There is reverence in the air and the sweet sound of jazz softly playing in the background as I sit here, perched on my stool.
I sense that what’s about to tumble out may not be easy for me to write about and publish. Maybe taking this pause will help me to fully acknowledge that I’m about to humbly offer up this experience from a place of absolute and unconditional love to myself, to you, to all women who desire to mother in some way. This kind of deep and searing feminine suffering is so rarely written about at length. Allow my story to hold you in whichever way you need, if only to let you know that you are not alone.
Although, in total honesty, years ago when my priority was competing, modeling, and keeping my body in tip-top shape, the last thing on my mind was breeding. I have played the ‘strong, independent, tough’ game my whole life—much to my detriment. I have spent the better part of my late twenties attempting to remember, at every corner, to soften. In deepening my relationship with myself, my attention shifted away from the world out there, and towards what I was feeling within.
Recently, I began suffering from unrelenting pelvic pain with a mind of its own; sometimes radiating to my abdomen, other times, my chest and left shoulder blade. This aroused my suspicion, as I had just finished my menstrual cycle—automatically disqualifying menstrual cramps and ovulation discomfort as a possible cause. I had my annual gynecological exam earlier this year, spanning the gamut: all normal.
There was still one low-hanging fruit I could reach for before my mind would default to fear first, think later: Ruptured ovarian cysts. I’ve had my fair share of ovarian cysts over the last couple of years, with at least one rupture I can remember vividly: It felt like my uterus was being stabbed repeatedly. Seemed consistent. Next stop: Transvaginal ultrasound. I didn’t want to discount the fact that the pain was radiating to other areas of my body, so I decided it would be best to see my primary care physician.
When I learned that he was on vacation, I went to a walk-in clinic. It’s always awkward when you find yourself in the care of some random stranger for the very first time, except he or she is about to know everything about you. We went through the motions.
Allergies? No, though there was this one time I was temporarily allergic to shrimp…
Surgeries? Yup, even have an entire organ absent as a result.
Medications? Multi, when I can remember.
Any health conditions? No.
That last question would’ve been an appropriate time to insert my history with eating disorders, but shame crept in. Most doctors just don’t get eating disorders. Nearly 80 percent of providers surveyed by the Alliance for Eating Disorders Awareness admitted that they do not feel they are adequately informed to identify and diagnose eating disorders. Although several major health conditions can be linked to a person’s diet, most American physicians don’t get much schooling in nutrition, either, so they will promote the notion that an individual’s weight is somehow indicative of their health.
Take it from someone who sat at a competitive 16% body fat percentage during her off-season and squatted almost twice her body weight. Weight—and more importantly, body composition—doesn’t tell even a sliver of the story when you’re in the throes of an eating disorder.
On the opposite end of the spectrum are physicians who understand the dry specifics, but are too clinical in their approach. It is easy to pathologize the experiences of patients with eating disorders because you’re spared the difficulty of testing their developmental, social, political, and economic contexts.
Eating disorders are, by and large, rooted in implicit learnings. Learnings formed in the presence of intense emotion form neural circuits in implicit memory that are exceptionally durable. The brain is working as evolution intended when, decades after the formation of an emotional memory, this tacit knowledge is triggered in response to current perceptual cues and launches behaviors and emotions according to the original adaptive learning. Whether this knowledge is objectively true or not is irrelevant; it only has to feel true to the individual.
Such faithful retriggering is, in fact, proper functioning of the brain’s emotional learning centers, not a faulty condition or dysregulation—unless you’re prepared to say that it is a dysregulation of evolution itself, not of the individual. For better or for worse, they are a survival-positive result of natural selection.
Emotional learnings contain implicit master constructs that define a dire suffering that is urgent to avoid (unmet emotional needs, feelings of defectiveness or shame, etc). The other constructs define the patient’s solution to that problem—a particular strategy or tactic that is compellingly necessary and purposeful to avoid that suffering.
Calorie restriction and overeating are, therefore, functional symptoms that are reinforced by the inevitable by-product or unintended consequence of the functional symptom, which is functionless by nature. By-products of dieting and overeating include cravings, hypervigilance around food, disconnection from hunger and satiety cues, and so on. Targeting the master construct, which acts as a scaffolding for the individual’s mental model of the world and how it works, is how we dissolve subordinate constructs in the cluster.
In bumping into the greater misery—the misery encountered by not having the ED-related symptom—you essentially awaken to an existential dilemma that has been largely unconscious and buried underneath the need to regulate your weight. This is what it means to arrive at the symptom’s emotional truth. Such exhaustive retrieval work cannot be accomplished during a 15-minute visit to the doctor.
I bring my awareness back to the present moment. “Ms. Laurent, your vitals are normal, and you do not have a fever. Please lay down.”
The doctor began by listening for bowel sounds, then rubbed his hands together, warming them up before placing his left hand firmly against my abdominal wall. I felt vulnerable and exposed. His percussion did not produce any significant pain.
“I’m going to send a medication to relieve symptoms in the gastrointestinal tract and a muscle relaxant. I will order an ultrasound, and we’ll take it from there.”
The next day, I was lying spread-eagle on the examining table—feet in stirrups, body wrapped in a paper gown, and a transducer three inches into my vaginal canal. We’ve been here before, I thought to myself, but this time feels different. I needed some sort of assurance that this was a ruptured cyst because, according to Google, I had ovarian cancer with a prognosis of five years, at best.
I touched my tummy and closed my eyes. I was having a Sliding Doors moment, in awe at our capacity, as women, to carry all things simultaneously. I experienced an assortment of emotions bouncing around inside of me—just as the sound waves were bouncing off my internal organs, transmitting images of my pelvis onto a monitor. The most painful question I found my mind returning to, is: What if my fertility is compromised? It was a question too difficult to contemplate.
