Ask Me About My Uterus Read online

  I’d recently acquired all of my medical records—in part because I was trying to be certain that the piles of medical bills I had were all accurate—and in the process, I began to reopen the emotional wound of leaving Sarah Lawrence. This particular night, I was in the living room at his parents’ house, chatting absently with Maggie after dinner. She innocently inquired about my health, not realizing the Pandora’s Box she’d opened.

  Despite the fact that I hadn’t known her that long, something let go inside of me. I told her the whole gruesome story—more than I’d told Max at that point. To my horror, as I flipped through page after page after page of medical records, I started to heave with tears. Immediately embarrassed, I tried to gather myself—and my paperwork—so that I could retreat upstairs. I didn’t want to make her uncomfortable. I also wasn’t quite ready for Max, let alone his whole family, to know what a goddamn nightmare I really was.

  She rose from her chair and I felt a pang of hurt and shame, thinking she was getting up to leave because of my display of emotion. Instead, she came over to the couch and wrapped me up in a hug. At first I didn’t know what to do. I hadn’t been hugged very much, certainly never held, during the years of my young life where most people learn how to give and receive physical affection. If I experienced physical affection at all, it was a brief “there, there” type of hug, where the other person would rapidly pat my back to signal that we’d touched for long enough and it was time to disengage. That wasn’t what Maggie was offering, though. She had fully embraced me such that my head was beneath her chin, my tears staining her very nice, sweet-smelling sweater.

  She didn’t say a word. She didn’t chide me or dismiss me with a “Now that’s quite enough of that,” pat-pat-pat on the shoulder. She let me cry until my whole body was numb. Other than the sound of my own sniffling, the room fell into such a hush that I could hear her heart beating against my ear. Though fear and anguish had risen up in me, there was something incredibly tranquil in that moment. I calmed, and expected the “there, there” dismissal to be issued, but she only waited. When my tears cycled up again, she held on as though it were the most obvious response. As though it were the only response. As though it were something that humans knew, instinctively, to do.

  At some point, a more ancient grief welled up and began to flood me. A deeply buried, nascent part of me could have stayed on that couch for eternity, and was petrified by the prospect of being released back into the wild.

  But the more mature, cerebral—and at times, callous—part of me resented that I’d even let it happen. That I had let my emotions overcome me when my ability to compartmentalize had long been my most remunerative asset. I was alternatively humiliated by the enormity of my need for comfort and heartsick thinking about how little of it I had experienced in my young life. At least in the way that Max’s mother was providing it.

  That all being said, it felt nice when Max held me, too. I felt small and somewhat effeminately delicate in his strong caveman arms. My evolutionary instincts were satisfied that he could build me a hut, if required. For this very primal reason, being held by Max—or any man—felt very distinct from the more gestational embrace of a woman.

  With Max, being held was pleasant but not exactly calming. It felt good to be close to him because I was attracted to him and aroused by him. Having his arms around me, in other words, was a nice feeling, but one that invariably led to, “Okay, now let me suck your dick.” It was the “hurts so good” intensity of attraction. His embrace was molecularly energizing.

  I’ve had strange moments throughout my life where it feels as though I am expanding infinitely out into the universe, as though every double helix of my DNA were unfurling. It felt like every atom of my body was being drawn back to the cosmos by some unseen force, and was trying to return to whatever star I came from. In these moments, I find myself desperately wanting to be held. But more than held—stilled.

  Physical closeness with a man (sometimes as little as proximity—touching isn’t strictly necessary) inspires sexual stirrings in me because I’m straight. At least that’s what I assume. I’ve never been stirred in that sexual way by physical closeness to a woman. Inspired to sob uncontrollably for no discernible reason, yes, but not sexually aroused. Not that I would have minded if I had been, of course, they’ve just always felt like two distinct phenomena to me.

