The Hypochondriac's Guide to Life. and Death.

by Gene Weingarten

  After careful consideration, begun in the previous paragraph, I have reached a decision.

  * * *

  Here are the pressure points, explained in simple terms:

  One immediately inside the point of each shoulder blade, about an inch to the left and right of the spine

  Two at the precise points where the schoolyard bully used to pinch you at the top of the back of your neck

  One at the very top and center of each shoulder

  One beside each elbow on the outside of the body as the arm hangs at your side

  One at the outside top of each buttock

  One at the center of the abdomen, approximately two inches directly above the navel

  One to the side of each knee on the inside portion of the leg

  Two at the base of the neck just below and to the left and right of the larynx

  Two immediately below and to the left and right of the indentation at the top of the sternum

  One beneath the chin, directly under the center of the tongue

  There. Now you have it.

  Except, there are two pressure points I have not given you. And I made up two that do not exist. If you feel pain there, it will instantly alert any doctor that you are a loon.

  Good luck.

  * * *

  1 This method of communication was first developed by men in the 1970s, when women began breast-feeding as a political act, florping out their personal apparatuses in the middle of restaurants, management training seminars, etc. Fortunately, this practice is on the decline. Now, when women wish to make male coworkers uncomfortable, they weep: copious, rolling torrents of lachrymation, loosed at ludicrously inopportune moments, such as during performance evaluations. Unlike the Breast Florp, the Sudden Weep is not easily countered by a man. There are several strategies, none of them foolproof. You have to do something dramatic to recapture the moment. Some men will wildly applaud. I start speaking in German.

  2 Don’t ask.

  3 How about “General Tso’s osteosarcoma”?

  4 Among doctors, there is a distinct hierarchy in medical specialties. If medical specialties were animals, orthopedic surgeons would be ocelots or jaguars—sleek, elegant animals that might be the pets of international drug dealers. Gastroenterologists would be plow horses, wearing doofy straw hats. Pediatricians are big, friendly, drooly dogs. General practitioners are chiggers.

  Why You Should Not Smoke

  Medical studies have proven statistically that smoking is linked to lung cancer, oral cancer, bladder cancer, osteoporosis, myocardial infarction, pancreatic cancer, strokes, bronchitis, esophageal cancer, high blood pressure, and for all we know, those chin moles with a single, revolting hair. And yet many hypochondriacs—more aware than most people about medical risks—continue to smoke. Why?

  Possibly because the evidence is statistical. Ever since Ross Perot took to the airwaves with flip charts the size of queen-size mattresses, mathematically proving that NAFTA would turn us into a nation of earthworm ranchers, prostitutes, and freelance garbagemen, we have learned to mistrust statistics. We know they can be manipulated. We want facts, not figures.

  Scientists haven’t learned this lesson yet. They scorn so-called anecdotal evidence—individual case studies that may prove their point—because anecdotal evidence is considered unscientific, prone to being emotionalized. So they continue to publish studies that read like this—“The incidence of malignant pulmonary neoplasms, endobronchial lesions and bronchopulmonary sequestrations showed a median increase of forty-six percent in patients who have exhibited sustained alveolar exposure to products containing nicotinated byproducts”—as opposed to this unscientific, purely anecdotal report published on May 22, 1997, and reprinted here as a public service:

  GAINESVILLE, Fla. (AP)—A throat cancer patient died after setting himself on fire trying to light a cigar. He was unable to yell for help because his illness had cost him his vocal cords.

  “I don’t ever want to witness anything like I witnessed this morning/’ said Katie Brown, sister of Abraham Mosley. ‘That will stay with me the rest of my life. He was a walking torch when I woke up.”

  Mosley, 64, was taken to a hospital Tuesday after the fire but died a short time later.

  Confined to a hospital bed in his kitchen, he apparently ignited strips of paper on a stove burner trying to light a cigar because his cancer left him unable to manipulate matches or a lighter. The flaming paper ignited gauze bandages that were around his neck. The fire then spread to his pajamas.

