Long ago I suffered what is sometimes called Medical Student Syndrome. When aspiring doctors begin to learn about the human body and the many ways it can fail, they often become hypochondriacs. At one point during medical school I self-diagnosed a small cyst as testicular cancer. Several times I felt short of breath and feared various respiratory diseases. And for a long time AIDS seemed a near certainty despite my very low risk for the disease.

The AIDS paranoia wasn’t surprising, since I started medical training in San Francisco in 1983, when the disease was widespread, completely unstoppable, and largely mysterious. I diagnosed it many times in guys exactly my age, and I felt awful watching terror dawn in the eyes of these unfortunate men. Scores of my patients died of AIDS over the years.

The worry about my lungs arose from my previous history as a heavy marijuana smoker. I gave up that pernicious habit prior to starting med school, but I feared lung cancer and breathing disorders for years afterward. (And as you’ll soon read, I suffered a couple of serious respiratory problems growing up, which probably primed this anxiety.)

The testicular cancer scare may have arisen from childhood mistreatment inflicted by my stepmother. After my sister moved out when I was eleven, my parents began hosting ‘free love’ parties, so the household became highly eroticized, exhibitionist, and unsafe. At the same time, my stepmother often humiliated me with emasculating language, and she sometimes intruded on my dressing and showering. My guess is that the combination of inappropriate sexual exposure during my preteen years and constant attacks on my budding masculinity caused heightened castration anxiety; Freud would likely agree.

This morning I’m looking at my current and all-too-real illness from the perspective of my earlier imaginary afflictions. As you can see from the above, hypochondria doesn’t occur randomly, but focuses on those body parts most loaded with personal meaning.

Could actual diseases come with symbolic baggage just like imagined ones do?

Most of my current pathology centers around my pancreas, which may be the organ ancient Chinese physicians had in mind when they spoke of the spleen. In Chinese terms the spleen (pancreas?) is considered an organ of digestion. It suffers breakdown under conditions of intense study and excessive worry (which are looked at as forms of mental digestion). During the past two or three years I worked hard to learn acupuncture, and I fretted almost non-stop about the difficulties of building a clinical practice. It wouldn’t be surprising, from a Chinese perspective, that something went wrong with my spleen/pancreas.

Or consider the fact that my sister died last October of liver disease. She suffered abdominal pain and her pathology was in the same general region as mine. Could there be an element of sympathy in all this?

But how could study, or worry, or sympathy cause a ligament to close off a major artery and lead to all my subsequent problems (e.g., internal bleeding and intestinal obstruction)? The underlying cause seems so simple and mechanical, it appears to lack the potential for subtle progression that could connect these putative causes with the known pathology.

Perhaps it would make more sense to look at the effects of the illness rather than its origins. For one thing, my sickness may very well terminate my holistic health practice. There’s a limit to how long I can afford the office expenses while the business sits closed, so if my incapacity goes on too long I’ll need to look for someone to assume my lease. Maybe this disease will force me to concentrate on writing and speaking rather than hands-on healing. Is this divine guidance or just bad luck?

Another instructive tack is to look at my relationship with illness in general. Back when my mother was suffering her many cycles of depression, hospitalization, and shock treatment, my childhood needs tended to get neglected. One of the few times I remember being the center of attention was when I spent weeks on a pediatric ward (under an oxygen tent) because of pneumonia. A few years later I sprained my ankle falling off a swing, and I continued to limp even after the pain had receded, simply because my mother acted concerned about me. Feigning injury seemed like a great strategy until my mom’s doctor friend called me on my ruse, and I felt ashamed.

Fast forward a few years and consider how my stepmother treated me when I fell sick. She hated to waste her time taking me to the medical clinic and always accused me of faking. For instance, when I was about twelve an attack of pleuritis made me cough vigorously with nearly every inhalation. My stepmother thought me exaggerating even as I neared frank exhaustion. Years later, in high school, I never told my family about symptoms of mononucleosis until a staph infection covered my entire tongue. I’d learned no one would believe me anyway.

Given these early illness experiences, is it a surprise that my initial reaction was one of relief when the first CT scan showed a liter of blood near my pancreas? I had awaited the result afraid the doctors would conclude I was exaggerating the discomfort of simple cramping or gas. Rather than feeling alarmed that something ominous had occurred, I was glad to be vindicated in my complaints of severe pain.

Well, this essay has gone on about as long as I like to let my pieces run, which is to say a lot further than the average effective blog post. And yet, there doesn’t seem to be any clear progression or larger point being made. But maybe I can wrap things up like this: everything we experience connects with history: our professional history; the world’s intellectual history; our childhood history. Nothing happens that can’t be interpreted in light of what’s come before.

A few posts back I emphasized how much value I find in mining experience for meaning. This doesn’t always yield lessons that are clear and unambiguous. For me, at least, the point isn’t to figure out why my life has unfolded as it has. Instead, I look at it as a sort of living poem that is open to various interpretations and can be seen from a multitude of perspectives. Like any good drama, it doesn’t offer pat answers, but it does offer food for thought.

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