91. Origin Stories

Depending on the doctor, the cause for fibromyalgia is different. Psychological distress. Lingering infection. Autoimmune disease. Physical or emotional trauma. After I am officially diagnosed in 2007, Dr. Birnbaum tells me that the onset of fibromyalgia as recognizably fibromyalgia sometimes occurs after a severe viral illness or physical trauma. I had cold flashes and nausea that May and thought it was the flu, but I haven't been as sick as the illnesses she describes in years, not since maybe 2002 when I caught "the December flu" while visiting Sri Lanka for the first time. I ran a high fever, shivered uncontrollably in the humid heat, vomited in metal basins, was too weak to walk to the bathroom by myself. Paatti touched my forehead with a papery hand, and I flinched and heard her murmur, "Aiyo, payanthu," she's scared.

I am, but what of? Not of pain, which I have endured since I was a teenager. In 2007, I have surgery on my right foot to remove "the most persistent wart" my podiatrist had ever seen. When he cuts into it, blood spurts everywhere. "This one goes deep," he says. "You can tell because it's so vascular. That's how warts work; they plant themselves in living tissue. They become persistent that way." I watch him chisel it out with a laser, and I change the bandages twice a day for months, until it greens and falls off, and tissue and skin grow back over the shiny raw flesh. But the wart returns a few months after the wound heals. Instead of undergoing another surgery I can't afford, I swig Stolichnaya vodka from the bottle and freeze the wart with nitrogen until the skin whitens and blisters open and I can cut it out with an X-Acto blade. The flesh is tender. It comes off in flakes. Blood pools into my hardwood floor. I cauterize it with a BIC lighter. I don't recall any pain. The tissue that grows back is an insensate knot of deadwood, but the wart never recurs.

If there's a physical trauma that might have triggered it, maybe that's it. But in 1999, I once dislocated my knees during high school marching band practice. Not wanting the whole band to do pushups for my fuck-up, I march on, then collapse on the grass with dry eyes and a vacant stare and have to be helped to the nurse's office, where the nurse asks me to rate my pain. "Seven," I say calmly. "Seven? You're a trooper!" she says with horrified admiration. She confides that most people who come to see her are malingering to cut class, but "I don't think you're like that," meaning she thinks I'm a good South Asian girl who never lies. It's the first of only a handful of times I'm hailed at the intersection of race and pain. The other time will be decades later, in the ER, when Mitch, a white man PA, will insist I'm pregnant on the assumption that South Asian American girls are secretly promiscuous but must deny sexual activity to protect their honor.

Apart from two conversations with Dr. Birnbaum and Dr. Sattva about being Sri Lankan and Tamil, ethnicity and culture barely enter into the equation at all. The central question in modern Western biomedicine is where does it hurt, which seeks an objective answer that yields a static and singular notion of (disease) identity and prognosis, uncomplicated by questions like where are you from, which provides a more informative, collaborative place to begin (Foucault, 1963/1994; Morris, 2000; Tribe, 2007).