Let’s face it: we’re all in this together, oh gentle reader, and no one – and that
includes you and me, both – gets out of here, alive.
Pariah Bodies, Sue Golding
The hypochondriac does not reject medicine yet endlessly exposes its limitations and vulnerabilities.
A Condition of Doubt: The Meanings of Hypochondria, Catherine Belling
The chronically ill is neither here nor there. Brain fog, they say, she can’t remember half the things she cares for, half the places she visited, half the words spoon-fed to her in school. But she has to carry on living, friends with the pain. Sarah Manguso in her book titled The Two Kinds of Decay writes, ‘All autoimmune diseases invoke the metaphor of suicide. The body destroys itself from the inside.’ When your own body becomes your enemy where do you go? Who do you ask for help? You grow distant from your body. You are wary of it. Every day is an anticipation of failure, a tapestry of diseases.
Friends ask you, “How can you develop new diseases daily?” You see, in your twisted sense of being, you forget that diseases have certain textures. About fifteen years ago, my grandfather was diagnosed with Parkinson’s. Fifteen-year-old me could not fathom the post-disease morbidity that sets in your mind and body. That is, until five years ago, I could not sit down to pee. My legs gave in, flapping like a wounded seal around the bush rock. The bathroom floor in my dimly lit hostel made me feel like an Artic hyperborean.
After certain medical advances in the 20th century, we thought we had conquered diseases. Of course, there are exceptions. Cancer, thalassemia, autoimmune diseases. Even the common cold serotypes restructure every year. After seeing two and a half score doctors, thirty medical tests, and probably six hundred different medicines, this moon-faced Kolkata rheumatologist told me I am HLA-27 positive. In those days, and possibly still, you had to rally outside the hospital from 6 in the morning to get a glimpse of the illustrious physician at 12. Approximately for 5 minutes. It was like seeing God at the end of a long, dark tunnel only to be disappointed.
The language of God is not English or Latin; the language of God is cellular and molecular. (Leary, 1996) But my God speaks neither. It is an MRI machine at Addenbrookes. Waiting to tell me how many of my bones can be salvaged every year. Hospitals smell the same everywhere, whether in Europe or Asia. Please do not quote me on this. The nurses bring you orange juice incessantly. As if some vitamin C will heal the pain in your sacroiliac joint. It reminded me of Valencia summers. Not because I have been there, but you could see all British oranges somehow seem to be imported from there. In fact, long before health influencers became a thing, Freud talked about the oral or ‘taste’ as the oldest intellectual instinctual domain of the human species. People hold special memories through food and connect through it. While the experience of any food has this imprint of exclusiveness, we aspire to commonality, if not communion, with others through shared taste. (M. Skubal, 1999)
And any inflammatory disease often makes you ‘individual’. People sneer at you when you reject that glass of wine at seminars. Friends call you uptight for not eating red meat. But they don’t have to sit with haemorrhoids in the middle of cold Cambridge nights, blood oozing out in circular streaks on the white of the pan till it hits the waters and becomes a mellow pink. Now food is your enemy, the bloating, the cramping, like walking amidst stinging nettles in a summer field. Even after a million fad diets, your IBS won’t settle—the rings of psoriasis map scars on this body made of glass.
The history of illness is rather sombre. In literary circles, people want to research it and write about it, but nobody wants to listen to it. You complain too much, they would say. (The actual thing they are trying to say is I cannot publish a journal chapter on post-colonial studies with your subjective anguish) So long after illnesses have hijacked your body, you develop hypochondria and let me tell you it is the worst of the lot. Like a brain-eating amoeba, this windy melancholy slithers around the marrow of my soul.
This was long before I discovered that Roman stoic philosopher Seneca was often said to be known as ‘the greatest hypochondriac of antiquity.’ (Russell, 1973) Neither could Emperor Marcus Aurelius escape this malade imaginaire. The DSM-V (The Diagnostic and Statistical Manual of Mental Disorders, which Caroline Crampton refers to as the Bible of psychiatry, is still unclear on the nature of this disease. It manifests as both a somatic symptom disorder and an illness anxiety disorder (527), its presentation unpredictable, its arrival shrouded in uncertainty. When one side of my face started to feel numb, followed by a couple of trips to the ER, I was convinced I had cerebral palsy. The doctors were at their wit’s end trying to convince me otherwise. When Jerome Groopman, doctor and writer for The New Yorker for the past three decades, was asked about hypochondriasis, he gave three reasons for the implied hatred doctors have against these patients: “Doctors want to deal with what they believe is real disease, meaning physical problems, and not constant complaining about imagined issues”; “hypochondriacs often fail to be reassured”; and hypochondria “is a sort of mirror to [physicians’] own compartmentalized fears.” But it was Belling’s theory which convinced me that rather than being ‘unreliable narrators, we speak difficult truths’.
Belling’s book brought to me a profound awakening, one that has lingered in the dim recesses of my thoughts. The memory of my medical encounters, once sharp and vivid, now seems to fade into a blur—fractured and indistinct, like the faint remnants of a dream upon waking. Time, it seems, has softened the edges of these recollections, not only because of the cognitive fog that lingers like an unwelcome guest due to my autoimmune disease but also because of the cruel uncertainty about the body’s reliability that courses through my veins. I try to remember the days spent in the waiting rooms of countless hospitals and diagnostic centres. As time seemed to collapse on itself, the faces of the doctors and the nurses blurred into abstraction-like neolithic cave paintings. Whenever I sought reassurance or a test came back negative, it felt like a fleeting illusion. Within a week, I would be back to panicking and questioning its reality. It was not simply that I couldn’t remember; it was that my body, even as it betrayed me, seemed to refuse to be fully understood.
