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A Place Called Sickness

In a sense sickness is a place, more instructive than a long trip to Europe, and it’s always a place where there’s no company, where nobody can follow. –Flannery O’Connor

In 2003 I was asked to write an essay in response to this line from Flannery O’Connor for Clear Blue, the annual in-house magazine of Blue Cross and Blue Shield of Minnesota.  I took the invitation as an opportunity to play with metaphors of place and travel while finding something to say about sickness.  I don’t know who ever read this essay.  The magazine wasn’t sent to policy holders.  For all I know, it fell in a hole.  So I’ve decided to run it here on my website.  Be forewarned that the metaphors run wild and occasionally even mix (horrors!)

“In a sense sickness is a place, more instructive than a long trip to Europe,” short-story author Flannery O’Connor has written, “and it’s always a place where there’s no company, where nobody can follow.”  O’Connor’s words invite one of those extended travel metaphors that easily crash and derail.  While the writer in me appreciates a good metaphor, my bodily self balks at linguistic tricks that sentimentalize illness and obscure its blood-and-guts physicality.  I cringe, especially, at the illness-as-journey metaphor, which would have us wend our way down obstacle-strewn pathways and up spiritual mountainsides to be rewarded for our uncomplaining courage at the summit.  That’s not likely what Flannery O’Connor meant, however.  “Sickness,” she wrote, plain and simple, not “illness” or “ailment” or the euphemistic “health condition” or “challenge.”  And being consigned to a “place” suggests exile rather than solo adventure travel.  The key word here may be “instructive.” Sickness is a place where there is plenty to learn, knowledge not easily shared with those left behind in the state of health.  So let’s give the metaphor a go and see where we wind up.

I am a seasoned traveler myself.  I have taken long trips to Europe and short trips to Asia.  I have also sojourned more times than I remember in the place called sickness.  I am ordered there abruptly, by the heavy, abrasive pain of biliary obstruction and the hallucinatory fevers of infection.  Over forty years, I have watched the security at border crossings tighten.  Travel arrangements are harder to make now.  “Press one, press two,” the gatekeeper’s disembodied voice commands, before abandoning you to a worn recording of “Tenor Saxophone Suite for Stalled Elevator.”  No, you may not see the specialist who can whisk you through customs and spare you the wanding or patting down.  Only your primary physician, who is booked up through the next season, is certified to approve your visa, unless you are willing to explain your rare disease and erratic history to the authorized stranger on call.

Unwelcome as a tourist, you declare yourself a refugee and risk the uncertain mercies of the emergency room.  You flash your insurance card, if you are lucky enough to have one, explain your danger three times over, wait in the triage line-up while the pain builds to intolerable.  “Where is the pain?” becomes an insuperable test when the pain has grown to encase you and is zigging back and forth across the room.  No one here speaks the primitive language of groans and grimaces to which pain and fear have driven your ordinarily intelligent self.  Unless you have brought along an interpreter, you feel utterly alone, cut off from any real communication.

As many times as I have crossed this border, I still feel vulnerable and wary.  I long for simple compassion, a silent understanding that doesn’t depend on my answers to questions, my lab results, the clues that palpation reveals.  I am sick, and I beg to be slipped into some remote and protected place where I will be soothed and cared for until it is safe to return home.  Instead, I imagine myself back in the mine-filled DMZ, staring into the expansive, forbidden landscape of North Korea, where no stranger can enter—no one, that is, except the cranes, Asian symbols of peace, who wing freely back and forth across the border and flock on either side, with no regard for human territorial claims.  If only I could ride the air currents to the place called sickness on the back of a crane.

But now I am confusing this place called sickness with the refuge where it is treated:  the hospital, or my fantasy version of it:  the genteel spa of nineteenth century literature, where hearty meals and clever conversation and mineral baths are thought to perform miracles.  Sickness, O’ Connor suggests, is a place of isolation, where no one travels with you.  A more aggressive bird inhabits this unpopulated place.  Disabled by a weakness you can’t describe and that others can’t intuit, you lie alone on a vast plain, nothing but the horizon on all sides, save for the eagle soaring and diving overhead, its eyes and talons out for prey.  When I learned in high school about the punishment dealt out to the Greek mythological hero Prometheus for stealing fire from the gods, I seized on the image as a way to make light of the abdominal pains that doubled me over without warning.  “There’s an eagle pecking at my liver,” I joked to my puzzled friends.  I was an ambitious kid in a culture where self-assertion is next to sinfulness, and I found some perverse, pain-diverting pleasure in imagining myself punished for wanting to master the fire within me.  Any of us left alone on the spare plain of sickness long enough will wonder what crime has gotten us banished there.  If only we knew, we might redeem ourselves and be welcomed back into the society of the healthy.  How ironic it was to be diagnosed, finally, with a congenital liver disease, to learn that I had been marked as eagle’s prey in the womb, without blame, and thus with no chance to absolve myself.  I was merely sick, arbitrarily and endlessly sick.