  The silent seconds until the smoke alarm sounded may have cost Mosley his life, although officials said he did not have long to live because of his cancer, which was smoking-related.

  Pregnant? That’s Wonderful! Don’t Read This!

  Pregnancy is a mystical, highly complicated physiological state in which the female body responds to timeless genetic imperatives by adapting itself to the arduous, totally natural though repulsive task at hand.

  To familiarize yourself with the basic processes of pregnancy, it is helpful to study diagrams of the male and female reproductive svstems.

  Male Reproductive System

  Female Reproductive System

  Because women are often mistrustful of male doctors—fearful that men, whatever their book learning, cannot truly understand the process of childbirth—they often do not ask basic questions and remain frightfully ignorant of the totally natural process that is going on. Accordingly, I will now explain pregnancy, for our women readers alone, in a simple, sensitive, accessible, easy-to-understand format.

  Basically, there are two stages of pregnancy:

  Stage One. You decide to wear that red dress with the back plunge, the one that shows off your behind, and that douche bag Warren keeps hitting on you even after your husband, who ordinarily does not have a jealous, possessive gland in his body, glowers him down a couple of times. Then, at home, you deny anything was going on, while doing that perky Elizabeth Montgomery thing with your nose, and just then, like it’s a total coincidence, you decide to do leg lifts in your underpants, exposing those crotch-side hollows that don’t even have a technical, medical name as far as I know, and then you get pregnant.

  Stage Two. You get real fat and your belly button pops out and you give birth to a baby.1

  The actual birthing process, from a physiological standpoint, consists primarily of grunting and screaming. Insensitive descriptions of the physical difficulty involved, usually by men, include such disagreeable analogies as pulling your lower lip over your nose or fitting a football through a keyhole. This is needlessly alarming. Giving birth is more like pooping a rocking chair.

  Fortunately, the birthing process has been made far more civil since the days of the primacy of Natural Childbirth, wherein women were made to feel that if they did not give birth the way Iroquois squaws did in the 1400s, they were somehow less than real women. Nowadays, birth is far more genteel, through the advent of two medical advances: episiotomies and epidural injections.

  Episiotomies. At the actual moment of childbirth, to eliminate the possibility of tearing, your obstetrician tears you open with pinking shears. This causes no appreciable pain, in the sense that the chafing of your manacles causes no appreciable pain while the villain is slicing you in half at the sawmill.

  Epidural Injections. This is when you get a shot in your back that numbs the lower half of your body. This rather astonishing technomedical innovation lets the woman watch herself give birth almost as a spectator. She knows about the supposed pain of her contractions2 but does not feel it. This is a great system of giving birth for those women who, through no fault of their own, are candy-asses.

  Basically, there are two types of babies:

  Babies with normal heads. These are delivered by cesarean section.

  Babies with heads like cucumbers. (Here is an actual picture of my daughter, Molly, moments after her birth.)

  Molly is now seventeen. She is a beautiful, brilliant young woman who,
as I am writing this, has just walked in the door after a visit to the hairdresser. She appears to have gotten her hair dyed the color of a regulation NBA basketball. I do not know if this is related to her cucumber-head birth; as a scientist, I am just reporting what I see.

  For most women, knowledge of one’s pregnancy begins with the time-honored ritual of urinating onto one’s fingers. Eventually, one hits the strip and it shows a little plus sign. In the ads for home pregnancy tests on TV, this news is usually greeted with a blissful smile and a phone call to one’s mother. Beside the phone is a vase of fresh lilacs. Someday I would like to see one of these ads in which the woman looks at the strip, gets up from a mattress on the floor of the basement storeroom she shares with a no-good, tattooed, unemployed shitheel snoring off his crack high beside her, walks to the kitchen, and sticks her head in the oven.

  Whether the news is perceived as good or bad, a positive pregnancy test is a sign of health and fertility, unless of course it is a sign you are going to die. This is a fact not usually trumpeted by the makers of pregnancy testing kits. These tests detect the presence of human chorionic gonadotropin, or HCG, which is a hormone that is produced by the placenta. Unfortunately, there is a rare ovarian tumor, called an embryonal carcinoma, that also produces this hormone. So you might not be pregnant at all! You might have a malignancy that can grow to the size of a roll of toilet paper. It is often fatal.

