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After fussing with his back leg, the dog turned to look at me, eyes wide with panic. I bent to check and found a bright yellow plastic fish with four wicked-sharp hooks dangling, three of them now hopelessly tangled in Willie’s coat. Somebody must have dropped it in the alley. I begged him to stay and stay still, then ran to bang on somebody’s door. Back with borrowed scissors, I sliced the hooks off easily; they had not dug into his skin. Gingerly, I carried the thing home to dispose of it safely. Then I noticed blood dripping from a cut on my finger.
Were the hooks rusty? They seemed pretty new, untouched by fish mouth or the elements. What were the symptoms of lockjaw anyway? A locked jaw? Was it reversible? My mind raced. Not about to drive somewhere for a tetanus shot, I would stay home and watch my dire future suffering unspool….
Hypochondriacs used to be fun, at least for everybody else. In midcentury comedy, they were usually skinny, high-strung men with a flair for self-indulgent drama. The cause was either neurosis, a pathetic need for attention, or a crippling cowardice.
Today, few poke fun, because the internet has turned all of us into borderline hypochondriacs. TMI 24/7, and now AI to help with the multiple diagnoses—how could you not be a hypochondriac, with the chance of some dread disease looming at every click?
I felt the danger in myself, though, long before the internet, thanks to what used to be called “an overactive imagination.” I could hear my mom cough and decide she was dying of tuberculosis, which I had read about in a nineteenth-century novel. Hypochondria by proxy? I did not imagine illnesses for myself, because I was still immortal. But I did catastrophize, and what else is hypochondria?
In his fabulous book The Hypochondriacs, Brian Dillon lets us watch the malady unfold in (his subhead) Nine Tormented Lives. Andy Warhol? Not a surprise. Virgina Woolf, natch. But Charles Darwin? (“I find the noodle and the stomach are antagonistic powers,” he once confided.) Proust, of course. But Florence Nightingale? Alice James had the best kind of hypochondria, cheerful and ironic, enthusiastic in welcoming each new disease.
Dillon’s book is so finely wrought, it will take your mind off any ache or pain. That said, I quibble with his opening quote from Georg Christoph Lichtenberg: “My body is that part of the world which my thoughts are able to change.” I think the body is the part of the world your thoughts cannot touch. Flesh outweighs the brain, thus wins every prizefight. Think what you like, dream up maladies or deny them. The body will be sick or well by its own schedule. (Yes, I can hear you pointing out that the mind exerts a powerful influence on the body, and you are right. But even that process is largely irrational, happening outside conscious deliberation, so I am right, too.)
Excepting the folly of his epigraph, Dillon writes like a poet, a philosopher, and the dryest wit in the pub. Each chapter is a miniature biography, so dense with that person’s essence that you end feeling you have known them, maybe even slept with them. And his own musings beg to be copied out: “You might reflect, in the interval before the doctor speaks or lays hands on your trembling person, that you have neglected to mention your most striking symptom,” he writes. “It is this: in the days since you first suspected your body of its treachery, you have started to live at the edge of your own life, to withdraw into a state of mind at once alert and somnolent. You listen constantly, in a kind of trance, for communications from your body; it is as if you have become a medium, and your organs a company of fretful ghosts, whispering their messages from the other side.” Too long a quote for fair use, but how could I stop? He has nailed it.
Years ago, after a diagnosis of melanoma, I read too much about that particular cancer. Trying to cheer me up, my husband reminded me that our butterfly bush would be in full bloom, covered with monarchs, just when I was home recovering from surgery. Instead of smiling, I burst into hot angry tears, secretly convinced I might never recover.
Unconsciously convinced, mind you. Consciously, I was humming along, asking for a few days off work, asking how big a dent they would place in my chubby arm. But in the irrational maelstrom beneath my frontal cortex, doubt swirled dark and powerful.
Reader, I lived. Granted, they couldn’t get the contrast dye to visualize, so the surgeon just had to guess which lymph node to remove. I wish he had lied to me, because for the next five years, I wondered. Not in a brooding way, not in any way that interfered with my life. Just in the way that lets your mind drift, in idle moments, to your funeral.
An overactive imagination brings every awful thing you have ever heard, seen, or read to bear upon some slight sign or chance, elaborating it into a full-fledged diagnosis that is somehow easier to deal with, even when dire, than the uncertainty of an indeterminate sign that could mean anything or nothing at all.
Montaigne understood. “I am one of those by whom the powerful blows of the imagination are felt most strongly,” he wrote. “Everyone is hit by it, but some are bowled over. It cuts a deep impression into me.” He felt everyone else’s symptoms and took ownership of them, sure that he now shared their fate. Suggestibility exploits imagination.
In his 1621 classic, Anatomy of Melancholy, Robert Burton gave us the “Symptoms of Windy Hypochondriacal Melancholy”: “Sharp belchings, fulsome crudities, heat in the bowels, wind and rumbling in the guts, vehement gripings, pain in the belly and stomach sometimes after meat that is hard of concoction, much watering of the stomach, and moist spittle, cold sweat….” The list ends with “grief in the mouth of the stomach, which maketh the patient think his heart itself acheth.”
Though Burton thought of hypochondria as primarily a physical disease, he believed it to be triggered by fear and sorrow, Dillon explains. Also, capable of persuading us that our body has been altered in some inexplicable, supernatural way. This raises more practical questions:
“How is it possible to know our bodies, in isolation from our experience of our bodies? How can we be sure of such knowledge when the body seems to change from day to day?” Which rednesses and swellings, pangs and buzzings, should we heed? When is it better to pretend ignorance and go on with our lives?
My husband sets any worrisome bodily change aside for two weeks. If it remains intrusive, he looks into the cause. Most things vanish in far less than a fortnight, so he remains unflapped. I, on the other hand, raised by a neurotic, over-loving mother who pounced on any possible problem and dealt with it in a blur of angst, race to the computer or, in wiser moments, email his doctor.
I say “his” because I am a lot slower to deal with my own body than with bodies I love. Imagination still overacts, painting pictures of medieval suffering and an early death, but the scenarios are easier to ignore. If I lived alone, though, and had no one to whom I could vent my wandering, alarmist mind?
Hypochondria, Dillon points out, is itself a diagnosis. But it is the only one we automatically discard.
Read more by Jeannette Cooperman here.
