Maladies of My Mind
Ch.4 Invisible Girl
The first time Awut tried to kill himself was when his genetic test came back positive. I found him lying on the bathroom floor with sleeping pills scattered all over. I took him to the emergency room and he threw up a bit, before a doctor made him drink activated charcoal. He was then hooked up to a heart monitor and the doctors put a line in him to draw blood and give him saline. After they concluded that Awut wasn’t going to die, an ambulance transferred him to a specialized facility, where he was put on a three-day mental hold. Awut told me that he spent most of his days hanging out in the lounge and talking with other suicide and self-harm survivors. A guy told him that people hurt themselves because of anger and that he needed to learn healthy ways to address it. So when Awut was released, he tried to teach me a game called “knuckles,” where we put our knuckles on a table and flick coins as hard as we can across the table at the other person to make them bleed. The loser is whoever flinches first.
Awut flinches when he sees me approaching. There are wires glued to his chest and coming up from the neck of his hospital gown. The gown has no back and lets everyone see the fat parts my brother might want to hide. It is the most embarrassing garment ever invented. Both his hands and legs are also strapped to the hospital bed as if he’s a cow about to be slaughtered. The doctors finally decided to restrain him after his countless attempts to hurt himself and others. His pupils dilate, black and with adrenaline, like rabid animal’s eyes– wild, unfocused, and full of rage. His wretched eyes are glued to my face because there is nothing else to do but lie in his bed, emaciated, and possessed. He begs me to kill him with desperate eyes.
I say quietly, “Did the voices in your head tell you to drown yourself in the tub?”
Awut opens his mouth to say something but hesitates. He then opens it again and says, “T-they said that if I don’t, you’ll come and dr-drown me yourself.” His voice is more staggering than the last time we spoke. It takes him more effort to finish his sentences. “J-just do it already! Kill me and get it o-over with!” He spits at me.
Paranoid schizophrenia-like symptoms occur in 6-25% of Huntington’s disease cases and my brother is one of them. Other than paranoia, Awut also suffers from auditory hallucinations. There are many types of hallucinations, including visual, auditory, gustatory, olfactory and tactile.
I slowly put my hand on his arm and notice how unusually stiff he is. He tries to pull away but has no control over his movement. His body twitches and his muscles spasm. I say calmly, “Why would I hurt you, Awut?”
“Because y-you’re just like him. You’re like f-father.” His limbs jerk involuntarily and his face grimaces, “Y-you want to get rid of this d-demon inside me like father did to mother.”
I touch the scar that runs across my forehead and licks away my brow. The memories of the shaman my father hired to whip my mom with the dried stingray tail rush back to me. I tried to protect her and was marred as a result. Despite my efforts, we ended up losing my mother anyway. My knees weaken and I kneel down beside Awut’s bed. I place my forehead on his arm and he struggles beneath my touch. “I’m not like him.” I feel tears trickle down my face and I fight to keep my voice straight, “If anything, I could turn out just like you and mom.”
Awut’s breathing becomes less erratic and his body relaxes slightly. When I lift my head and look at him, I notice that his facial expression softens. I say, “Awut, I think I’m ready to take the test.”
I wake up beside Sujin. My cheeks are covered with a cocktail of sweat and tears. I’m breathing heavily. Sujin leans over me and brushes a wet strand of hair out of my face. I asked him to be my counselor for the genetic test but he refused. He said he’s already attached to me and it is unethical for him to be my physician.
I shouldn’t get involved with him. But waiting for my test result has been so stressful that I often find myself getting drunk and ending up in his bed. He gently grabs my hand and whispers, “Are you okay?” That’s become his constant question. Almost recited.
It’s been almost two weeks since my genetic test and I have one day left until the result is out. Although specific procedures vary among testing centers, genetic testing for Huntington’s disease generally involves several sessions, including pre-test genetic counseling, neurological examination and psychiatric interview, that can last for months. The genetic test itself is a simple blood test. The blood sample is sent to a laboratory where DNA testing is performed to check for the expanded CAG repeat within the Huntington gene. My fate depends on these three little letters. If the CAG repeat size is less than 35 repeats, I do not carry the genetic mutation for the disease. But if I carry more than 40 CAG repeats, I test positive and am cursed with the devastating illness.
I often wake up gasping, my eyes hunting frantically for the family I’ve lost and the family I have decided not to have. This cursed disease can extend its claws and prey on the next, innocent generation. Even though I’m not religious, I often find myself praying to all the gods in every religion in hope that one of them can overturn this curse. I try not to show my concerns but my eyes always betray me. Sujin often tells me that I can still have a family if I want to. He says that I can get what he calls ‘Test tubes babies’ through pre-implantation genetic diagnosis. I respect those who choose that path but I still don’t want my children to witness my mental and physical deterioration like Awut and I went through with our mother. I stare at the wall across from us, lost in my nightmare, and Sujin has to tap my foot with his to snap me out of it.
“I’m fine,” I say as I look away. Sujin develops the habit of stroking my hair and kissing my tears away. He runs his hand down my scarred back. Even though I received this unwanted art piece years ago during the fire my brother started to rescue our mom from the shaman, the smell of my burning flesh still haunts me. My tender skin has toughened into an unnatural patch of quilt work. I despise the pattern but Sujin always reassures me that I’m beautiful. A labored breath escapes my lips and I snap at him. “Stop.” The lump in my throat threatens to choke me. I say coldly, “I can’t be bothered with menial displays of affection right now when I have so much at stake.”
He removes his hand from me and pretends it doesn’t bother him. “If that’s what you want, Orasa.” His words, meant to be mature and comforting, instead sound faker the more he says them. “Well, I’m here if you want to talk about it, birdie.” His cheeks flush when he uses my nickname. The hint of a smile appears on his face, pulling me in with its irresistible warmth. But this time, he doesn’t try to hug me. He doesn’t reach for me or scoot closer to let our shoulders touch. He doesn’t stroke my hair, whisper reassuringly into my ear or rest his head against mine. I hadn’t realized how much I’ve grown to crave these little things he does.
I hear humming on the bed and I turn to Sujin. “Do you hear that?”
He looks at me, confused. “Uhh…I don’t think so.”
I grunt, “I swear I heard something.” I search through the sheets and finally find my vibrating phone.
I pick it up and hear a girl’s panic voice. I recognize it immediately. It’s the daughter of the acid assault patient I met in the emergency room. “D-doctor,” The girl sniffles. “Are you free right now?”
I look at the clock. It’s 4 in the morning. I have to perform a surgery in a couple of hours but the girl’s shaky voice prompts me to tell her otherwise. I reply, “Yes I’m free, kiddo. Where are you?”
“At the hospital,” the girl pants. It sounds like she’s running away from something and I can sense fear in her voice when she adds, “My father’s here. Please help me!” I hear the girl screams before the line goes quiet.
“Hey, kiddo! Hey!” I yell into the speaker but I hear no response. I try to redial but I go straight to voice mail. I immediately jump off the bed and scramble to get dressed.
Sujin asks, “What’s going on, birdie?”
I fumble to put on my buttoned clothes. I reply, “I just need to go somewhere.” My hands tremble slightly. It must be from my lack of sleep. “Can I borrow your car?” I pull out the drawer and grab his car keys before Sujin can reply.
He gets up from the bed. “What’s going on?”
“I don’t have time to explain!” I respond a little too aggressively and Sujin seems taken back by my outburst. I pace towards the door and mumble. “It’s just something I have to do.” I look at his befuddled face one last time before rushing out of the apartment.
I get inside the car and hit the pedal. I hit the pedal harder, wanting to go faster and wanting to scream, break something, rip out my hair, scratch my skin off or throw a punch through the window. But, I’m stuck. Bangkok traffic is betraying me. The girl’s scream still rings in my ears. Why is she running? Is her father abusing her? I’m so angry at the injustice the girl is facing. Why isn’t anyone at the hospital helping her? Why doesn’t anyone care? I try to redial the girl again but I still get no response. The burning rage inside me is tearing through me. I feel possessed, a puppet strung to the sadistic hand of a devil.
I finally arrive at the hospital’s underground parking lot. It’s mostly empty, except for a few cars, and it reeks of rotten sewage smell. There’s a glass door at the end that leads me to an elevator and a set of stairs. I run towards the door and swing it open. I bang my finger against the elevator’s button repeatedly. I tap my foot, impatient at its snail pace. It’s taking too long. I decide to use the stairs instead.
As I rush upstairs, I misstep and descend downward. I skid down a couple of steps on my back before I have the presence of mind to stop myself with my palms. I ease myself up to sitting, and I can already feel a nasty series of bruises blossoming on the knobs of my spine. I twist around to examine the stairs, expecting to blame some kind of obstruction. There’s nothing.
When I look up to the top of the stairs, I find the girl I’ve been looking for running towards me. How did she get here? Did she know I’d be here? Logic tries to reason with me but it quickly vanishes when I hear the girl screams.
“Help me!” The girl whimpers, “Please, doctor!”
I lift each arm up and notice that both my elbows are scraped and bleeding. But I don’t have time to examine it. I stand up and grab the girl’s hand. We need to get out of here before her father catches up.
“Where are you taking my daughter?” I hear a chilling voice echoing through the parking lot. I turn around to find a man eyeing the girl like a prized piece of prey. The man’s voice turns eerily calm as he walks towards us and politely says. “Doctor, this is a family affair. Please turn my daughter over. I just need to teach her a lesson that’s all.”
I take a deep breathe and say, “Sir, I’m sure whatever conflict you have with your daughter, we can resolve it over coffee.” I try to distract the man while keeping my chin down and eyeing the girl beside me. But, the first punch glance my chin. I notice too late it is a feint though and the second punch doubles me over and expels the last bit of choked air from my abdomen.
“Please don’t hurt the girl,” I say, lying on the concrete floor. I feel another blow to my guts. My eyes plead for the man to leave his daughter alone. Instead, the man grabs the girl by her hair and starts dragging her away from me. The girl screams again and again as he tugs her away. As if to mock the dire playing inside my head, the girl’s scream plays a familiar dance tune that reminds me of the times I screamed for help when my father punished me as a child.
I cough out blood. “Stop!”
The man stops walking and he turns around. He lets go of the girl’s hair. His face turns red at first but then his lips curl into a vicious, animalistic smile. I can’t decide whether to let my eyes rest on that wicked smile or on the girl’s teary face. Another blow throws me across the floor and my abdomen blazes with pain. I slump against a wall but bear the punishment silently. It is just another bruise. I have dealt with them before. “I heard you’re a surgeon,” the man finally speaks up. “I wonder what kind of trash you’ll be if you can’t operate anymore.”
He eyes my hands with a predatory gaze. Understanding comes later. “No! Please No! Not my hands! I beg you!” I scream but here, in the empty parking lot, no one can hear me.
I limp across the hospital lobby, cringing at the smell of puss leaking out of my bruised hands. I hide my hands behind my back when hospital staff members greet me. I don’t have time to explain my condition as I drag my feet across the floor. I need to get to the security room. There must be a camera in the parking lot. If I’m able to obtain the footage, I can use it as evidence to charge the girl’s father with domestic abuse. Even if the man bribes the police, hard evidence like video footage of him beating the girl up will surely get him arrested.
I’m so close to my destination when I see one of my surgical residents runs towards me. “Doctor, you’re here! We’ve been paging you all morning. You have a surgery to go to.” When he approaches me, he gapes. “Doctor…Did you get into an accident?”
He tries to examine the wound on my face but I push him away. I wince while doing so and the resident notices my bruised hands. His eyes shift between my hands and my face. He finally says, “Doctor, I don’t think you can operate in this condition. Don’t worry about the surgery. I’ll call in another attending surgeon while you get your injuries check out–”
“Just prep the OR!” I yell and I notice that everyone in the hospital lobby turns towards me. No one speaks but just stares at me. They’re all mocking me. They’re just like the elders in my village, who think all girls are worthless. Do they think that because I’m a woman, I can’t do my job as a surgeon? I despise the patriarchy in my country. White-hot rage consumes me, the pressure building up and pressing against every cell in my body. I’m sure I’ll physically explode if the rage doesn’t leave me. I turn to the resident and growl, “I said prep the OR! I’ll be there in a minute!”
