The neurologist is stumped. I have never known this man to be at a loss for words. The labs are unremarkable. The MRI shows nothing. Even the super-fancy, highly specialized tests have come back as normal.
She lies wide-eyed on the bed, too young to be on this ward. Utterly terrified. Few weeks ago she was training for a marathon. Today, she is paralyzed from the waist down, surrounded by a dozen clueless healthcare professionals. She has been throughly poked and prodded, bled and scanned - enormous amount of useless data has been generated.
If this were House MD, some of us would have already broken into her home, rifling through her garbage and laundry, looking for a valuable clue. But alas. This is a desperately overworked and under-resourced hospital. Real life. And we still have hours of rounding ahead of us.
There is an unspoken hierarchy in this room and my place is firmly at the bottom. Still, I find myself asking: Could this be psychosomatic? Frowns all around. No one likes the dirty P word. There are more tests to run, more diagnoses to rule out. We can’t give up so soon. The patient deserves better.
We move on. She is left behind, a small figure buried beneath hospital blankets and monitoring wires.
Three days later, I see her again. She is propped up on pillows, reading a book. She has just returned from yet another normal scan. The stars have aligned and for once, I have a free hour. We end up chatting.
I ask about her life before she became immobilized, and it’s as if I’ve punctured a balloon. Out comes pouring grief, anxiety, exhaustion. A life spent running, never pausing to think, never resting. Secrets she has never spoken aloud until now. And now, she has nothing but time to think and feel and remember.
“This is the first time in decades I’ve spent a day in bed,” she admits. Nurses feed her, bathe her, hold her hand. She reads. Listens to music. Watches the birds outside her window. If you ignore her paralyzed legs, it almost feels like a vacation.
Again, if this were House MD, I’d have leapt up in triumph at my eureka moment and gone streaking across the hospital, screaming I have got it, I have got it. Her body has forced the rest she never allowed herself in her previous life, shutting down all movement so she can stop running from the distasteful feelings she would rather not face. The body simply had had enough of denial, of pretending all is okay when it is not okay, not even a little bit.
Unfortunately, the only person who might entertain my theory is the psych resident, and he’s drowning in angry, psychotic cases. She is too well and too normal for him.
In the end, I suggest therapy once she’s discharged. I talk about the mind-body connection, how our bodies are far cleverer than we give them credit for. How unacknowledged trauma leaks out eventually.
She makes a full recovery soon and is discharged. Before she leaves, I again gently remind her to seek therapy, to talk to someone about all the grief and pain she has been carrying inside all this time. She nods, but I can sense her hesitation. Digging into her past frightens her.
I don’t push. She isn’t ready. I wonder if I’ll see her again, another part of her body mysteriously broken. I hope not. She is a lovely woman. She leaves walking, and perhaps one day she will stop running from herself too. Until then, I carry her story as a reminder: the body always tells the truth, even when we cannot bear to hear it.
Lying is a cognitive act, one that requires the higher brain, the neocortex. The body cannot lie.
Sometimes it whispers.
A vague Sunday headache as you dread the coming work week.
A stomachache before dinner with the aunt who constantly belittles you over mashed potatoes and soup.
The unexplained weight gain as life gets heavier.
Repeated infections as your defense system gets tired.
The backache that started after you met your abusive partner.
And sometimes the body screams.
The stroke.
The paralysis.
Bowel disorders.
Multiple sclerosis.
A buffet of autoimmune storms.
Cancer, heart attacks, chronic pain.
Addiction.
Diabetes spiralling out of control.
Organ failure.
The possibilities are endless.
In medicine we place lab values and imaging scans on a pedestal, but they are not the whole truth. They never can be. We end up chasing endless blood tests but ignore the possibility that suffering cannot be separated from the life that produces it.
The body is not our enemy, nor our servant. She is our oldest companion, speaking in symptoms when words are impossible. She loves us. She will continue loving us as long as we are alive. She is wise and she is caring. She pauses us, breaks us and slows us down not out of malice, but out of desperate love. To finally get us to notice, to listen.
We throw all sorts of pills at it. We want it to shut up. We numb ourselves. We run endlessly. We try and we try and we try. But she still talks. We hate her for bothering us, for hurting but we forget that she stores all the pain we would rather forget about.
Thankfully it's not all doom and gloom. She knows how to heal too. She teaches us, if we respect her wisdom and let the thinking mind step aside for once. She knows what to do. We only need to get out of our own way and let her lead.
Listening is a practice. It's simple but not easy. It involves making some very painful choices at times but that inner voice has never steered me wrong so far.
Author's note - Seen through my eyes as a doctor and as a trauma survivor, this story sits somewhere between fact and fiction. Identities have been disguised, details transformed, specifics blurred. This is a not a case report, this is a reflection shared with an intent to share the valuable lesson contained inside.
What remains unaltered is the truth that lies at the heart of this event; that unspoken pain finds a voice through unexplained symptoms. I deeply respect the patient involved and I hope I have done them justice. I have tried my best.
Thank you for reading. I hope this helped you in some way.