Fall Risk
A meditation on a period of weakness with no known cause
The following is excerpted from “Fall Risk,” an essay by Madeleine Watts published on the Believer Logger in 2020.
DISCUSSED: Ana Mendieta, CitiMD, D.W. Winnicott, Nordic Literature, A Particularly Feminine Pathology, The Emergency Room at Mount Sinai Beth Israel, “The Cares of Winter,” Sunstroke, Hypotension, Santería, A Firework-Maker, The Smell of Piss, Yoga, Ski Gloves, Italian Workerism, Environmental Failure, and What Happens Between the Head and the Heart.
In the cold early morning hours of the second day of 2018, I took myself to the doctor. I had not been able to sleep all night for coughing. I felt breathless, as though I couldn’t get enough air in. I explained this to the doctor at CitiMD. I had hoped he would give me something to help me breathe. Instead, he asked if there had been anything else wrong lately. I explained that I had been tired, light-headed, and prone to feeling very cold. I could never get warm. I had been fainting.
He stopped me at “fainting.” How many times had I fainted? The answer was, perhaps five times, in a six-week period.
The doctor looked at me like I was mad. “It didn’t occur to you to come to a doctor when you fainted the first time?”
I told him it had not.
“There’s no reason why a young lady such as yourself should be fainting and feeling dizzy all the time,” he said.
Then the tests commenced. I took off my cardigan and my shirt, and sensors were placed on my chest so that the nurse could perform an EKG. When the doctor came back into the exam room he looked concerned. The EKG had detected some abnormalities.
He told me to go to the ER immediately. He asked whether he should order me an ambulance, or whether he could trust me to take myself there on my own.
I told him that he could, but that I didn’t understand what has going on. I asked whether a hospital was really necessary.
“They can do blood work and X-rays more quickly there than I can here,” the doctor explained. “Hopefully everything is fine. If they find something they’ll refer you to a cardiologist or a neurologist, to try and find out what’s happening between your head and your heart.” As he spoke he placed one hand to the side of his head, and one on his heart, as though to embody the metaphor of my own disequilibrium.
I spent the next eight hours in the Emergency Room of Mount Sinai Beth Israel on 3rd Avenue. I had been sent to that pale orange Emergency Room before, a year and a half earlier. On that occasion I had pulled a muscle in my back and suffered spasms so excruciating I couldn’t walk. My husband called 911. The paramedics carried me down the three floors of the apartment building strapped into a chair, still barefoot and wearing a nightie, and took me in an ambulance to the hospital so that I could be administered with a heavy dose of muscle relaxants and Percocet. When the paramedics had wheeled me into the emergency room that last time, a nurse had attached a yellow bracelet to my wrist. It read “Fall Risk.”
Now I was back in the Emergency Room at Mount Sinai Beth Israel, a “Fall Risk” again. Tests were performed. My blood was taken. An X-ray was done. I was given two further EKGs. Between tests I lay on a bed separated from the bed on the other side by a blue curtain. My husband brought me a muffin and a bottle of water. We sat there together reading our books and waiting for the diagnosis. I put a hand on my heart, every so often, to check that it was beating correctly. It seemed okay to me.
And, in fact, it was. When the doctor on call at last came to talk to me, she explained that the abnormalities in the electrical function of my heart were certainly present in the tests they had administered, but didn’t seem worrisome. “Abnormalities aren’t always abnormalities, that’s to say, they might be entirely normal for you,” she said. They couldn’t determine why I had been feeling faint or light-headed after all the tests, but she advised that I rest, drink water, try to extricate myself from any stressful situations which might have been causing me distress. When I was given my discharge papers, I looked at the official diagnosis the hospital had given me. It read “Weakness, with no known cause.”
The fainting had begun in November. It happened for the first time on a warm afternoon in downtown Phoenix, in a bookstore, on the Friday after Thanksgiving. First, my peripheral vision closed in. Next, things went quiet, as though the volume knob had been turned down on the world. Finally, a swooping sensation that started at the back of my skull and located itself just as squarely in my throat. The swooping produced a feeling of dispersal, and darkness. It was very much as though somebody had walked through the rooms of my self, gradually turning out the lights. I fell, and came to after a few moments by the books on the bottom shelf.