I don’t bother to see his reaction but continue limping down the corridor. I find myself in the dark security room with the only source of light coming from sets of computer monitors hanging above the long metallic table. I point my finger to the screen and demand, “Check the underground parking lot about half an hour ago. A man was abusing my patient’s daughter.”
The two slightly obese guards stare at me. They’re holding grilled meatballs sticks in their hands and their mouths gape in confusion. They seem inexperienced and unsure of what to do. I roll my eyes. I ram one of the guards against the wall with my elbow and press him deeper into the wall. He drops his food on the ground and I yell, “Check it now!” I eye the other guard. He quickly throws his meatballs away and types something on the keyboard. When I see a screen pop up, I let the fat guard off my grip. He rubs his neck with wide eyes, scared out of his mind.
I pull a chair over and sit on it. My elbows rest on the table as I examine the footage on the screen. I point, “There! That’s the man I was talking about.”
The security guards exchange weird glances. “D-doctor…I think there’s a misunderstanding.”
I growl, “What are you talking about?” The footage is clear. It shows a middle aged man beating me senseless and pulling the girl by her hair away from me.
The guards blink confusedly. One of them finally speaks up, “The video…There’s just you in it….” He pauses for a long moment before he mutters, “You’re throwing your fists against the wall.”
What are they saying? That’s absurd. The girl’s father must have bribed these pigs to say all this nonsense. “How much did he pay you?” Heat rushes through me. “Is that why you’re turning a blind eye?”
“No doctor,” The guards raise both their hands defensively. “Please, doctor. Please calm down.”
I push back from the table to stand, but the push is dramatic and forceful, and the chair crashes to the crappy linoleum floor. I stumble over the upturned legs as I back up, and now both the chair and I are on the ground.
I hear mocking laughs leak out of the guard’s mouths. “How dare you make fun of me?!” I bellow. The guards quickly shake their heads and tell me they didn’t. Liars.
Now riding the back of humiliation, my rage accelerates. Ignoring the throbbing pain of my bruised hands, I stand up, lift the chair by two legs, and smash it against the floor. The legs crack off and several of the back spindles break apart. I toss the legless chair to the ground and march towards the guards.
I look at them and grunt, “What’s your name? I have to get to surgery but once I’m done, I’ll make sure I get incompetent fools fired.”
Both of them look at me in horror. They won’t answer me so I look at their nametags. I pull out my phone to jot down their names. But my hands suddenly feel weak. My fingers flick, as if they are doing their tap dance over my phone screen and ignoring my command. I’m concentrating on my fingers as if I’m performing the most difficult surgery in the world. I try to will my thumbs to type down the names of the security guards onto my phone, but no amount of focus will stop them from trembling.
Heat is building inside me, and I’m holding my breath, losing patience, about to throw the stupid phone to the ground. Even though the room has an air conditioner, the air suddenly feels thick with moisture and humidity. The heat is unbearable and I feel a bead of sweat slowly drip down my neck and sacrifice itself to the cotton confines of my already damp shirt. The entire room seems to be slowly melting. I could swear those security guards were a few inches fatter a couple minutes ago.
When I look up, I’m surprised to find the girl standing beside my surgical resident. She has a gash across her forehead. Instead of helping the wounded girl, the resident rushes to me and says, “Please doctor…Please pull yourself together.”
I point my finger at the girl, “Why aren’t you helping her?” Apparently the girl’s father must have bribed the resident too. I spit in his face. “Can you even call yourself a doctor? How much did the acid assault patient’s husband pay you to turn your eyes away from their abused daughter?”
“Doctor…” He’s sweating, frazzled and directing his eyes towards where I’m pointing. He takes a deep breath before whispering, “I can’t see the girl, doctor. Besides, the acid assault patient doesn’t have a daughter.”
My eyes widen. What is he saying? Of course she has a daughter. She is standing right in front of me. Before I can retort, I feel a pair of small arms wrap around me. I look down to find the girl hugging me. She pleads, “Please doctor. Don’t listen to them. To them, I’m just a poor girl. No one cares about a poor, abused girl.” She cries, “To them, I’m invisible. But you care about me. To you, I’m real.”
I look at the girl’s wound across her forehead. It singes her eyebrow and slightly misses her eye. I frown. “Did your father give you that?”
The girl shakes her head. “No.” The girl takes few steps away from me and says quietly, “The shaman did…with a dried stingray tail.” She pauses before speaking in a somber tone. “I tried to stop him from hurting my mom and I got hurt as a result.”
I hear my heartbeat pulsing in my ears, blocking out all other sound except the breath that is raggedly moving in and out of my mouth at irregular, gasping intervals. I cannot tear my eyes away from the girl. The wound across the girl’s forehead has captured me. I cannot comprehend what is happening to me. The connection has to hold. If it breaks, I fear something within me might break as well. I step towards the girl but she takes another step back. I grab her arm and twirl her tiny body around. I pull her shirt up and stumble back when I see a burnt scar running its tongue across her back. I trip over my feet and fall to the ground. I raise my trembling finger towards her and ask, “W-who are you?”
The girl turns around and heads towards me. I push myself backward until I’m trapped against the wall. She looks down to me and puts her palms together in a Thai prayer-like position as if she is greeting me for the first time. She smiles and says, “I’m you.”
For more information on the association of HD and schizophrenia-like psychosis in HD pedigree, please refer to this article.
Before the diagnosis my husband would lose his temper at me. He’d leave the house and I’d not know when he would return. He wouldn’t go to marriage counseling, so I did. What was I doing wrong?
Then one day he lost his temper at our child. I’ll never forget that moment, and our child holds it still. Our family was hurting.
Years after diagnosis I suddenly realized the temper episodes stopped. Cold turkey!
I could look back before the diagnosis, and I saw we had been in denial, and I realized we worked very hard at supporting our denial. Perhaps my husband’s anger was part of his denial tactics, a masquerade of a “normal” person under stress. Before the diagnosis the stress of denial disrupted our family, and after the diagnosis, Huntington Disease disrupts our family, too. But now struggles are genuine and contain a good measure of peacefulness and acceptance.
I subscribe to a caregiver’s newsletter from Mayo Clinic’s Alzheimer’s Disease Research Center. Recently it had an article on “Pleasant Dementia”, the characteristic of some people with dementia who, like my husband, are “stuck in the moment” which is one filled with ease, appreciation for each sunrise, deep love for his family and silly jokes.
For us, going from before-diagnosis to after-diagnosis is not about losing your whole life, although the losses are many. Rather it’s about replacing denial with acceptance, anger with letting go, and worries about the future with being fully present with today’s life.
The author who submitted this story to HOPES wishes to remain anonymous
After noticing some unusual mental and physical behavior, appointments with and tests by a neurologist, we got the startling diagnosis of Huntington’s disease (HD) in March 2010. It was an unwelcome surprise as we were not aware that this genetic brain disease was in her father’s family. Katie’s reaction was, “I don’t want to know that…” and even now, almost five years later, while resigned to her fate, there’s still some denial.
I was glad to know what we were dealing with, but had no idea that I would spend my retirement as a 24×7 caregiver. We’ve been married 53 years and had plans to continue the world travel that began in Japan after our marriage. But it was not to be. Our new adventure is learning about and managing the symptoms for this neurologically degenerative disease for which there is no cure.
HD often first shows up with involuntary movement known as chorea (Greek for dance) or tentative gait, and Katie began to walk very slowly even pulling me back if I had her arm. And, as home manager, she was having difficulty making decisions, paying bills, handling checks and compulsively collecting newspapers. In the last year she has become more emotional—sudden crying, anger, angst.
The diagnosing neurologist referred us to the Huntington’s Disease Center of Excellence at UCDavis where we met with the HD team for an evaluation. A year later we switched to the UCSF Memory & Aging Center that takes a more horizontal approach to neurological diseases and was geographically closer.
We met with several team members for observation and consultation. The prognosis was annual observation that has become semi-annual, and for the past 12 months the anti-anxiety drug Mirtazapine before lunch and bed. If she’s still agitated and unable to sleep we back up the Mirtazapine with Melatonin.
As it turned out the most significant meeting was with the physical therapist, who, after a brief interview, showed us strength and balance exercises, and how to get up after a fall. But her most important recommendation was: “Get a dog!”
It had been about 18 years since our last dog. We had enjoyed a black Lab, then a Siberian Husky while our two daughters were growing up, but they had gone off to college and out into the world, so we did not get another after the Husky died.
Our younger daughter had been advocating a dog for several years and Katie, who had been our leader in acquiring dogs, had said she would like a lap dog that would sit with her in the car or next to her on the couch while she watched TV. I had balked at the idea as I thought it would just be more work for me.
While thinking about a dog, we joined two HD support groups, one for caregivers only, the other for caregivers and patients. Both formats are good, but I found the combined group to be more helpful as hearing from those affected and those who care for them was usually enlightening. And it didn’t seem that caregivers held back in talking about their challenges, problems and successes.
We connected with some distant relatives and learned about other family members who had been affected. I talked with the niece of one of Katie’s cousins who was just 50 and was about to enter a care facility. She has four children, a husband who has left, but a loving sister who has taken care of her.
I reached out to Care.com and posted a physical exercise job, got amazing response and found a professional caregiver who began a weekly Walk &Talk with Katie getting her out of the house without me—good for both of us.
I met with Family Caregivers Alliance to learn about their services, educational programs and workshops. I asked our housekeeper to come every week and do some part time care giving. She, in turn, introduced me to a caregiver relative who comes weekly for six hours so I can see my grief counselor and meet up with friends.
Finally in September 2012, just after Katie’s 75th birthday, we went to an SPCA Open House Adopt-A-Pet Event in San Francisco. We couldn’t find the “right” dog so Katie said, “Let’s go to Berkeley Humane,” a place we often passed. When we told the attendant that we were looking for a small dog, 20 pounds or less, 1-2 years old, she said, “You should meet Flo who’s in the next room.”
It was love at first sight. Flo is a tan Border Terrier-Dachshund mix with brown eyes, black eyebrows and muzzle. We took her for a walk and said we’d like to “rescue” her. After two hours of paperwork we got in the car and took our new little friend home. I told Katie that she still had good dog karma.
Flo was just one-year old, in late puppy-early maturity development, and after some environmental adjustment was just fine. With our daughter and son-in-law we took her to a park and to everyone’s delight she loved to run and fetch a ball, bringing it back most of the time. With training she has become a great little retriever, but most of all she’s become a comfort to Katie and a little pal for me.
Having a “third party” helps us keep a positive outlook, and she is a great stress reducer as she loves to play with a ball or chew toy in the house, then curl up in Katie’s lap when we go out in the car. Katie has become less mobile so holding the dog in her lap allows me to run into stores for quick errands.
Flo is a great little watchdog barking when the doorbell rings, then settling down after the guest enters our home. And, she likes TV. Her favorite program is the PBS Nature series, and she’ll often watch an entire show, charging the screen and barking at animal close-ups, but just watching during the long shots.
One of the most rewarding values for me is dog and dog owner sociability. During our early morning and late afternoon walks we have met nearly a dozen new neighbors down the street and around the block because the dogs react to each other and their owners generally talk, get acquainted and sometimes become friends. These daily encounters are welcome mini-respites.
One dog walker has become a part-time caregiver. She and her dog come three days a week for two-hour periods allowing me to do some work around the house, run errands and attend my Tai Chi class. The dogs play to everyone’s delight. We now have part time caregivers everyday but Sunday.
We caregivers need to take care of ourselves so we can be effective in helping our loved ones and those for whom we care. Even with part time caregivers, support groups, workshops and professional guidance, I have a long way to go to become a better caregiver as I get frustrated, fatigued and angry.
Care giving is more art than science. And an unconditionally loving, four-legged friend can make a big difference.
This story was originally submitted to the 2014-15 John A. Hartford Foundation Story Contest. The author who submitted this story to HOPES wishes to remain anonymous.
Maladies of My Mind
Chapter 3. Drowning
The cold collar chafes my neck and makes the shivering hard to control. At least I am no longer in the claustrophobic tube, while the machines click and whir around me, listening to a disembodied voice telling me to hold still while I try to convince myself I can still breathe. Even now, when I’ve been assured there will be no permanent damage, I hunger for air. The residents are scheduled to remove the collar around my neck today but it takes them a lot longer than I expected. My patience is wearing thin. I’m not sure if their reluctance is out of their fear of hurting me or just of me, their superior physician.
