Sick: A Memoir

Porochista Khakpour

Porochista Khakpour has always been sick. But why?

Her story will be familiar to anyone who knows the standard Lyme narrative: years of mysterious ailments, frequent diagnoses of mental health problems, the treatment of which only made her problems worse, the growing worry that she was either crazy or dying or both, the elation at having a diagnosis of Lyme disease, the struggle to actually find a treatment that would work, the relapses, and so on and so forth.

There are a couple of things that make “Sick” stand out from the general run of Lyme memoirs, although I’m of the opinion that one can hardly read too many Lyme memoirs, perhaps because I have a superstitious belief that if I just pore over the texts carefully and intentionally enough, I myself will be magically healed. But anyway. “Sick” stands out first of all because Khakpour was a writer before she was a Lyme patient, and she brings a writer’s sensibility to the text, which is organized in a “writerly” way. For readers looking for a straightforward narrative of A then B then C, this may be a trifle disconcerting, and even for some “ordinary” literary readers the jumbled, surreal nature of sections of the book has been a bit of a shock. I guess you have to have Lyme disease or some other reality-altering condition for the perceptions that Khakpour describes to seem normal.

Second of all, Khakpour combines her Lyme experience with her experience as an Iranian immigrant to the US, as an academic and a writer, and a person with a on-again-off-again drug problem and recurring relationship issues. All of these things meld together to create an experience that is both alienating from the average American experience, and quintessentially American: what could be more American than the Lyme-disease-ridden immigrant woman who constantly fears racism while frequently passing as a member of the white majority, who spends years (and loads of money) getting ineffectual treatment for mental health and drug problems while her worst medical problems are deliberately denied, and who is a glorious melting pot of self-aware intersectional privilege and discrimination?

Khakpour also delves deeply into the world of mental illness and addiction, where she and her doctors all thought for years that she solely belonged. She describes deliberately addicting herself to cigarettes her first week at college, all the drug-laced parties and events she participated in as a student, and then, particularly disturbingly, her descent into prescription drug addiction, fueled by medical professionals who kept pushing antidepressants, anti-anxiety drugs, and sleeping pills on her as the solution to her problems. She gets clean, gets diagnosed with Lyme disease…and then slides back down the rabbit hole during a relapse in which no one considers that her insomnia, panic attacks, and weird hearing and vision problems might be the result of a spirochete infection *she had already been diagnosed with*, not…whatever else they thought might be causing it.

“Sick” highlights many of the problems Lyme patients face in getting diagnosis and treatment. Aside from the lack of training at medical school and the inadequacy of the current tests, Lyme patients are often their own worst enemies, even if unintentionally. As the spirochetes attack your body and especially your brain, you can develop horrendous insomnia, anxiety, and panic attacks (after all, a fearsome predator *is* eating you alive, and your body on some level knows this), confused perceptions, a sense of alienation from your body (which has, after all, been hijacked by the above-mentioned fearsome predator), addictions to the drugs used to combat the pain and fear that’s debilitating you, and so on and so forth. Meanwhile, you “look fine,” and most testing shows nothing alarming. So it looks to the outside world like you’re crazy, and maybe addicted to drugs, and you you may sort of be so.

Khakpour also admits that she’s a “bad sick girl,” as she puts it. She’s never embraced the strict diets many Lyme doctors endorse, and even still sneaks a smoke from time to time. So is her sickness the result of a life full of trauma and difficulty; her bohemian, artistic personality; her experimentations with drugs of all stripes; or her Lyme disease, which she’s never quite sure when and where she picked up (she provides multiple possible infection moments, and maybe she *was* infected multiple times)? Or all of the above?

If it makes anything clear, “Sick” suggests that it’s D, all of the above, but that a huge problem is Lyme disease and the way it’s treated. The sections on Khakpour’s dealings with the depression-industrial complex, as I call it, are terrifying, as the doctors she goes to for help do nothing but re-addict her to the drugs she’d already had to get clean from once, and which she actively doesn’t want to take again, but does anyway because it’s the only salvation that’s offered and she doesn’t want to be labeled any more “noncompliant” a patient than she already has been.

“Sick” ends on an only partially hopeful note, as Khakpour relapses while writing the book, something that she chronicles as part of the story. This is not so much a story of triumph as it is a story of tenacity in the face of obstacle after obstacle, some of them self-created. Still, it’s a gripping story of one woman’s battle with one of the most fearsome and misunderstood medical monsters of our time.

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