What follows today is a hell of a monster of a behemoth of a post. It’s nine single-spaced pages in Microsoft word. This bulk amounts to around 5000 words. This is not a number to sneeze at. In fact, it is regarded as a number that screams “don’t go there! You’ll lose all your readers!” to any blogger who knows just about anything about just about anything.
Nonetheless it is one of the best blog posts I have ever read (because I certainly did not write it). I thought I’d roll my eyes a paragraph in, click the little red X in the corner, and be on my happily scheduled productive way. Instead I was sucked in by line 2 and read every single word, a torrent of emotion and insight and stunningly beautiful prose.
I could go on, but I’ll let you see for yourself.
This is the story of Elissa Washuta and her body. It is full of so much love and hate and love and hate and fear and hope. Few stories can show us better (and have shown me better) the visceral truth of what it means to be a human animal in a concrete word.
Stab Wounds: Killing My Gallbladder, Wounding My Brain
An Essay by Elissa Washuta
I was twenty when the nausea came to stay. The feeling coiled around my stomach one morning when I woke up beside my boyfriend, picked my way across our fallen textbooks, and dry-heaved in his moldy bathroom. Every week, as directed, I had pressed a fresh birth control patch onto a blank expanse of skin. We wanted so badly to draw on the patch, but the prescribing instructions had forbidden it, so we sharpied beside it, around it, and all over each other’s torsos. No fetuses, he wrote on me, and drew a tadpole with a line through it. Ever since I was old enough to cover my scrapbooks in stickers of Mr. Yuk and unicorns, I was compelled to coat my life in adhesive badges.
As I sat on the grimy toilet and a phantom python tried to force all intruders out of my empty gut, I worried, transdermal ethinyl estradiol and norelgestromin notwithstanding, that the linty-edged sticker on my ass was no more magical than the neon Lisa Frank teddy bears that covered my fifth grade diary.
Hours before the roommates woke to shuffle off to class, my boyfriend drove me to the pharmacy. I bought three pregnancy tests for good measure. I peed out a negative. The attacks of nausea persisted, soon leading to pains that would break open my right side with an invisible shiv, then swiftly retreat. Over the following weeks, I lost my ability to stomach frozen pizza and box-mix brownies, and my diet moved toward hard liquor and liquid sugar. I was not pregnant, but I felt something inside me alive and howling.
This was 2005, and as a college sophomore and a hypochondriac since puberty, I learned to take my visits to Dr. Google to the next level. Swinging between starving and nauseated, I haunted WebMd and PubMed until my symptoms and family history locked into perfect alignment. Nothing sounded more elegant than porcelain gallbladder. I said cholecystitis over and over, as though a hidden door would slide open and show me a new world of hurt that was a cold, clinical alternate dimension. My own world had flipped from bright to hostile halfway through sophomore year, when my campus turned from brochure-bright to haunted. My bones felt rocked by the constant thuds of big university life: basketball-inspired couch-burning, rabid chants of obscenities upon every Maryland win or loss to Duke, and rows of Mid-Atlantic brick behind unwelcoming white columns. Rage, joy, and thirst seemed to have been written into the college’s charter. There was a time when I saw none of that—when my school was a place for learning.
My mother, a nurse at the county hospital back home, made the arrangements I requested while I kept my focus, as usual, on my grade point average. I traveled home to New Jersey to visit a surgeon. I told him my guts were tangled. By his order, a radiologist shot me up. When I asked about what I was going to feel, she told me, you may experience the same discomfort that brought you to your physician.
Cholecystokinin, meant to send my gallbladder into a panic, spread everywhere, from the crook of my elbow to my eyeballs. A radioactive tracer chemical collected in my liver to light up my hepatobiliary system under the gaze of the gamma camera. Will this stuff make me a superhero? I wanted to know. I needed protective powers of all kinds—self-defense and then some. She wouldn’t answer. Soon enough, I only wanted to save my own gut, empty my veins onto the gray floor. As my gallbladder seized, wrapped by the atomic-radiated python, clenching with ten times its normal strength, I implored the snake, Kill me, kill me here.