It was Belling who suggested that even living with doubt can be a form of self-preservation. It is far more intimate than knowledge, providing me with a heightened sense of embodiment. Doubt, I realized, had become a kind of tether, anchoring me to my body in a way that certainty never could. I doubt the veracity of every sensation, ache and pulse, acutely aware of my body like the waning phases of the moon. When the mind is clouded by uncertainty, the body becomes both a riddle and a mirror, reflecting every nuance of a cortisol spike, every shift in temperature or texture. Even when the answers elude me, I am left with the relentless immediacy of the body itself—alive, trembling, but always, indelibly, present.
This blurring of memory, this disentangling of certainty, this concealment of control is a form of preservation in itself. For in doubting, I have become more attuned to my corporeal existence. I no longer reach for the comfort of elusive authority over my body, no neat line between what is imagined and what is real. Yet, this intense focus on the self, the obsessive awareness of every bodily sensation, and the heightened anxiety tires me out. The aching knees, the flicker of pain behind my breast bone, the way the blood feels thicker in my veins during a flare—these are the constant. This tactile relationship with my body far exceeds my memory. At times, they are all I have. It is not just the disease or the diagnosis but the way my mind remembers it. In fragments, like broken orange peels desperate to be whole again. In its own haggard way, my illness and the doubt feed each other, entangling memory and sensation in a web of uncertainty. But the rawness and the nuances of my embodied uncertainty keep me in the present, always aware, rescinding my past. I may not be able to trust my memories, or my body’s signals, but in this constant questioning, I am undeniably alive. In this curious space of doubt and conviction, I have recognised a peculiar kind of truth; that to live with illness is to live with an ever-present tension between what is real and what is imagined. And in this tension, the body whispers—not in clarity, but in a language far more intimate than any diagnosis could offer. An inscrutable Cartesian dualism.
Juggling between the chronic and imaginary, sometimes I wonder if I am just a hypocrite. The word hypocrite, borrowed from the Greek word hypokrites etymologically means an actor or stage player. Interestingly, hypochondriacs are often mistaken as malingerers, a term reserved for people faking illness to gain some kind of favour. In an article published in 1978, J.E Groves called us ‘hateful patients’ and divided us into four stereotypes: dependent clingers, entitled demanders, manipulative help-rejecters and self-destructive deniers. I wonder what kind of ‘countertransference’ I might have caused to Dr. Schembri, my primary care physician in Newnham Walk. Am I untrustworthy, split between the subject and object of my narrative? Moliere captured this dichotomy in Argan’s character, who was caught between trusting a doctor and becoming a doctor himself by the end of the play, The Imaginary Invalid. I recall a strange sense of relief washing over me when I learned that Molière had succumbed to death right after his final performance, as though the curtain falling on his life mirrored the end of his play. A critique of the then-medical system, this testimony makes me wonder if he somehow manifested his death in an ironic turn of events. Despite the control over the play’s narrative didn’t he lose control of his life?
During my Masters, I learned that Franz Kafka’s psyche was clouded by this archaic affliction, which seeps through his narratives, particularly in the subterranean paranoia of The Burrow. In one of his letters to his fiancé’s father, he wrote, “Everything I am, and am not, is a result of this. I am taciturn, unsociable, morose, selfish, a hypochondriac, and actually in poor health. Fundamentally I deplore none of this: it is the earthly reflection of a higher necessity.” Now when I run out of my spoons each day, I am left with a similar spirit.
I still don’t know which version of me Dr Schembri sees—the one performing clarity, or the one quietly unravelling. Even imagined illnesses leave traces. Some stories, like symptoms, don’t want answers. They just want to be noticed.
To speak them is to split myself—to be both patient and observer. And if I’m a crock, then maybe I’m just holding what can’t be resolved: the doubt, the noise, the need to ask. Molière died in costume. Kafka burrowed into the page. Maybe there’s no neat line between what we feel and what we invent. Maybe the point was never to diagnose—only to keep telling it until something starts to make sense. Maybe it is all futile after all, the ceaseless interplay of the action and the reaction, in this universal tireless exchange of cosmos.
But still, I choose to breathe.
Spoon theory is a conceptual framework developed by Christine Miserandino (2003) to articulate the lived experience of individuals with chronic illness or disability. It employs the metaphor of “spoons” as finite units of energy, where each physical or mental task requires the expenditure of a certain number of spoons.
Works Cited
1 – Countertransference” is the word that Freud coined to mean emotional reactions to a patient that are determined by the psychoanalyst’s own unconscious conflict.
2 – Spoon theory is a conceptual framework developed by Christine Miserandino (2003) to articulate the lived experience of individuals with chronic illness or disability. It employs the metaphor of “spoons” as finite units of energy, where each physical or mental task requires the expenditure of a certain number of spoons- .
Manjari Thakur is a writer based in Cambridge. Her research interests lie in trauma studies, poetry, and psychoanalysis. Her writings have been published in various journals, including Muse India, Tendon Magazine, Johns Hopkins and Cusp Magazine.