After I change into my normal clothes and put on my white doctor coat, I slide the curtains that surround my hospital bed open. I am not surprised to find a shapely woman in a voguish red dress and black heels. Kris is my best friend and at one point, even more. But I broke things off with her because I believe serious commitment isn’t an option for me. Kris greets my residents with a traditional Thai wai. She slightly bows, with her palms pressed together in a lotus position and says sweetly, “Thank you for taking care of Orasa.”
The young doctors swoon over her. They quickly press their palms together to accept her wai. A resident adjusts his glasses and scratches his trimmed pepper beard nervously, “Oh– yes, of course. Umm…With pleasure, miss.”
I roll my eyes. I send a dismissal hand signal to my residents. They won’t pay any attention to me but continue to stare at Kris’ smiling syrup lips. I finally find my voice, “Shoo.” The residents turn to me. I growl slightly, “You’re all dismissed.” The minions scurry out of the room.
I turn to Kris and ask, “How’s Awut?” I straighten, tensing. Doctors and nurses nearby were able to subdue him after he strangled me the last time we met. Even though he has just begun to show subtle signs of motor disabilities, my brother’s cognitive and behavioral symptoms are growing rapidly. Coupled with his existing anger issues, the aggression and paranoia symptoms from Huntington’s disease exacerbate my brother’s violence.
It’s been a while since I’ve heard any real updates on Awut’s condition. My eyes scan Kris’ face, searching for clues. I notice that her pupils slightly dilate and her face conveys anxiousness. What is she going to tell me? Or perhaps it’s no news at all and she’s simply going to tell me what she usually does. ‘Not much change, today, I’m afraid, but at least he’s still stable.’ I’ve grown so used to hearing that.
“Is he lucid?” I ask.
“Yes,” Kris says quietly. My pulse quickens. The news is so sudden. One minute my brother is being strapped in bed, losing control of his identity day by day, and now he’s awake and himself. Just like that.
I break into a smile, and before I can stop myself, I pull Kris into a tight hug. She stiffens. I haven’t held her this closely in a long time. She smiles and pats my head awkwardly, but I don’t care. I want to see my brother. “I’m going to the psychiatric ward.”
Just as I am about to head out, Kris grabs my hand and her smile wavers. She says, “Awut told me he doesn’t want any visitor.” My heart twists until it threatens to break. “He just felt really guilty for hurting you. He’s not eating much and has trouble sleeping.” Her voice trails off quietly, “He said he wants some time alone to rest.”
“Oh,” I say lamely. I take in Kris’ words and my fist tightens
“I’m sorry,” Kris replies guiltily. Now that I take a closer look at her face, I notice how stressed out she looks. Her under eyes blacken from the lack of sleep.
Over the course of my brother’s hospitalization, Kris has always been so supportive. I try to come up with ways to thank her but even now that she is standing in front of me; all my thoughts go to mush. I manage, “Don’t apologize. You’ve done all you can for my brother and me. I don’t know what I’ve done to deserve such a great friend like you.” I unclasp my hand from hers. “I have a lot of work to catch up with anyway,” I mumble. I know I’m supposed to take a few days off from work but I need to distract myself right now.
I give Kris a weak smile and numbly walk out of the room. As I exit, I find a surgical resident leaning against the wall. He is holding a red clipboard with notes on it, which I am assuming are lists of patients’ stats from his round this morning. He is also sweating profusely and fidgeting.
“What do you want?” I deadpan. I’m dumping my frustration on the resident.
The resident jumps lightly. He adjusts his glasses and stammers, “I’m waiting for your friend, sir… I mean ma’am…doctor. I-I’d like to ask for her number.”
His stammer annoys me. Typically, I would let it slide. But for a second, I want to smack him in the face with the stupid clipboard just to shut him up. “Do whatever you want to do,” I mutter and grab his red clipboard. I quickly scan through the list of patients’ stats. My eyes stop at the name Sang Boonsawang. I swivel my head towards the resident and raise my voice, “Here it says that the acid assault patient is conscious but still unable to speak.”
I ran the surgical procedures I performed on the patient through my mind. Maybe the surgery wasn’t a success like I thought it was. Maybe the damages to her vocal cords are more extensive than I suspected. Maybe I missed something.
Unsure of what to say, the resident just stares at me. I feel a boiling rage seeps through my dry demeanor. This useless brat is a waste of our government’s resource. “Uhh…I’m not sure…It could be a complication.” He finally clears his throat and says, “There’s another attending physician looking at her case right now.”
I glance over the patient’s room number. 202. Perfect. That’s just two rooms down the hall. I shove the clipboard back to the resident and head to my destination. As I enter, I notice that the room has a low light on, and there are cords hanging down by the patient’s side for the nurses’ call button and the IV solutions. The patient is sleeping; but there is an empty aqua colored glass with a bent straw in it and a half eaten tray of food with the big metal cover that is on the plate.
“Hello, doctor.” I hear a small, squeaky voice. It’s not coming from the patient. Following the source, I bend down to find a little girl with a bob hair cut and uneven bangs. It’s the patient’s daughter I met in the emergency room.
I hear the door propped open and the sound of sensible shoes squeaking on the pristine tiles approach me. The girl raises her index finger to her mouth and whispers, “Shh…” I’m confused at her gesture but I decide to play along. She’s probably just shy.
When I stand up from my crouched position and turn around, I bump into a well-built figure. I inhale his overly strong cologne and recognize the scent immediately. The man speaks with a weird accent, “Birdie, it’s good to see you again.”
I bite my lips, trying to hide my frustration. I didn’t expect to find a psychiatrist; especially the one I had a one-night stand with, as the consulting physician for my surgical case. “What makes you think this is a psych case, doctor?” I ask.
Sujin runs his hand through his hair and says, “The patient has gone through tremendous emotional trauma. It is possible that her loss of speech may be due to psychological reasons.”
Despite our different specialties, he makes a valid point. However, physiological causes should still be considered. The patient could have had a stroke during the surgery that affects her brain’s Broca’s area in the left hemisphere, which typically disrupts the patient’s ability to speak or comprehend language.
I turn my attention back to the patient. There is an electronic machine sitting on a cart with wires leading to it, and a curtain hanging from a track on the ceiling. The patient’s chest is moving steadily and her heart monitor indicates that she is stable. Sujin walks towards me. “I have another consult but feel free to contact me when the patient is awake,” he hands me a small clean-edge business card with his name and number on it.
“You can also call me for other reasons, birdie.” His lips curl into a crooked smile, “I’ll be going to a Thai boxing match this weekend if you want to come along. It will be Champion Veera’s first return to the ring since his leave of absence.”
Nostalgia of my days when I practiced Thai boxing rushes back to me. I started practicing it because I couldn’t take my father’s abuse anymore and I wanted to fight back. I miss the feelings of wrapping my hands with ropes and dipping them in water to harden them. Because ropes are abrasive and able to cut, they’re used to increase blocking and striking power. The elders in my village claim that females are not worthy enough to practice this sacred sport. However, I was able to practice it because I had a hideous boy cut so people mistook me for my brother. As an avid fan, I’m tempted to go with Sujin just to witness how Champion Veera’s first return to the ring will turn out.
But I can’t. Dating leads to attachment and I can’t afford any attachment. It wouldn’t be fair for either of us. I answer professionally, “I’ll contact you if I want another consult, doctor.”
Sujin’s smile falters slightly but he immediately returns to his cavalier tone. “Well, if you change your mind about my latter proposal, you have my number, birdie.” He winks at me before heading out of the room.
At the sound of the door shutting, I hear shuffling noises of skin and clothes rubbing against the floor tiles. The small girl props her head from under the patient’s bed and crawls out of her hiding spot. “He sounds cute,” she says innocently. “I like his accent.”
I ignore the girl’s observation and ask, “What were you doing down there anyway, kiddo?”
The girl rubs her neck sheepishly, “I was hiding.”
“Not what but who,” she corrects me.
“So who were you hiding from then?” I rephrase my question.
The girl sucks in her round cheeks and stares at the ground. Avoiding my eye contact, she mumbles, barely audible, “My father.”
My heart drops. According to the reports, the patient’s husband is the main suspect for the acid assault. However, there isn’t enough evidence and because victims of domestic violence rarely come forward to testify, the husband is still free.
I notice the bruise on the girl’s cheek and say, “Did your father hurt you too?”
The girl doesn’t reply and continues to look down at her feet. I understand her reluctance to talk to me. When I was younger, I avoided answering any question regarding my father’s abuse like a plague because I didn’t want to face more punishments.
I walk towards the table by the patient’s bed and grab the empty glass of water. I pour water into it and return to where the girl is standing. “You should tell the authorities,” I hand the girl a glass of water. “Here, have a drink and then we can talk more about it.”
Her eyes harden and her cheeks turn red. “The authorities don’t care. No one cares. They’ll just say it’s none of their business and that it’s a family affair. They’ll say that my father is just teaching a disobedient daughter like me a lesson. To them, I’m invisible.” The girl raises her voice and pushes me away.
I lose my balance and drop the glass of water. The glass shatters and water spills all over. Immediately, I reach for the napkins and start wiping the floor. I look at the shattered pieces of glass and suddenly stop cleaning. I remember what the elders in my village taught me: how to carry beverage without spilling, how to cleanup after someone else makes a mess, how to be a good girl, how to be a virtuous daughter, how to respect even if the person doesn’t deserve it simply because he is a man and your father, yet still, how not to respect your own self worth. I can relate to the girl’s pain and burden.
I feel a prick on my index finger and notice blood flowing out of it. A broken glass must have cut me. The girl’s eyes widen and she snaps out of her anger. She scoots closer to me so she can look at my wound. She says quickly, “I’m so sorry, doctor. I didn’t mean to push you. I’m so sorry.”
“Don’t’ worry about it, kiddo. It’s just a little cut.” I smile. I know that if I continue to probe the girl about her father, she will just shut me out. I need to gain her trust first. I reach into my pockets to search for my business cards but I only find the business card Sujin gave me. So I grab a small stack of neon sticky notes and a cheap hospital pen I found on the nightstand near the patient’s bed.
I write my number on it and hand the sticky note to the girl. I say, “Feel free to contact me if you have questions about your mother or just want a friend to talk to.”
The girl reluctantly takes the sticky note. She looks up from it and I notice that her face is filled with concern. “I was so caught up with my own problems that I forget to ask.” She says, “Who’s the man that hurt you the other day?”
I tilt my head slightly, trying to figure out how she knows about Awut’s attack. Then, I remember that the girl was there when it happened. I reply calmly, “He’s my brother. He’s just sick, that’s all.” I keep the tone light. “Don’t worry about it, kiddo. Siblings quarrel all the time.”
The girl giggles, “I think I can relate to that.” She nudges me lightly, “But y’know… if your brother is sick, maybe you can ask that cute doctor for a consult. His accent makes him sounds like a knowledgeable British knight.” The girl reaches into my pocket and pulls out Sujin’s business card. She places it on my palm and beams, “Here. Call him. If you end up going out with him, I want to hear all the details.”
I look at the business card and then at the girl. Even though it’s obvious that the girl is playing cupid, it doesn’t hurt to call Sujin since I have to contact him about the patient’s psychiatric consult anyway. Maybe the girl will open up more if we talk about boys and knights in shining armor or whatever. I smile and say, “Alright, kiddo.”
I walk into the hospital’s café, distinguished from the other parts of the hospital not by walls or a door but merely a change in the pattern of the floor tiles from plain white to different shades of beige. As soon as I step into the café, warmth embraces me. I approach the glass display glittering with meals and desserts. I scan the treats then look up to the chalk menu hanging on the wall above the coffee bar.
“What can I get you?” asks the barista in a bored, drone-like voice. I gesture with my index finger and give him an amiable, apologetic, and closed-lips smile. I’ve been so busy with surgeries lately that I barely have time to go to cafés. Occasionally, my residents get me coffees in hopes of getting on my good side, but I actually don’t drink coffee. I’m going to cherish this moment, where I can place my own order.
“It’s just a drink, birdie,” Sujin whispers, leaning towards my ear. He turns to the barista and chirps, “Double espresso for here please.”
Ugh. Double espresso? Disgusting.
