Fatigue

August 21

I am sure it is my thyroid.  When friends ask how I am doing, I launch immediately into my history of borderline hypothyroidism and reassure each and every one I will be right as rain as soon as I get on some thyroid medicine.  The fact that we haven’t had any rain all summer and the lawn in Addison is brown as toast and brittle under your feet and hasn’t needed a mowing in weeks, should have served as a warning that getting rid of the growing fatigue I’ve been experiencing this summer would not be so simple.

Fatigue.  This must be the right word.  Surely it isn’t tired that I am feeling. Not even the tired that once came after a fifty mile bike ride.  Or the tired from seeing seven hours of patients or working in the garden all day.  What I feel is miles beyond tired.  Deeper than tired. Heavier than tired. It’s as if I’ve been slipped a potion, a powerful soporific now coursing through my veins that leaves me awake but feeling ponderous. Lifting my body from the chair is impeded by a new kind of gravity that presses hard on my flesh, makes rising so difficult I want to fall back down and sink into the cushion like soft clay. Thinking comes slowly, as if my brain were mud flats the neuropatways have to cross in heavy boots before an idea reaches me on shore. Enthusiasm for most things is hard to come by. It’s the third week in August and I haven’t written in weeks. 

“Perhaps,” said the Physicans Assistant after looking at the results of my blood tests and reporting that every test came back with evidence of my robust health, “we should talk about a referral to behavioral health.”  I don’t know when the medical profession switched from the term “mental” health to “behavioral” health, but I am dead set against the word. It conjurs up the image of severe looking clinicians in white coats turning people with problems of mind and spirit into rats who must learn, let’s say, a backward summersault in order to get their cheese. The PA, a young woman with a wedge haircut similar to one I got in 1969 at the Vidal Sasson salon in Chicago, suggested I was, perhaps, depressed.

But this time, unlike the time my supervisor, fifty years ago, asked what I did when I got depressed and I ran as fast as I could to the nearest psychiatrist’s office, I don’t think I’m depressed and am definitely not inclined to go “see someone.” It’s possible I am blind to my own depression. But after more than fifty years of diagnosing depression in other people, I’d say classic, clinical depression is not what ails me.  I don’t have a lot of negative thoughts, I don’t perseverate on worrisome ideas, I don’t wake up feeling blue, low, down in the dumps. Nor do I wake with a swarm of gnats in my stomach.  I still enjoy seeing people.  I am sleeping fine.  There are still things I look forward to: my writing group, seeing family, walking with friends. 

On a walk with D. soon after we get back to Freeport, she asks why we’d come home.  I told her it is so I can get a blood test and see a doctor about how utterly fatigued I am.  I feel the need to add the adverb just to be sure I make myself clear.  “Oh,” she said, “I am feeling exactly the same way and have called my doctor’s office to get a test too!!”  We compare fatigue notes.  I tell her I had no luck with the quest for the magic pill.  It must be covid we conclude. Not as in have covid but as in we are living in covidtime, covidworld.

“And you,” she says, zeroing in on me with the laser mind she uses to assist organizations in trouble, “must be grieving the loss of your book in the world.  All last year you dealt with your fear and sadness around the climate crisis by focusing on the book and the dialogue it had begun to create in the world.  Then suddenly, covid swept all of that away.”  Then looking at me like a teacher who knows you haven’t done your homework, but doesn’t want to accuse you outright, she asks, “Have you taken the time to grieve?” 

Amazing how one sentence from a good friend can push down a door in the wall behind which all those unwanted feelings of loss and anger lie restless and grumbling.  Though Elizabeth Kubler Ross’ model, now fifty years old,  for the stages of grief has shaped our understanding of what the process of grieving is supposed to look like, I’ve never found the model to be of much help either when I am faced with loss or when helping others. Grief is so much more elusive, like fog it shape shifts, conceals, floats, disappears, returns early next morning. When D. asked that question, I said something like “mmm…yea, you’re right…it is a pretty big deal.” I had at that moment an image of a great empty space, a space that once had sustained me with purpose and hope and connection to community but was now vacant, like a sumptuous room someone had moved out of.  With her witnessing the great import of the loss of the book, I was able to see not the fact of it, but the size of it.  And in recognizing its girth, I felt something about that vacancy rearrange itself, something of the fog lift.  “Oh,” I thought, “grief again, loss.” 

D. too has many things in her work life which have rearranged their shape and make her work much more difficult.  Complexities of power, racial and gender disparities are in the field now as never before.  Previously unexamined stories are rising up in organizations in ways that are hot, strong and unpredictable like the hundreds of California fires this summer started by wild lightning strikes or the dual hurricanes just now hitting Louisiana and Texas.  Old skills for dealing with these newly unleashed narratives are proving of little help.  It is no wonder she too is feeling fatigued. 

The way forward holds so much uncertainty.  But the present holds so many losses, so much grief. No wonder I am utterly exhausted.

*******