Parmakon in the Time of COVID-19
By: Deirdre Mikolajcik
Tags: Covid 19, Womens Health, Mental Health, Gender, Narrative

A Section of Plate 3 from the Papyrus of Ani. The Papyrus of Ani is a version of the Book of the Dead for the Scribe Ani. Plate 3 contains half of the first (and longer) instance of Chapter 30B in Ani’s Book of the Dead. The title of Chapter 30B is: Chapter For Not Letting Ani’s Heart Create Opposition Against Him, in the Gods’ Domain.

Two weeks ago, I underwent a liver biopsy to discover the source of some concerning anomalies in my mid-November bloodwork. Given the results of the biopsy and my medical history, a week ago, my doctors determined that the likeliest explanation was an acute liver injury caused by the hormonal IUD I’d had placed in May 2020. While rare, this diagnosis explains a number of seemingly unrelated symptoms and events from the last six months. Today, my bloodwork indicates that my doctors were correct about my IUD as my liver function is improving and returning to the levels recorded during an early-March 2020 physical. We will monitor my liver function for 60 days, but all should be well and there should be no long-term damage. I remain, as ever, a huge proponent of IUDs and other LARC options, despite this experience.

“No long-term damage” deceives though, as it refers only to my physical health and not the mental and emotional fallout of having been sick for six months while I and those closest to me wrote-off increasingly alarming symptoms as being no more than anxiety caused by COVID-19, anxiety over the election, errors in judgement, unhealthy coping mechanisms, and the evergreen diagnosis for female maladies: “You’re crazy”/“you’re imagining things.” As an educator, a scholar of literature, and a student of feminist theory, I am well-versed in theories and studies of female characters who are and are not “crazy” — theories that extrapolate about female agency and choice. “Characters,” however, “are not people,” a former professor chides persistently in my memory. And my life is not a novel.

Over the last month, I found myself repeating this as a mantra. Inhale — This is not a novel — exhale — I am not a character. As 2020 has revealed, many aspects of our society read better as a novel rather than experienced as a life. We know this because we are, by many accounts, living in a dystopian novel right now. And while we are not characters, we tell and retell our stories and others’ stories daily in a thousand different ways. Control over how a person is defined — whether they are monstrous or angelic, insane or sane, hypochondriacs or seriously ill, witches or wise women — is to control their narrative and to hold a position of power in the relationship. This is relevant now, more than ever, as we are in the tenth month of a global pandemic filled with misinformation, isolation, tragedy, and a general sense that we are falling over the edge of the map into the unknown. We are, all of us, on the precipice of madness.

Erasmus Darwin, father of the more famous Charles, wrote that “The only cure for madness is forgetfulness.” Several years ago, at a conference on Charles Dickens which I helped organize, a presentation on David Copperfield explored whether insanity causes us to fixate on bad memories or if bad memories cause insanity.[i] Is memory, as Darwin suggests, an illness? Listening to the paper, I was reminded of the Black Mirror episode “The Entire History of You” in which all humans have a memory grain embedded behind their ear. The grain allows characters to replay, fast forward, slow down, and pause past events right before their eyes, and to share their experiences with others. The grain can be cut out, which leaves a person with only their faulty human memory and mere language for explaining what they experienced. Viewers of the episode are ultimately asked to conclude that the memory grain is a curse, that those without certainty in their memories are happier. I have, for years now, been intrigued with these technologies of memory and the ways in which identity, particularly gender, informs our interpretations of memory and madness.

Over the last week, I have clicked through my symptoms from the summer and fall as if on a Kodak Carousel: losing fifteen pounds — constant dehydration — sleeplessness — persistent fatigue even when I did sleep — mental fogginess — memory gaps and lost time — sporadic moments of manic behavior — intermittent pain in my torso and uterus — that week my hands turned yellow, and we wrote it off as a consequence of constant handwashing and sanitizing…I find myself wishing for a memory grain; a wish renewed each time I am called upon to explain six months? How could you not notice for six months? I have, instead, only my faulty human memory and a layperson’s understanding of how the liver’s inability to filter properly will lead to toxins in your blood that impede brain function among other, less-dastardly symptoms.

