10. Strange Bodily Sensations

This is the reality today, the President was saying. Today, this is the face of the enemy that we face. It's not a pretty picture and it's not a clear picture. Because this enemy that we face is not out in the open. This is not an enemy that shows themself. This enemy is like Bigfoot, like Sasquatch: this enemy hides in the shadows and moves through the underground. This is an enemy that understands stealth, and understands secrecy to achieve its nefarious goals. Goals of spreading evil and sowing atrocity and corroding away our freedoms. That's why the importance of vigilance and patriotism is so important today. If we are not vigilant, if we do not keep both eyes open, even while we sleep, then we can rest assured you me that this enemy, this neo-fascist threat to our country, our beloved homeland, this threat that lurks in the shadows and threatens to undermine everything that made America great, from those first cries of independence, that first great holler of the American spirit, saying we would not be subject to a foreign power, that we would be strong and free in our hearts and in our homes and in our streets and in our schools, yes that is the cry we must hear echoing down the halls of history today and tomorrow and on into the future, for freedom, for country, and for our children.

Drew switched off his PDR in disgust—but of course the Presidential address was being mastercast. At the moment, he hated freedom, he hated his country, and he hated children. He especially hated waiting rooms.

He breathed through his mouth to minimize the chance of infection and avoided eye contact. He would not sit. Instead, as on all his visits, he paced up and down the small room, and, alternately, browsed through the display of pamphlets.

He skipped the STI and STD section except to reassure himself that RTX was still treatable. (He didn't have that, but it was good to know.) He dipped into Hodgkin's disease, which he always confused with Huntington's. The symptoms did not really match his own, which was heartening for five seconds, until he realized this must mean that, in fact, he had the other one, Huntington's. But there were no brochures on that. He'd have to ask Bruce. He passed over the diabetes section. Hepatitis and herpes, with all their protean forms and varieties, left him disquieted as usual. To cheer himself he looked at menopause, perimenstrual distress phenomenon, cellulite, and a highly allusive treatise on the possible causes of vaginal discharge—one of which, he noticed, was a very rare (but benign) disorder that the publisher of the pamphlet just happened to sell a treatment kit for. Modern medicine!

He probably need not worry about prematurity, torticollis, or acute necrotizing ulcerative gingivitis. He passed over the diabetes section again, and found himself before the Ask Your Doctor section: those brochures for treatments for novel or shameful maladies left unnamed. Here were brochures of pastoral landscapes brooded over by sulky storm-clouds: "Feeling down?" Here were troubling checklists of symptoms, and appeals to search your body and your conscience for the early signs. The Ask Your Doctor section was Drew's favorite.

He did not have dry mouth, but thanks for your concern. He did not have mysterious open sores or loss of memory, knock on wood. He did not have very serious headaches. No hair falling out, no red itchy eyes, no tingling in his extremities ... Where were all the pamphlets about bizarre gastrointestinal fuck-outs? He was not anxious, he was not shy at parties, he did not dread getting out of bed in the morning (or, if he did, who did not?). He did not hear things.

All of us "hear things" from time to time, he read, things that aren't there, things that others around us don't hear. Most of the time this is perfectly normal: those strange sounds may be due to stress, fatigue, distraction, or other natural and everyday events such as the common cold.

When the information coming to the brain from the ears is imperfect or partial, too soft or too loud, too high or too low, the brain can make mistakes, jumping to bad conclusions. The result is a "mistaken audition," or, in plain language, hearing something incorrectly. And it is nothing to worry about.

But persistent auditory hallucinations—"hearing things" on a regular basis—is not normal, and may be the sign of more serious problems.

If you or someone you love is experiencing persistent auditory hallucinations, it is important to first consult a hearing specialist. By performing careful hearing tests, they may find that the problem is in fact a physical one, due to an obstruction or defect in the ear organ itself. Nowadays, such problems can often be remedied easily and inexpensively.

If however a physical component has been ruled out, the problem may be psychological. At this point, you should consult your family doctor or your psychiatrist. You may also get more information by calling the PIMH hotline (see number below).

Of course, before any psychological diagnosis can be made, it is necessary to collect more information, in order to get a more complete picture of the individual's state of mind. For example, your doctor or psychiatrist may ask you (or your loved one) if, in addition to hearing things, you have experienced any of the following symptoms.