There are certain landscapes that lend themselves to metaphorical use as places of isolation.  The desert—the Biblical wilderness—and adrift at sea are the favorites, and the most hackneyed.  I prefer the stark beauty of the Icelandic heath, treeless miles of hardened lava, unsheltered from sudden blizzards, rough to the step, pocked with deep craters of glistening blue water that will swallow you if you tumble down their gravelly slopes.  I have walked in a place where the world is truly splitting open:  Thingvellir, where two continental shelves, the European and the North American, merge and diverge, tugging away at the ground to form crevices narrow enough to step over and abysmally deep. Here Ginnungagap, the void where the creation of the world occurs in Norse mythology, yawns just under your feet.  Being sick over a lifetime is like walking forever on this rift line, always alert to the possibility that the earth will open underneath you.  Rather than fall to a sure death, you will be suspended in some vice-like strait barely out of hearing of others and beyond their reach.  Your only hope is that another tremor will thrust you out again, and as you anticipate that awful wrenching, you promise to make the most of your rebirth.

Sickness can be a place of terror.  Fever dreams, hallucinations force you into hostile territory, where dark, knife-edged silhouettes march and pivot across the inside of your sweaty forehead.  You dodge them, try to blink them away, pray them away, but they turn and glare at you with laser eyes.  Familiar faces from the home country join them sometimes, but they behave nonsensically and ignore your appeals for help.  All night you toss and pant and struggle to evade these menacing creatures, but they won’t give up their pursuit of you.  By morning light, you lie exhausted and clammy in some sympathetic farmer’s haystack, resting up until they ferret you out and the chase begins again.  More frightening than the hunt itself is the realization that these hellish images are products of your own mind.  Between fevers they lurk in your brain cells, waiting for the command to attack.

Normally, I avoid war metaphors.  The “courageous battles with cancer” in the daily obituaries make me mourn the paucity of the language as well as the loss of life.  I tread lightly with analogies to war, exile, racism, genocide—calamities that befall living people in the material world.  I’m protective of illness, too, and don’t like to see it appropriated for uses that distort or diminish its reality.  So, you are working feverishly, you say?  Try working in the bone-rattling chill that drives your body temperature to 105.  Yet I can imagine writing feverishly.  Hallucinations also reveal an other-worldly beauty and a creativity too prolific for daily life that I would keep as my victory booty, if only I could rig a direct feed from brain to computer.  Fever leaves me too depleted to wield a pen.

That place “where nobody can follow” is also a place of keen observation and contemplation.  Throughout my twenties and into my thirties, I took many trips to Sweden, for academic research.  I chose to travel alone, and to park my life’s baggage at the border.  I could pass as Swedish if I didn’t say enough to betray my accent.  My imagination thrived on the silence that Swedes maintain among strangers, on cross-country trains, for example.  People I met and spent time with knew me in the immediate moment and weren’t concerned with my history.  Hearing my name pronounced in Swedish, I felt like a pseudonymous version of myself, purer and freer than the heavily obligated person I was at home.

As a writer, an introvert by nature, I cherish the opportunity to mingle unnoticed in the crowd, then hover on the margins for a while, observing and recording what I see and hear for later interpretation.  So many glorious things escape your attention when you are distracted by the society of others.  Being sick is a surrogate form of anonymous travel.  In the hospital, I shed my home identity for the nurses’ “14-2,” the doctors’ “Caroli’s syndrome,” and my first name scrawled incorrectly on the whiteboard above my head:  “Cheryl” copied from my chart, rather than the “Cheri” I otherwise go by.  Once pain is medicated away, life distilled to its basics—seeing, hearing, breathing—is a fertile garden.  You learn perseverance from the morning’s first bird songs, read meaning in the course the shadows follow along the wall, and marvel at the divine art in the translucence of cranberry juice.

As health returns, and with it familiar worries and regrets, solitude gives way to loneliness, and anonymity begins to feel like humiliation.  After a time, Sweden’s order and homogeneity made me long for the relative chaos of American life.  The attempted sterility of the hospital room makes me miss the clutter of home.  Eventually, the social being inside wants out, and you wave your passport in everyone’s face, as if to say, “Look at me.  See who I really am.  I have so much important living to get on with.”

Returning from a good “instructive” trip is not easy.  Etiquette dictates that you not hold dinner guests captive to your vacation videos.  Recounting your trip to the place of sickness is an even greater taboo.  Nevertheless, casual tourists persist in describing exotic meals, grand vistas, diagnostic tests endured and medicines swallowed.  We serious travelers know better than to try.  You have to have been there to appreciate it, after all.  The discoveries we long to tell about will, we suspect, only baffle the healthy stay-at-homes.  How do you convey the muted blue twilight of a wintry place where the sun barely shines; the soundless, loving message of hope that throbs inside you as you pass back into consciousness; the way the shifting sand settles and hardens under your feet and leaves you so firmly grounded not even a wave of euphoria can knock you over?

There are those who say that Flannery O’Connor’s peculiar creativity was nourished by sickness, that her edgy plots and quirky characters are products of a fevered imagination or of a long enforced solitude.  I believe that she was gifted enough without lupus and that her early death, at 39, cost us at least a couple of decades of highly original, skillfully crafted stories.  I would never dare say that her wisdom was worth the suffering, only that she did learn plenty, and what she said about sickness is right and true.