Chapter One: Are You a Hypochondriac?

We must begin by abandoning antiquated, stigmatizing notions about the hypochondriac, a person who imagines himself afflicted by disease. Like alcoholism, hypochondria is not the hypochondriac's "fault," or a moral weakness, but a disease.

Hmm.

To hypochondriacs, I offer reassurance: We are no longer living in an era when every little symptom signaled the onset of some dreadful condition with a goofy name, like "consumption" or "whooping cough" or "St. Vitus's dance," disorders that meant you would spend the remainder of your tragically truncated life drooling out your viscera into slop buckets. Today illnesses have really hip names like "astroblastoma, " and you drool out your viscera into state-of-the-art, hypoallergenic, FDA-approved polypropylene "viscera receptacles."

Just kidding, hypochondriacs! Good Lord, get a grip. Look out the window. Do you see tumbrels in the streets? Nowadays, nearly everything is curable. Magazines are filled with ads for cancer support groups and "empowerment seminars," with pictures of survivors who are reassuring you that one can go on to have a normal, disease-free life. Typically, these people are wearing wigs that fit like yarmulkes.

Do you suffer from hypochondria? We are all susceptible to it -- it is part of our survival instinct, imprinted in our brains from infancy. We are in our crib and our diaper is wet, so we howl and thrash and whimper, and pretty soon someone comes to help us. It is our mom. She coos to us sympathetically and slathers our behind with products that make us smell like the sitting room of a nineteenth-century San Francisco bordello. An important behavioral arc has been established: Complaint brings attention; attention brings relief.

(The more loving and attentive your mom is, the more likely you are to become a hypochondriac. This is simple anthropology. Remember Binti the gorilla, the ape whose maternal instincts were so strong she rescued an injured child? It is a little-known fact that Binti's children are sniveling pantywaists. While the other young zoo gorillas are engaged in ordinary gorilla activities such as pleasuring themselves in front of kindergarten classes and consuming one another's lice, Binti's kids are off in a corner, fretfully examining their armpits for lumps.)

As he leaves infancy, of course, the developing hypochondriac must refine the nature of his tantrums. Adults cannot continue to demand attention by fussing and mewling and smearing their excreta everywhere, unless they are professional athletes. And so the hypochondriac learns the art of suffering in silencecourageous silence, deafening silence, valiant, stolid, stoic, selfless, resolute, gloomy, lip-trembling silence, until you have to strangle him to death with the drawstring of his bathrobe.

It is easy to make fun of hypochondriacs. The hypochondriac is at war with his own body. The ordinary person will notice a slight spastic tugging on his eyelid, that rhythmic twitching we all feel from time to time, and go, "Hmm."

That doesn't happen with the hypochondriac. A hypochondriac would not go "Hmm" unless you told him there was a new fatal disease whose first symptom is the inability to say "Hmm." Then he would say "Hmm" 1,723 times a day until he got laryngitis and could no longer say "Hmm," which would of course constitute proof he is dying.

No, if a hypochondriac gets an eyelid tic, his mind will instantly race through everything he knows about twitching -- health textbooks he has read and articles he has downloaded from arcane medical databases -- and he will eventually focus on the most frightening evidence he can think of, no matter how dubious its authority, such as the scene in the movie Airplane! in which Leslie Nielsen, playing a doctor, describes the symptoms of fatal food poisoning, which begins with twitching, and the pilot, played by Peter Graves, dies farting.

So the hypochondriac will know he has been poisoned. He will call the Poison Control Center.

Hypochondriac: My eyelid is twitching once every six point four seconds.

Poison Control Person: (Pause) Omigod.

Hypochondriac: OMIGOD? (Beatbeatbeatbeatbeatbeatbeat)

Poison Control Person: Quick. You need to prepare an antidote. Do you have any anchovies?

Hypochondriac: Yes!

Poison Control Person: OK, now do exactly what I say. Make a drink of mashed anchovies, root beer, and tartar-control toothpaste...

My point is that Poison Control people are shitheads. They love to have their little fun with hypochondriacs. The whole world loves to have its fun with hypochondriacs, and I am frankly tired of it.

Listen, hypochondriacs. This hook will not insult your intelligence by telling you to grow up, that it's all in your mind. It will insult your intelligence in far more sophisticated ways. This book is going to feed your disease, symptom by symptom, chapter by chapter, until -- to use complicated medical terminology -- you are so gorged on your own self-pity you puke it all out. And as everyone knows, puking it all out is a great way to purge the body of toxins. Unless it leads to a rupture of the esophagus, septicemia, peritonitis, febrile dementia, and death.