  Ordinary, levelheaded women often exhibit subtle signs of hypochondria when they are pregnant, calling their obstetricians at all hours to report mundane bodily events. Such behavior is completely normal, particularly for a first pregnancy. This is because the woman senses that for the first time in her life she is responsible for a life other than her own. The sensitive obstetrician will try to deal with these complaints with patience, gently but firmly reassuring the caller that everything is fine.

  Caller: Doctor, I seem to be belching an awful lot.

  Doctor: That’s perfectly natural. Caller:

  Caller: Also, I have a sore that won’t heal, blood in my stool, sudden weight loss, a mole whose appearance has changed significantly in the last week, and a painless lump under my armpit.

  Doctor: That’s perfectly natural.

  A pregnant woman frequently notices changes in her body that she might find alarming or distressing. These are, however, natural processes, designed to anticipate the wondrous events in her future. The woman and her doctor should work to emphasize their positive aspects. Her breasts will swell and may become sensitive in preparation for lactation, for example; this can be sexually attractive to her husband or partner Because her appetite increases, and because the fibrous tissues that hold her joints together become slightly more elastic to prepare for childbirth, the pregnant woman’s hips might spread so she has the overall muscle tone of a Hacky Sack. Her gross morphology may resemble those plastic punching-bag pop-up clowns with a wad of sand at the bottom, There are men who find this attractive as well; many of them advertise in the back of swingers’magazines, sometimes including Polaroid self-portraits taken in the restroom stalls at bus depots.

  Medical books take great pains to emphasize that pregnancy is a totally normal, healthy state. Then they devote entire chapters to explaining how it can complicate virtually every disease the human body is subject to. Pregnancy increases the demands on the pancreas, so a diabetic is vulnerable to dangerous fluctuations in glucose levels. When pregnant, women with kidney diseases like glomerulonephritis can experience kidney failure. Women with sickle cell anemia can get serious infections or congestive heart failure. Women with heart disease have been known to bring a baby to term, give birth, and then die. Pregnancy can dramatically intensify the symptoms of lupus erythematosus, rheumatoid arthritis, and multiple sclerosis. Pregnancy typically elevates blood pressure, so a woman with hypertension will sometimes have a stroke. A fetus can also dangerously complicate diagnosis: Because the fetus pushes the appendix up, when pregnant women get appendicitis, the pain is not where it customarily is. It seems to be gas or normal abdominal cramping; this can lead to a delay in treatment, and sometimes a life-threatening crisis of peritonitis.

  Here is a listing of symptoms sometimes exhibited by the pregnant woman. In column 2 are the most likely explanations. In column 3 are the most terrifying explanations. Hypochondriacs are urged to ignore column 3.

  Symptom Most Likely Explanation Most Terrifying Explanation

  Nausea, vomiting You are pregnant. You have serious hyperemesis gravidarum, an imbalance of fluids and electrolytes. This may require hospitalization and sometimes abortion. Also, you might have a gastric tumor. Sometimes this can grow to the size of a Schnauzer.

  Breast lumps You are pregnant. You have breast cancer. Lumps caused by the ordinary processes of pregnancy, such as enlargement of the milk ducts, resemble some tumors, Even experienced obstetricians sometimes get confused, The delay in diagnosis can kill you.

  Swollen ankles You are pregnant. You have preeclampsia, a serious elevation of blood pressure in the third trimester. If untreated, It can lead to eclampsia, which can result in seizures, strokes, abortion, or death.

  Fatigue You are pregnant. You have thyroid disease, congestive heart failure, hepatitis, or pernicious anemia, which involves a deficiency of vitamin Biz, This last one is particularly insidious because it features additional symptoms that mimic symptoms of pregnancy, including constipation and tingling in the limbs. Therefore, it can go undetected in a pregnant woman. Worst-case scenario: degeneration of the spinal cord, madness, and death.

