Heartbreaking But Also Insane

On humor and hypochondria

It feels impossible to write anything right now—the heat, my hunger, the strange whoosh of effort that flows through my limbs when I move them. Due to a strange and painful and lengthy reaction to so much as a few sips of alcohol, I recently decided to adopt a very restrictive diet, which required me to stop drinking coffee a few days ago. I am trying to cleanse the histamines from my gut, which supposedly can build up and, depending on the overall health of one’s microbiome, cause a variety of symptoms, from chronic fatigue to digestive issues. Based on my internet research, it seems this will prove either the magic solution or complete quackery. I just want a beer.

It is, probably, always something. As a child, I was engulfed by a pervasive and foreboding sense of terror that I slowly learned to manage through avoidance and strict bedtime routines and frequent visits to the doctor (“manage” being a relative term). The fear was both externally and internally sourced, tending more toward the latter as I grew older—after all I was not wont to wander far into dark alleyways or anywhere alone, but the body was always capable of more erratic betrayals.

I measured time in ailments—months, years of a particular obsession. For a time in junior high I occasionally experienced a constriction in my throat—this lasted and lasted; I went to the doctor, I avoided common allergens, I breathed deeply in and out to make sure I could still do it. Then it was my heart—a strange pain or numbness in my left arm which had no explanation but the obvious one. Of course I understood it was unlikely I, at the age of 15, was having a heart attack, but logic did not assuage the sense that there was something deeply, catastrophically wrong—and even if there wasn’t, what if there was?

*

I am right now fretting about a pain in my back—is it my kidney? Or is it just muscular? At the doctor’s office this morning, I asked about it. I have asked this doctor and many others about my current alcohol-induced affliction, and no one seems particularly concerned—my blood tests were normal, I was sent on my way. I left angry, deflated yet again by the affectlessness of the healthcare industry, my 15-minute appointment window and $40 copay, and always the doubt induced by their dismissal—am I crazy? Have I made it all up?

But now I am sitting on the living room floor, all my furniture sold to strangers in preparation for my move, and of course I’m sure I haven’t. I worry instead that I didn’t articulate well enough the problem—how the dull ache I am experiencing now comes and goes but seems exacerbated by alcohol, how the rest of it—dizziness, brain fog, fatigue, headache, the inflamed pain in my gut—only occurs for long, slow days following a single glass of wine on a Friday evening. I’m quitting my plus-benefits job tomorrow, so I fear I won’t have another chance to try again anytime soon. So I will meticulously record my symptoms in preparation for some undetermined appointment, some imaginary physician to patiently ask all the right questions and look at me without looking through me.

I read a 2012 article in The New Yorker the other day about hypochondria in which the writer Alexander Nazaryan claims a common attribute of hypochondriacs is to tell people about their various aches and pains: “We simply cannot help it, unable to extricate ourselves from a bathetic cycle of fear and reassurance. Listen to us, pity us, do not discount what we fear.” I remember, as a child, having the distinct conviction that if I did not detail my every physical sensation, how would those around me know what to tell the doctors if I should lose consciousness? And still, the self-indulgent desire to tell anyone, everyone, hoping that one of them can cure me. Maybe that’s what this post is, maybe I am writing, without metaphor or hyperbole, to stay alive.

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A few years ago, my friend thought she had breast cancer and saw several doctors who continued to send her home undiagnosed. After several weeks, she finally requested a mammogram, and the doctor explained to her that, were there something gravely wrong, it would have shown up on another test; a mammogram likely would show some sort of abnormality because most scans do, but the vast majority of the time, the body simply resolves them. The body, he told her, is a mutable organism, fluctuating and rumbling and living—things happen, and they unhappen, and mostly there is no real explanation but that we are alive.

