Live and let live

 

On tolerance and easy-going laissez-faire, how dear to the heart of the recovering alcoholic!

The whole thing about that chippy little AA saying ‘Live and let live’ is that it is no problem at all if I am advising someone else to give things a break, let go and let God, take it easy etc. I have no real problem doing it myself so long as it is not my housemate in a huff. I have no probem forgiving small puppies whom I adore. I can even read the news headlines without frothing at the mouth over First World idiocy and Third World corruption and Two-Thirds World poverty. I release publishers into an ambience of goodwill. I choose not to hold grudges. I have no enemies in my life today and am glad of that.

 

But looking at my dates diary this morning (blissfully empty since I left media) I see it is Laura’s birthday, her 46th birthday.  (Her name is not Laura of course and identifying details have been altered.)  And she would love to hear from me but I am not going to call. Laura worked with me for nearly seven months and she always remembers my birthday. I know my silence and distance puzzles her. She has never done anything to hurt me and the distance is all on my side.

In theory I believe myself to be understanding and compassionate towards those suffering from mental illness. One of my dearest friends is bipolar and I make more allowances for her than for anyone else in my life. She can call me at 3am in the morning to rant about conspiracy theories and I will just give a sigh and isten patiently for two hours. She can’t (not won’t) understand boundaries and the lithium only works intermittently.

Another friend has schizo0phrenia and I write to her each week. She has been hospitalised for about 30 years out of 45, a brlliant mathematician in her early 20s.

But Laura is not mentally ill in the clinical sense. The problem is much more mundane and one that I tried to overlook for a long time.

 

Hypochondria.

I hired Laura one bright summer’s morning in  about 2000. She was to be a trainee graphic artist and office assistant. She was obviously a very gifted artist, but she had almost no work experience. That should have set bells ringing in my head but it didn’t. Many women take decades out to raise children or care for elderly parents or do drudgery to support alcoholic husbands. Second careers come later and many women thrive on their late entry into workplaces.

Besides, Laura told me she had been ill for six weeks with suspected meningitis. I have had meningitis myself and hated the lumbar puncture. I hired her and told her to rest up before she started work.

 

Laura arrived at work on her first day with a cluster headache and at noon I sent her home. She stayed away a week but sent long detailed progress reports by email each day and no fewer than three doctors’ notes.

When she came back she confided that she was about to begin tests for a brain tumour. I was horrified and urged her to get to a specialist as fast as possible. I reassured her that her job was safe. I spoke to other managers and the human resources department so as to ensure she got support. Laura went around the office asking others if they knew anyone who had survived brain surgery.

Then she went off sick for a week and again sent me detaikled reports, but mostly self-diagnosed. I suggested she wait for test results and perhaps see a counselor. She went to see a counselor but said that the counselor had not understood anything  about what she was going through, had lacked any medical knowledge about brain surgery. I began to wonder, just a little.

Laura came back, just for an hour the following Monday. The tumour  tests had been inconclusive but she had realised that she had contracted tickbite fever on a visit to her brother’s farm. Off she went for three weeks. Tickbite fever is common in South Africa and very unpleasant.

When Laura returned, she had severe cramps in her legs and was walking on crutches. The tickbite fever had resulted in  a potassium shortage and she was also suffering heart palpitations. She set out her meds on her desk and I could hear her discussing her symptoms all morning with colleagues in the open-plan workplace. I realised I knew nothing about Laura except that she was always ill. She had not yet completed a single work assignment.

 

Hypochondria is a communications disorder in its most extreme form. All of us have hypochondriac tendencies from time to time. It is as common as envy or depression. Extreme hypochondria or what is sometimes called Munchhausen’s Syndrome may result from childhood neglect, when the only way a child got any attention was if he or she was sick. There are other explanations but that one sticks with me. Hypochondria turns all communication into a health crisis, a demand for help and treatment. It is  an obsession with the unwellness of the self but with no acknowledgement of emotional distress or the ordinary human need for comfort and attention and nurturing.

Laura would pop into the chemist on her way to work. She would see doctors in her lunch hour and constantly visit new doctors or specialists. She would take pills throughout the day, but changing meds so often she could scarcely keep track. Not psychiatric meds because she distrusted those. There was no emotional illness in her family, she insisted. In fact everyone in her family was in the pink of health. Only Laura herself was unlucky enough to keep getting sick. She had always lived at home so that her parents and older sister could look after her. When her brother left home and married, she had suffered a violent asthma attack and had been hospitalised for weeks.

As Laura turned the office into emergency casualty each week with new complaints ranging from suspected sudden-onset diabetes to ovarian cancer to food allergies to congestive heart failure, other staff members insisted I get rid of her. Just being around Laura upset everyone and we all felt very angry with her. I dreamed about strangling her and then finding out she had been really ill all along. And sometimes I thought she might in fact be really ill with some obscure undiagnosed disease. I felt guilty. I felt responsible for bringing her into a busy workplace. I could not get her to talk to me about anything except illness.

And some of us in that office were concealing our own undiagnosed and hidden addictive illnesses, I do recall that too.

Laura left eventually after several warnings. She thanked me and said it wasn’t my fault I didn’t understand how ill she was. I was the healthiest person she knew. By then I had realised I was looking at an intractable delusion and had stopped trying to communicate.

After that Laura gave up on the workplace and has lived at home ever since. When her older sister fell ill with a degenerative muscular dystrophy, Laura was mysteriously paralysed for six months, unable to move her legs or arms in grotesque parody of her sister’s immobility.

 

And Laura stayed in touch with me, sending me birthday cards and read my published articles and calling me her friend. I flinch to think too much about this because I still can’t pick up the phone to Laura or even write to her. I refuse to communicate in the only way Laura knows how to communicate and I am not skilled or detached or compassionate enough to keep trying.

Alcoholism is not the only baffling and cunning and unpredictable disease or delusion or illness or obsession. And there are no easy cures for extreme hypochondria or Munchhausen’s Syndrome either. We know so little about human nature it is laughable.