* Anxiety

* Depression

* Insomnia

* Restlessness

* Irritability

* Distractibility

* Neglect of personal appearance (uncharacteristic)

Well, this was good, thought Drew with a smile. Whatever this was, he had it in spades. He read on, but his amusement soon turned sour.

* Strange bodily sensations

* Food tastes strange or different

* Difficulty concentrating

* Disordered thoughts

* Indecisiveness

* Mood swings

* Inappropriate emotional reactions (e.g., laughing at a funeral or crying at a funny movie)

* Reduced emotion or "flattened" affect (i.e., no highs or lows)

* Reduced ability to experience pleasure from sensory, bodily, or interpersonal experiences (e.g., walking on a beach at sunset or having sex)

He chuckled at that. How profoundly these psychologists understood the human heart!

But it was disturbing too. When was the last time he'd really felt pleasure?

* Socially inappropriate behavior

* Feelings of "unreality"

* Paranoia—everyone is "out to get you" (when they are not)

* Delusions (odd or unusual beliefs)

* Belief in wild "conspiracy theories"

* Other (i.e., non-auditory) hallucinations (e.g., seeing or feeling things that are not there)

* Hearing voices (may be aggressive, insulting, or obscene)

If you or someone you know has experienced, in addition to mistaken audition or auditory hallucinations, three or more of the above symptoms for a period of at least one month, then the problem may possibly be related to the schizophreniform family of psychological phenomena.

Oh, fuck out of it.

Someone coughed pointedly. He turned and saw a withered woman, her thin grey hair collected at her pate in a bun the size of a plum, sneering at him. He sneered back, then realized that he must have spoken out loud.

"Drew Dunkel?"

He followed the new, less pretty receptionist to the examination room. She flourished a clipboard importantly and asked him the reason for his visit.

"It's complicated," he said.

She began to write this down, then pursed her lips in a little frown.

"I'd rather talk to the doctor about it directly, if that's alright."

"Of course." She looked at him sadly, pen still poised.

"Just put down, 'Stubborn asshole.'"

She wrote something and left the room.

He still had the pamphlet in his hand. He crammed it into a pocket and began to undress.

By the time Bruce blew in—hair awry, hands chapped, cheeks red, and a grin on his face like he'd climbed a mountain in a blizzard to get here—Drew had spread a sanitary sheet across the examination table and was sitting naked on it.

"I see we're getting into a rhythm here, you and I," Bruce said. He made jazz sounds with his teeth and tongue, tossed aside Drew's chart like a man kicking off his boots, retrieved it to write some notes, tossed it away again, and came at Drew with his tongue lolling and his stethoscope raised.

"Ow. It's cold."

"I keep this one in the freezer just for you. So what's on the menu today?"

Drew waited for him to finish the examination before replying. Bruce checked his heartbeat and blood pressure, listened to his breathing and his coughing, felt his lymph nodes and his testicles, looked into his eyes, ears, nose, and mouth, then stood back and looked at all of him.

"You're looking better," he said.

"Just give me the numbers."

"The numbers are the same," Bruce conceded, and said them out loud as he wrote them on the chart. "But you've lost weight, surely. Should we weigh you?" He clapped his hands at the idea.

"Two sixty-five. I did it at home."

"That's indescribable. Really. You've been following the diet then."

"Of course." In fact it was closer to two fifty, and he had not been following the diet, but he did not want to complicate matters.

"Congratulations, buddy. Really. Feels better, doesn't it?"

"As a matter of fact," said Drew, "it feels worse." He slid off the table, peeled the sanitary tissue from his backside, and began to get dressed.

Bruce crumpled the sheet of paper, stuffed it in the hazardous materials bin, scrubbed his hands at the sink, sat leaning back in his chair, lifted one sneaker onto the desk, cracked his knuckles, and looked at the ceiling thoughtfully. He asked Drew about past symptoms, but with courteous offhandedness, so that Drew need not feel embarrassed to admit that this or that concern, once gravely life-threatening, no longer bothered him much.

"Well, what can I do for you today?"

Drew had intended to tell him about the insomnia, the mood swings, the difficulty concentrating, and the uncanny thing that had happened in his guts yesterday. But somehow it no longer seemed like a good idea.

Instead he requested a refill for his rash cream, and complained about his knees.

"You mean like a crackling or a popping?" asked Bruce, listening as Drew bent them.

"Sort of like that," he said.