“Coconut Thai Tea Latte for here, please,” I finally place my order.
Sujin and I saunter towards the drink-delivery end of the counter. “Double Espresso,” the barista calls out, leaning over slightly as he places the ceramic cup on the counter. Sujin takes the cup, taking a sip immediately without a thought. That disgusting hot water probably burnt the tip of his tongue.
After I receive my order, I take in the perfect image and aroma of my beverage. Its orange color and sweet taste come from crushed tamarind seeds and condensed milk. When I turn the cup at certain angles, I notice that the reflective sheens from my coconut Thai tea latte catch light and play tricks with anything and everything that screams ‘paradise.’
We head towards the corner table that is squeezed into the small space, shoved amidst the shelves with selections of coffee beans and tea bags. We sit there, taking off our white coats. Sujin’s brown eyes look at me as he excitedly devours his espresso like an addict. When he finally places his drink on the table, he says, “It’s too bad that this isn’t a date. I’ve managed to get us front seats at the boxing ring.”
My ears perk and before my logic can stop me, I ask curiously, “How did you manage to get that?” Darn it. He successfully reels me in.
“Champion Veera is a close friend of mine,” he replies smugly as he returns to his nasty drink. “If you want, I can get you his autograph.”
Interesting. I’ve heard rumors that Champion Veera had to take a leave of absence because he was suffering from hallucinations in the middle of a boxing match. I can’t help but ask, “Are you the psychiatrist that treated his Schizophrenia?”
Sujin stops drinking and says quietly, “You know that’s confidential.” His gaze shifts from my eyes to his espresso and then back to me. “But even if he does have Schizophrenia like the rumors say, schizophrenic patients, like other patients with any illnesses, can live a relatively normal life with proper treatment and support. I have patients with mental disorders who go on to have families and successful careers of their own,” he adds protectively.
I take a couple sips of my coconut Thai tea latte and look to the right to avoid meeting Sujin’s gaze. Suddenly, I feel a vibration in my pant pocket. “Excuse me,” I say quickly and move my fingers downward to pull out my mobile phone.
When I answer it, I hear panic seeping through the speaker. All I can manage are a few “ahuh” and “I’ll be there soon.”
“What is it, birdie?” Sujin asks.
I try to compose myself but somehow the air in the café seems thin. I can’t breath and I feel like I want to vomit. The coconut Thai tea latte is betraying me and is climbing its way up my throat. Restroom is the first thing that pops into my head. I tell Sujin I have to go. I almost run when I see the restroom sign. Forcing my way through the crowd, I lack the time and motivation to throw out redundant apologies but simply use my palms to push people off my way, unable to focus on anything but the growling queasiness rising inside my stomach.
There’s no one in line so I lunge at the stall. Without bothering to shut the door, I lean over the toilet stall and move my head closer to the water. A loathing sound escapes through my lips. I taste the acid, battling its way up my throat. I bring my face closer to the water, arching my saliva between the liquid and me, as if bringing two star-crossed lovers together, our lips longing for a desperate wet kiss. I wonder what will happen if my face unites with the water and I just allow myself to drown in it. I wonder if it will be the happy ending to my tragic story. I used to love happy endings but then I grew up and realized that they are all lies.
I pop my eyes open to find Sujin, kneeling beside me. A string of saliva pathetically hangs from the corner of my lips. My chest heaves heavily and I try to take in as much air as possible. Sujin hands me a brown paper bag with the café logo on it and says calmly, “You’re having a panic attack. Just breath into this.”
I take the bag and put my face into it as I breath in and out. When I finally manage to control the dizzying sensation, I straighten myself up and take some toilet paper to dry my mouth. I push the door open and attempt to get out of the stall only to stumble and hold onto Sujin’s arm for support. I push him away and take two steps away from him but then turn back as if a string has attached me to him.
Maybe I’m emotionally vulnerable right now or maybe it’s the lack of oxygen that impairs my judgment. But I pull Sujin towards me, and my arms wrap around him. I’m so unused to touch but instead of pushing him away, I close my eyes and collapse against his chest. His shirt is rumpled and soft against my skin, and beneath it, his warm body pulses with the faint beating of his heart and it calms me down. A labored breath escapes me. “I-it’s my brother.” I bury my head against Sujin’s shoulder and finally let myself cry. “He tried to kill himself.”
For more information on the coping strategies for HD patients going through depression and suicidal thoughts, please refer to our article.
Maladies of My Mind
20 Years Later
Ch. 2 Sticks and Stones
Screams pierce the air as the smoke engulfs my father’s praying room and the collapsing wooden roof mows down a group of monks in orange gown. A strangled cry comes from my throat but no words follow. I lost grip of my icy demeanor, when I see the fire creeping towards me. I inch my hands to my ears, trying to block out the angry sounds of the crackling flames. When I straddle the corner, I swing my right foot up over the side. Suddenly, I feel something catch my feet, dragging me across the floor. Panting and trembling, I try to crawl away from the grasp and grab the edge of the wall for anchor. The image of my mom rushes back to me. I remember her anguish cry and her shaking body as the shaman whips her repeatedly with a dried stingray tail.
“Mom…” I croak into the abyss, heedless of being recognized. “Mom…”
“You need to get out of here!” I turn my head towards the source of wilderment and catch a glimpse of a pair of eyes that scare me to my bones. Father.
I smell the leaking gas nearby and the next thing I know is that my father is carrying my body as he limps towards the door. We are so close…for a moment my father looks at me.
Then, he flings my body and I stumble to the outside world. I open my mouth to call after him but that is when I see an explosive shockwave consuming everything and everyone in its path.
There are ringing in my ears. My head throbs and I want to vomit. But soon the nauseous feeling is replaced by a single sensation—agony. Flame runs its tongue up the back of my body and I can’t feel anything else but the unrelenting burning of my flesh. I open my eyes to see my brother, Awut.
‘You’re not supposed to be here,’ I want to say. Father will be upset if he finds out Awut comes to his praying room. So what is he doing here and why on earth is my older brother holding an oil container and a lighter in his hands?
I jolt awake in bed, gasping. I can barely breathe as my lungs heave in an attempt to suck in air. ‘It’s just another dream,’ I remind myself. I look around frantically. The unwelcoming white walls blind me, and the smell of harsh cleaning solvents fill my nostrils. The floors are black and white tiles arranged in checked patterns, and the walls are interrupted by sets of glass, revealing views of the bustling Bangkok city outside.
I turn to the side and notice a bright neon sticky note on the nightstand with a neat cursive handwriting on it. I pull the note off and take a closer look at it. “Your clothes are folded in the closet,” I read quietly. That’s odd. When I wake up at a stranger’s place, I usually find my clothes scattered across the floor.
After I am dressed, I find the man I came back with last night sitting by the kitchen table. Noticing that the man is reading a newspaper, I try to walk out of the apartment as discreetly as possible. I stop when he says, “Good morning, birdie.”
He has a weird accent and is a lot paler than most people I’ve seen in Thailand. I can’t tell his ethnicity, which is unusual around here, considering how few foreigners there are since the military coup in Bangkok a couple months ago. He looks Caucasian. No wait, Thai. A mix maybe. I don’t know but he’s attractive in a way that distracts me.
Before I could utter a response, the man walks up to me and says, “Are you free this weekend, Orasa? I have an extra ticket to a Thai boxing match this weekend.”
I’m slightly taken back. The man with the weird accent just replaced ‘birdie’ with my actual name and asked me out on a date. I thought I told him not to get attached.
“Look…” I try to remember his name.
“I’m Sujin,” he beats me to it.
“Oh,” I nod slightly, biting my lips as my cheeks color. “Look…Sujin. You seem like a nice guy but I’m just not looking for a relationship right now,” I use the same line I’ve rehearsed many times before to men and occasionally women I hooked up with. I roll my hair back and confine it with a clip I found in my pant pocket. I’m all business now, taking refuge in the formality of my professionalism. “I have to go to work if you’ll excuse me– ”
Sujin pops a grape into my mouth, “Aye, Orasa. You’re one rude birdie. First, not remembering my name and now you’re going to leave without eating my home cooked breakfast.” Taking advantage of my befuddlement, he grabs my hand and tugs me to the kitchen table. He places me on a seat and heads to the kitchen. He returns with two plates of breakfast and says, “I couldn’t recognize you at first but now that you roll your hair back like that, I think I’ve seen you at the hospital before.”
I flinch. Is he a patient? Or is he a hospital staff member? This is bad. What if he’s one of my co-workers? I gulp. I tend to forget a lot of faces at work; and I don’t want to break my personal rule of not getting involved with someone I work with. I speak casually, “So, are you a patient?”
“No, I’m a doctor,” he replies.
I pretend to act cool. “I see. So, what department do you work in?” Please not surgery. Please not surgery. I chant mentally.
“I’m the new attending psychiatrist,” he adds enthusiastically. “I just moved here from the States. I’m originally from the UK though. My father’s British and my mother’s Thai. To be honest, I’m quite excited to back in my mother’s home country.”
He gives out too much familial information for my taste. Nevertheless, I’m relieved. At least psychiatrists and surgeons in Thailand do not interact that much and I probably won’t see him again. Soon my relief turns into confusion. I look around the room and notice Sujin has a nice apartment. From what I recall last night, he has a fancy sports car too. I blurt, “How much money do you make?” A long silence follows and I break it, “I mean, this isn’t the States. Thai people don’t use shrinks. Shouldn’t you be broke or something?”
He stares at me. I didn’t mean to offend him because I was actually curious. But it’s probably better this way. No strings attached.
Finally, he smiles and pushes a plate of breakfast towards me. Thai people tend to eat porridge for breakfast but I notice that Sujin has prepared a Western style breakfast. He made me bacon and scrambled eggs with grapes in one corner of the plate and steamed vegetables in another. I look up and notice that he isn’t eating his breakfast but using his fork to separate the corns, carrots and broccoli from the vegetables mix into their own smaller piles based on the types of vegetables. Without looking up from his plate, he says, “Oh, don’t worry about it, birdie. I have Obsessive Compulsive Disorder. I’m better now though. I used to pop tons of pills.”
I’m surprised at how casually he reveals this private information. Finally, I manage a question. “How can you admit it so easily?”
He looks up from his plate and returns my gaze. “Would you hide the fact that you can’t produce insulin if you have diabetes?” He explains, adding quietly and sitting straight, “Psychological actions can result from of physiological causes; and I think we shouldn’t treat mental illness differently from other diseases.”
I take in his words but don’t say anything. I look at my breakfast and take a spoonful of steamed vegetables into my mouth.
The hospital corridor is stale and the air has a tinge of bleach. The walls are white and are dented in places from the patient trolleys that have countlessly bumped into them. The portraits on the walls are prints of the Thai royal family and above the sliding glass doors is a slim red plastic sign with bolded white letters that say ‘Emergency Room.’
Wearing my blue surgical scrubs and surgical cap, I am standing by the Emergency Room’s entrance and waiting for my patient to arrive. The patient is being transferred from the outskirts of Bangkok to a city hospital. The patient is a thirty-seven year-old female victim of an acid attack. According to the police reports, the jealous husband is a suspect. However, there are no witnesses other than the victim, who is in critical condition. The medical effects of sulfuric acid to the face are extensive. The severity of the damage depends on the concentration of the acid and the time before the acid is thoroughly washed off. However, according to the paramedics’ reports, the acid has rapidly eaten away the patient’s skin, layers of fat beneath the skin and underlying bone. The patient’s skull is partially deformed and her nostrils are closed off completely due to destroyed cartilage. She has also inhaled the acid vapor, which exacerbates the restriction of her airway.
I close my eyes for a moment, trying to conjure and mentally prepare for all the complications that could arise during the surgical procedure. Not everyone appreciates the attractions of surgery like I do. When I was a medical student in the operating room for the first time, and I saw a surgeon press the scalpel to someone’s body and open it like a juicy peach, there were two types of reaction. You either gagged in disgust or gaped in awe. I elicited the latter reaction. It is not just the blood and guts that entice me. It is the idea that a mere human being could have so much control over someone’s life with just a scalpel in her hand. Maybe I have no control over my own life and that’s why I am so addicted to the control of over someone else’s.