  In my situation, being straight has probably simplified the process of parsing unmet emotional yearnings from other instigators of intimacy. If I’d been physically yearning for women—emotionally and sexually—I think it would have been incredibly challenging to examine and isolate the various threads of meaning within those experiences. Certainly there have been women in my life who have interpreted the mighty need I have for their affection to be sexual. I suspect because they have never felt the touch-hunger of a mother-starved child. The women I’ve met who have known that yearning immediately know what I’m talking about, and they, too, regard it as being fundamentally different, and separate from, their sexuality. I doubt it even exists on the same plane of consciousness as sexual desire. Freud would disagree—but who asked him?

  This separateness is evidenced by two important points: first, although I am not always aware of my mother-yearning in the moment—only realizing in retrospect that I was inexplicably, emotionally upset by the presence of a woman—I am always aware of my sexuality when I’m engaged with a man. True, sometimes when a man is trying to flirt with me, I don’t realize it. But that has more to do with my self-esteem than my perceptive abilities. Sexual attraction is glaringly obvious and easy to understand in the face of a more subtle, pernicious, and at times smothering need for the love of a parent.

  Humans have, for millennia, pursued the arc of falling in love and being sexual creatures. Even when we get burned by love, we keep on looking for a match. We strike until we hit a spark; we move through space seeking that blissful friction of attraction. We rally for it, we race straight into it and leap, we dive, we plunge into love because even when it hurts, it’s good. And when it’s good? Oh, it is so truly, madly, deeply good.

  The exhaustive quest for mother-love is nothing like that. It never feels good. We can understand why people want to fall in love again, why a sexual craving is enough to splinter the mind from its conscience. We’re biologically hardwired to find a mate, but we’re not born prepared to spend our lives yearning for a mother. We’re supposed to be born and nurtured throughout our young lives so that we can live long enough to fulfill our sociobiological prophecy to fornicate, propagate, and spoil The Walking Dead for our coworkers.

  There is no wiring, no sympathetic nervous system or empathetic external system that exists to help us out beyond the initial survival of maternal neglect. Technically, evolution dictates that if the baby doesn’t bond to the mother or caregiver, it dies. It’s actually extremely cut-and-dried, there’s no subtlety here. It’s beyond being fed and given a place to sleep. Do I really need to bring up Harry Harlow’s monkeys again? Because I will.

  LATER, WHEN EVERYTHING BEGAN TO unravel, the prospect of losing Max became greater than losing the man I loved. It was losing an entire family that loved me.

  In the face of uncertainty, of true challenges and disappointing realities, love is sometimes not enough. The years I spent with Max were largely happy ones. We traveled together, went sailing, were often stopped on the street by complete strangers who said seeing two people so in love had brightened their day. And we were in love. But it wasn’t enough. I wasn’t enough.

  I came to understand that sex would always hurt for me, and that therefore I probably wouldn’t be having much of it. While this never seemed to get a rise out of any doctor when I fretted over it, once I started taking Max with me to appointments, and he corroborated—or better yet, expressed his own frustration—suddenly it seemed like doctors started to listen. I was extremely peeved to have made this observation. It either meant that they hadn’t believed me in the absence of Max as an alibi, o
r that they had believed me, but my suffering alone wasn’t enough to inspire action. Becoming a disappointment to a man, though, seemed to do the trick.

  Max in tow, I went back to Dr. Paulson. Now that they knew I couldn’t put out like a woman should, they seemed to have an abundance of suggestions. I tried birth control. I got an IUD. I did pelvic-floor physical therapy until it became too excruciating to continue. I have, in the name of pain management, had a varied assortment of objects inserted into my vagina: hands, garlic cloves, polished stone, colorful plastic “expanders” that are actually just medical-grade dildos, slick transducers and icy speculums, catheters, swabs, scalpels, and gauze. I saw homeopaths and naturopaths and took all kinds of tinctures and pill-pods. I drank raspberry tea until I could no longer stand the smell of it. I tried castor oil packs, I tried TENs units (that is, transcutaneous electrical nerve stimulation), and I held electric heating pads against my bare skin until they burned me. I lived in, and for, hot bathwater.

