You don’t want to think it’s your heart. You want to think it’s a pulled muscle, pinched nerve, or bad posture because you’ve always forgotten and slouched. But you agree to the stress test because if it is your heart, this is an early find. You’re only forty-seven. There’s time to repair.
It’s been happening when you’re on the elliptical or when you walk the dog up over the long hill, and you’ve tried to discount it. You’ve considered you aren’t breathing right. You’ve never been a good breather.
You try to see the imminent appointment as a date, one for which you must purchase a new bra. The instructions said no food after midnight, no meds, no underwire bras. You had to read the bra rule twice. Interference with the heart monitor’s recording. You don’t own an underwire-less bra.
You interrupt the girl at Victoria’s Secret right in the middle of her spiel about the Body-By-Victoria line’s cute new bralettes. “I need support, though. I’ll be on a treadmill for a stress test. They said I can’t have a bra with wires.”
This is not a story she’s ever heard and she furrows her perfectly shaped brows. “Well, no worries, we’ll find something just right,” she says and measures you swiftly with her tape, then squeezes your shoulder. And, just like that, you feel like you are a team.
She asks you your name and gives you hers and you mention that it’s a nuclear stress test with a radioactive tracer and her beautifully lined eyes with long mascaraed lashes widen and you widen yours along with hers and nod. She pauses, then says, “So will you glow?” You both giggle. You are definitely in this together. She’s chosen a black lace one. Sexy stress test, it says to you. And you smile. You feel better already.
As she shows you to the dressing room, she breaks the store’s rule and doesn’t mention there’s a sale on panties.
“Just press this button if you need anything,” she says.
You don’t believe you need anything until you see your body in the mirror and realize you certainly need tissues. You’ve cursed at your body in every single dressing room for the last twenty years for not looking youthful enough, but now it suddenly looks so terribly young, much too young to die.
You find only rough napkins you stashed in your purse from the lunch you treated yourself to and you wipe all that worry away and straighten up and nod. This is the one. You don’t look at the price tag. You haven’t bought a new bra in years.
You dress and open the dressing-room door to a store that’s never looked prettier. It appears as shimmering as it did the first time you walked in with the man who’d be your husband, daring him to select a bra and panties for you. You watched his callused hands afraid to touch anything. And all of a sudden, you decide you need panties after all because what if you fall from the treadmill and they have to do an emergency stent procedure and you are wearing your ratty old underwear. So you take your time selecting five pair with black lace waistbands because the sale is for five. You consider buying ten. Something hopeful in that.
It’s not until she is wrapping everything in tissue—something she’d do for a woman getting ready for a different kind of big date, but still does it for you—that you start to worry again about what this really means. You’re going to have to walk back into the hospital where you once almost died and have your heart examined. You don’t want to push your heart too much, stress it. And now you feel light-headed, flushed.
The last piece of tissue she tucks into the bag has hundreds of little hearts stamped onto it. Your head thrums. You take in a slow deep breath, concentrate on just one thing: sliding your card back into your wallet.
And in the moment she smiles, hands you the pretty bag filled with a pretty lace bra and panties, and says, “Good luck,” you realize she’s not seeing you as a typical VS customer. When she hands you the Secret Rewards coupon and says, “When you come in next time, we’ll reveal how much your reward will be for your purchase, but you can’t use this for another month,” she wrinkles her brow for a moment. You wrinkle yours, too, because maybe you’re both considering you may never make it here again. If the test shows something’s wrong, your husband may never get to see you wear all five panties until the lace wears thin and they become your ratty pairs.
“Good luck,” she says again, and you try to say “Thanks so much,” and when she adds, “Don’t forget to come back in and use that coupon, okay?” you turn away before hugging her seems entirely fitting.
***
I wrote this several years ago just before I had my first stress test. I tried to capture my thoughts and actions but I didn’t come anywhere near the ways in which my mind and body reacted in the face of this challenge—simply buying a bra for a fairly routine test. I’m not even sure it’s possible to write that. But let me explain a bit more about why crafting it was so difficult.
My mom’s side is known for cardiac issues. On my dad’s side it’s vascular, too: hemorrhagic strokes. With this family history, and as I’m approaching the age my mom was when she had her first heart attack, I’m vigilant about getting to my cardiologist two times a year. He’s amazing, but more importantly, he’s serious about keeping an eye on potential problems.
