Joan Marcus

“I’ll make a deal with you,” my daughter says.

We’re driving in her Scion IQ, a flashy orange two-seater she calls her “clown car.” Folks honk at you in a car like this one, doesn’t matter how well you’re driving, and I’ll admit it makes me a tad self-conscious, but Nora doesn’t seem to mind. Today she’s wearing a crop-top she crocheted herself and purple and green parachute pants—the kind of unapologetic outfit I wouldn’t have touched at her age. She’s twenty-two, so much more comfortable in her own skin than I ever was.

She also smokes more weed than I did—every day in fact. I just told her I’m not crazy about that. “It doesn’t have to be loaded with nicotine to be bad for you,” I remind her. I think about my father, who didn’t kick his cigar habit until his sixties, patting my back when I was a girl to hear the hollow sound of my clean lungs. “Like a drum,” he’d declare. You could pat his back and hear what a lifetime of pollution does to a body, how dense and dull it sounded. I think of my sweet girl, the pink of her lungs clogged with mucous and tar. Oh love, I begged her, can’t you please just stick to edibles?

“What kind of deal?” I ask. I don’t like the sound of this.

“I’ll quit smoking,” Nora says. “But only if you see a doctor.”

Right. I guess I should have expected that.

It’s May of 2023 and the WHO just declared the global public health emergency over. That doesn’t mean the COVID pandemic is over—pandemics and health emergencies are different things—but most of us don’t know the difference. Even in my ultra-liberal college town, where until recently practically everyone masked in the supermarket, people are splitting desserts and taking sips of one another’s cocktails. We’re buying theater tickets, dancing with strangers. And we’re getting all those medical checkups and screenings we put off back when the world shut down—if we haven’t done that already.

Not me though. I haven’t seen a GP in, what, six years? Eight? Longer? I know I should, and honestly, “should” is stating it way too mildly. I must see a doctor, and soon, but I can’t. Not now. Not yet.  Any time I do, my gut twists and my heart rate notches up past 130. This happens even if I’m there for something minor like a prescription refill. It’s the antiseptic smell that does it, the lurid posters of mouth sores and skin lesions. It’s the pressure cuff and metal scopes hanging on the wall. Or, fine, it isn’t that, because I panic in the waiting room too. Maybe the details don’t matter. The lounge is crowded or empty, bright with plants and gossip mags or bare and low-lit with drab furniture. Either way, I’m in all kinds of hell.

I start panicking when I wake in the morning and remember what the day has in store for me. I panic on the car ride over. By the time I’m there for real and hear the rip of Velcro and feel the cuff slide up my arm, my heart is slamming and hiccupping and it literally feels like I might die.

Sedatives don’t touch my panic, so for decades I’ve avoided the doctor as much as possible. Now, three plus years into the pandemic, it’s even worse. After all the masking and Zoom meetings and dodging crowds and parties, I’m curled in on myself, stuck in a state of torpor. I just can’t make myself do it.

Avoiding doctors doesn’t mean I don’t worry about my health. If I’m not grading papers or distracting myself with word puzzles or dumb animal videos, I’m thinking about my thick waist and cruddy metabolism, or wondering whether the dinner I’m cooking will give me acid reflux, or if the pills I’m taking for reflux will give me heart disease, or if not taking them would give me throat cancer. This mix of obsessive worry and complete avoidance baffles even me. I know it worries my daughter.

“And you have to get tested for diabetes,” she says.

I mean, sure. I’ve been pre-diabetic for years, and my last fasting bloodwork had me just a smidge over the line into genuine Type II. But look, a diagnosis requires two readings above 125. If I watch what I eat and don’t bother with a second test, I get to say I don’t have it, right? Yeah. I’m pretty sure that’s how it works.

Blood sugar isn’t my only problem—not by a long shot. Heart palpitations have dogged me since menopause, and recently they’ve gotten worse. One time I drank a glass of Riesling at dinner and my heart started racing unevenly, like an engine that needs cleaning. I made the mistake of admitting this to Nora, who took my wrist and felt for my pulse. “That’s terrifying!” she cried.

“It’ll pass,” I told her. It always passes. I know that doesn’t mean I’m okay, but really, how can I go to the doctor for my heart when just thinking about it triggers more palpitations?

I need a mammogram. I’m eight years overdue for a skin check. I haven’t had a pelvic exam with a real gynecologist since my follow-up after Nora’s birth, shortly before 9/11. Believe me, I understand how bad all this is. “I might have made a tactical error in not going to a physician for twenty years,” said Warren Zevon on the Late Show with David Letterman in 2002, shortly after his diagnosis of terminal pleural mesothelioma. “It was one of those phobias that really didn’t pay off.”

Sweet Warren, with his round glasses and acerbic wit, who released Life’ll Kill Ya two years before his diagnosis. As though writing about mortality were a reasonable stand-in for self-care.

“Look, I’m working on it,” I tell Nora. “For real. I’m in therapy. It could happen as soon as this summer.”

“That’s good,” she says. She rolls to a stop at the big intersection near Wegmans and waits for the light. She throws me a quick side eye. I know she doesn’t believe me.

“You sure you’re prepared to give up smoking?”

“Absolutely.”

“Because I’m really going to do it.”

“That’s good.”

Nora is the exact age I was when my mother died. Mom’s battle with degenerative neuromuscular disease ended five weeks after my twenty-second birthday, when she was sixty years old. I will turn fifty-nine in six months. Nora and I are both painfully aware of these numbers; we both carry in us the fear that a pattern could be forming. As busy as Nora gets with school and jobs and an active social life, she always drops by the house every few days to hang out and watch videos or maybe stay for dinner. Yes, we’re a close family, but I know it’s more than that. I know she’s afraid she’ll lose me.

When your mother dies young of an illness with no clear cause, you always have that number poking at you. She didn’t live past sixty. If I never see the doctor, if I hold my breath and cover my ears, maybe that won’t happen to me. In childhood I was terrified of bursting balloons, the violent snap that seemed like it should hurt physically. Once I went to a party at the home of a girl I barely knew and endured a game where dozens of balloons were tossed on the ground and the kids had to pop them. The one who destroyed the most balloons must have gotten a prize—I don’t remember. I stood off to the side while girls and boys sat on balloons or stomped them or picked them up in their hands and squeezed, squeezed, squeezed. I covered my ears. For many years after that, if something bad happened out of the blue, for instance if I was riding in the passenger seat and the car was about to hit a squirrel, I would reach up and cover my ears.

I’m still covering them. This is not a rational tale. I’m full of contradictions and nervous habits, always picking at my skin or working my jaws around a wad of gum. I’m doing my very best to survive my dysfunction, for my sake and for Nora’s, and for her father and older sister too, but I can’t promise anything.

Nora parks her car in front of the market and we sit there in silence for a moment. I think I should ask her to shake on it, but I can’t even make myself do that.

---

Essays and stories by Joan Marcus appear in The Sun, Fourth Genre, The Smart Set, Laurel Review, Alaska Quarterly Review, The Georgia Review, StatORec, and elsewhere. She is a two-time recipient of the Constance Saltonstall Foundation grant for New York state writers and has been awarded residencies at the Constance Saltonstall Foundation for the Arts and the Writers’ Colony at Dairy Hollow. Avoidant Type, her memoir-in-progress, tells the story of her decades-long struggle with medical anxiety. She is an Associate Professor in the Department of Writing at Ithaca College, where she teaches memoir and fiction.

←previous     •••    next→