It is impossible to ignore the COVID-19 pandemic as a direct contributor to my situation: the above symptoms during “normal” times would have been less-easily written-off by others and myself. Losing fifteen pounds — over 10% of my body weight — in under three months would have been glaring without the convenient excuse of COVID-19 anxiety and the distractions of financial worries; I’d have seen more people so that even if those closest to me remained unconcerned, someone else would have forced the issue. Sporadic episodes of out-of-character manic behavior would have been alarming without the ready-made excuse of stress and the extraordinary circumstances of quarantine and a global pandemic constricting everyone. Yellowing of the skin would have been a dead giveaway of “something is wrong” if it weren’t for the constant use of soaps and sanitizers from local distilleries. Instead, though, I lived with a quiet, relentless feeling of something is off with me only to be told “everything is off; no one is happy; no one feels good, Deirdre, get it together” when I voiced my worry. And when others, whether those you love and trust or the world at large, unite to offer a counter-narrative to you that you cannot fully contradict with your human memory and language, is it surprising you begin to doubt what you know, that thoughts become hungry ghosts? No one wants to believe they’re sick. And so, you accept: yes, this must be in my head. I’m making excuses for myself and seeing monsters where there are none. Maybe I’m the monster. In extreme cases this is called gas lighting, a buzzword many of us are sick to death of hearing and others sicker to death of experiencing.

I am not the first to write about the effects a pandemic has on healthcare access for everyone and the way everyone’s health suffers because of the attention and resources diverted to address the pandemic. This is particularly true for women when it comes to reproductive-health services. My IUD was replaced in May, not late-March as originally scheduled, because my reproductive health was not considered an “essential” procedure during lockdown. Beyond healthcare, women also shoulder the weight of increased domestic work and caregiving as schools shut down and family members fall ill; we face greater economic instability; we are at greater risk of domestic violence. (For an in-depth discussion of this, check out “The Coronavirus is a Disaster for Feminism”.) My story is one of many stories from this pandemic that will not be reflected in the statistics of tragedy and destruction this virus has wreaked. I am lucky that I have insurance, good doctors, and a few friends who care enough to take me to and from the hospital, who care enough to risk accompanying me to appointments, and who care enough to hold my hand in the era of “no touching!”

My story is a story of the pandemic, a story of healthcare in America, and a story of gender and narrative. These different threads — pandemic, healthcare, gender, narrative — are interrelated now more than ever, particularly because of their relation to power. To author one’s own story, to define one’s self is an act of power. It is an act frequently denied to minorities, women, and the poor. We are living in a global shake-up of stories, and the comforting narratives about who we are as individuals, as a country, as a people that once sustained us are fracturing. “The centre cannot hold.” It does seem at times as if the only cure for my “madness,” for our collective “madness,” is forgetfulness. “What you need is a gramme of soma!” But is that really a cure? Or is it a refusal of acceptance and responsibility? These are questions for which I have no answer. Perhaps there are no answers.

“Negative capability”: John Keats’s phrase from his letters to describe the beauty of artistic uncertainty and the power of that uncertainty to inspire genius. The answerless questions for Keats were the only ones worth pursuing. I wonder, however, if Keats conceived of the horrors of the void, of — as Albert Goldbarth writes — the “here there be monsters” nature of going over the edge of the map as you lay in a hospital bed sifting through shards of memory that cut your hands as you hold them. But, yes, Keats must have known. Two hundred years ago as he lay dying of tuberculosis, he told his friend, the painter Joseph Severn, “I shall soon be laid in a quiet grave.” This was on February 21, 1821. Severn wrote that when Keats saw the sun the following morning Keats cried, but the Italian sun and air were no match for the bacteria rotting him from the inside. On February 23, 1821, Keats slipped over the edge of the known world into the quiet of the grave.

The Kentucky sun and air were no match for the device slowly poisoning me. I was no match for the toxins in my blood. But my Kentucky doctors were. Amidst the blanks in my mind, my polluted blood, the whispers of madness I’d been handed, and a global pandemic, they plotted a clear course of treatment and recovery. They took the shards and fashioned them into glasses to help me see through the mental fog, the trauma, and the self-doubt. Our fight against COVID-19 is not over. Our reckoning with broken narratives is not over. Our quest for self-definition is not over. As Auden writes, “About suffering they were never wrong, / The old Masters: how well they understood / Its human position: how it takes place / While someone else is eating or opening a window or just walking dully along.” And 2020 has been a year of suffering on a personal, national, and global scale beyond what most of us could imagine. And we are, in turn, facing a reckoning on a personal, national, and global scale. In the Egyptian Book of the Dead, when a person dies, the goddess Maat weighs their heart against a feather: are you worthy of paradise or do your actions weigh heavy on your heart? And as I sit here looking out my window at the thin winter sunlight, through the shards-of-memory-turned-spectacles-of-understanding, I know that a return to wellness is occurring and, with it, a reclamation of my power to tell my story. There is a lightening of my heart.

[i] Walters, Darby. “‘Mists and Shadows of the Past:’ Miasma and Memory in David Copperfield.”