The ultrasound was unremarkable.
I normally bleed with the full moon.
Breasts, tender. Belly, bloated.
Life, suspended in the longest of moments.
What was going on in there?
I dug my heels in deeper. I needed fucking answers.
At the same time, It was like I had plunged into a dark, melancholic abyss. My mind was fragmented and my heart was heavy and my bones were brittle, and there was no one in there but me. I bellowed for a name, for someone to acknowledge me—but the words could not escape my lips. My womb contracted, and the darkness blackened evermore.
During a follow-up visit, a stat CT scan of the abdomen and pelvis—with contrast—was ordered.
I arrived at Lenox Hill Radiology the next day, after leapfrogging over the bureaucratic obstacles and red tape involved with approvals for advanced imaging. I only had one CT scan prior to this, and it was to check for internal bleeding or blood accumulation in my brain after falling off a horse. Fun times.
I spent the next two hours drinking 1.5 liters of barium sulfate, a contrast agent that works by coating the inside of your gastrointestinal tract, which allows them to be seen more clearly on a CT scan.
I brought reading material with me, but that was eclipsed by the Chris Watts triple-murder audiotape confession and news that House Democrats were demanding documents from 81 Trump associates. Needless to say, the time passed quickly.
When my name was called, I was asked a few redundant questions, briefed on what to expect, and asked to change into one of those unsightly hospital gowns.
There are few curses worse than needing an IV insertion and having shitty veins—veins that run deep or play Houdini by simply disappearing. Such are the veins in the crooks of my elbows (my dad has this problem, too).
Here I am, lying on this motorized examination table, thinking: This could take a while. The actual procedure of locating and accessing a vein has not changed much in the last 200 years. Smacking, slapping, flicking and tapping the vein, as well as the tourniquet, are still used. These techniques generally do not work on me.
“You may have better luck with the left arm,” I said pointedly.
“Naw, I’ll find it.”
Ah. Okay. The ego is kicking in.
Ten minutes pass. He asks me to excessively pump my fist, demonstrating with his own.
That’s not going to help, I thought.
Every hospital or test center has that person who’s a ninja at sticking veins. Would it be rude of me to ask the technician to find me that individual?
He tries to engage me in conversation to distract.
“You know, I’m actually pretty new to this—”
“At my previous job, the CT Tech didn’t, like, mess with needles and stuff; someone else did that. I had to learn how to do that when I came here.”
I smiled awkwardly at his matter-of-factness, bit my lip, and clutched the side of the table with my left hand.
An additional three minutes pass.
“Okay, I think I found it. Wish me luck,” he said enthusiastically.
Once we were in the clear, he did a saline flush before delivering the iodinated contrast solution. This improves the image quality by highlighting certain structures, such as arteries, blood vessels, and vascular organs, such as the spleen, liver, pancreas, and kidneys.
As soon as the contrast solution hit my bloodstream, I felt like my entire body was on fire. Not in a painful way, but more like an out-of-body experience. About thirty seconds later, a metallic taste in my mouth followed. The actual scan time was only about 15 minutes, but the preparation and discharge—including time spent waiting for the images to be sent to the doctor to ensure they are readable—took about four and a half hours.
Later that day, the doctor called.
“Ms. Laurent, do you have a few moments to go over the results of your CT scan?”
I knew that this could potentially reveal incidental findings that had nothing to do with my pelvic pain, but the only thing I could think about was my reproductive organs.
“Yeah, just give me a sec,” I replied casually. I took a seat… and a deep breath.
“Okay, yeah, go ahead, doc.”
“So, Ms. Laurent, I have some good news and some bad news. The good news is the CT scan was unremarkable. The bad news is I don’t have any explanation for why you’re having this pain. Your liver is of normal size, shape, and contour. We did see that your gallbladder is surgically absent and that your bile ducts are within normal limits. Your pancreas, spleen, and adrenal glands are also within normal limits; your kidneys are normal in size, shape, and position. Your urinary bladder and small and large bowel are unremarka—”
“My uterus, doc? What about my uterus? My ovaries?” I said, increasingly frustrated. I should have been relieved. What the fuck was wrong with me?
“Yep, I mean—there’s no there there, ya know? Both ovaries and your uterus are unremarkable and normal in size. You are perfectly healthy, Ms. Laurent, and after reviewing your ultrasound results, too, you are perfectly poised for motherhood.”
Motherhood. A few pleasantries were exchanged about my gallbladder surgery some twelve years ago, and we ended our call.
From the gorp of my tenderized body, I felt wings press into these walls: My wings. From crevices of rock and of rotten stumps of trees, sprung clarity: There were still things I was carrying that I needed to release, in order to create space for carrying, and giving life to, what matters.
And I remembered that even chocolate moths, with their rich brown, slender beige stripes and lacy fringes, winged wonders like me.
And I remembered that if I were never that tender—if I could not feel so intensely—then this metamorphosis, too, would have eluded me.
Dis-ease in the body, in the absence of a clinical explanation, requires that we start exploring influence, relationships, and the decrowning of our sovereignty.
I talk a lot about the brain, but the body is a powerful indicator of our implicit knowings. If they have largely remained outside of your conscious awareness, as they so often do, the body will reveal them.
Where might we be relinquishing our power? What might we be resisting? How do we navigate relationships in our lives when we know—on some level, if not viscerally—that they are a functionless by-product, serenading us and then putting us to sleep?
It’s time to awaken from our slumber.
Because the body keeps score.
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