I open my eyes when I feel a tug on the hem of my surgical scrub. I look down to find a small girl with a bob haircut and uneven bangs, which look like she may have cut them herself. She’s carrying a leather bag pack that seems too heavy for her spine. There’s also a cotton tag on her public school uniform that says she is a seventh grader. However, her malnourished appearance and small stature make the girl looks like she’s no more than ten years old. “Doctor,” she tugs the hem of my surgical scrub again. The bruise on her round cheek and the cut mark across her forehead grab my attention.
“Hey kiddo.” I crouch to the girl’s level and say, “Let me take a look at your forehead.”
She flinches away at my touch. “Please help my mother first, Doctor.”
I cock my head curiously, “Where’s your mother?
The girl raises her tiny hand and points her finger at the Emergency Room’s sliding door as a patient trolley rushes through it. The paramedics shout, “Incoming!” I’m not sure how the girl managed to get into the hospital before her mother but she is the daughter of the patient I have been waiting for. I rush to the trolley and a group of surgical residents flock after me.
“Who’s the attending surgeon in charge?” the paramedic calls out and looks at the surgical residents, who happen to be all male. Even though medical schools are trying to recruit more women to create diversity, trauma surgery is still a heavily male dominated field.
“I am,” I announce.
The paramedic turns to me, surprised to hear a female voice. He regains his composure and speaks professionally, “This is Mrs. Sang Boonsawang. 37-year-old female. Victim of an acid attack.”
I look at the patient and realize that the damage may have been more extensive than the report. Her ear cartilage is partly destroyed and deafness may occur. Her eyelids are burned off, leaving the eyes extremely dry and prone to blindness. Her mouth becomes shrunken and her lips are partly damaged, exposing her teeth. She may lose her mouth’s full range of motion. Eating and speaking can also become difficult. In addition, she faces the possibility of septicemia, renal failure, skin depigmentation, and even death.
I look at one of the residents and say, “You.” The resident turns his attention to me. “Prep OR 7 and scrub in.”
I turn to another resident. “And you.” I look around the Emergency Room, trying to find the patient’s daughter but have no luck. I turn back to the resident, “Find a 13-year old girl who looks more like she’s 10. She has a laceration to her forehead. Make sure she’s all stitched up.”
The patient is wheeled into the pre operative area of the theatre suite. She is convulsing in pain and trying to cry out but no voice follows. It is possible that her vocal cord is damaged as well. Her arms and legs are secured to the operating table with bonds that are strong but padded so she won’t hurt herself as she struggles.
“Relax, I’m here to help you through this.” The anesthesiologist says. Because the patient’s nostrils have been damaged, giving her an anesthesia through a gas mask isn’t optimal. Instead, the anesthesiologist inserts a small plastic tube into one of the veins on the patient’s backhand. He then puts a blood pressure cuff around the patient’s arm and attaches ECG electrodes on her chest.
The patient is then wheeled into the operating theatre and slides onto the metallic table. She is still awake at this stage. “We’re putting you to sleep now so you won’t feel any pain,” says the anesthesiologist. It will take about two minutes to get the equipment plugged in and for the patient to fall asleep.
Her breathing finally slows down, indicating that the anesthesia worked. I turn to one of the scrub nurses and stretch out my gloved hand, “Scalpel, please.” The nurse hands the sharp object to me. I press the instrument to the patient’s body and open her up like a juicy peach. I am in control now.
The surgery is a success. The patient is transferred to the recovery area for a short while, and then returns to her room on the ward. However, she is still in critical condition and complications may arise during her recovery. Even if the patient recovers physically, acid assault survivors usually face social implications. Such attacks typically leave victims handicapped in some ways, rendering them dependent on either their spouse or family for everyday activities, such as eating and running errands. In some cases, acid victims are psychologically persecuted. Despite having operated on a few acid assault cases myself, I rarely see the issues covered in the news. The media overwhelmingly avoids reporting acid attack related violence. If covered, the description of the attack is minimized and sometimes the media blames the victims, omits women’s voices, and treats husbands who commit these crimes sympathetically.
I enter the waiting room, which is empty except for the victim’s daughter sitting on the hospital bench. She appears to be engrossed in a hardcover government issued biology textbook. I remember reading an earlier edition of the textbook when I was in middle school. When the girl hears me approaching, she asks without tearing her eyes away from the text, “Is my mother going to be alright?”
“The surgery was successful but we still have to watch out for any sign of complications,” I say. The girl nods but continues to read. Usually, I would leave the room at this point. I’ve done my job as a physician by telling a relative about the patient’s condition.
However, I find myself trying to strike up a conversation with this girl. I ask, “How did you manage to get to the hospital before the paramedics came in with your mother?”
Once again, the girl speaks without looking up from her textbook, “I was at school when it happened. I heard that it was severe so I rushed to the nearest city hospital because I knew the local clinics wouldn’t be able to handle it.”
Impressed, I can’t help but compliment her. “You’re one smart girl.”
The girl finally looks up to give me an appreciative smile. That’s when I notice the gash across her forehead. I thought I told the resident to stitch her up. The sight of the girl’s bleeding forehead sets off my rage. I’m going to make that resident’s life a living hell. I look down to the girl and say quietly, “Wait right here. I’ll go get a suture kit to patch you up real quick.”
I smile reassuringly and turn around. I look up to find a brawny man wearing a hospital gown. He resembles a bear more than a man. Despite the patchy, unkempt beard and thick glaze over his eyes, his eyes bear a striking similarity to mine. His hand traces the hospital wall slowly and he limps towards me. Suddenly, he trips and I immediately rush to his side. Just when my lips are forming his name, his fingers lock around my throat and he says in a deep voice, “It’s good to see you again, sister.” He spits out the last word like venom. His grip tightens. Oxygen is sucked out of my lungs and I am losing the battle to hold onto my consciousness.
“Sticks and stones will break my bones
But words will never hurt me”
I first heard of the Sticks and Stones children’s nursery rhyme when a group of English missionaries came to our village when I was in pre-school. We call these towering, pale foreigners ‘Farang,’ which is also a Thai word for the guava fruit. I was curious as to why we call them guava because the two bear no similarities at all. One is green and delicious. The other is white, at least the ones I have seen when I was younger. Most importantly, I doubt that a foreigner tastes as a good as a guava. After days of burying myself in the public library, I finally learn that foreigners are called Farang because the French were the first Europeans to establish ties with Thailand. I guess the words Francais and Farang sound close enough that they become interchangeable.
Even though it has been years since those Farang missionaries have taught me the meaning behind the Stick and Stones nursery rhyme, I disagree with the lesson behind it. The rhyme persuades the victim of verbal assaults to ignore the pain that comes from words, to refrain from retaliation, and to remain calm and good-natured because words can’t break your bones.
I have been broken physically countless times at the hands of my drunken father. But those broken bones never hurt me like words do.
There were two times words destroyed me.
The first time was when I learned about the devastating impact my mother’s illness had done to our family and what it could continue to do.
I was lying on the hospital with my back exposed. The nurses had just finished rinsing my burned skin with cool water and left to retrieve antibiotic ointments. I recalled crying in pain at each contact to the open blisters on my back.
I saw my brother, Awut, walked into the room. He approached me and I noticed the dirt stains on his round cheeks. He kept a straight face and said, “I just gave the police a statement about the fire accident.”
The memories of him holding an oil container and lighter crept back to me. I avoided his eye contacts. I said quietly, “An accident huh?” Maybe I was mistaken. Maybe I was imagining things when pain from the fire consumed me.
“That’s what I told the police,” Awut replied stoically. I sighed in relief. Of course, my sweet older brother who cried at the most mundane things wouldn’t do the unimaginable. “But just between you and me,” My train of thought suddenly stopped when Awut continued in a cold, distant voice, “Father shouldn’t have left his lighter within a child’s reach.”
My face, the once blank canvas, broke – first into confusion, then shock and finally realization. My mind witnessed wave after wave of emotion; as it crashed down, my lips trembled slightly. Before I could utter a word, I heard the door propped open. My brother’s back straightened and he asked, “Doctor, do you have news about our mother?”
The doctor led Awut to a seat and cleared his throat, “You might want to sit down for this.”
I blocked out all the noises in the room and just stared at the glass of water on the table stand nearby my hospital bed. Through the water in the glass, I saw a distorted image of myself. My eyes traveled up to where a wound licked across my forehead, singeing away my brows but missing my eyes. The scent of blood curled into my nose, down into my throat, squeezing it tight with despair. I was brought back to the memory when a shaman whipped my mother repeatedly with the dried stingray tail. I tried to stop him and I was hurt as a result. But it didn’t matter at that time because my mother was alive. All those years that I thought she ran off with another family was a lie. She was actually sick. My father had hidden her away from the world because he was ashamed of her mental illness. When her conditions worsened, he paid an undertaker to fake her death so he could hire a shaman to drive my mother’s illness away without suspicions.
But by the time the hospital ambulance arrived after the fire, my mother’s health had deteriorated due to constant beating and starvation. Not long after her hospitalization, she passed away. I also found out from the doctors what mental illness my mother was suffering from. I had to ask the doctor to repeat the name of the disease twice because it was in a foreign language. The disease was named after a Farang physician, George Huntington, who wrote about the illness in the late 1800s.
The doctor concluded that my mom had Huntington’s disease; a rare mental illness often described as a deadly combination of Alzheimer’s, schizophrenia, and Parkinson’s. The doctor explained that in Thailand, there has only been one reported case in the past twenty years. However, this low number may result from under reporting and the extrapolated statistics of Huntington’s disease prevalence in Thailand is approximately 2,000 people.
A few key words seared into my memory regarding this disease:
- 50 % chances of inheritance
- Symptoms begin at age 30 to 50
- Losing control of mind and body
Early signs of the disease vary greatly from person to person. Behavioral symptoms may include mood swing, anxiety, memory loss or hallucinations. Physical symptoms progress from clumsiness and loss of coordination to the point where speech is slurred and vital functions, such as swallowing, eating, speaking, and walking, are abysmal.
I took in the doctor’s description of the symptoms. My first response was denial. From what I remembered, my mom was an adventurous woman who loved to take Awut and me to swim in the lake. But then I recalled how her body twitched uncontrollably when I encountered her in father’s praying room. Coupled with Awut’s account of her incorrigible speech, the doctor’s description of the disease my mom was suffering from sounded accurate.
My second response was anger—anger of what my mom had to go through and anger towards my father for putting her through more suffering. But selfishly, I was most angry at the fact that my brother and I could inherit this devastating curse at just a coin flip away.
I recalled the doctor saying there’s a genetic test I could take to see if I carry the gene for the disease. Since there is no cure anyway, I didn’t want to know. But, my brother believed that knowledge is power.
The second time words destroyed me was two weeks after Awut’s eighteenth birthday when he told me his genetic test came back positive.
For more information on Huntington’s Disease and its symptoms, please refer to this our articles.
Disclaimer: Even though the image above depicts the monster holding a U.S. coin, Huntington’s disease affects families around the world. It is just not often talked about. Maladies of My Mind is inspired by interviews of Thai individuals affected by different mental illnesses, but it does not cover the entirety of a Huntington’s disease experience in Thailand. Significantly, the main character and her brother suffer from paranoid schizophrenia-like symptoms, which occur in a minority of Huntington’s disease patients. The story aims to explore themes of abuse and domestic violence in hope to shed light on the negative consequences of what mental illness stigma can do to a family. Nevertheless, these experiences are not necessarily synonymous with all mental illness or Huntington’s disease experience.
The following is a series of fictional short stories from the perspective of someone with Juvenile Huntington’s Disease. These works do not represent the experience of any one individual, nor do they aim to encompass the entirety of an illness experience such as JHD. Rather, these stories strive to capture and explore themes presented across different JHD and HD experiences through a collection of punctuated narratives. Hopefully, engaging with JHD through storytelling will allow readers to better empathize with, and understand the nature of, the experience of this illness.
