Hypermenorrhea: The Valley of the Shadow
“Physician, heal thyself!”
Desperation engulfed me. I rested my forehead against the cool tiles. Tears of self pity prickled my eyes.
I won’t die like this, I decided. My legs might not support me, but I could crawl. Inch by inch, I dragged myself across the yards separating my bed from the bathroom door. I hauled myself up on the mattress, then flopped back, exhausted.
That final bleed had been the end of me. It felt like I had just flushed the last of my lifeblood away. Darkness closed in. Snapping for breath, I began to panic.
Don’t hyperventilate; you need enough carbon dioxide to prevent your breathing centre from conking out.
I recalled that fact from med school even though I hadn’t applied the knowledge for years.
But breathing was hard; it took all my strength to make the muscles between my ribs move. Try your belly, my inner voice advised. The diaphragm is more powerful than the intercostals. That was a reasonable argument. I breathed in deep. It worked. Not too deeply; I didn’t want to overdo it. My head was spinning. I held it. That was better. Concentrating on the shoulders helped too.
I didn’t know how long I could keep it up; regulating each breath was exhausting. After a while, I realized it was futile.
I’m so tired, maybe death wouldn’t be such a bad thing, I thought. The darkest night of my life would be my last. But, if I was going to die, I would die well. That much I could do. It was 3:13 a.m. on Monday the 9th of January, 2006; as good a time to die as any other.
Death rested heavily on my breast, snuggling against my bosom. The last breath had been pretty shallow. I wasn’t sure I could draw another. Perhaps, just one. What should I do? It was too late for a life review. Besides, I couldn’t concentrate.
I gave up.
“Lord, into thy hands I commend my spirit,” I sighed. It felt like a nice thing to say as the last breath leaked out.
I waited for the darkness to deepen. My chest was leaden; it was never going to move again. I didn’t mind. I was ready to die. Resignation wasn’t so bad. In fact, it felt a lot like freedom.
Another breath! I hadn’t drawn it, but there it was, creeping into me by itself. I was so shocked, I laughed aloud. And there, that made another breath!
Words began to flow, tripping across my mind with the ease of habit. “The Lord’s my shepherd, I shall not want…” I recited the 23rd psalm, then, moved on to a mantra from Sögyal Rinpoche’s Tibetan Book of Living and Dying. By the time I got to humming hymns, air was chugging in and out like an invisible breathing machine.
Finally, I slept.
A friend of my mom’s called to ask about the piano later that morning.
“Do you know a good doctor?” I asked.
She considered for a moment, then answered, “There’s one at the medical centre…”
“Lord Jesus Christ, have mercy!” the receptionist exclaimed, when I walked into the clinic. She told me afterwards she could have sworn she was seeing a ghost.
The good doctor was more discreet. He helped me to a stretcher. “Tell me,” he said.
So I told him.
I can still recall a pink, pastel haze from the educational film our guidance counselor showed in high school. Menstruation is harmless, a natural thing. My bleeding was a raging torrent. The birth control pill had made matters worse, changing my regular cycle into a constant bleed. I abandoned the pill and decided to live with it. And for decades, I did.
Until one day, after a stress situation at work, the real bleeding began. I passed my first pancake-sized clot.
I picked a friendly gynecologist out of the phone book and admired the baby pictures on her walls. She diagnosed three small fibroids on the ultrasound. But when she found out I didn’t want surgery, there was nothing she could do for me. I left her office and never returned.
The university clinic was worse. First a trainee doctor, then a harried surgeon and finally a pre-retirement matron quickly reviewed my “case”. None of them knew my name. How could I entrust myself to their care?
A conscientious GP explored cutting edge conservative therapies with me. Hormonally induced premature menopause caused emotional turmoil and hot flushes, while my body bled on. Moxibution put color back in my cheeks, but the accompanying herbal tea was vile. After months of compliance, I couldn’t swallow it anymore. I retired early from my job, hoping less stress might help, then bled myself out on volunteer work instead.
“I even tried that diet,” I concluded, mentioning the name of a local holistic healer.
“That charlatan!” the good doctor spewed. “The medical association wants him banned.”
“It helped a little. The fibroids got smaller.” I put a hand on my abdomen where I could palpate the masses.
“Dieting reduces muscle mass. No miracle in that,” the doctor grunted.
I chuckled. He had a point.
I finished up with the part about the homeopath. She was on vacation in Bali over Christmas. I had paid 24,000 Jamaican dollars for the remedy, a tiny sachet of white powder with the essence of…something.
The doctor looked grim for a moment. Then his face softened. “What do you want me to do for you now?” he asked.
“I don’t know, can’t think,” I told him. “You decide. Just help me, please, if you can.”
I closed my eyes.
A trainee nurse came to take blood. She couldn’t find a vein. She dug the needle into my arm five times. I couldn’t hold back the tears. How many people I had hurt that way over the course of my medical career?
A more experienced phlebotomist saved us. She filled five vials from a surviving vein. I eyed the purplish fluid jealously, every drop was precious.
“Hemoglobin 2.8,” I heard the whisper.
I should have been in a coma, or dead. The normal range is between 10 and 13. Anemic women have 5-8 sometimes. A sickle cell patient in crisis with an Hb of 3.6 was the lowest I had ever seen. Even my hardcore consultant had balked and made me pump three pints into her—stat.
At first, I didn’t recognize my blessings. They were too close, wrapped around me like a shroud. The pint of blood from an anonymous donor, the clean, crisp sheets of the hospital bed, the kind night nurse who helped me settle awkwardly on a bed pan for the first time since I’d passed potty-training.
The first dawn after the day I “died” touched me like never before. The birds chirping in the almond tree were an angels’ choir.
And there was much more; the dexterous gynecologist who operated and saved my womb; she had known my mother when I was a child. The anesthetist who marveled that my heart kept beating steadily after my blood pressure plunged: he was a friend of mom’s too. Another friend of hers loaned me the money to pay the hospital bill. And my 76-year old mother fed and bedded and cared for me more lovingly than any professional nurse.
That was the silver lining.
Before I left the hospital, the surgical nurse confided to me that she also suffered from fibroids and heavy bleeding.
And a lot of other women have since shared similar stories. It’s not something people talk about openly. Bleeding women are steeped in shame. They suffer alone.
I have a new lease on life, and I’m not wasting it. I know what I have to do and I’m doing it, one step at a time. The first big step was to dance on the dew at dawn when I got home. And if that wasn’t a miracle, I don’t know what is.
I’m the physician who’s healing, bit by bit, and it’s marvelous! I am filled with a sense of gratitude for the wonderful privilege of life.
I don’t waste energy speculating about a future that may never come; I work to create the future I want instead. I am grateful for each breath, everything I have, and all the people who enrich my life every day.
Yet, “death shall have no dominion,” as Dylan Thomas wrote. Silver linings are everywhere. In fact, sometimes the world looks so brilliant, I’m grateful when an occasional cloud shields me from the glare. Life is beautiful, whatever shade it comes in. I welcome the darkness that reveals my guiding star.
My most recent blessing was a weird encounter with a woman who survived an Ebola needle stick accident. I can’t wait to see how her miracle pans out. We’re discovering bits of silver together. And here’s the best part: the silver linings we unearth are merely a weak reflection of a far greater treasure—true gold that glows from the depths of caring hearts.