  The gynecologists told us to try different positions, angles, and speeds, though I’d insisted that we’d already done that and would have thought that was obvious. We were a pair of virile twenty-somethings, so how did they not assume we had already repurposed every surface of our home and several undisclosed public locales for the express purpose of our mutual sexual gratification? I’d been sneaking peeks at Cosmopolitan since at least the age of thirteen, and Max had no doubt been a connoisseur of Internet pornography for years, since all ’90s kids learned the hard way that White House Dot Com would not help us with our history reports.

  Beyond that, I was dubious that sexual positions with names like “The Viennese Oyster” or “Alligator Fuckhouse” were going to solve the issue of painful sex. The latter sounded more likely to cause it.

  Was I lubricated enough? They’d always ask this. I couldn’t have been more lubricated. But I wasn’t sure how to prove that to them. I have to say, of all the issues I’ve had gynecologically, wetness has never been one of them. I wish I could be proud of that fact, but it’s proven a major impediment. It only stood to obfuscate the pain I experienced and somehow invalidated my claims of discomfort.

  When it came to the pain, I had a difficult time articulating that it wasn’t at the opening of my vagina, which was what doctors usually thought when I said “sex hurts.” Vaginismus is very real: it’s a condition where the vaginal wall and opening contract involuntarily to prevent penetration. Despite the fact that anecdotal evidence suggests it’s fairly common, it has not been well studied. This was not where or why sex hurt for me—at least not when it started. Over time, my body did attempt, however, to involuntarily guard against the pain it came to expect—pain that would resound in my pelvis during coitus—and eventually that meant I stopped getting to the point of penetrative sex at all.

  The pain emanating from my pelvis was much deeper than the pain women get with vaginismus; it came from somewhere that seemed to me to be so deep as to be untouchable. It was heavy, full, aching. There was almost a soreness to it, like a tender bruise, but on the inside. The rhythm of penetration made what had become a constant, dull pain every day into a momentary swell of intense, staggering, asphyxiating pain. I buried my face in the pillow and waited for sex to feel like something I’d risk my life for. At first, I swallowed down the yelps, gritting my teeth against the sensation of my organs being ripped away from the pelvic wall, or torn up like plants by the stalk. Roots that I had put down with Max. Though I had been afraid at first, I had come to feel secured by them. Roots might trap and entangle, but they’re nice sometimes: when you’re grounded, not every gust of wind breaks your neck. Roots are also necessary for nourishment. For growth. So I braced myself against the pain of intercourse and told myself that growing hurt.

  Afterward, when I would go to the bathroom to wash up and there would be blood, and undulating waves of nausea, and an ache that spread down into my upper thighs, I told myself that this was just how sex was. It didn’t take very long for me to begin to dread sex altogether, despite the fact that I was madly in love with Max, very attracted to him, and certainly felt that I wanted to have sex with him. Over time, the anticipation of the pain made me reluctant. Max couldn’t help but take the rejection personally. How could he not? I was turning away from him. I was wincing at his touch.

  LESS THAN A MONTH AFTER Max and I moved back to the town where we’d first met, I got a job at a hospital. I was already familiar with its emergency room because of my own visits to it since leaving New York. There had been an opening in the medical records department, and the head of it took a chance and hired me. I am forever grateful to her for seeing something in a plucky, if not sickly, twenty-two-year-old girl with no college degree.

  People are often surprised to hear that I still worked, as sick as I was, but the simple truth was that I didn’t have a choice. I was in no position to be taken care of. What money I’d squirreled away had long run out, and the mounting medical debt was crushing. I couldn’t afford to be sick. I didn’t have the luxury of just healing.