  Shortness of breath You are pregnant, You have a lymphatic tumor in the mediastinum, which is the area between the lungs. Because your fetus cannot survive chemotherapy, you may have to choose abortion» or if you prefer it because of death.

  Watery discharge You are pregnant. You are not pregnant. You have a tubal carcinoma, which is a cancer of the fallopian tubes.

  Spotting; bloody You are pregnant. You are pregnant, but you are not carrying a baby, You are carrying a “hydatidiform process,” which is a big, hairy mole.

  And finally, some commonly asked questions about pregnancy.

  Do you think some women milk their pregnancies just a little too much, making their husbands run out in the rain at nine o’clock at night to pick up some nauseating combination of food, like blueberry yogurt and sardines, and then bursting into tears when you suggest, real politely, an alternative snack, God forbid she should have to eat tuna fish?

  No.

  HOW did you, personally, discover what female genitalia look like?

  I was approximately eleven years old and went to the bathroom in a doctor’s office. On the wall, discreetly placed, was a card with an illustrated diagram showing men and women how to use a sterile tow-elette before giving a urine sample. The illustration was extremely clinical, but also extremely detailed. I stole the card.

  Is that the only thing you ever stole? In your life?

  I believe so.

  What is the funniest headline ever published?

  That would be the headline printed in the Bucks County (Pa.) Courier-Times in 1977, above a medical story: CERVICAL CANCER CAN BE LICKED.

  I am a pregnant woman. Can you please scare the hell out of me?

  Sure. The birth of grotesquely abnormal fetuses is a rarity, but it is common enough that there are dozens of clinical Latin medical terms for fetal monsters. Most are born dead. Here are the top ten:

  Harlequin: Looks like a hippopotamus. Skin is covered with thick, horny scales and plates.

  Acephalobrachia: Lacks both arms and a head.

  Cephalomelus: Arm or leg protrudes from head.

  Cephalothoracopagus: Twins united at the head and neck and chest.

  Cryptodidymus: Twins in which one fetus is hidden entirely within the body of the other.

  Hemicephalus: Half a brain.

  Hemiacephalus: No brain.

  Holocardius amorphus: A blob.

  Holocardius acephafus: No heart, head, or c
hest.

  Holocardius acormus: Just a head.

  1 Unless you give birth to something else. A fabulous 1896 book I found, Anomalies and Curiosities of Medicine, reports the case of a woman who experienced a full-term pregnancy and then gave birth to a worm. This book is filled with dubious, poorly documented case histories that should be given little credence, including the case, in Paris in 1830, in which a woman gave birth to a child with three buttocks.

  2 Contractions are that physiological process wherein a woman’s cervix is dilated preparatory to birth, through hours of excruciating rhythmic pain. When you think about it, this is a highly inefficient system for what is supposedly a completely natural process. It is as though God actually made a mistake.3 It is as though every time you swallowed food, it caused a searing pain in the eye.

  3 Other notable mistakes by God: menstruation, nipples on men, the need to “wipe.”

  Things That Can Take Out an Eye

  Go to the bathroom and get your toothbrush. Open your right eye. Now, using a vigorous side-to-side motion, brush your eyeball.

  You didn’t do it, did you? People are squeamish about their eyes, particularly hypochondriacs. Hypochondriacs do not think of the eyeball as just another organ. They think of it as an extremely vulnerable object that, in a disastrous design error, was placed right out in front of the body, as though Toyota accidentally made the bumper of the Corolla out of Limoges. Hypochondriacs think the eye is like a water balloon and that any puncture of it will result in a sickening pop, a gush of viscous fluids, and permanent blindness.

  Don’t worry. The eyeball is more like a firm green grape. Try an experiment. Get a firm green grape. Now take a pin. Puncture it. See, it does not explode! Now take a razor and slit the grape horizontally, about halfway through. See? Just a little leakage. It sort of looks like Oscar the Grouch!1 In fact, the eye sometimes behaves like one of those self-healing tires, which repair their own punctures.