It’s the first day of classes and I’m late. I’m running both towards and away from my destination, unable to nail down a sense of direction. Suddenly I arrive, unsure how I managed to find the room. The door swings open to reveal a huge lecture hall full of people. I trip on my way in. Darn it. I look around and see an ocean of faces all trained on me. I don’t recognize any of them, their features blurry and indistinct. Then a few gazes lock with mine and suddenly they are familiar. My high school classmates. I don’t even question their presence at the same college as myself, but instead sit down in a desk immediately in front of me and hurriedly dig out a notebook. When I look up the room has changed and my backpack is gone. I’m at a round table with people I don’t know, blank faces that look somehow identical and radically different from each other. I have a feeling we are waiting for someone, a professor perhaps? When did I sign up for this class anyways? The door opens and someone enters the room. The furniture and people disappear, and I’m standing right in front of the newcomer. She introduces herself and reaches out to give me a hug. Where did everyone else go? Stepping back, I look into her face and see my own eyes staring back at me.
My 5am alarm jolts me awake. Smacking at my phone a few times, I finally manage to hit the snooze button, but it has already done its job. Lying in bed, I attempt to stay in my dream haze as long as possible. I grasp at memories just at the edge of my mind, trying to recall the scene I was pulled out of. A room. A different room. That face.
Nothing, it all slips away. Except for those eyes, the same ones that have been haunting me all week. Big, brown eyes with flecks of gold in them, the same as my own.
Their owner never says a word. She appears, attempts an affectionate gesture, and meets my gaze for just a moment before I am pulled back to reality. I know it makes the most sense to say that this woman is my mother, showing up in my dreams as I prepare to embark on ‘adulthood’. But I have long since adapted to living without her and my high school graduation doesn’t seem like a good enough reason for her sudden presence.
You can’t miss what you never had right?
I rotate onto my back and stare at the ceiling, contemplating the significance of the day — I’m almost free. Graduation day is bittersweet for a lot of people, but I feel only relief at its arrival. Once today is over, only a single summer stands between me and the rest of my life.
As Valedictorian and Athlete of the Year, I am giving a single double-length speech, the two titles usually going to separate individuals. I attempted to turn down the offer to speak, not feeling much excitement about speaking to a group of individuals I was hoping to never see again. However Carley talked me into it and helped me write the speech, so I guess I’ll put on the bunny ears for a day.
Luckily we are both heading off to Duke, her on pure merit, me on running. It’s actually a miracle I pulled off good enough grades to stay Valedictorian and not have my offer rescinded; second semester was tough once the burnout caught up with me and I could not focus in any of my classes. Senioritis is not something I had expected of myself.
All right, I’ve wasted enough time staring at the ceiling, time to get going. I slowly stand up. My body resists the movement, straining at the change in position. I’ve been remarkably stiff in the mornings lately, my muscles tightening almost to the point of pain. Maybe I should stretch more.
Walking to the bathroom, I can hear my aunt and uncle snoring in their room down the hall, their dog Elvis padding towards me to say good morning, and the soft coos of the mourning doves out back. I close my eyes and enjoy the pre-dawn sounds— this has always been my favorite time of day. On autopilot now, I throw on shorts and a sports bra before grabbing my favorite Nikes. In June, even the early mornings are warm enough to build up a sweat, and I remember to throw on sunscreen before chugging some water and heading out the door.
Outside, the horizon is a blooming shade of coral above a still dark landscape, a new day just moments away. I set off at a leisurely pace on my usual path, enjoying the pain in my legs as they work out the tension from the night.
The beginning of this run is flat and bare, a few Joshua trees the only greenery, but I remind myself to stay focused so I don’t lose speed or trip. When I reach the top of a nearby hill, I pause, needing a breather. I gaze out at the now brightly lit view.
Without the pre-dawn shadows to hide behind, I can see the entirety of the town. There is the high school whose fences I have fought for the last four years. There is the single street of downtown where adults go for a night out and kids go to get into trouble. There is my dad’s house, only a few miles away from my aunt and uncle’s. There is the Old Mill Bridge, crossing 50 feet over a long ago dried-out riverbed— maybe my mom thought there was still water in it to catch her when she jumped. I turn away from the sight and take off down the hill, hoping to put some distance between my thoughts and my body.
Why is she on my mind again?
I need to stop obsessing over someone long gone and buried. For the most part what had happened was thoroughly swept under the rug — or in my dad’s case drowned in gin. But throughout the years rumored mental health problems have been brought up by more than one of my peers. Whatever the reason, at the age of only 20, Denise Thompson took a swan dive that left her husband in a 17-year tailspin and her year-old daughter without a mother.
She was not that much older than me.
Disturbed, I push myself to move faster, but quickly falter. Still panting, I am overcome with exhaustion and have to stop again. Shoot, I need to get back to a normal training schedule; I am getting way out of shape. I have not been able to finish my morning trail at a decent speed in weeks. I need to kick it up a few gears if I am going to be ready for the fall.
I’m still tired but have caught my breath, so I continue the descent at a slow pace, watching the ground to avoid any slipping— my hands are still raw from where the gravel cut my palms last week and my knees have scars from the months before.
Hot and sweaty in my dress and graduation gown, I struggle to keep my cap on against the wind. Everyone is lined up on the soccer field adjacent to the stadium, waiting for the ceremony to begin. A class of only 57, I can recite all of our names in alphabetical order in my sleep. The music finally starts and that is our cue. We walk into the stadium single file, trying to look as though we don’t all have minor heat exhaustion. I arrive at the front row and take my seat next to Carley, resisting the urge to hold her hand. Once everyone is seated, we say the Pledge of Allegiance and someone’s little sister sings the national anthem. Our principal starts the speeches with a few non-specific words about school pride and tradition. The District Superintendent follows him, rambling on for a solid 20 minutes before it is inevitably time for student speakers. Going first is Joey Anderson, the student body president and town’s future mayor to hear him tell it. He stumbles over a few cheesy words about our accomplishments thus far and our impending entry into adulthood before closing with our (only) school cheer.
I know I am next but still futilely hope that I’ll be saved the pain of giving the fluffy, inspirational speech written on my notecards. When the last ‘Go Bulldogs’ has finally faded away, Joey smirks and sarcastically introduces me as the school’s “star student”. No one else seems to pick up on his tone but me— does everyone think he is praising me?
No. The little rat is taunting me. I feel a boiling rage begin to build up inside of me as I stand to walk the few steps to the stage. I want to throw Joey off of it with every fiber of my being, but he returns to his seat before I get to him.
How dare he mock me? Yes, I am the star of this mediocre school and town. And I worked incredibly hard for it. Screw him and everyone else like him in this town— telling me my whole life that I was crazier than my mom, that my plans were nothing but a pipe dream. This town has given me wall after wall to tear down on my way to success and now that I have finally done it, I am being teased as though I’m just some third-grade brownnoser. Not a pat on the back, not an apology for doubting me— for holding me back.
Forget them, I don’t need this.
Standing at the podium, I look out and realize that my face must be betraying my emotions.
Good. They should know how I feel.
The speech Carley and I wrote flies out of my head and I have nothing left to say but the truth. “I have hated the last 17 years here and I hope to never come back. Good-bye and good luck. Actually, just good-bye.”
I stalk off the stage, across the turf, and straight out the main gates, leaving shocked silence behind me. Still fuming, I kick at a trash bin and knock it over, scaring a flock of birds out of a nearby tree. As I watch them fly away, my anger dissipates and all I feel is emptiness.
Arriving back at my aunt and uncle’s, I look around my room unsure what to do.
Should I pack?
No I guess that’s bit extreme.
But staying is going to be exceptionally miserable now that I have basically flipped off the entire town. I feel a twinge of guilt for my aunt and uncle, who are probably embarrassed after my stunt. They don’t deserve that. They took me in when I had nowhere to go and they’ve always been kind to me, hell they even showed up to a few races. I hear the front door open and cringe at the thought of facing them, but I know it is inevitable.
They knock on my door before entering. Standing there, they look worried, exceptionally so actually. This strikes me as odd, I had anticipated anger.
“Michelle, we need to talk to you,” my aunt says.
Ominous, but expected.
“Yeah okay. Look, I’m sorry about what I did back there, I was angry at Joey and it got me rolling,” I explain.
“That’s okay, we get it. You have some right to be angry— the kid was being petty. But it was just a dumb comment. What made you so mad?” my uncle tentatively asks.
“I mean he was being a jerk. And it’s not fair that he can just get away with that.” I see the look in my Uncle’s eyes and feel guilty; I must have really embarrassed them.
“And okay yeah I guess I overreacted. But I was just so angry— I can’t explain it. I’m… I’m sorry guys.”
“We forgive you,” my aunt responds, “but we’re worried about you.”
Do they think I have anger management problems or something?
“Look, I’m sorry I worried you, but I’m okay. I just got a little angry,” I say in defense.
My aunt looks at my uncle before responding, “Michelle we know, but you seem to get a little angry a whole lot lately.”
“What are you talking about, no I don’t,” I snap.
My uncle steps in now, “What about after that final race earlier this year? You almost bit off your teammates’ heads.”
“My last race? You mean the one where I came in second? Of course I was angry I had a right to be! I shouldn’t have lost,” I say.
Thinking back I remember that day. I had fallen and twisted my ankle. I kept running but didn’t stand a chance at taking State after my mistake. It killed me to lose.
“Alright, what about last month when you couldn’t find your shoes? You tore this room apart,” my aunt says.
“Ugh, okay, maybe I overreacted then. But you know those are my favorites, I thought Elvis had eaten them. Look why are you bringing this up, do you want me to go to anger management classes or something?” I ask.
My aunt glances down, “No Michelle nothing like that, we don’t think it’s your fault… You, you may want to sit down, we need to tell you something.”
All right, this is weird.
“Um okay… what is it?” I ask.
“Well, it’s about your mom…” my uncle answers.
Looking at my aunt, I see something that looks like fear in her eyes. Or maybe it’s grief; she has never been willing to talk about her sister.
Why do they want to talk about my mom?
I can’t help but think about my recent dreams, my obsession with the Old Mill Bridge. Maybe they know about the dreams.
Have I been talking in my sleep?
Hesitantly, I perch myself on the edge of my bed.
“My mom? Um, okay, what do you want to tell me?” I ask.
“Has your dad ever told you why she killed herself?”
Surprised I respond, “No, he didn’t. I thought she went crazy, people have said she was… distressed,” trying to save my aunt’s feelings.
My uncle looks at my aunt and she nods, her eyes glazed over with tears.
Confused, and more than a little afraid, I shoot off a stream of questions, “What the hell is going on? Why are you both acting so weird? What do you want to tell me about my mom?”
My uncle looks at me and says, “I don’t know how to tell you this Michelle, but your mom was sick. That’s… that’s why she jumped off that bridge.”
“Sick?” I ask, “ Like she was insane?”
Are they trying to say she was schizophrenic or something?
What does this have to do with me?
My aunt suddenly jumps back into the conversation, “No, no, she wasn’t insane. Michelle, your mom was diagnosed with early-onset Huntington’s.” She looks visibly ill as she forces the words out.
Surprised I reply, “Huntington’s… I’m sorry what, what is that? Why does that sound familiar?”
“It’s a brain disease, we don’t know that much about it but… it’s fatal” my uncle answers, my aunt too choked up to say anything more.
After a moment I ask, “Wait, so she killed herself because she was going to die anyways? How long did she have left?”
I feel surprised and hurt, old wounds I thought long ago healed opening up. My mom chose to die. I always thought it wasn’t her fault… she had a mental illness or something. She went crazy— you can’t blame someone not in their right mind for their actions, for abandoning their child.
“No, no that wasn’t it. I mean partly yes, but it was the guilt that killed her. Michelle, this disease— it’s genetic,” my uncle responds.
All the blood drains from my face as I realize what they are trying to tell me.
Even my one biology class had taught me enough to realize what that meant. I might get it.
“Why are you telling me this now?” I ask them, not wanting to hear the answer.
My aunt can’t look me in the eye.
My uncle answers, “Because the doc told Denise that there was a 50% chance she passed the gene on to you. We, we always hoped that you wouldn’t get it. That maybe it was a mistake, or that you would beat the odds. But today… well, your mom was angry a lot before she was diagnosed. She… couldn’t control it.”
My aunt finds her voice again and continues, “She got clumsy too. She had been a dancer, but all of a sudden she was tripping over doorways.” Overwhelmed, she buries her head into my uncle’s chest and the floodgates open. But her sobs feel miles away.
My runs. I fall all the time.
No, there is no way.
I realize that my hands will not stay still.
50% chance, that’s a coin flip.
Looking up at my aunt and uncle, I realize that they are horrified at the sight of my shaking hands.
“Please get out,” I say.