I knew the flesh was dead inside me before I had to be told. The surgeon summoned me back to his den. He said that I had no stones, but the organ had ceased to function. He gave it to me in brief, wasting no words: the gallbladder’s job was to release bile into the duodenum as food passed by, emulsifying lipids, but it had gone kaput. He could take it out, the liver’s bile ducts would enlarge, the liver would take over the gallbladder’s job, and everything would be beautiful. There was almost no chance that open surgery would be needed, as the whole shebang would be laparoscopic. There was a ten percent chance it wouldn’t work out. Meaning, what?—my mom wanted to know. I don’t remember what he said—something abstract, I think, about the bile ducts being unable to enlarge to compensate for the loss. I only know that his words weren’t gruesome enough to stop me from telling him that I needed him to cut it out of me.
While I waited to be opened at the end of 2005, some of my college friends mused that nobody really needs a gallbladder anyway. Others asked if I could get a transplant.
Things I don’t need: my kitchen; my eyeglasses; my hands; my lips. I puked thin green chemical spills. I convinced myself that I could live like the saints I venerated throughout my Catholic upbringing: the self-flagellators, the hairshirt enthusiasts, the starvation devotees. I ate nothing but Cheerios and soy milk, read every food label, consumed no fat for weeks. Kill me, kill me here.
As finals week approached, students began leaving their customary offerings to Testudo the terrapin, the bronze idol of our mascot that lives on a pedestal outside the library. The gifts have become more elaborate in recent years, but back then, standard offerings were coins, flowers, votive candles, pints of booze, to-go coffee. I left nothing. I wouldn’t even rub his nose for luck when I passed, the standard turtle greeting. I didn’t want luck, a purposeless force shaping my life without my control. I wanted to put my hands into my own works, broken by the unknown forces of illness and the known force of another person’s venom, and finally set myself right.
The person close to me who had no gallbladder told me not to go through with the surgery. “If I had to do it all over again, I don’t know if I would,” he said. I don’t even remember what else he said, because I couldn’t listen: all I wanted was to be sliced open so that the thing rotting deep inside me could be snipped out. I wanted my innards to be scrubbed clean with antimicrobials. I wanted the team to give me a brand new body. I wanted to tear open the cellophane and start over on my life. I must have told him that I was going to go through with it, because I did.
Right after Christmas, at age twenty-one, I put on a gown, asked for an IV in the back of my fist instead of my perpetually bruised fencing arm, and faced the knife. Nobody told me, in dramatic cinematic fashion, that I could back out anytime. I was Hibiclens-clean, properly foodless, and eager. The dream team was ready for the minor abdominal surgery that would be easier to my surgeon than an application of eyeliner was for me. Right before I went out, as I entered the bright operating theater, I thought, They will take off these clothes they gave me, and then they will open me, and I won’t even know if I die naked.
The women watching over me in the post-op recovery room wanted numbers. Seven, I yelled. Seven, again. I’m sorry, I cried. Seven. They said they’d hit the morphine ceiling. I had no eyeglasses. They silenced me with Demerol. Finally, my frontal lobe had been overtaken.
In the bed they said was mine, I was more nauseous than I knew I could be. My gut looked like an alien pregnancy, big but not happy, marked by four tiny cuts. The nurse called them stab wounds: a hole for the camera, a hole for inflation, a hole for snipping, a hole for yanking out the thing. She said that when they were trying to get the gallbladder out of that tiny hole, my belly would have been stretched so far away from my body it was like a cartoon.
The nurse said I could only leave after peeing, which took half the day. My mom sat with me in the bathroom while I tried to get empty. I went two drops and Mom made the announcement.
I was told not to fence for a month. While the morphine nausea persisted, Mom read me short stories and I hid from the light; after the drug wore off and I beat at the throbbing with vicodin, I busted the stitches on one of my stab wounds as I slipped off the couch after a fallen saltine while watching a 24-hour marathon of 24.
