Pseudoleprosy

A man, aged thirty-five, a wife but no children, develops a strange condition. By dint of some neurophysiological anomaly, he believes his own flesh has begun to rot. He applies make-up, generous dumps of cologne. Anything to cover up the smell and sight of it. Initially he suspects these are symptoms of some kind of glandular problem; a visit to his family care physician, however, disabuses him of the theory. A psychiatrist writes him prescriptions for Xanax and Purzatrine; the man insists, however, only a high dosage of steroids would help. He loses his wife, the children they didn’t have; he loses his job and house. Loses everything but his mind, which remains certain: he is rotting right beneath everyone’s noses; but so attuned are olfactory nerves to their own expectations and rote responses, they miss the rot altogether. Looking at him, how can they not lose their stomachs to nausea? The psychiatrist’s interest in him increases, so perhaps there’s hope. This man, the psychiatrist will report years later, before a convention room filled with four hundred specialists and colleagues, suffers from a curious case of localized dysmorphia—“Epidermal Dissociative Disorder”, or, more memorably, “pseudoleprosy”. Sufferers of E.D.D. waste away quite slowly. Their appetite spoiled by putrescent ideations, they cannot so much as chew their food without souring at the thought of swallowing it. Agoraphobia is a secondary disorder associated with advanced stages of the condition, as well as acute insomnia, a half dozen species of interrelated anxieties, depression. The worst cases, such as this one, Patient X, end in self-harm, burn marks, bruises, lacerations. Attacking the skin that they believe has begun to die, against their will and prematurely, without their permission. Loss of all forms of organized cognitive ability soon follow. Patient X, it should be mentioned, can be found in an isolated secure care center in Lemonhurst. Better results have been achieved for patients who have self-selected regimens of exercise, skin care, and positive outlook training. Vitamins, supplements, moisturizers, ointments, herbal therapy, facial masks: the labor applied by these subjects to maintain the appearance of good health, or rather their belief in their own relative freshness and youthfulness, provides a life structure which affords them some measure of normalcy and comfort. In the best instances, these subjects can live longer than the national average for their demographic, and report a greater sense of agency and confidence. Though by their own admission they cannot bear the prospect of being touched, and for decades have remained unwilling celibates. To be touched would risk re-infection, they argue. Such is the contradictory nature of their condition: not one would express concern about infecting others, because even they know, though would be averse to admitting it, the disease is limited to the conventions of their own mind.

Patient X (Testimonial)

