The Medicine

The Monthly (Australia) - - THE MEDICINE - KAREN HITCH­COCK

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.

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