Prove to Me Your Pains by Kaitlyn Piggott

My general practitioner is old now. Time has not done him a service. I guess he could say the same to me. His overweight body hangs off the stool; my borderline underweight body curls into a corner of the exam table. His fingers are cracked, wrinkled, and unclean; mine are cold and nimble.

“So, what brings you in today?” he questions.

“I had an …” I trail off. “… an episode.” 

I lean against the vomit-colored walls, swinging my tanned feet. As his second office, I once fell in love with the bursts of bright rainbows and child-like décor, yet it is squeezed out now. The last time I was here I was young and healthy. 

“Last week, I was getting ready and suddenly, I collapsed into this shelf I have in my closet. My arms were thrown up over the ledge. My vision became tunneled. My extremities were numb, and I felt off. Then, my arms started convulsing, full-on flailing about.” 

Momentarily, I demonstrate. 

“I could not tell you how or why I was still standing. I was still like that until I blacked out. When I came to, my arms were still violently uncontrollably flapping about. Eventually, I was able to regain myself. So, I contacted my cardiologist. She said to get a seizure workup; and since she is out of state, she said to get a name from you.”

Expressionless, he does not look up from his lap. He’s the doctor I have seen the longest, but also the one who doesn’t witness my struggles. The one who seemingly forgets my poor state of being. Perhaps he still sees me in simpler times. I don’t. 

 “It wasn’t a seizure,” he replies nonchalantly. Relief flushes through me, a coursing heat through my veins. “People who have true convulsions do not realize they have them. Someone tells them later.”

I suspected that too. 

“What was it?”

He spins around in his stool, while my shoulders drop, free from tension. 

"Are you taking any medications?” I am set aback. Answer me, and I’ll want to answer you. I hand the list over, nonetheless.

He pulls on the stool with his hand in between his legs. The only sound is coming from him clicking through my chart and the chatter of nurses behind the wall. They chuckle deep within their stomachs, it’s calming.

His thoughts become aloud. 

“Why did you contact a cardiologist?” His tone is riddled with accusation.

“Well, she treats me for my POTS,” I reply. Postural orthostatic tachycardia syndrome (POTS) is a blood circulation disorder. “Fainting is a common symptom, but it never happened before. I was curious if she thought I should change treatment.”

His face contorts with bitterness even crossness. Confusion is what I know best. Slowly, I inch away causing rustling and ringing ears. I came to him years ago displaying with textbook POTS symptoms: lightheadedness, fainting, and rapid heartbeat. He blew me off. Since then, I had been seen by a local cardiologist, twice at Mayo Clinic, and the leading specialists, all of whom diagnosed me with the condition. No one refutes the diagnosis. Except him.

The man shakes his bobble head. 

“Well, she told you to get a seizure consult because from her end the only thing she would know about was a cardiac seizure, which this was not.” The air is thick with his lack of interest and the mustiness of a decaying office space.

“She definitely wouldn’t think that,” I say to no avail. “She would say it was POTS if she thought it was her area. Convulsing is not normal.” My earnestness is met with him looking down on me while I sit straighter. My other doctors know the ups and downs, understand my real symptoms. Yet, I am slapped with the reminder of who I was talking to. He sets up for our failures: me with POTS, my papa’s cancer levels, and my non-drinker grandmother’s pancreatitis.

The past dozen appointments he had written me off. It was not so much of “missing” the condition rather he didn’t want to give me the time of day to figure it out. Anything I came into his office with was no big deal. Yet, I thought it would change. Recently my father came in with knee pain, the doctor ordered him an x-ray. When the x-ray came back normal, he ordered an MRI, when the MRI showed normal degenerative injuries, he sent him to a sports medicine doctor. With an array of conditions tacked onto my name, he has never referred me out. 

He tilts his head slightly like I am the six-year-old needing a sucker for a shot. Maybe he still sees me with my skinny legs and buck teeth, and not the 19-year-old who knows her health and requires accurate treatment. He is a reminder of my healthy childhood, and now I must prove that’s in the past. I know me best. Not him.

“If she thought it was POTS," he says, "she would have ordered a tilt table test. Or you would have fainted again.” 

My eyes make him seem blurry. Perhaps, he’s the framework of a dreamworld. I must prove to my immature friends that I am ill. Why do I have to do the same with him?

“Um, no,” I answer with a daggered tongue. “I failed two tilt table tests from different hospitals. So, they proved I have POTS. I’ve had POTS for about three years now and I fainted once.”

He rocks back and forth, or is that me? The taste of acid rises in the back of my throat, turning in my stomach when I swallow. Something happened. I don’t want it to be a seizure. I don’t need it to be.

