In-Depth Notes on 'Sick: A Memoir' by Porochista Khakpour

Also by Porochista Khakpour

• Sons and Other Flammable Objects
• The Last Illusion
• Sick: A Memoir

Quotes on Illness and the Past

• Virginia Woolf's observation on the wars between body and mind highlights the complexity of facing illness, emphasizing the need for profound courage.
• Leonora Carrington's dialogue suggests that the past, although painful, can be cut off by the present, illustrating the struggle of leaving past traumas behind.

Author's Note on Lyme Disease

• Lyme disease is defined as a clinical diagnosis caused by the spirochete Borrelia burgdorferi, typically transmitted through a tick bite.
• Symptoms vary and may affect multiple organs. Less than half of patients recall a tick bite or develop the characteristic rash known as erythema migrans (bull's-eye rash).
• A significant limitation exists in testing, with the ELISA (enzyme-linked immunosorbent assay) test missing up to 35% of proven cases.
• Lyme disease has multiple stages:
  • Stage 1: Early localized Lyme disease; treatable with antibiotics before expansion.
  • Stage 2: Early disseminated Lyme disease; bacteria have spread.
  • Stages 3 & 4: Known as chronic and late-stage, respectively; requires prolonged treatment, with relapses common.
• The author reflects on personal experiences, detailing costs associated with chronic Lyme disease, estimated to reach between $20,000 to $200,000 for late-stage cases. Annually, Lyme costs the U.S. up to $1-$3 billion.
• The author acknowledges challenges in tracing the disease's onset and the consequent impact on lifestyle and mental health.

Personal Reflections on Body Image and Identity

• The author conveys a lifelong discomfort in their own body, describing a sensation of inhabiting a 'wrong body' that encompasses deeper issues than gender or appearance.
• Experiences of PTSD and displacement from childhood may have exacerbated this feeling of otherness.
• Chronic illness further complicated the sense of identity, impacting self-perception and sense of home within one's own body.
• Acceptance of discomfort and understanding illness as an integral part of identity becomes crucial; the author reflects on the alienation that can occur even in intimate spaces.

Prologue to Life Events

• New Year's Eve 2016: The author recounts an overwhelming sense of isolation; previous celebrations contrasted sharply with their current reality due to chronic illness.
• A recent car accident heightened feelings of vulnerability and fear, particularly with Lyme-induced relapses affecting physical and mental health.
• Amidst preparations, the author acknowledges their limitations while feeling the estrangement and distance from societal expectations around health and participation in life.

Reflections on Lyme Relapse and Isolation

• The author describes the early symptoms of a Lyme relapse, predominantly psychiatric issues such as fatigue, anxiety, and melancholy, indicating deeper struggles with personal health.
• Recollection of support efforts through communication with friends, detailing the hesitance to reach out for help or confess the level of deterioration.
• The car accident serves as a catalyst for escalating symptoms, leading to heightened sensations of unreality and panic attacks, intertwining the trauma of Lyme with external accidents.

Experiences in Medical Settings

• Encountering skepticism and misunderstanding from medical professionals regarding Lyme disease illustrates the pervasive stigma attached to it.
• The narrative includes feelings of rage and helplessness faced within medical facilities, affirming the systemic challenges in obtaining legitimate care for what is often dismissed as a non-literal illness.
• The hospitalization experience is marked by frustrations surrounding acknowledgement of Lyme disease, underscoring the pervasive battle for recognition and respect in medical spaces.

The Impact of New Year’s Eve

• The experience culminates with New Year's Eve introspection, realization of genuine solitude, and confrontation with the concept of 'home' in the context of chronic illness.
• The significance of shared moments juxtaposed with isolation propels reflections on survival and the psychological toll of living with a misunderstood and debilitating illness.