I thought about the flaws in my fencing game, picturing my broken body vertical, functional, flexible. I thought about my sweet boyfriend back in College Park, waiting for me to come back and play house. I spent a lot of time with my laptop sitting hot on my stab wounds as I Googled words I’d been afraid to look at for a year: post traumatic stress rape trauma date rape acquaintance rape college rape statistics denial. My stab wounds began closing over, starting with the smallest one, while the two longer lines refused to swallow their stitches. I couldn’t eat without feeling my insides sloughing off. Was it normal to hand in nausea and receive the runs in return? The photocopies from the hospital said nothing about it—I had been instructed not to make any important business or personal decisions for 24 hours following surgery, not to engage in sports until my physician gave permission. In bold capital letters, I had been told to make arrangements for someone to stay with me for the first night. I had not been told about the achy sojourns between toilet and couch, my incisions screaming. Creeping my way up the stairs, I worried that wide gashes would be torn across my punctured abdominals. At my destination, I’d remember that my wounds were buried deep: my liver sobbed over its loss.
My surgeon was inaccessible during an extended European vacation, so I saw the primary care doctor who had told me, before I left for college, to be careful with my virginity—what would my future children think about a mom who had slept with a bunch of guys? Now, she told me my only recourse was Imodium AD. Until when? I wanted to know. This wasn’t a cure, she told me. This was a treatment: two with food, as long as symptoms persist. How long would symptoms persist? Well—how long did I expect to be gallbladderless?
What’s worse: nausea or the shits? Going to work or being bedridden? Having an organ never work again or never getting it back? A heart full of fear of the imagined first time having sex or a head wracked by memory of the known experience?
After three weeks on the couch, I went back to school. No surgeon was around to tell me not to fence, so I took up my epee a month after surgery; I traveled to a regional tournament, got wasted on Smirnoff Ice in the hotel room, woke up still drunk, stuffed my bloated body into my stiff white knickers and jacket, and fenced all day. By evening, I had my first fencing medal, and my topmost stab wound was losing the ends of its stitches as my overworked abdominals groaned. I accepted my shiny disc, dosed myself with vicodin, and curled up among the gear against the wall. During the dark bus ride back to Maryland, my teammates played “Never have I ever,” increasingly scandalous secrets about sexual dalliances coming out at every turn, while I sanded down my brain with pills and told them nothing.
I didn’t notice that my brain was spoiling. It just started getting mean.
I was standing on the subway platform one day, commuting home from work, when I realized that I had been raped that year before, by that boy who had first penetrated me. My heart was a train and it plowed through my head.
I called the campus peer counseling and crisis line and a grown man answered. I told him I thought I had been raped approximately one year ago, by a boy I was just beginning to date, and he said that in his professional experience, women who are raped or sexually assaulted are usually beaten within an inch of their lives, usually have their clothes torn off, usually they’re in pretty bad and bloody shape. I hung up and tried to eat my own mouth so it wouldn’t tell anyone else what I’d divulged.
I began showering at least twice a day. I showered whenever my insides shed while I cried on porcelain, begging kill me, kill me now, a secret held more deeply than any other, because no college student can ever tell the authorities that she wants to die, even if it’s not a true wish to die, but a wish to be physically reborn with new guts, new skin, new hymen stretched like a tarp, like a whip.
I don’t know what lobe of my brain said it, but someone inside my head told my boyfriend, “I need to know what it’s like to be with other people,” and he said he didn’t want to lose me. At the moment of crisis, my boyfriend coming in through the window and my heart flaccid, I knew that, despite the sad scene I had set up so I might rewrite my memory, another boy’s small hand was not the body part I was missing.
I developed a fixation upon a slightly younger boy who had no intention of dating me, preferred World of Warcraft over sex, and hadn’t dropped his baby fat. I left the boyfriend with whom I had psychic conversations and built love forts. I still didn’t eat. My back was the back of my bony fist and I wanted to curl up and bloody the face of the world.
