Persistence Hunting

I try running. Again and again, I try it. At first, my father and I train together – he, used to running marathons; me, unable to run for a minute without gasping for air. We follow a program: Couch to 5k. I make it to two minutes, then three, and cling to each sixty-second interval, the sweetest victories I’ve ever won.

On the treadmill, I feel cramping. It’s not time for my period; I stop and go to the bathroom to check anyway. The pain that blooms in my lower abdomen over the next few minutes takes my breath away, and I writhe in silent agony until at last it relents. Several days later, while running outside, the cramping begins again, and I am left cowering on a street corner, texting my mother to come rescue me. Each bump and jolt of the car on the ride home makes me want to tear open my soft stomach and get at the awfulness within.

My father suggests we slow down the training. He suggests that we are pushing it too hard. He suggests I am just not that good at running – yet.

We slow it down. I try on my own: the treadmill, the track, the street. Pain, I learn, lurks around the ten-minute mark. Eventually, I can hold it at bay for twenty minutes, but no more. Over the months, it gains on me, slicing off my well-won minutes.

I Google it. Ultra-runner blogs suggest that I have poor form. Desperate questions sit unanswered in old forums, collecting digital cobwebs. Whichever dead end I hit offers the same conclusion: running is difficult. Of course it’s going to hurt. My mother suggests mentioning it anyway at my annual doctor’s appointment.

~THE PEDIATRICIAN~

I have always shared a relationship with my doctors like that between a desperate prosecutor and an impartial judge. Worse: prosecutor and jury. I ruffle my invisible papers, straighten my spine, and tell my doctor my symptoms. She doesn’t look at me as I speak; she types into an endlessly complex computer system, and I imagine her clicking a box next to HYSTERIA. “Some people just can’t run,” she says. “It’s probably nothing. I wouldn’t worry about it.”

I was raised with a popular belief of ancient humanity, an idea that posits running was our survival. We outlasted our prey, waiting for it to keel over with exhaustion. When I imagine my ancestors, all those thousands of years ago, I imagine them jogging across arid plains. For them, I thought, running was simply the way of things. To just not run, then, would be to surrender to the great darkness of death. It’s a dramatic thought, laced with the sort of angst only a teenager can muster.

Unacceptable, I decide. With no physical evidence of my supposed inability to run, there is no reason I can’t. No reason except, perhaps, a lack of the same mental fortitude that my ancestors had in spades.

After that appointment, my attempts to run flare up like match fire. Freshman year of high school, senior year, my freshman year of college. The agony grows alongside me, ceaseless in its pursuit. My sophomore year of college, I go to the gym almost daily, measuring my progress in the scraping-by of seconds. I have goals, discipline. The numbers tick by on the treadmill screen. Inevitably, the cramping begins. I learn that I need to hide or embarrass myself, that I need to sit or risk falling, that I need to bear down and receive nothing for my efforts.

Words fail. They stumble to a stop when faced with that sort of pain. Only snapshots of memory exist from the seconds before these blackouts: a groaning, animal experience. In the moments before I am lost, I do not think with words. That part of my brain fails. I think instead with the mind of prey twisting in predators’ jaws, the fox chewing its leg free of the bear trap. I think in the colors of blood and birth. Then memories stop forming. A survival tactic of the faltering brain.

A few moments (or minutes, or lifetimes) later I return and find myself hunched over and shivering, soaked in sweat. I stumble out of the bathroom stall, mouth dry, tongue tacky, and look at myself in the mirror. The blood has leached from my face. My eyes are bruised-black, hollow, haunted. People avoid my gaze as I walk back to my apartment with small, shaking steps.

My mother once again urges me to talk about it, this time with my new doctor, who’s a young woman just like me.

~THE GENERAL PRACTITIONER~

“It’s probably nothing,” I tell her. “I’m not really worried about it.” The words are tugged from my throat by her lab coat and sterility, words that have hung barbed in the soft tissue of my lungs for far too many years. When she asks questions, her concern manifesting on her face only as an increasingly neutral mask, I feel my heart begin to beat faster.

Finally, a referral. “I didn’t know I had it until I was in med school,” my doctor says. She’d been overheard, as a resident, telling a patient who was bleeding through multiple tampons in the span of a few hours that she had nothing to worry about. A senior doctor had had to correct her.

Strange, how that same nothingness has taught me to bite my tongue and smile as blood seeps through my teeth. Nothing takes up such an inordinate amount of space.

~THE GYNECOLOGIST~

The gynecologist asks me four or five questions. She does not smile. “Yeah, sounds like endometriosis,” she says when my words dry up. “But we’d need a laparoscopy to be sure. and I wouldn’t recommend an unnecessary surgery.”