My uncle hesitates, but looking at his sobbing wife, decides otherwise and gently guides her out the door. Before he closes it he looks at me and says, “Please talk to us. You can get a test done to check. You might not have it,” trying to infuse his words with hope. They ring hollow.
Quietly, they exit the room. The moment the door shuts, I jump across the room to my old desktop and open up the web browser. I type in “Huntington’s Disease”.
Almost 3 million hits.
The first is the HDSA site — Huntington’s Disease Society of America.
Shoot, this is real.
Reading quickly, I see “fatal genetic disorder,” “deteriorates physical and mental abilities,” and “no cure.”
Do I have this thing? No way. There’s no way.
“Symptoms usually appear between the ages of 30 to 50.”
I’m too young.
Then I see a header “JHD Overview,” followed by a short paragraph. “In approximately 10% of cases, HD affects children or adolescents.”
There’s no way, I have to be too old for that. I’m 17.
Opening a new search bar I type in “Juvenile Huntington’s Disease.” I find a different site.
“20 years or younger.”
Too shocked to move, I stare at the screen. I’m looking for something — anything — that will confirm this isn’t me. I come up empty. Frustrated, I stand up and grab my backpack on my way out. I don’t know where I am going but I need to get away from here.
Maladies of My Mind
Ch. 1 Father’s Praying Room
I see sacred white strings tied around my mom’s ankles and wrists. Although I haven’t seen her since father told us that she left us for another family, I want to see her one last time. The charred body lies before me, burned beyond recognition, but the necklace father gave her years ago is still recognizable. I wouldn’t have believed that the burnt corpse was my mother if it was not for that necklace and my trust in the elders. They say my mom died in a fire accident. She is laid out on a table with her hands held together in a prayer-like gesture, holding a lotus flower and incense sticks. I look down at her blackened face and graze my hands over her necklace. Bits of ash flake off onto my hands. The act alone almost causes me to break mentally. The smell makes me turn my head and gag. My hands start trembling so hard that I push them against my black dress in an attempt to steady them. The undertaker pulls me aside and gently puts a coin in my mother’s mouth. I don’t know what sets off my anger, maybe it’s the ash stains on my hands that I can’t seem to rub off or the fact that my dead mother has broken her promise to never abandon me for the second time. First was when she left me for another family and now she has left me forever.
It’s been seven days since my mother passed away but the monks continue to chant and people in black continue to weep. They take turns pouring scented water over her hands. Most make blessings or ask for forgiveness for past misdeeds. The line to my dead mother is endless and I am waiting for my older brother, who is almost fourteen and a year older than I am but his squeaky, stupid sobs put me in a bloody temper. “Stop crying, Awut. Father will be displeased if he finds his eldest son crying like a little wuss.”
“But that drunken fool isn’t even here, Orasa.” My brother stops crying and those angry brown eyes are now playing tricks in the light coming from the candles situated around the temple. “He won’t even come to Mom’s funeral.” His dirt marked face wears a painful expression and while I am not crying like he is, his face mirrors my own. My dark short hair makes me look more like a boy than a girl; and more often than not, people mistake my brother and I for twins. My train of thought is interrupted when I feel drops of water falling onto my face.
“It’s raining. Let’s go home before father knows we are here,” I mutter. When Awut gives me an accusatory look, I deadpan, “Or would you rather face father’s wrath tonight? I’m not in the mood to get kicked out of the house again because of your stupidity.” My brother looks like he wants to beat the shit out of me. Instead, he sucks in his round cheeks and stares past me. Even though he’s my older brother, I’m the scarier of the two of us and he follows me around like he’s the younger one.
We find ourselves rushing to our house on silent feet. I nearly slip. It has begun to rain and everything turns slick. We make our way to the wooden fence that circumvents our house, and I climb on top of it. As I crouch on the apex of the fence, I look down to my brother and tilt my head to signal for him to follow my lead, “Come on over, you coward.”
He ardently shakes his head. He’s too scared that our old man will be waiting for us on the other side. I roll my eyes. I dangle on the edge of the fence for a few moments before my trembling hands finally let go. My legs crumple beneath me when I land. The impact knocks the breath from my chest, and for a moment I can only lie there on the muddy ground, drenched in rain, muscles aching, fighting for air. Strands of my hair cling to my face. I wipe them out of my way and crawl onto my hands and knees. The rain adds a reflective sheen to everything around me. My focus narrows. Awut and I need to get back into our house before father discovers we went to mom’s funeral. I scramble to my feet and just when I am about to call out for my brother, I hear something. I freeze in my tracks. At first the familiar deep voice seems distant, almost entirely muted by the rain, but an instant later it turns deafening, “ORASA!”
I tremble where I stand. Father. Before I can think of anything else, I see him, a sight that sends terror rushing through my blood –my father, his eyes flashing, materializing through the fog of a wet midnight. “Where were you coming from, Orasa?” he asks, his voice suddenly turns eerily calm.
I try in vain to escape his grasp, but his hands only grip tighter until I gasp from the pain. My father pulls hard – I stumble, lose my balance, and fall against him. Mud splashes my face. All I can hear is the roar of rain, the darkness of his voice. I peer through the fences to see if my older brother is still on the other side. Of course, he is nowhere in sight.
“Stand up, you ungrateful brat,” my father hisses in my ear, yanking me forcefully up. I smell alcohol on his breath. Then his voice turns soothing. “Come now, dear. You’re making a mess of yourself. Let me take you home.”
I glare at him and pull my arm away with all my strength. His grip slips against the slick of rain. My skin twists painfully against his, and for an instant, I am free.
But then I feel his hand close around a fistful of my hair. I shriek, my hands grasping at the empty air. “So rebellious. Why can’t you be more like your brother?” he murmurs, shaking his head and hauling me off away from the wooden fence. “Where did you come from? Did you run off to the funeral? Answer me!”
I scream. I scream with all the air I have in my lungs, hoping that my cries will alert the people in the village, and they will witness this scene unfolding. Will they care? I doubt that. I’m just a daughter after all. Girls are expendable. My father tightens his grip on my hair and pulls harder.
“Come home with me now,” he says, pausing for a moment to stare at me. Rain runs down his cheeks. “Why don’t you be daddy’s little girl? You know daddy knows what’s best.”
I grit my teeth and stare back. “I hate you,” I whisper.
My father strikes me viciously across the face. I stumble, and then collapse in the mud. My father still clings to my hair. He pulls so hard that I feel strands being torn from my scalp. “You look so much like her,” he whispers in my ear, filling it with his smooth, icy rage. “You look so much like your mother.” My father slowly pulls out his belt. I immediately recognize that predatory look on his face. I shut my eyes and pray for the beating to be over soon.
Later that night, I wake up to the sound of a thunderstorm. Water drips from the leaky ceiling, running in streams and splattering over my head. The electricity is cut short but I can still hear the echo of footsteps heading towards me. “Orasa! Orasa, wake up!” It’s my backstabbing brother.
I mumble, “Go back to sleep, Awut. It’s just a thunderstorm.” My body aches from the beating I received from father. I roll to the side and try to cover my body with the ragged blanket. However, the blanket is too small to cover my feet and I can feel my toes freezing as the wind blows through the cracked windows. As if the wooden floor I’m sleeping on and the water dripping onto my head are not making me cold enough, my brother has to put his cold hands over my face in an attempt to wake me up. Frustrated, I finally turn towards him. “For Buddha’s sake, what do you wa—”
I stop midsentence when I see the look on his face. Despite the darkness, I can see how pale he is. His voice is shaking, “Orasa…I think I did something I don’t think I’m supposed to do. I think…”
I roll my eyes. “Spill it out already.”
He fidgets and rubs his hands together nervously. “I went to father’s praying room.”
“You did what?!” I sit up and grab my brother’s shoulder tightly. I wince slightly at the throbbing pain that runs through my body. My brother looks at me with concern. I know he’s sorry that he didn’t stand up for me; but of course, my cowardly older brother would never do anything about it. I regain my composure. “You fool. You know what father will do if he finds out you went into his praying room.” I grab his shoulder tighter as if I’m trying to force a confession out of him.
“I didn’t go in though,” he continues weakly. “I followed the monks from Mom’s funeral. I saw them heading towards father’s wooden hut in the forest so I thought they were going to pray for mom. I was about to follow them in but then I heard something.” At this point, Awut’s entire body is shaking uncontrollably and his puffy red eyes are starring into empty space. He whispers, “Her voice wasn’t soft and smooth like I remember. But I heard her, Orasa. I heard Mom calling out for us.”
I sit still and stare past my brother’s face. He looks at me and his hands reach to grab mine as if to comfort me. My body is shaking and I think he is expecting me to cry. Instead, I give him a small chuckle. “You fool. I think you ate too much of that free intestines soup at the temple today.” I push my brother away and slump back onto the ground.
“But, Orasa. I – “
“Go back to sleep.” I cover my face with the blanket and mumble. “If you talk about this nonsense again, I’ll beat the crap out of you.”
I hear my brother sighs in defeat as he scuffles back to his sleeping spot. I hear him shifts uncomfortably at first but eventually his breathing levels, indicating that he has fallen asleep. I try to go back to sleep as well but my brother’s words keep haunting me. A fragmented image of my mother comes back. I can barely remember what she looks like. All I can see is that charred face with none of mom’s resemblance at the funeral. Despite the cold weather, my brow is covered with sweat, and my cheeks are wet with tears. I’m breathing heavily. I sit up, brush a wet strand of hair out of my face and rub a hand wearily across my eyes. I feel dumb. Crying doesn’t solve anything. It’s pointless now to go back to sleep so I stand up and take one last look at my brother before I walk out of our room. As I exit, I make sure that father isn’t around. I look first at the stacks of crates in one dark corner, then at the burlap lining the floor, and lastly the little sack of jasmine rice and water sitting between them. Good. He’s nowhere in sight. It takes me a minute to reorient myself and direct where I am heading.
Father’s praying room is situated in a hut in the middle of the woods away from where we actually sleep. He says that the praying room is too sacred to have little brats like Awut and me running around. As I take a step out of our house, the cool air washes over my face and the moonlight drenches the whole night in dark silver. My heart pounds erratically in the way it does after running away from my drunken father when Awut or I have disappointed him. My train of thought halts when I reach a lake our family used to swim in— when we were still a family that is. I hesitate but quickly shake the happy memories out of my head. I turn the corner and head towards a tiny, boarded-up hut with faded inscrutable Thai characters carved on its door.
Gingerly I climb my way over the rusty aluminum roof, and then listen intently for any sound from within. Through the roof’s gaps, I see and hear bald men in orange gowns chanting prayers. I still can’t see the entire view but these men must be the monks my brother told me about. They are sitting in lotus positions and forming a circle but I can’t see what is in the middle of that circle. I hear shuffling noises inside but they are soon subdued when I hear father’s shaky voice, “Please. Please. Please.” I can’t believe my ears. The last time I heard him say such a polite word was when mom was still with us. My pulse quickens. I need to see more. I go from one spot on the roof to another until I finally find one that has a crack between two of its aluminum boards. Father is standing furtively in the corner of his prayer room with his head in his hands. I see him reach for a small family portrait. The moonlight shining through the roof allows me to make out the image of father smiling in the picture. “Please release her,” he mutters. My father suddenly swings our family portrait across the room. His breath comes in ragged sobs, and he claws his scalp in agony. Blood trickles down his face. The sight of it alone triggers the smell of iron filling my nose. My father puts both his hands to his face and I hear him cry in despair.
It’s too dark inside for me to immediately make out the figure in the middle of the monks’ circle. However, I can see that one of the men who was sitting among the monks stands up and walks towards the figure in the middle. He appears to be wearing a different outfit from the monks. Instead of having his head shaved and wearing an orange robe, this man is in a white robe and he grows his hair and beard wildly. He holds out a long sharp object and after squinting my eyes, I realize that it’s a dried stingray tail. I gasp. I have never seen one up close before but the man in front of my eyes is the shaman. The elders said that a person’s illness or drastic change in behaviors is caused by black magic called “tai”. Specifically, it is an object that is magically implanted in the body of the afflicted person by another person. The shaman must then suck this object out before a cure can happen.
