An American Malady

When I woke up with a nose bleed, my first thought was, of course, “cancer.” This got refined to “brain tumor” when I started feeling painful pressure in my temple every time I bent over. As the constant buzzing in my head that I normally hear increased in pitch and volume, I could even pinpoint how I’d caused my own probably-soon-to-be-fatal malignancy: too much listening to audiobooks with earbuds. Felled by overindulgence in my most effective productivity tool. The pitiful irony nearly brought tears to my eyes.

Gradually it dawned on me that, since my son had been hacking and snuffling around the house for days, maybe I didn’t have noncommunicable brain cancer after all, but only consumption.

While waiting observantly for my symptoms to develop, for the spatters of blood to start appearing in my handkerchief, I holed up in my room or drowsed in the sunshine on the patio. I read novels, drank tea, listened to our flock of house finches warbling, and contemplated the Brontës’ fate.

My son, on the other hand, did none of these things. During the whole course of his own obviously abominable head cold, I bet he never once indulged in imaginative meanderings involving brain tumors or Brontës. Instead, as he dragged himself to both of his jobs without missing a day—scattering contagion like dismal confetti—he probably dwelt on basic economics.

As a part-time hourly employee without sick leave, staying in bed with a cold means a day’s lost income, which equates to a tank of gas that he can’t pay for, but which he needs in order to get to one of his jobs. If the illness drags on for a few days, it probably means not only losing the income, but also paying out, since our high-deductible health insurance won’t pay for him to go to the doctor’s office to get a note for his supervisor confirming that he’s genuinely sick and not merely malingering.

It’s really a shame that the same fertile imagination that conjures dramatic diagnoses for humdrum symptoms also forces me to envision the many millions of truly ill people whose experience in life is more like my son’s than my own—but without the safety net that Ned’s father provides. It sort of spoils all the fun of being a little bit sick.

By the end of the 18th century, the incidence of hypochondria and hysteria had reached epidemic proportions, at least among the class of people who could afford to retain the sorts of physicians who had the time and inclination to write about such things. One doctor, pioneer self-help guru George Cheyne, dubbed it “The English Malady” because the melancholy that led to imaginary illness arose, he believed, from British wealth, luxury, and excess.

In recent years, the United States seems to be suffering from a peculiar asset-aligned illness all its own. The complex network of neurons firing above and below the cortices of some voters and many legislators seems to have been impaired in such a way that, for example, they cannot imagine the experience of people whose lives differ from their own in terms of income and access to healthcare.

This impairment of imagination prompts them to propose ridiculously implausible remedies for the national healthcare emergency. The elderly and the disabled should, like the unskilled “get better jobs” that will supply them with generous insurance benefits. The poor should maximize their contributions to health savings accounts rather than squandering their income on the electric bill, so that they can watch a few thousand dollars disappear in a flash right before their next emergency room visit sends them into bankruptcy. The addicted should shop around in order to take advantage of the free market.

It really must be some illness beyond their control, and not simple, voluntary meanness. At least, that’s what my own imagination—in an act of conscience* self-soothing—tries to convince me.

*I noticed I’d typed “conscience” where I thought I meant “conscious” after publishing this post. And then I wondered if that was an example of unconscious conscience. So I left it.

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