“Anything else going on?”

It comes out before I process it.

“I’ve lost 25 pounds as a result of extreme abdominal pain.” I do not want to lie, but I know I’m setting myself up. Truth is a virtue. “My team is trying to get it under control.”

He nods. “Where does it hurt?”

 I show him. 

“It’s just gas.”

"Gas?” My voice becomes high pitched with bewilderment. Not one of my four specialists I have seen before him, brought up anything remotely like gas. He inquiries about my diet. I list off the products in a single breath, all of them on a constant cycle. 

“There it is.” He acts like he has solved world hunger by slapping his palms together. His pride a deep redness separating us. Pride is a deadly sin. “Apples. Apples are fermented. Anything that can be turned into wine is gassy.”

“I peel over in pain every night with or without the apple.” His nature brings out my sarcastic undertones. “I eat small quantities because it is what is tolerated, not my choice. It has been a rough last couple of months. I want to eat. I just can’t right now—”

“That’s probably what happened,” he cuts in. His condescending voice comes back in as a plague. “You weren’t getting enough nutrients because of your gas and because you are malnourished your mind thought something was wrong when you thought you passed out.”

We're back to the fainting?

I speak defensively. “I’ve spoken to my GI about making sure I don’t become malnourished. I’ve brought up vitamins, minerals, diets to give me some protein, everything. It is just so hard because I am allergic to nearly everything. I have a restricted diet for many reasons.”

“When your body acts up it is showing that something is wrong. It is telling you it needs food.” His comment seems rhetorical, but he says it like he is my teacher, and I am his first-year student. My face flushes a deep scarlet.

“Yeah, well, I’ve been saying that,” I put out.

With his hands, he motions to check my abdomen. His touch is clammy as he presses down long and hard. At my tender spots, I flinch back and my arms guard it. 

“Oh, that’s your stomach.” His surprise temporarily overshadows his superiority complex.

 “I know,” I reply.

“It might not be gas then.” He pulls away from me so I can finally recoil better. In my hands, I cradle my stomach, the bloated and inflammation hidden under my shirt which now hangs off my shoulders instead of clinging to my body. “It still very well might be. You know what I think it is?” I don’t want to hear it, but still he goes on. “I think at one point you had really bad gas and now you are afraid to eat.”

I don’t even know how to respond.

“You need more calories,” he adds, his back to me. “You need to drink your calories. You are doing everything that someone trying to lose weight would do, drink only water, limit food, eat fruits and veggies.” His voice is edged with harshness, like I am missing the obvious strobe lights blaring before me. His eyes are darting over his computer screen. To him, I am irrational for believing rapid unintentional weight loss is bad; or I brought this upon myself. “Maybe a protein replacement drink? Something rich in calories.”

I say his name with a drained voice. My annoyance and anger have subsided, replaced with worn-down. “I react to everything. Those shakes are filled with ingredients that would force me to take additional Benadryl or send me into anaphylaxis. Plus, I must drink lots of water for my POTS, especially in a flare-up.”

“Just give it a try.”

I'm a goner. He hasn’t looked at my extensive notes. Fighting his disregard will get me nowhere. I am a female in pain which makes his ignorance validated. Therefore, I simply nod my head. I scratch my arms lightly until it becomes my distraction. I didn’t come thinking he would cure me of my issues, I just wanted a name. It is a reminder of who I became -- a young woman with complicated answers. Proving my life to him is a losing game. Since then, I have yet to grieve the healthy me that I was. 

On the way out, he murmurs, “If you want me to write a referral to see neurology, I can do that. It is just going to be a waste of your time. You are still trying to find answers and you’ve had so many tests.”

Tests that brought numerous answers. I have diagnoses that can be explained. Don’t act like I have nothing going on. He can look the other way when I leave the room. He can forget and sleep at night. Whereas I still battle with the obstacles. To him, I am just the girl who is frantically searching for answers, a hypochondriac. To me and everyone else, I am the one with numerous positive tests. I am a warrior battling the demons of chronic illness.

Later, I learn my stomach paralysis had gotten worse. My GI sent me to Cleveland Clinic who investigate surgery and sole nutrient for weight stabilization. Neurology deemed the fainting episode to be convulsive syncope, a temporary loss of consciousness because of falling blood pressure.

This doctor gets to remember me as the grinning little girl who ate her fruits and vegetables, who played outside, and the only illness she’d ever get was an ear infection. He gets to remember the kid me, the one without difficult symptoms. The one who didn’t need to be courageous. 

To prove to him I’m not okay is a waste of time. I know myself well enough. I’m old enough.