mother was in town for the holiday and was able to stay for a few extra days to help ferry me to doctors while my husband cared for the children. I was in bed for nearly a week.
One month later I had strep throat again, from one of my kids (who got it from preschool as a skin rash). This time, I was down for another solid week. My husband stayed home from work to care for the children.
One month after that was the day before I was to leave for a writer’s retreat (which was partly an attempt to lift my spirits from all the illnesses of the previous few months). But, I had strep again (from my other child—despite Cloroxing the shit out of our entire home). This time, I was hospitalized for severe dehydration (again, from being unable to keep down fluids), where they pumped liter after liter after liter of saline into my body, and it never seemed to be enough. My husband stayed home to care for the children once again, and we forfeited the cost of my missed vacation.
While lying in bed with the high fever and vomiting associated with strep throat for the third time in as many months, I fantasize about morphine. I don’t know much about the effects of painkillers. Didn’t accept any pain relief during childbirth, even though I genuinely thought I was going to die from the pain (as in literally, it was so torturous and relentless, I thought it would cause my heart to stop). Didn’t accept the prescription for painkillers even after childbirth with massive tearing in three separate locations (who knew there were as many as three?). Again, the ingrained resistance to any admission of pain. In that instance, my wounds became infected unbeknownst to me and were so excruciating I was unable to walk more than a few steps during the weeks leading up to my postpartum checkup, and yet it never occurred to me that something might be wrong or that I might obtain relief; I had expected to be in agony. “Don’t be a hero,” the midwife tsked at me when she saw me hobbling into the office. But I wanted to be one. I had something to prove, namely, that I could hack it. That I could “be a man” about it all.
But now, in bed with strep, I try to put my brain in a state such that it might produce its own kind of opiate and kill every feeling. I want more than anything in the world to be unconscious, but the one thing I can’t do in my condition is sleep, so if that means death, so be it. I don’t really mean that, but I feel it in the moment. The only sensations I feel are pain and nausea, both at a sustained nine on a scale of one to ten—and in this state, my only thoughts are animalistic: stop it, stop it, stop it, stop it. All I have at my disposal for dulling the pain is classical music because I can’t even keep down Tylenol, which is fine because that doesn’t work anyway. Tchaikovsky, Rachmaninoff, Debussy, and Mozart are my only drugs. I remind myself to pledge to the classical public radio station when I am well again.
It feels maddeningly frivolous to be writing about strep throat. It is so eminently fixable, the epitome of unpleasant but not fatal childhood diseases. It isn’t malaria. It isn’t cancer. It isn’t Ebola. I have health insurance (!).
But at the same time, I haven’t been able to lead a life. I haven’t been able to make or maintain deep friendships. I haven’t volunteered much at my children’s preschools or applied for any sort of part-time job after caring for my kids full-time while they were babies and toddlers, because I knew I could not be relied upon to consistently show up. As of last September, I hadn’t been to an eye doctor or a dentist in over eight years because every single time I made appointments I’d have to cancel due to sudden illness (I’ve cancelled five such appointments this year alone; my eyeglasses prescription predates my marriage). On top of that, the kids are very often home sick and under quarantine with their own normal preschool illnesses—pink eye, stomach bugs, fevers, and rashes—in between all of mine, and so we just don’t see people, period. I’ve been in near-total isolation for several months of the year for years, now. I’ve been going crazy. I am going crazy.
Boo-hoo, I hear my tough-gal, internal critic say in response. Go cry into your pillow.
But that critic—fuck her, by the way—is why it has taken me until I was thirty-five years old with two children to try to get this taken care of. According to my mother, I had four to six strep infections per year as a young child, and the current guidelines for removing a child’s tonsils to improve their quality of life is three or more infections per year for three years, but for whatever reason, it didn’t happen. After the third persistent throat infection in three consecutive months this year alone, I was offered a referral to an ENT from an exasperated doctor at my local urgent care clinic who had personally seen me twice in less than two months. I made two appointments with the ENT but had to cancel both of them the morning of because my children were sick and couldn’t go to preschool, and I just gave up after that. It sort of felt natural that I should be so ill and in so much sustained pain so much of the time. Leslie Jamison coins the term “post-wounded” to describe a woman who “conducts herself as if preempting certain accusations: Don’t cry too loud; don’t play victim. Don’t ask for pain meds you don’t need.” The shock of recognition for me here is striking. Misery had become normalized. Everyone around me thought I’d suffered enough and urged me to get it done, but I was acclimated to suffering. Admitting that I needed the surgery felt (stupidly, arrogantly, macho-ly) like the moral equivalent of admitting defeat in the Blitz. What I felt I needed instead was to stoically endure.
An old childhood friend—a combat veteran and recurring leukemia survivor—recently expressed disgust on social media at what he termed “The Pussy Generation,” by which he meant Millennials. He was lamenting an article reporting that many new recruits couldn’t pass the physical standards to be in the military, that young men these days were “weak,” and he concluded it was because our culture encouraged them to be that way. But that very same week, he posted about the anniversary of meeting his wife, and how at the time he’d recently drunk himself out of a well-paying job and was at a personal low before she helped him turn his life around. Presumably he’d turned to alcohol abuse to numb the psychological pain of losing friends and colleagues, men and women under his command, during his multiple tours in Iraq and Afghanistan. I marvel at how he could simultaneously believe that men needed to be tough as nails while tacitly acknowledging that attempting to live up to that standard had nearly destroyed his body and his life.
A turning point.