So, the other night, after working all day at the computer, tediously reading through the galley of Sidle Creek, I felt a familiar pain, one that led me to the cardiologist in the first place. With this new pain, the old questions came, slipping over the typical terrain with an additional worry: Will I make it to the date of my book launch? That question filled up my head. May was a few months away. I immediately tried to make a list of what I should do as I took in a few deep breaths, rubbed my upper left chest, straightened in my chair. I need to cut out all the salt, exercise more, get my blood pressure and cholesterol down, get my A1C down. Even if I don’t have a heart attack or stroke while doing a reading, what if my blood sugar plummets and I look like I’m three sheets to the wind at the microphone? What if I’m arrested for public drunkenness? I wasn’t completely catastrophizing. My extended family is sprinkled with alcoholics. It wouldn’t be a stretch to think this true. I’ve had my own taste of potential alcoholism and shut it down before it went too far, but. What if?
I googled “What if I pass out during my book tour?” Then “smelling salts.” Then “defibrillator” (which are actually available to laypeople but they are also $3000.00!) And then, “What if I have a heart attack during my first book tour?” This query led to an excellent essay by M Dressler titled “When Your Book Tour is Interrupted by a Near-Death Experience,” in which she links another superb essay about pain by Eula Biss. I read each, earnestly considering my own situation.
The reality is that, sure, I’ve been stressed. Stress can cause heart attacks. Much of my stress has to do with everything most people around me are feeling: economic issues leading to credit card debt, the ever-looming fears that loved ones will contract some new or old and horrid form of COVID and die, family drama, the difficulties of launching a child into a world that’s so unsettled. I have my own individual ones, too, of course. My mom’s health—she had abdominal aneurysm surgery back in August. She’s eighty-six. My son is twenty-two and navigating early adulthood in a pandemic, trying to find his way. I’m grieving my dad who’s been gone five years now even more these last few months. I’d hoped he’d be alive when my first book was published. He hadn’t known I had finally signed with an agent, finally had a book deal. But he knew I was writing stories that had a bit to do with him, figuring out those relationships between kids and fathers. He knew I’d used some of his favorite expressions in them. He’d laughed when I read them aloud. In fact, before my first ever reading in NYC, he told me I must read a story about him. I did. Bed-bound, he was not able to attend. That story later found its way into the pages of one of my favorite journals, the same one that led my agent to my work, but my dad didn’t know that would happen. Or, maybe he did somehow?
And, yes, I’m stressed about my first book making its way into the world. I won’t dare call it my book baby.
So the other night when this pain came, instead of telling my husband I was having pain, I said, “What if something happens to me and my book sells really well and you know, we don’t have a will and will you get the royalties?” He nodded, smiled and said, “We’ll have to look into that.” But he, like me, doesn’t want to think about our own mortality or wills. But he, unlike me, doesn’t have medical PTSD. When I gave birth to my son twenty-two years ago, it was a near-death emergency birth during which both of us almost didn’t make it. This is not an exaggeration; this is my reality. This event led to my PTSD diagnosis and treatment. That’s why I won’t call my book a baby.
My husband went on with his evening routine after my will and royalties question.
I ruminated. No, I panicked.
Then, when I finally went to bed, and despite this pain, I fell asleep. Maybe my trapezius muscle relaxed, maybe it was only sitting in an uncomfortable position that led to the back and chest pain. But I didn’t sleep well. Intrusive thoughts. Nightmares. The same old ones that pop up fairly regularly when I’ve been triggered again by some medical concern.
But here’s the thing: I looked very calm while all that was going on earlier in the evening. I went to bed and didn’t thrash around, cry, or get up and pace the floors. I actually look calm most of the time, relaxed even, as I do my desperate Google searches for information, as I ask three thousand questions in my mind, as my head thrums, my stomach aches, as I get light-headed, lose my ability to take in deep breaths, feel that squeezing throat pain. And then, eventually, as long as my blood sugar levels don’t go out of whack, I calm down. I feel better. I move on. Sometimes I have to take a shower, or a brisk walk around the block, breaking sometimes into a full run which always discharges the panic. Fight or flight or freeze and all that. Sometimes I find a podcast to listen to and just fall off to sleep. My husband can tell, though. And sometimes my son can, too. It’s all in the details.
