Back in 2020, I saw myself as something of a Covid resistance fighter. When Covid-19 first hit, my ward was converted into a Covid unit (admittedly not for the very ill), and, despite taking advised precautions, it’s hard to believe I managed then to avoid that nasty little virus. But I stayed well, and even became a vaccinator, almost, but not quite, a hero. I saw myself as invincible, assuming that I’d probably had it asymptomatically, or was just naturally immune. A couple of my daughters had it mildly, and I guessed they had likely inherited their weakness from their father – who hadn’t actually had it either, but I didn’t let that minor detail bother me.
How are the mighty fallen. It was very obvious, returning from holiday a couple of weeks ago, that my husband had contracted it, and he took a test on our return. ‘Negative!’ he cried in relief as he gazed at the two lines, until I explained their significance. His symptoms worsened immediately.
Bizarrely, I still assumed that there was little, if any, chance of me catching it. I did daily tests, to reassure my workplace rather than myself. Then a strange thing happened. Lying in bed one night, I woke to find my husband’s face near my own. He was sleeping peacefully, but in that moment I ‘knew’ that he had passed the virus over to me. Obviously there was no way of proving this, but my confidence took a drop, and on the Sunday, I started to feel very odd indeed. I was both surprised and also very unsurprised to see those two blue lines bursting through the white. I was even more surprised that I also felt ill.
I’m not very good at being ill, and fortunately I am physically reasonably healthy. I can’t communicate it well; I just don’t have the language of illness. I think illness, and certainly staying off school, was discouraged when I was a child, probably because my mother had no family or local friends who could have looked after us. Some of my friends seemed to be off for relatively minor ailments; I used to wonder what would have to happen for me to be off, and I couldn’t imagine it, still less imagine myself telling my mother of these terrible, yet unknown, symptoms. When I became a doctor, I learnt the language of illness, but in relation to other people. I never saw it as applying to me.
But here I was, with proven Covid, and even I could not deny it. I wondered how I was supposed to feel. My husband had described shivers and fevers, and had really been quite eloquent. I was fairly confident that I felt ‘funny’. I was surprised at how little as I was able to do, and concluded that this was a valid component to the illness, but probably not one I would have recognised had I not known that I had Covid. I was slightly relieved when I developed a very painful sore throat a few days in, as it was easy to recognise (my husband’s had been agonising).
Now, in the convalescent stage, I find myself reflecting on previous illnesses, that I have tended to deny to myself, and others, with a quick ‘fine’ always being my answer to any queries. And I wonder whether my mother’s need for me not to be ill, and my desire to please her, led to an ongoing inability to describe symptoms or illness. As a child, I must have subconsciously known that my mother’s response would be to hope that my symptoms were less than I said they were – so I needed to underplay them, or deny them, to keep her happy. She herself suffered badly from allergies, something which didn’t stop her working, but caused her a lot of distress, and she referred to these in quite dramatic terms at times. This left me even less able to describe my own feelings, as I had nothing comparable.
Probably none of this matters – I was brought up to be stoical, which may have stood me in good stead. But when I developed mental illness in my twenties, I was similarly rendered dumb. In fairness, I think mental illness is harder to describe, but I had no words at all – apart from ‘fine’. I knew I felt wrong, but I had no way of answering the questions people asked, and I imagine I came across as sullen and unhelpful. But my childhood lexicon of illness included nothing that could help me – I literally had no words.
Since then I have learnt some ways of describing my situation, perhaps through words which seem to have been understood when I was previously ill, so I use them again. It is less of a description, and more of a grasping at what seems to work. I still have little or no ability to describe the more subtle nuances of early warning signs of relapse.
As a psychiatrist myself, this makes me wonder about the questions I ask of others. If I can’t describe my own illness, how can I expect that of others? This is difficult, because without understanding what framework of illness an individual has grown up with, how do I know what their words mean? It comes back to the need to recognise one’s personal understanding and descriptions of illness, because otherwise one can’t even begin to understand the holes and oddities in those of someone else.
But maybe we need to accept that sometimes people can’t answer our questions, not because they are being difficult, but because they don’t understand what we are asking, or it doesn’t match their life experience. They don’t have the words to do it. And if their answer doesn’t fit our question, then maybe what we need to do is to start by changing that question.