I’m not sure if this is necessarily comforting to me so much as it is just another impenetrability, a vagueness. It is a relief like driving across a western state between cities—tumbleweed and the sky so huge and ongoing—is a relief: an unavoidable reconciliation with one’s smallness. Or how at times, as a sleepless child I would lie in bed and imagine zooming out—the roof of the house, the L-shaped bench my dad built in the yard, our curving street, the town, the hills, the hills, somewhere a coastline widening into ocean. My insignificance, how I could lose my subjectivity in this broader scope, and the odd calm of doing so. The world going on as it was supposed to, and I tucked there within it, one inconsequential mammal among many.

In the New Yorker article, Nazaryan derides hypochondriac memoirs for “almost universally treat[ing] hypochondria with a jokey remove, as if slightly embarrassed to be talking about the condition.” Undoubtedly, this is how I talk about it, laughing about the miniature terrors that plagued me as a child or, as is often the case, yesterday. “This is highly unsatisfying, to read a memoir that lacks the conviction of its own anxieties,” Nazaryan writes. “The humor is just a pose. If you were scared shitless, have the courage to write it that way.” But of course it’s just a pose—isn’t it obvious? I think it’s the humor that reveals the extent of the anxiety; the attempt to hide it exposes its affect—a fear so real and unmanageable you can’t even really say it aloud.

Also though, that “jokey remove” allows the hypochondriac to claim self-awareness, some sort of control over their fear—to cling to their sanity when even they suspect it may be gone. It’s like Bo Burnham’s highly praised Netflix special in which he admits that “self-awareness doesn’t absolve anybody of anything,” and nonetheless offers little but self-awareness in the face of a system that benefits only the “pedophilic corporate elite.” By which I mean we remain where we started, unchanged, scared. Just a little more annoying.

Nazaryan writes of Catherine Belling’s 2012 book, A Condition of Doubt: The meanings of Hypochondria, in which Belling states that hypochondria is “always ironic.” “Despite all its convolutions,” Nazaryan explains, “hypochondria is always right. You will get sick and die. The question is only when and how. The bus is coming.” Of course the melodrama of the hypochondriac is ridiculous and funny and stupid. Of course the fear is warranted.

Here is a short Louise Gluck poem I love:

Telemachus’ Detachment

When I was a child looking
at my parents’ lives, you know
what I thought? I thought
heartbreaking. Now I think
heartbreaking, but also
insane. Also
very funny.

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In a review of Brian Dillon’s 2009 book, The Hypochondriacs: Nine Tormented Lives, Ian Pindar writes that hypochondria is “characterized by an intense scrutiny of the body.” How fastidious I can be, and uptight because of this hyperawareness—my daily walks and reserved hour for exercise, my meals planned, my Nalgene always full and weighing down my purse. And the discomfort of surrendering that control, the way I become itchy and intolerable without regular access to my gym, my produce aisles and particular breakfast fruits.

No. I am not so careful; I embrace its opposite when control evades me. Then eating is all pleasure—presence, a cautionless and ecstatic approach to sustenance, and the expansiveness of this indulgence, how swept away I let myself become, carried away and into the potential and predictable consequences. The ease with which I dive into that freedom, my eagerness to be casual and uninhibited in this, in anything. It’s like when I was in college and my friend and I, teetering around the edges of disordered eating, bought American Spirits and said to each other let’s smoke instead of having lunch, unsure if we were serious or not. My self-destruction interrupted the regular rhythms of panic and defense—it defied the impulse toward bodily equilibrium by purposefully seeking out its predictable opposite. I remember how liberating it felt, to abandon constant vigilance over heartbeats and blood pressure and embrace a known hazard, albeit a distant one.

The desire for control, the desire to lose it. Losing it. I have failed already at my elimination diet. I am convinced it was bullshit anyway.

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In his recent collection from Fonograf Editions, Returning the Sword to the Stone, Mark Leidner’s deft use of irony and absurdism seem to press on humor like a bruise, rendering an unexpectedly sincere pain; what we assume to be a wide chasm between irreverent jokes and the implied or understood horror of mortality becomes barely a crack.

When the pandemic first started, and those of us lucky enough to have homes retreated to them, and there was panic everywhere, and it was wide-eyed and walking large semicircles around one another, I felt great relief—finally here was everyone else, looking at the bad world and feeling scared.