This book will also describe many rudimentary medical tests that, in the hands of the trained clinician, can be invaluable diagnostic tools. These tests are so simple that you could perform them on yourself, in the privacy of your home. Not that you should. Doctors have spent years studying the proper techniques of physical examination. No reputable writer would encourage untrained persons to engage in self-diagnosis, particularly hypochondriacs, who may be needlessly alarmed. For quick reference I will thumbnail each test with a handy icon.

• Quick! Go to the mirror. Open your mouth. Look at your uvula, the thing that hangs down at the back like a garden slug. Is it pulsing? It shouldn't be. When your uvula throbs in time with your heartbeat it is called Mueller's sign, and it can indicate heart disease! You could die!
  
  
• Now insert the tips of your three middle fingers into your mouth, making a vertical stack, without touching your lips or teeth. If you cannot open your mouth that wide, you might have temporomandibular joint syndrome; worse, you might have systemic sclerosis, a grotesque progressive illness in which your skin hardens and contracts and can slowly garrote the life out of you.
  
  
• With your palm facing you, tap lightly on the very center of your wrist. You are performing the Tinel test. If you feel a radiating numbness in your hand, you might have early carpal tunnel syndrome, which can eventually turn your hands into appendages as useful and attractive as a tyrannosaurus's.
  

In the end this book is going to present a surefire cure for hypochondria-a dramatic, natural remedy as effective as Bactine on a boo-boo. I could disclose it here, but I won't. This is a literary technique called foreshadowing, previously employed by famous literary individuals such as William Shakespeare. In the hands of the unscrupulous, foreshadowing can be nothing more than misleading hype. The responsible writer promises no more than he can deliver. I will say only this: I am going to keep hinting at my cure for hypochondria until I finally disclose it, and you will have an orgasm.

There are other excellent books available to those persons concerned with their health. In the interests of fairness and full disclosure, I will briefly describe these volumes and list their principal advantages and disadvantages.

The first group consists of books with names like The Family Medical Guide, or The Home Medical Encyclopedia, or The Doctors' Guide to Good Health, generally published by the American Medical Association or other renowned physicians' organizations. These are helpful, responsible diagnostic books, featuring listings of symptoms in easy-to-follow flow charts, each chart terminating in a row of exclamation points urging you to see your physician without delay.

The second group are clinical texts, intended for doctors and available mostly in medical bookstores and libraries, containing lines like this, from page 458 of Current Medical Diagnosis and Treatment, 1995: "Disorders such as disseminated intravascular coagulation, thrombotic thrombocytopenic purpura, hemolyticuremic syndrome, hypersplenism, and sepsis are easily excluded by the absence of system illness. Thus, patients with isolated thrombocytopenia with no other abnormal findings almost certainly have immune thrombocytopenia."

These books are characterized by the use of humongously scientific Latin-influenced terms such as "sternutation" and "epistaxis" and "cutis anserina" and "pyrexia" and "diaphoresis" and "singultus," which are too important and complicated to be understood by unschooled morons such as yourself.

Many of these medical books also contain pages of photographs.

So these books can be highly entertaining, though they cost much more than my book and make you vomit.

The third type consists of books arranged on endless shelves labeled "alternative medicine." These usually begin with solemn advice against succumbing to quackery, followed by a simple nine-step formula for curing lymphomas via the teachings of Mohammed Ibn Rajneesh and the use of beet suppositories.

Alternative medicine books take elaborate measures to appear serious and scientific. I am right now leafing through Alternatives in Cancer Therapy, by Ross Pelton and Lee Overholser, featuring an endorsement on the cover by Linus Pauling, the two-time Nobel laureate. Alternatives in Cancer Therapy soberly evaluates treatments that include eating mistletoe, taking enemas made from strong coffee, and drinking urine.

My book is like none of those. Unlike the family medical guides, this book will dispense no practical medical advice whatsoever. Unlike the alternative medical books, it will advance no mountebank cures. Unlike the medical texts, it will not be condescending to the reader. It will mention thrombotic thrombocytopenic purpura only for the purpose of observing that, among all diseases the author has encountered in the course of his extensive medical research requiring many, many footnotes, it has the second-funniest name.

Last, let me say that although this book will raise some legitimate concerns about health, it will not use scare tactics to inflame the public's fears in the manner that, say, untreated appendicitis can inflame the appendix until it bursts, choking the bloodstream with deadly toxins and snuffing out your life in fifteen minutes of writhing agony. We are living in an era of fabulous preventive medicine. After all, it is not every day that some guy goes to the doctor because he is peeing a lot and learns he has a prostate the size of a bagpipe, though I personally know of two people this happened to.

They did not buy this book either, and now they are dead.

Copyright © 1998 by Gene Weingarten