I sat down with my surgeon and told him about the runs. He told me he wished I would’ve come in sooner. This thing had a name, postcholecystectomy syndrome, and if he could name it, he could smite it. He prescribed packets of Questran, a bile acid sequestrant once used to treat hypercholesterolemia, for my bile acid malabsoroption. How long will I have to take this? I asked. It’s cheap, he said. Mixed in some water, you can barely taste it.
Postcholecystectomy syndrome is the name for a bundle of symptoms after surgery, either a continuation of the pre-operative symptoms or the development of new ones. The problems are caused by changes in bile flow into the GI tract.
PCS is found in 5-30% of patients, with 10-15% being the most reasonable range. [. . .]
If the procedure is performed for stones, 10-25% of patients develop PCS. If no stones are present, 29% of patients develop PCS. [. . .]
Freud found age and sex differences.Patients aged 20-29 years had an incidence of 43%; those aged 30-39 years, 27%; 40-49 years, 21%; 50-59 years, 26%; and, 60-69 years, 31%. Patients older than 70 years did not develop PCS. Females had a 28% incidence of PCS, and males had a 15% incidence. [. . .]
Note that half of patients with a preoperative psychiatric disorder have an organic cause of PCS, whereas only 23% of patients without a psychiatric disorder have an organic cause. [SOURCE]
I became certain that I was addicted to love, or romance, or attention, or crushes, or being around magnetic people, or not going to work. My boss at my part-time federal government job said, “You had a major organ taken out. That’s a big adjustment for your brain.” I used all my sick days. I quit the job. I started working all night at the 24-hour service desk in the apartment lobby and then went home and drank alone.
One day, walking in my high heels to the liquor store in the suspended sweat of a Maryland summer, I realized that I might be one of those girls in the glossy magazines—not the ones with concave bellies and hips like dolphin backs, but the ones whose brains are horror stories, cautionary tales about the brinkwomanship of pressing against the edge of institutionalization.
I cut off all my hair. Then I did it again and again and again, daring someone to want me without it.
Until my boss mentioned the connection between my gallbladder and brain, I hadn’t thought they were related. Bipolar disorder may be associated with immune system dysfunction and pro-inflammatory cytokines, though results in individual studies are conflicted, according to a recent meta-analysis. Cholecystectomy has been found to result in cytokine release. I’m not a scientist; I’m a writer. I can’t prove that, when my surgeon cut into my gut, a phantom twin scalpel scored my brain. But the connection between the gut and the brain is coming into clear focus, and I know that when the surgeon took my gallbladder, he performed a lobotomy of the belly.
At the beginning of senior year, in 2006, I saw a psychiatrist at the university health center. According to my questionnaire responses, he found me depressed and prescribed Lexapro. Over the next few months, I would get all the drugs whose names had titillated me as a straight-edge kid in New Jersey: Wellbutrin, Ritalin, Ativan, lithium, and others I’d never heard of. I would break out in a rash signaling a potentially fatal reaction. I would get so depressed my doctor would write notes requesting assignment extensions. I would get so manic I would leap on my bed and think my ribs were god’s xylophone. Almost every day, I drank beer or Grey Goose screwdrivers. When the scale reported the number that was, by BMI, underweight for my height, I jumped up and down.
I gained forty pounds after moving to Seattle and going on a new antipsychotic drug. I would’ve tried to yank all my flesh off my body if the mania hadn’t been sanded down by the Seroquel and the depression by the intense endorphins of all the avocado-hummus-provolone sandwiches I was eating. Seroquel is thought to cause insulin resistance. My new doctor didn’t tell me that; she told me it would be a good drug, and it has been. Years later, she added Topamax, and twenty pounds dropped off. I figured out, through paleo—thank you, Level 4 CrossFit Seattle and Dave Werner—that I had celiac disease, and once I cut out gluten, the diarrhea stopped. Just like that.