Diagnoses, I learn, are saved for suffering more serious than mine. There is no way to tell what damage has been done without slitting my stomach and taking a look at the tenderest parts of me. No technology to survey or scan or detect; nothing but my word against theirs. They give me pills with mile-long warnings – perhaps the medicine will make me want to kill myself, or kill someone else, or perhaps it will fail in its singular purpose and tell us if you get pregnant, because chances of complications are low but never zero.

I ask about hormonal changes, about the horrors I’ve heard from other women. “Most people don’t have any negative reactions to birth control,” the gynecologist says. “I wouldn’t worry about it.”

I take the pills. I swallow the questions, the wondering. I probably have endometriosis. I probably won’t become infertile. I probably won’t need surgery. My life is a held breath that only burns when I think about the last time I exhaled.

The medicine helps. Most of my life is now spent outside the confines of my innards. I run a mile, a mile and a half. I learn how it feels to stop because of exhaustion instead of pain. To drive my body to the edge and remain standing afterwards. To remember the minutes following a run.

I go for two miles, two and a half. It tastes like blood is rising in my throat, and phantom cramps send me halfway to the bathroom before I realize it’s only my expectation of pain, not the real thing. I reach three miles and cling to the accomplishment with a white-knuckled grip; this, at last, it cannot take away from me. The pounding of my feet, the beating of my heart; these things are mine and mine alone.

~THE ULTRASOUND TECHNICIAN~

I chug a bottle of water and prepare for my bladder to protest. The waiting room is for two departments – ultrasound and emergency. Patients with bloodshot eyes and mask-covered faces study me, a young woman hidden within a large sweatshirt, a girl barely old enough to drink. They think they know what has brought me here.

Finally, when my bladder is about to burst, I meet the ultrasound technician, a jovial older man. We’re here to see if my organs are twisted or covered with cancerous growths, if it is, in fact, tumors that have weighted my steps and kept me from motion.

“Your uterus is a little tilted,” the ultrasound tech says as we watch my insides on the screen, flat and fuzzy around the edges. “But you don’t need to worry about that. Everyone’s is tilted. My uterus is tilted.”

I laugh. I don’t need to worry about it, and so I laugh.

~THE UROLOGIST~

The birth control works but other parts of me don’t. A urologist thinks adventurous uterine tissue has rendered part of my bladder unusable. Tissue sounds so fragile – like paper wrapping a present, or softness held to a snotty nose. I have felt this tissue swell and ache within me in places it should not. It is not fragile. It has had years to do its work, this organ that divides the population and warps my body. Maybe a diagnosis years earlier – birth control as soon as I began to bleed –

When I tell him, my father asks how we fix it. “They can’t fix scar tissue,” I tell him, not knowing if this is true. Maybe they can. But they can’t fix this scar tissue, and no matter what they’re able to retroactively correct, part of another organ is dead, razed by tissue. It is finding new ways to hunt me, trapping me further within my body, claiming my insides as its own.

~THE THERAPIST~

There are three months where I cannot run. Remote seasonal work, a job I took in search of an adventure, ironically shackles me to slower paces. I call my mother and cry without understanding why. At last, though, I realize: I want to move, I want to go. I want to run until I cannot run anymore, until saliva thickens my throat and sweat slicks my skin. I want to surrender to a pain I can control, discomfort I get a say in. Not here, though, not now. I cannot run, and all the while I feel myself withering away, starving in sedentism.

“Exercise is important to you,” my therapist says in our first appointment after I’ve returned home. “It makes sense that you’d miss it.”

I’ve missed this, too; an unspooling of my emotions without worrying about the weight I’m placing on others’ shoulders. I started seeing this therapist after receiving my tentative diagnosis. It is the only part of my life that I’ve found can make this professional crack, causing frustration and fury to blaze brilliantly through her carefully constructed calmness. She is angry on my behalf. I feel like I shouldn’t revel in it, but of course I do.

The first time I go on a run after returning home, I feel like a sled dog tugging at its harness, frothing at the mouth. I run until I taste bile and blood. I run until I think I might die. Gasping for air during the cool-down, I can’t stop a giddy smile from spreading across my face. Flushed and sickly-looking, near vomiting – I’ve never felt better. I think of street corners and bathroom stalls. I think of shin splints and distant horizons and beasts felled by simple persistence. I think of nothing.

~THE HUNTED~

It is not mine, this nothingness. It is a thing of sugar pills and hot teas. It is a thing of clenched muscles and gritted teeth. It is pain from an organ that is not my own but nestles in my body as if it is.

Votes are cast. Politics shift like the wind. I call my mother. Tears blur my vision but do not fall. “I can’t lose my birth control,” I say, my own desperation tasting sour. “I can’t.”