In a brilliant review of Leidner’s book, Bianca Stone writes: “These poems are concerned with human predominance for hypocrisy and denial, showing us how we are trapped in an act of pretending to be at ease, but mostly knowing deep down that gruesome horror is imminent.” Often I am astonished by the casual ease with which people move through a world, their bodies, which are trying to kill them in a million different ways. It’s enough to make me lock myself inside my apartment until the next pandemic when everyone else will once again join me. (I mean that mostly as a joke, but I mean it when I say I barely left my house last year.) But then I would worry about the dust and the likelihood of developing asthma at the age of 27, so the better response is probably to stay up all night smoking cigarettes and drinking Four Lokos. (I mean this mostly as a joke too, but I also mean the loosening of attention toward the body sometimes happens, and it is always a relief, however momentary, however long I can call it a joke.)

Perhaps it is the “remove” of Nazaryan’s “jokey remove” that dilutes the genuine anxiety of the hypochondriac. The opposite, I think, is what makes Leidner’s poetry so compelling—his unflinching attention to the joke, the seriousness with which he constructs it (in internet parlance: his “commitment to the bit”).

In an interview from 2011 in BOMB, Leidner discusses this tension between sincerity and humor:

Because the logic of jokes hinges on misdirection, maybe jokes are inherently insincere, and therefore counter to poetry. You get the audience thinking one thing, then flip them. But poetry, it seems to me, is language stripped of misdirection. If the thought flips, it is because the thought has flipped the thinker. Joke-tellers know where their punchlines are going to land. Joke-tellers know, poets don’t. … So the challenge of bringing the knowing aspect of joke-telling into the unknowing aspect of poetry is what I am interested in. I want to mix opposites, forms that do not belong together. Jokes ought not to fly. That is what birds are for. There is the B-52 mentality. Instead of birds, finding metal that belongs in the ground—cold, soulless, logical, and insincere—mechanizing and contorting it into a shape that flies—is insane.

Can a joke be revelatory and protective? When I joke about spending the afternoon researching whether or not an untreated broken toe could cause some sort of life-threatening circulatory issue, am I actually shielding myself from being seen? Or wanting you to understand?

Leidner’s solution is not a real solution, but it lies, sort of, in art. Here are some of my favorite lines from the book:

Life is long for a brief time, then brief for a long time.
The problem with irony
is that it is too soothing.
It suggests a pattern to tragedy
and therefore mitigates the terror that tragedy is random.
Were tragedy patternless, we’d be meaningless
and all the ironies of literature are a dam against this despair.

I meant for this to be about food, but it has become about poetry. Food (arguably a form of art, but I prefer to regard it as more utilitarian than that) is too a dam against the despair of mortality, of imminent yet impenetrable ends. Though it is perhaps an ironic one as well, as most forms of living are. I started this cleanse for the same reason I drank two cups of coffee this morning: because I will die someday, because I am scared, because I want to live, and live well. Because I have no self-control.

“The double irony is that it implies nobility and need for irony, while also showing it as self-soothing avoidance,” writes Stone of those lines from Leidner.

What is said is that we’d be meaningless without our literature, but what is meant is that that’s meaningless mollification: not exactly an answer to meaninglessness. Which ultimately might have to be accepted, to allow us to understand that we create our own meaning. In art. Again, doubling back to art actually being what does dam against despair.

I cling to humor—in poetry, as in life—because I often find it more genuine than sincerity, which often becomes so myopically interested in its pursuit of the sincere that it turns self-involved. I don’t know. It is so hard to say what you mean. I mean it when I say I’m scared, and I mean it when I say it’s funny. “To mean every word with total vulnerability and yet be irreverent at the same time!” Stone writes. “How is that possible?”

One body cannot really know another—I cannot experience what you experience. “I wish I could jump into your body,” my friend said to me as I fretted about a stomachache I was certain was not just anxiety. He couldn’t of course, and this is why we have language, literature, this is why I write—to make my body an understood, tamed thing. It is always a failure, always inevitably ungraspable. Also very funny.