In one swift movement, the shaman whips the figure in the middle of the circle with the dried stingray tail and the silhouette shakes wildly. The sound the figure makes is incoherent but I can see the anguish etched into every single crumpled, devastated muscle of the uncontrollable body. It does not take long for me to realize what, or more specifically whom, that body belongs to. The sound of her crying is so foreign that it tears my heart. I’ve seen my mother cry before, but never like this.
For more information on Exorcism in Mental Illness Across Different Cultures, please take a look at this article.
I stand at the starting line alongside the other competitors, stretching and jogging in place, contemplating the race ahead. Just shy of six miles long, the course winds through the desert relentlessly, pulling runners further into the heat until every ounce of moisture is drawn from their bodies. This is easily one of the most difficult runs in the area, but I am always ready for a challenge. Past successes confirm my knowledge that I am stronger than everyone else.
Out here in the middle of nowhere it is easy to get lost. The trail we will follow, lined with mismatched rocks of various shades of reddish-brown, offers no comfort or guidance in the face of this lifeless climate. Without obvious landmarks or pretty scenery to keep one company, runners have to rely on the fortitude of their minds to push through.
In spite of the bleak road ahead, or perhaps because of it, I am excited. This stretch of land off of Highway 62 is familiar to me and I thrive in the heat in a way that my coastal counterparts can not. When you say “Southern California,” most will immediately conjure up images of the beach and palm trees, 70-degree weather, and vibrant cities full of beautiful and interesting people. That is not the case for my small town. Here, the drought is old news and most people live lives about as full as the reservoirs. But I have hardened myself against the harsh conditions of such monotony and after suffering through this place for years, I anticipate a landslide win in my territory.
My thoughts continue to wander and, willingly or not, I land on my favorite topic—Carley. I secretly hope that she will make it from work in time to see the race, though I would never consider asking her to come. Thankfully, despite my stubbornness, she always knows when I need her and shows up anyways. Carley is the one distraction I appreciate and winning feels better when she is there to see it.
I have often wondered if it is wise to allow myself to care so strongly for her, but despite efforts over the years, I have never been able to distance myself. We both have college dreams and are well on-track to achieve them — I run fast and she is the smartest person I know. But I constantly worry that I will be forced to choose between her and my dreams. If we are split up, or God forbid one of us ends up stuck here, long-distance is definitely not an option.
Shaking off my anxieties about the future, I try to refocus. I need to stop letting myself be so easily distracted, especially during races. Senior year is my last chance at recruitment and I need to dominate. I take a deep breath of dry desert air, clear my head, and ease into my pre-race routine.
Preparing myself, I block out the rest of my thoughts and focus on the race specifics. Seeing the twists and turns of the path in my mind, I make a plan for the run. First, a smooth and strong takeoff, launching into the race with perfect form. Then I will settle into a comfortable speed at about 6th or 7th place for the following four miles. At around the two-third mark I’ll kick it up a gear and move ahead a few spots. Finally, in the last stretch of the race, I’ll take the lead and win by a solid 50 to 100 meters. It’s the perfect formula for victory.
With a couple of minutes to go, I systematically begin flexing and relaxing my muscles in preparation. The temperature makes loosening up easier, but I still have some trouble shaking out my calves— a chronic issue that my coach claims is due to not weight training enough. Since I am the strongest runner as well as team captain, he feels the need to give me advice, warranted or not. I have never exactly trusted his judgment though, given his status as a mediocre former athlete and my old man’s long-time drinking buddy. When neither of them made an appearance this morning, one not invited and the other abandoning his coaching responsibilities, I was forced to organize the carpool and bring all the food and drinks for the rest of the team. I suppose I shouldn’t be shocked at the incompetency of someone put in charge of minors — after all I lived with it for about a decade with dear old dad.
Darn it, my mind is wandering again. But I can’t help being bothered by the whole situation. Although I care for my team, I am frustrated by anything that pulls my attention away from my own needs, my own race. I can’t afford to be distracted.
I know I will win. I see the course in my mind again and am certain. Victory is not a question but an expectation. Not just because I know I am better than everyone else, but rather because I have to win. Barring death, few ever leave our town. Caught up in young marriages or family-owned businesses, there is never any encouragement to work for better, to hope for more.
People tell me my mom was smart, I wonder if she ever had an escape plan. I guess even if she did it was foiled by her pregnancy with me. My plan is to make a run for it, literally. Victory is a standard I have set for myself ever since I realized that running could be my ticket out. The goal is an elite Division I school. A place where I can take advantage of the countless opportunities that will be laid out for me in a neat little row, one after the other.
The gun goes off.
I am embarrassed beyond belief but hastily regain my footing and launch into the first phase of the run. What the hell just happened? I’m not concentrating and it ruined my start. A rookie mistake, I need to do better.
I steady my breathing and lengthen my stride, working to make up the lost ground. After a few minutes I find 6th position and resist the urge to take the lead of the pack in retaliation for my earlier blunder. Instead, I find a comfortable pace that will keep me poised to overtake those ahead of me while simultaneously conserving energy. Self-control is the key to my wins. Even in a pre-season training race such as this one, I never stray from my mantra.
Start slow and steady.
Beat ‘em to the finish line.
I always find a certain sort of pleasure in that final surprise. As I run, alert for anyone creeping up behind me, I visualize myself pulling up to the front of the pack, still calm and breathing steadily, perfectly in control. Feeling me on their heels, others will quickly lose morale and I know that I have won.
The desert passes by unremarkably for the next couple of miles, the pounding of my feet and the sound of my breath all I can hear, the puffs of dirt with every step all I can see. My mind is the clear, still surface of a seemingly endless lake and I feel strong.
About three miles in I wobble and almost fall, a rut in the dirt my feet do not react quickly enough to. I lose no time but my meditation is broken, and the slight error strikes me as odd. I typically respond to the irregularities of the dirt path reflexively, without thought. I am not paying attention again. I must be letting myself become too relaxed.
Focus, focus, focus.
My ability to command my body to continue, to push further despite the screaming of every muscle fiber, is my greatest pride— complete self-control.
My father used to tell me that the key to success in life is power. “Powerful people can have what they want, do what they want, control their own destiny.” I now know this for what it was: the angry rants of an unemployed alcoholic with absolutely no authority over anyone or anything. However, there is a certain truth to the old fool’s words, and I value my power over myself extremely highly.
Almost five miles in now. I am still towards the front of the group, hovering just behind the current leaders and feeling strong. My shoulder feels weird though, stiff and sore as though I had slept in an odd position. I try to rub the ache out.
The final stretch is my favorite part of a race. Most runners feel a rush of exhilaration as the finish line approaches, but I feel a rush of almost inhuman energy. My body filled to the brim, I feel as though I have been given a good scare and all of my basic instincts are yelling, “run!”
I throw myself forward, ready to strike everyone in that last half-mile. I at my strongest, they at their weakest. I pass a few runners, briefly indulging in the looks of exasperation that flash across their faces before I move onwards. About a minute later though, with just over a quarter-mile left, something odd happens— I can feel my legs weakening. Suddenly, they feel as though they are made of lead, drained of all the power they contained only a moment ago. Despite my best efforts, I cannot will them to run any faster and I know I am falling behind. Looking forward, I see that there are still two runners ahead of me and not enough dirt left. Steeling my mind, I practically scream in my attempt to catch up and manage to pass one of them, but seconds later the other cruises across the finish, a full 10 seconds ahead of me.
The spectators are cheering as my teammates pat me on the back, saying how great I ran and that I had State in the bag this year. I’m not listening to any of them. I look down at my legs and they shake, as though the shear effort of holding me up is too much for them anymore. The post-race exhaustion hits me like a wave. Usually a bearable feeling, this is much worse than anything else I have ever endured. It is the sensation of all my dreams crashing around me, pushing me down into the dry desert ground. I stare at the earth as though I am afraid it will swallow me whole. Looking up I see people cheering, including Carley, who managed to make it to the end of the race. She looks at me with concern, but I find no comfort in her gaze. Slowly, I sink to the floor and grab my ankles, too drained to move any further. I ran my race and I lost.
Why did my body disobey me?
Something is wrong.
My usually infallible confidence fails me and suddenly I am afraid.
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I get an odd rush out of telling people how nervous I am about the Bar results coming in today. And it’s true, I suppose I’m somewhat antsy about them and it’ll be great to know officially. But I’m not actually worried: I do well on standardized tests. I studied for months and I felt fine when it was over. Yet here I am, refreshing the results website every two minutes, frantically dissecting with my colleagues what we can remember of the exam questions, feigning more nervousness than I have. It took me until 2:53pm today to realize why:
I didn’t get to do this the last time around.
Years ago, during a summer break from college, I worked as a lowly intern at a small newspaper. I didn’t get to do much substantive work (again, intern), but I enjoyed the office and my co-workers and the blueberry danishes they sometimes brought in. But as the summer crept along, tension and frustration churned in my stomach. I knew what was coming. Before the job started, I’d made the first appointment to get tested for Huntington’s. I respect people who make the decision to hold off on testing, to let it go until there’s a pressing reason for it. I wish my brain could work like that. But it has to know more, has to keep asking questions, has to know more than it has earned and more than it should. It was a surprise to exactly no one when I chose to get tested almost immediately after finding out about being at risk. I also knew myself well enough, however (at least I thought I did), to postpone getting the results until the day after my summer job ended in case things went poorly.
From the moment the phlebotomist walked away with my sample, the summer turned slow and agonizing. For all my confidence in the psychiatrist’s office about my support network, I didn’t trust myself enough to talk to any of them. I didn’t want to burden my family about it, so I tried not to let out more than small snippets of my anxiety to them. My friends were on the receiving end of slightly larger bits of crazy, but there was only so much stressing I could do over e-mail before I knew that their eyes might be glossing over or they might just skip reading my epic, five-page and completely self-absorbed email entirely. (How dare they, I know.) My boyfriend, a truly wonderful person who played a key role in this support network, wasn’t my boyfriend anymore. I’d picked fights and pushed him away ever since learning about HD, and even when I realized I wasn’t being fair to him, that I was projecting my fears about what was happening and what might happen onto him and our relationship, I couldn’t stop myself from deciding I was finished.
That left my co-workers, the people I spent most of my waking hours with. Of course I couldn’t talk to them. Those were the people from whom I’d be seeking recommendations, the people with whom I wanted to work in the future, and to let them know that my mind wasn’t entirely on work so much as it was on the degenerative illness I might have that would destroy my brain function? Not a great idea. Looking back on it, I was probably underestimating their empathy (and overestimating the impact that co-workers during one college internship would have on the rest of my career), but not talking about it at all to them did help me maintain a professional facade in the workplace when I felt nothing but nerves inside.
The waiting seemed endless, of course, until it ended. My best friend sat next to me holding a box of tissues and the genetic counselor looked so somber and the neurologist was direct when he told me I fell on the wrong side of 50/50. For a moment, I wanted to be back in the waiting, but then I felt the knot in my stomach dissolving and was grateful that, no matter what was in store, at least I’d made it through this part.
The pass rate for the Bar exam I took is a little over 50%, unfortunately and eerily symbolic of that summer a few years back. But this time I’m waiting on results that I put a great deal of effort into, gave myself the best possible chance on, and frankly, did well at. (If I failed, I take this all back.) So I’m not nervous today, not by how I’ve started defining “nerves” since I took my HD test. But everyone else seems to be, and I’m happy to make a show of it for my co-workers, for my friends, and for my parents. My parents have called and e-mailed often, wanting to talk about what the waiting is like and how excited and nervous they are. My mother even told me about a nightmare she had about waiting for Bar results. (I wouldn’t be surprised if, a few years ago, there were lots of nightmares about the waiting that she didn’t and never will tell me about.)
And when I get my results back, I will post them on Facebook, because there’s no one in the world I have to hide it from.
The author who submitted this story to HOPES wishes to remain anonymous.
HOPES is excited to present a new Stories section on the website! This section is meant to be an open space in which individuals affected by Huntington’s disease (patients, caregivers, and friends) can share their experiences with HD in the form of anonymous text excerpts. We believe the sharing of narrative can have healing qualities and promote connectivity within the greater HD community.
Stories can take the form of submitted text or transcribed, in-person interview. We are open to all forms and styles of writing. If you are interested in submitting a story or setting up an interview, please contact HOPES member Annie Rempel (firstname.lastname@example.org).