And here, then, is the crux of my fear: how I can cling to my life with such strength and still others can tear it from my grasp. Doctors barely pay me any mind; politicians pay too much. All eyes are on my insides, and all I want, all I’ve ever asked for, is to live without pain. It does not matter what treatments I am given for my mind or my body. Both can be taken away, stripping me down to that god-awful nothing. The beast has reinforcements.

The knowledge of this churns my stomach until at last something else gives way. I am tired of being afraid. I am tired of this ancient terror that wears different masks but never changes its face. I’m exhausted from bowing to a single part of myself, one that holds such a sharp sword above my head, the blade hovering a hair’s width above all that I love. My fear turns into hate turns into rage.

Its hunt is not over. Perhaps mine isn’t, either.

~THE HUNTER~

At last, I run towards the enemy from whom I’ve only ever fled. I begin to research it. I learn that birth control often does not slow or stop it, only controls its symptoms. I cannot feel the disease as it destroys me, and that is the best they can offer. This, at least, I can have: the knowledge that if my medicine is taken from me, it will probably, medically speaking, change nothing. There is a good chance it changes nothing now, even as I dutifully take it. I can run free of pain and still, manifest destiny, the tissue spreads.

Someday, I might lose parts of myself. Cancer may lurk in dark and damp shadows, bundles of tumors that will make my stomach swell until I birth a monster. Scar tissue might chew and chew and chew me up until at last the decision is made to tear that terrible hunger out at the root. My pain might worsen, the pills might stop working, and I might need that unnecessary surgery, and a host of other surgeries besides.

I have options, limited and terrible though they might be. Others, lingering in corners of the Internet that did not exist during my first Googling all those years ago, have compiled lists: doctors who listen, doctors who care. At last, my reinforcements have arrived. It’s nothing I want to act on yet. I am young and my medicine is both functioning and legal. But there are numbers to call, clinics to visit, just in case. In the meantime, I can host this thing a little longer.

If I can make it through the decades, through the doctors, through the pain and blood and nothingness – then I will arrive at a natural solution. My body and mind, both on the precipice of slowing, will loosen my bindings and set me free. The organ will slow to a stop like a puttering, gasping, failing engine. I have only to wait. And I have already waited for so long. What’s another three or four decades?

~THE NIGHTMARE~

Sometimes – often, if I’m being truthful – I think of the future. Will those organ-bearers who occupy the future have more options than me? Fewer? There is no telling. There is no telling if I will have more or less options in my own future. For now, I know, I am lucky – luckier than the women of the not-so-distant past, anyway.

Thinking turns to imagining, which gives way so easily to ruminating. It’s an odd relationship, the one I have with my own body. Odder still to think of part of myself as the enemy, but I’ve been left little choice.
In my nightmares, that enemy grows, persists. It absorbs its wet and fleshy neighbors until nothing remains. In my nightmares, I have no need for eating or sleeping, drinking and dreaming. I’m not worried about such mortal needs. I’m not worried about anything.

Instead, I am only a husk sheltering the most hated, worshipped, misunderstood, analyzed organ. I house life, creation itself, and my skin is pale as porcelain, my eyes bruised as ink. I think without words and remember with half-rotted memory. I bare my bloodstained teeth at people, and they mistake it for a smile. I take careful, heavy steps and dream of nothing faster. In my nightmares, it catches me – at last, it catches me.

I learn many years after that failed appointment with my pediatrician that my romantic notion of humans as persistence hunters has no firm scientific support. In fact, there is compelling evidence against it: the bones of our ancient kills, pocked with tool marks, belonged to young, healthy creatures. Animals at their prime are hardly the easiest prey if you are chasing your dinner to death.

The truth, then, appears to be far simpler: we hid and plotted. We used wits and trickery to trap the meatiest, most substantial animals, and used cleverly engineered tools to butcher and eat them. Our hungry intelligence was our lifeline; it proved – and proves – more effective a killer than persistence hunting could have been.

After years of pain, I cannot cast myself in the role of persistence hunter anyway. A formless disease that stalks through my innards already plays that part so well. More often than not, though, I also cannot imagine myself as the intelligent, ancient human. I feel more kinship with the young, healthy animals that graze unknowing as hunters hiding a few feet away prepare their weapons and snares.

There is hope for me, though, whether I cast myself as hunter or prey. The shifting tides of political landscapes make my medical future uncertain, but I have lists of surgical recommendations from others who suffer. And on the days when the pain is too great for higher thought to interrupt it, there is still a glimmer of hope to be found in my aging, when crow’s feet settle in the tender skin beside my eyes like footprints in fallen snow. When I no longer make such good eating.

I cannot change course; I alone cannot hunt the hunter or scavenge what parts of me it has left behind. This, though, I can do: either call in my reinforcements or bide my time and allow my joints and skin and spirit to weaken. If I cannot best it, then I will outlast it. I will strategize and manage and cope and though it may nip at my heels and breathe hot down my neck, I only have to persist.