  The fact that I got a job didn’t exactly lend any credibility to my assertions that I felt wretchedly ill. But beyond the simple fact that I had to earn money, I was desperate for my life to have something in it besides illness. It’s worth noting that the job I undertook didn’t ask much of me: I sat at a desk most of the day, had reasonable hours, plus paid vacation and sick days, and it was an elevator ride to the ER if things got particularly bad. I also did little else aside from work; there was no energy left for anything else, including things like cleaning house, having a social life, or putting effort into the relationship I was in—which I wanted to be in. I was just so tired that sleep was usually more attractive than anything else.

  Sometimes, well-meaning people point out to me that if I hadn’t had to work, if someone had taken care of me, if I could have properly recuperated the first time around, without having to worry about where I was going to live or pay my bills, maybe I wouldn’t have gotten so sick. I suppose that may be true, but it’s a slippery slope I’d rather not go down, because you could apply that logic to my entire life.

  Once, years ago, during a particularly harrowing session with Jane, she had studied me from across the room, from the sanctity of her wingback chair. “Imagine if we could have plucked you out of there, given you to a different family,” she mused. “With that mind of yours…” The rest of her thought hung suspended between us, and I hadn’t dared reach for it.

  My mind was about all I had left, so when I noticed that the hospital housed a small medical library, I took up residence whenever I could, purloining copies of journals to take back to my regular desk. Having access to medical journals would prove invaluable to me over the course of the next year. If my life was to be one of pain, I wanted to learn the best I could how to cope. More than that, I wanted to understand categorically what was causing it. Whatever it was, I wanted to be an expert in it.

  That had more or less been my modus operandi as a kid: when my brother was diagnosed with autism, I wanted to learn everything about autism. When I figured out my mother had bulimia, I wanted to know everything about bulimia. In the face of scary things, knowledge was always a comfort to me. No matter what the subject was, if I could find a book or two about it, I could squash any anxiety that it might provoke. As my heroine Scully once said, “The answers are there, you just have to know where to look.”

  Sitting at my desk going through back issues of the New England Journal of Medicine, I thought I knew where to look, but I didn’t find much about endometriosis. I understood what an ovarian cyst was, and why it happened, but endometriosis had always been only a partial answer in the back of my mind. Maybe it was a big deal, or maybe it wasn’t. What little I found about it in semi-outdated textbooks of gynecology wasn’t exactly informative.

  So I began to broaden my search. Day after day, I saw history and physicals—neatly transcribed in medical records—shuffle across my desk. I heard doctors murmuring in
the dictation room, saying words like “hyperlipidemia” and “angioederma,” but they floated through the office devoid of context. Medical terminology came easily to me, though. If I was processing a chart or sending off a surgical note and encountered a term I didn’t know, I’d write it down and spend my break trying to solve the puzzle of its origin. Learning the language of medicine truly is like learning another language altogether: the prefixes and suffixes, the Latin roots. Like any other language, it has its aphorisms, its slang, and its inside jokes.

  It occurred to me that even though I was no longer in college, no longer getting an education in the proper way, I was still learning. Probably more than I would have on any ivy-coated campus, really, because my motivation was beyond a degree at this point. I was trying to save my life.

  One of the first things I did was write up a very thorough History and Physical of myself—as though I were the doctor for a moment and not the patient. I typed it up neatly, using the same template any doctor would have, and threaded in all the proper terminology. Or what I knew of it, at least.

  HX OF PRESENT ILLNESS:

  Patient is a 22-year-old gravida 0 para 0 female who complains of persistent RLQ pain that began in the fall of 2010. Pt reports cyclic pelvic pain, heavy menstrual periods, chronic nausea, progressively worsening fatigue and muscle weakness. She has also had frequent bouts of swollen cervical and supraclavicular lymph nodes, which may not be clinically relevant. She reports RIGHT-sided abdominal pain, which she indicates is at McBurney’s Point, that is worsened by activity and sexual intercourse and not relieved with rest. Previous imaging studies did not reveal any indication of appendicitis.