Sunstroke, I thought on the floor. My husband and I had been on a hike with his parents to the top of Piestewa Peak earlier that day. I probably should have worn a hat. I should have drunk more water. My husband helped me up from the floor and out of the bookstore where the shimmery weirdness of the city was resolving into dusk as we walked down wide streets framed by mountains towards the car. We drove back to his parents’ house down freeways bordered by saguaro, all of it taking on a gauzy quality in my newly-loose perception of the world. Back at the house my father-in-law, a rheumatologist, brought out a blood pressure monitor from a cupboard and strapped it to my arm while I sat at the dining table. My blood pressure is always low, but that afternoon I had hypotension. Probably sunstroke, nodded my father-in-law. I wandered outside and fell asleep on garden furniture by the swimming pool. When I woke up the stars were out. The night was chilly, but nothing so cold as the coldness that had descended on the east coast.
By the time the fainting started there were any number of worrying situations that might have been causing me distress, revolving in constellation around me. Winter had begun, which I’ve never, since moving from the snowless climate of Sydney, dealt with well. I had finished graduate school at Columbia six months earlier. I had completed a novel, and was waiting to find out what would become of it. My father and I had recently stopped speaking. I often had nightmares in the middle of the night.
Most of the time, I was alone in our Brooklyn apartment, working while my husband went back to Phoenix for days or weeks at a time, to be with his mother who was dying from pancreatic cancer. An old friend was diagnosed with leukemia, another stopped speaking to me, many others moved away. Holiday parties that year felt quieter than normal, pointedly well-lit, the atmosphere one of rage and grief. We were at an impasse, my friend Cam observed outside a bar one night. He described this period as “a space of time lived without narrative genre.”
What underlay everything else was the limbo created by the American immigration system. My husband and I were approaching the date set for our green card interview. We had been waiting to be interviewed for over a year, since we had married at the beginning of 2017, a time during which I had a tenuous and undefined residency status. I longed for stability, to sense that the ground was firm beneath my feet. In this period of waiting I was beset by the anxiety that something would go wrong, some policy would change, some calamity befall us, and I wouldn’t be able to stay.
There were, in short, many worrying situations mingling together at once, but it did not occur to me that I was upset about any of them. What I was, was dizzy. What I was, was tired. It took me some time to see that the issue might be the relationship between what was going on between my head and my heart.
During university I enrolled in a course called ‘Metaphor and Meaning.’ The class explored how the human brain understands metaphor by examining various theories of comprehension. The theory I was most taken with was Conceptual Metaphor Theory. “Our ordinary conceptual system, in terms of which we both think and act, is fundamentally metaphorical in nature,” wrote George Lakoff and Mark Turner in Metaphors We Live By, the fundamental text which first outlined the theory in 1980. Conceptual metaphor theory works on the principal of “embodied cognition.” In other words, the metaphors we use most commonly are rooted in the ways our bodies experience the world. We use physiological terms to describe abstract concepts: argument as war, love as a journey. Our bodies are the containers for our thoughts, the theory suggests, and our metaphors originate in our bodies. Physicality precedes articulation.
Conceptual Metaphor Theory is a flawed concept—for one thing, it has difficulty accounting for the ways in which our cultures, not just our bodies, impact our understanding of metaphor. But even though I could see the problems with the theory, I loved it. It suggested to me some essential truth about the way we use language, and how we create meaning. I received a Distinction for the paper I wrote for that class, although my professor wrote me a note explaining that he thought I was letting my partiality for the theory cloud my capacity for reason.
I bring this up because it seemed to me then, and seems to me now, that my tendency to faint and fall that winter was a product of embodied cognition. I was weak with no known cause. Something was going on between my head and my heart.
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“The Art of Not Living,” an essay by Miranda Mellis
“A Good Exit: Ahmed Naji,” by Anna DeForest
“On the Parental Gaze,” an essay by Amy Fusselman
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