Last month, the kids each came down with a virus with a high fever one after the other and each missed a full week of preschool, back-to-back. My husband was consumed with a work emergency, so I was unable to leave the house for two solid weeks in order to care for them, except to take the other one to school when the sick one wasn’t too sick to ride in a car but still had a high fever and couldn’t go to school (or the playground, or the library, or even the grocery store). I took one desperate 8 p.m. run to Target ostensibly for more children’s Tylenol, but really it was for my sanity. I stayed for two hours.
When those two weeks were over, I immediately fell ill with severe tonsillitis for several weeks. During the worst of it, I slept one hour each night for two nights and zero hours the third night. It was the end of September, and I had to cancel a much-anticipated outing with a new friend. I hadn’t been out with a friend, not even for coffee, since early July.
On my third day of little to no sleep of my fourth infection this year (perhaps my hundredth or more in a lifetime), I finally made it to the ENT for the first time ever.
There are two orange-and-black “No Trespassing” signs posted in the front windows of my ENT’s office. There is a giant poster on the wall of the exam room diagramming the human ear, with an inscribed date of 1952. What appears to be a blood pressure gauge attached to the wall coils out in fabric-wrapped tubing, seemingly predating the use of plain rubber. It is October, and the atmosphere smacks of Halloween, though there are not any Halloween decorations, per se.
“Are you ready to have your tonsils out?” my doctor asks on his way in, with the gruff enthusiasm of a baseball coach entering the pre-game dugout.
“Sure,” I reply. What else can I say?
He writes me a prescription for the post-operative pain medication I will need and explains that I can’t eat on the day of the surgery. He goes over my health questionnaire.
“All your hospitalizations have been throat related?” I have already written that down, so he is asking out of incredulity.
“Yes,” I confirm. I am remarkably healthy in most other ways. I went home four hours after giving birth to my first child, despite having to be sewn up for half an hour because of all that tearing.
“What took you so long?” He has already asked this before and doesn’t expect me to respond. The question is rhetorical, and there is a hint of an indictment, an implication that I have been lacking in sufficient self-care, though he does not say it without empathy. Still, I can’t help but wonder if this doctor would be so concerned if he hadn’t been able to see my swollen, infected tonsils from across the room. If he had to rely solely on the self-reporting of my own history, my own past experience with pain and sickness.
I’m doing it now, at least. Because I am tired of hearing my husband say, “Mama’s too sick to come say goodnight,” in response to my three-year-old son’s tearful requests that I do so. I’m tired of isolation over large portions of my year, of being unable to commit to any kind of sustained responsibilities. Of missing vacations, coming home early from vacations, refusing to book any more vacations out of fear for having to cancel them. Of being removed from my own life. I’m tired of being a tribe of one.
This idea that a subset of the population shouldn’t admit to suffering seems counterproductive for everyone. I am about to be made physically stronger for having finally admitted to unacceptable levels of pain, and that’s not nothing. I’m not suggesting that female pain is especially different from male pain, but we are certainly conditioned to think that it is. I’m also not trying to argue for an end to toughness in general as a character trait; it certainly has its time and place, and I still admire it when appropriate. I’m proud, for instance, to have hiked down to the bottom of the Grand Canyon and then to have hiked back out, and to have done so with swagger, even though it hurt. But I am suggesting that we could all—men and women both—benefit by being a little more honest in our self-reporting of pain. To be tough when we can and vulnerable when that makes more sense. Go ahead. You go first.
Honestly, though, where would we start? It strikes me that we could do worse than re-examine how we as a culture view the experience of childbirth. It’s just one small adjustment, sure, but from someone who’s been on the other side of it twice now (and who’s about to do it one last time—wish me luck!), I can say that it’s nothing like any idea you’ve ever had of what it is like, the way you thought you knew something about how sex might feel before you’d ever had it and turned out to be completely wrong, except that you are a hundred-million times more wrong about childbirth than you were about sex.
I know it’s not like this for everyone, but birth, for me, was like the extended torture that a POW might receive, but if torture sessions lasted all night or sometimes days, and there is no mercy, no stopping it by giving up information to the enemy—you either bear it or you don’t survive. It required the endurance of an ultra-marathon through the badlands with an elevation gain of 15,000 feet. It kills people, often very strong, healthy people, all over the world and every day. It’s fucking badass, is what I’m saying. But I had no idea. I thought it would be beautiful. Transcendent. Instead, it was more like a battle than anything I’ve ever read about, and I emerged a grisly warrior at the end—except that it’s a secret; no one would believe me if I told them what I’d been through, and the only people who know are other mothers. We are warriors made invisible and quaint, rewarded for our valor with posts as nurturers—the official kissers of owies, makers of apple pie. But I don’t want flowers on Mother’s Day, I want a twenty-one gun salute, a noble statue in every town square. I want fucking cannons going off in our names. More than anything else, it would go a long way toward fixing these moronic ideas about women and pain.
So I got the surgery finally. And I know that a tonsillectomy is not a panacea. It’s not going to prevent me from ever getting sick from colds or the flu, or even some throat infections. But I can’t help but think what a turning point it has been. Lunch with friends. Season tickets to the small live theater on our block. A weekend at a friend’s house in the mountains. More nights out. More sex. Joy, in general, as a thing that I experience now and again. We weren’t even open to conceiving this third child until those tonsils came out. So I’m done with the soldiering on, or rather, I’m saving that for when this baby comes. It’s going to be brutal. I’m doing push-ups and squats to prepare.
A node is a point on a branch or a stem where a leaf grows. I am a leaf, ready to unfurl.
Rumpus original art by Lauren Kaelin.