The Medicine

Ionce slipped while running on a treadmill. It was eight years ago, but I still clearly remember the sickening feeling of my right foot gliding backwards instead of connecting with the belt. I landed palms, shins and knees on a strip of rubber that continued to rotate at 12 kilometres an hour, taking my skin with it. I fell to the side, surveyed my energetic bleeding and the pink patches that would soon bloom deep purple. I started to cry, not in pain but in anger: at the machine, my stride, my runners, but most of all because I couldn’t keep running. The next morning I stood at the side of the pool, my legs plastered in bandages, asking my coach if he thought my ruptured skin posed an infection risk to the rest of the squad, if I was allowed in. One of the guys from my lane looked up and said, “I wish I got cut up like that, it’d be a good excuse to have a week off training.” We weren’t professional athletes. We were engaged in a voluntary (albeit slightly mad) activity. If we didn’t turn up, no one would give a damn. For whom did he need a sick note?

I thought of him last week as I developed a head cold. You know how it announces itself: first your throat gets prickly, then it hurts to swallow and your cervical lymph nodes swell up like ripening plums. Throughout the day the virus spread its havoc. Heavy head, aching limbs, blocked ears, litres of snot. I ran through the things I had on for the rest of the week and thought, Good. It’d been a while since I’d spent three days drinking sweet tea, in my pyjamas, in bed. I went home, made a few calls, swallowed two paracetamol and picked up a novel.

So the next morning I was lying in bed thinking that as long as there was milk in the fridge, analgesics in the cupboard and a babysitter to get my girls from school, I’d be happy to do this sick thing for a while. I was thinking, Why do I really do all the things I would have been doing had I not inadvertently inhaled some no-name airborne virus? One needs money, of course, and for most of us that means we must work. But there are many other drivers that fuel our activities in the world. In countries that offer a guaranteed income to all of their citizens the entire population doesn’t down tools and take to their beds. Outside of doing enough to ensure our basic material needs are fulfilled, it’s a grab bag of imaginary stuff that fuels our work. That night I watched a recording of American stand-up comedian Ali Wong. She was heavily pregnant. Mid show she said, “I think feminism is the worst thing that ever happened to women. Our job used to be no job.” I laughed so hard I almost choked.

I’ve heard it said that the alcoholic drinks hard not for the pleasure, abandonment or oblivion it brings him, but for the depression he’ll suffer the following day. The enforced downtime. Getting sick in a temporary, non-life-threatening way offers us the opportunity to pause, to reflect, to assess what the hell it is we’ve been doing and wonder why. Flung off the treadmill, lying broken, do you look at its incessant rotation in horror, or in desire?

Athletes often have a potent and complex relationship with their coach. Nothing fuels hard work as effectively as love can. But the coach is as much a fantasy as a real person, and has to pull their charges back as often as push them. I no longer have a coach, but were I to fall running today it would be in a park, and I’d let my skin heal before soaking it in chlorine or sweat in some absurd display of dedication to an indifferent audience.

Getting sick has its advantages: time off work, the presence of doting loved ones, fiscal compensation, identity solidification, sympathy, attention, the list is endless. In medicine these advantages are called “secondary gains”. Sometimes illness is all about secondary gain. There are people who pretend they’re sick in order to garner these benefits. Sometimes – through some trick of the mind – they actually do experience symptoms of illness although their body is perfectly well and should function smoothly. Push yourself (or be pushed) long and hard enough, without reflection or any way out, and the sickbed might feel like bliss, the thought of leaving it seem terrifying and you may not be able to haul yourself out. Sometimes, being sick may be your only escape.

I once saw a young man who’d been tired for a few months and had been sent to my clinic because his GP had failed to find a clear cause. I flicked through his old medical notes before I called him in. He was a retired competitive sprinter and had been heavily investigated a few years back for an unusual symptom: as he crossed the finish line at the end of each race (races he often won) he’d pass out cold. He’d had every cardiac, respiratory and neurological test known to medicine and the conclusions were consistent with what anyone’s eyes could see: he was a fine-tuned Formula 1 machine. The specialists were stumped. It was either that (unlike all other human beings) he didn’t stop before he surpassed his physiological limits, or the pass out was psychosomatic. A trick of the mind. An unspoken internal protest that this racing business was intolerable. Although no pathology had been detected, one of the cardiologists’ letters contained a recommendation that he stop running, given the risk of serious head injury. I brought him in. He shrugged when I asked him about the end of his running career. Nope, he didn’t really care. And neither did his father, who had been his coach.