The crazy never stopped. I found the right medication cocktail and got better at letting my hair grow out, but I’ll always be bipolar. I’ve seen practitioners who suggest I consider going off my meds. I think about the old days when I’d sit on a pile of high heels in my closet, wondering if I could get away with never coming out again, hoping if I starved for long enough my exhausted hepatobiliary system might reset and sprout new buds, wishing I could tweeze the pain from my skull. None of that happened. I spent seven medicated years writing a book about my body and my brain, and the regular wringing-out mechanism wore out every nerve until the shock of my brain’s tangle had worn off. I wrote the word rape, once as off-limits as a secret password, until it didn’t look like a word anymore, and rebuilt it as something I could begin to understand.
The only thing to do is find the wound and rub in the salve.
There’s a lot of talk in the paleo community about the over-prescription of psych drugs, but my meds keep me functional. Maybe I wasn’t born broken, but I’ve been broken into, and someone walked away with my treasures. There is too much at stake to try to disavow the chemicals that have patched my world back together. I hear, too often, that we should all be able to mend ourselves with the right food, the right movement, and sunshine. It’s easy to tell people they don’t need drugs when you don’t know what it’s like to need drugs, to wander around all night hoping you’ll find the end of the earth, to pummel the floor with another panic attack, to self-medicate with another handle of vodka because the right medication still hasn’t appeared. Maybe I could find the right combination of foods and movements that could replace the meds, but I could lose my mind while searching. This much is irreversible: I needed to get some dense nodule of hurt out of me, and so I agreed to that surgeon’s swift medicine and made wreckage of myself. I am no longer the intact human who arrived on this earth in 1984. I will do what I need to keep my brain from taking me down.
My moods are fairly stable now, the bipolar peaks and valleys having been evened out by medication and good practices. I still have a fat gut on my skinny, flamingo-legged frame. I still have keratosis pilaris—chicken skin—on my upper arms and thighs, signaling possible nutrient absorption problems. A couple of years into paleo, I developed dramatic cystic acne that comes and goes, seemingly related to a mysterious family of food intolerances (possibly, it seems, as broad as all salicylates). I have other symptoms. I still have a gut feeling that I am a destruction site, and now, it’s informed by too much knowledge: bad choices, genetic mutations. Regularly, I take 5-MTHF, fermented cod liver oil, offal, chicken foot broth, gelatin, butyrate, l-glutamine, ox bile, and so many other talismans to charm the snakes inside me. The most terrifying part is that nobody really seems to know how to make my snakes sleep—I try and I err and I eliminate foods until almost nothing remains. Humans are resilient, but we are not unbreakable, and the mending process is consuming me.
Almost ten years have passed since I was raped in my campus apartment by a boy who had my consent for kissing, for more than kissing, but not for the breaking of an emotional seal I feared more than anything: first-time sex. I suppose I could say I have “healed” in that I no longer act out in direct response to my tangled emotions. But it’s hard to say I’ll ever really get over being raped when I know I had my gut mutilated because I wanted to scalpel out my own crawling brain, my own dark heart. I thought I loved my illness, once it arrived. But in truth, I loved that it gave me the power to point to a part of myself and order its execution.
Last week, my friends and I went to the mystical bookstore. I don’t usually go for the new age stuff, being an actual Native person, but I like a good field trip. I went right for the table covered in stones: pink stones, green stones, crystals, stones with high polish. While Claire examined the pendulums, Catherine read from a book about the stones that could give me power, the stones that could heal me. I found a strand for my left wrist, a strand for my right, and a ring. This stone provides energy and protects from bad vibrations; this stone makes one invincible in battle. I know, in truth, as I put my hands into these stones, that they move nothing but my mind. Maybe, now, I need to stop shunning luck, start rubbing the terrapin’s nose and asking for intercession. I am tired. Keep my tissues untouched. Give me no other cure.
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