Which brings me to how characters with PTSD might look on the page when they are in the throes of triggers. How might they sound? What is going on in their bodies and minds that can be rendered accurately in a scene? How does one write the external actions or the interiority of someone with PTSD, especially if one’s never experienced it. And I don’t mean triggers like most people talk about them nowadays. I mean the kinds of triggers that people with acute PTSD experience. Because as much as I’ve tried to render my own bits of panic in the above piece, as well as other CNF pieces I’ve drafted that focus on those first two years following my trauma, I never come close to verisimilitude. Not by a mile. The way the brain and body truly react to PTSD triggers is individual and unique to each situation but, in my case at least—medical PTSD—it can be a constant source of distraction and a completely dizzying fragmented panic. I live in a body that was medically traumatized. When there’s any hint that I might have to revisit the place where I was traumatized—a hospital—I go, literally, for a bit of time, out of my mind, or, more accurately, my mind becomes hyper-aware, hyper-vigilant. I don’t lose faculties. My faculties are supercharged. What I do lose is the present moment.
Why does any of this matter? I think it’s important to consider how we as a culture “see” those with acute PTSD, how we might, in error, rely on the stereotypes, especially those of us who make art that the general public might consume. It can be dangerous to show only a small sliver of the real-life ways people with PTSD move through the world. The problem is that when a person is going through the acute stage (and this can be minutes or years after the trauma—it’s just whenever the brain decides to deal with it), it is truly debilitating.
There are authors I respect greatly who’ve come close to rendering this condition. Kurt Vonnegut, in his handling of time in Slaughterhouse Five. Tim O’Brien in the structure of the collection, The Things They Carried, especially in his use of repetition. Leslie Marmon Silko in Ceremony. There are movies, mostly about war veterans, like Katheryn Bigelow’s The Hurt Locker, and there’s a non-war movie, Robert Redford’s Ordinary People, based on Judith Guest’s novel, that in particular expertly illustrates the ways people mask how much they’re hurting, saying “I’m fine” when they clearly aren’t.
But there’s one thing people with PTSD need that many people might not realize. They need people surrounding them who can lovingly normalize their concerns without poking fun (but maybe using humor), without being scared (but taking it seriously), without dismissing them (and keeping them in the present moment). They need that second character in the scene to treat them like a fully fleshed-out character. Just like that salesperson I’d encountered a few years back at Victoria Secret. She took me seriously. She didn’t treat me like a worry-wart or ignore me or laugh it off. She became a team mate. She was simply doing her job, normalizing, and as someone with PTSD can attest to, that is so comforting. People who are simply moving on with life, acknowledging there are problems to be solved, and helping others solve them,
matter-of-factly,
simply,
kindly,
lovingly …
Those people are a gift. A secret reward.
People with PTSD present like any character. Of course, they may be angry, melodramatic, but they may also be quiet, hilarious. They may be chatty. They may be whistling, singing. There are ways to show their states of mind without having them throw a bottle of vodka, or shoot a gun, lie in fetal position on a bed, or crouch in the bathtub sobbing. Maybe they tap out the syllables of words as you talk to them. Maybe they walk to the nearby marsh each day looking for the eggs of red-winged blackbirds and read futures on those eggshells. Maybe they stay out all evening, several evenings, in their workshop sanding wood so smooth it looks like glass. Maybe they identify every tree they see. Maybe they are birders. Maybe they tat lace.
And maybe they sit at a keyboard, take in a deep breath every few minutes, and look out the window for that one doe who’s on high alert, too, to find some strange camaraderie in a prey animal that knows, like the person with PTSD knows, what danger means at the body level. Or, maybe they see that the doe is somehow calm in this one, singular present moment, because in this backyard, my backyard, where the secret pond waits, where the secret mineral block sits, there are no hunters. She’s safe. You’re safe, too.
Jolene McIlwain’s fiction has been nominated for the Pushcart Prize and appears in West Branch, Florida Review, Cincinnati Review, New Orleans Review, Northern Appalachia Review, and 2019’s Best Small Fictions Anthology. Her work was named finalist for 2018’s Best of the Net, Glimmer Train’s and River Styx’s contests, and semifinalist in Nimrod’s Katherine Anne Porter Prize and two American Short Fiction‘s contests. She’s received a Greater Pittsburgh Arts Council grant, the Georgia Court Chautauqua faculty scholarship, and Tinker Mountain’s merit scholarship. She taught literary theory/analysis at Duquesne and Chatham Universities and she worked as a radiologic technologist before attending college (BS English, minor in sculpture, MA Literature). She was born, raised, and currently lives in a small town in the Appalachian plateau of Western Pennsylvania. Jolene’s debut short story collection, Sidle Creek, is on sale now.
Photo credit: Liam McIlwain
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