The meds are working; so now, maybe, while I have my head, I could explain it. I’m Irish, did you know that? I mean, I’ve lived in the States my whole life, but if you check my birth certificate you’ll see I was born in Limerick. “Stab City” as the Irish call it. A place so poor, I guess, no one can afford a gun. I don’t remember much except the embarrassment I felt at trying to learn Gaelic in class with the other kids, failing to pronounce even a single word correctly. I’ll never know how I didn’t get held back a grade—though maybe it was a case of the teachers hating me so much, they couldn’t bear the prospect of me sitting in their classrooms another year. Ah, Monaleen. You know what we had there for a playground? A cow pasture! Dried patties of cow shit on the ground. We’d pick them up and throw them at each other. Far beyond anyone’s standards of good hygiene! The air was clean, I remember that, and the fields were as advertised—supernaturally green. Especially after a long spring rain. It rained so often there in Castle Troy we didn’t bother waiting for it to stop; not a kid in the neighborhood kept indoors. I didn’t really appreciate much of it, I have to say, until my parents had moved back to the States and I’d done the usual things at high school and in college. After which, as with everyone, that amorphous destroyer, The Working Life, took over. Soon it was marriage and a job and politics and vague sympathies for the downtrodden of this world. Call it sentimentalism, but I really did believe fellow feeling was a kind of psychic power: if I concentrated on loving even the worst off of my brother and sister travelers, I thought their minds would be healed by some trick of homeopathic telepathy. Turns out, not so easy. Then the usual setbacks to my own optimism started to take hold: grandparents got sick, became funerals; parents smiled without any reason to; job ate more than its share. I remember the night when I first realized there was a problem that needed to be identified, really dragged out of its hiding place and studied, was when the sight of the candidates in the second presidential debate sickened me. I was watching a live feed of the debate on my laptop. My wife was peeling and chopping potatoes. The crispness with which the candidates’ talking points clicked into place, the sharp chops and slits of the knife: I found myself looking from one to the other, their lips, the repetitious slip of the knife. A rehearsed confidence. Potatoes falling on either side of that bright gliding. The two images coordinated in real time triggered something stronger than nausea—a spontaneous, frighteningly visceral revulsion at the very presence of my body. That was when I first caught scent of it: hot, mealy, spoiled flesh. I asked my wife and she said, “No, what?” I sniffed the air, my face a rictus of abhorrence. “Not me, I hope.” A sniff in her direction: “No”. Two more sniffs and bile was in my mouth. Up at the ceiling, down in the carpet, along the countertop and in each cupboard. Then, out of curiosity, the hand which held the oven door open: a strong horrible whiff. Of me. The hand, the wrist, the forearm. The shoulder, the chest, the waist. The right thigh, knee, calf, the left as well. The other arm, the whole body. A look in the mirror did nothing to explain the reek of it. Curdled, bulbous, rotten. I’d give all the free nights of my youth in green Ireland to get back the unsuspecting kindness of my wife’s face, the way she would look at me without even trying to those first years of our courtship and marriage, before that first evening I extended an arm to her, as far away from me as I could reach it, and asked her, “Smell it?” “What?” she’d asked. But the look on her face had changed, reorganized into strange fear, a suspicion closer to terror. By the end of the year, she had moved out. Not long after which she appealed to me in the gentlest ways possible, a divorce might be the first step to take on what was sure to be a long progress towards healing. I said yes, without knowing how to convince her otherwise. As far I knew, I was rotting alive, dying. As far as she knew, I was out of my mind.

Wife of Patient X (Testimonial)

One day we’re laughing and loving each other, caught up in the usual compromises of a normal life; the next day we’re in a psychiatrist’s office, supplemented by couples counseling. There’s nothing complicated about it but I still don’t understand it. One day he begins to smell this horrible stink and won’t let me touch him at all. There was literally, from what I could see, nothing wrong with him. But from his behavior, I mean, real panic, no one could look at him and say, “Now here’s a healthy man.” Oh god, the way he talked. The wild weirdness coming off his face. No sleep, no showers, no eating. That first night we rushed to the emergency room, but no one there took him seriously. My confusion at his behavior didn’t help. The next day we scheduled an appointment with our doctor. She didn’t see anything wrong with him. She took me off to the side and recommended a psychiatrist. That was when the real fright settled in because that man, that fucker, seemed so interested. Here my husband was moaning and wrenching in his chair, and at each answer to the doctor’s questions seemed to brighten him into this wonderland of curiosity just a little more. My husband was all but writhing on the floor by the end of it, and I was holding a list of prescriptions. And when months of that didn’t improve things, the fucker then was really interested. But by then I was already moving out…the worst shame of my life, my husband gets sick and, coward that I am, I turn him over to the first person that will take him. The excuse I used to make to explain it was true enough—that mass of choking and whimpering on the bathroom floor, no matter how much it might resemble him, wasn’t the lighthearted man I’d loved so much and for so long, to the point of marrying him. He was imaginary pain incarnate. So why not put him under the care of an imaginary doctor? He signed papers, I signed them too. He was so sick at that time he would agree to almost anything. The psychiatrist was so delighted, he could have hugged me. Something my husband could no longer do. When I last saw him, he was crawling on the floor of a small room, gripping the closely cropped carpet with his fingernails. He wouldn’t even look up to acknowledge me. I left the Center, and I remember this specifically, at 2:45 in the afternoon. The sun was shining but it was raining. That damp, rich smell, of earth blooming out the ground after a rain.

Sean-nós (Theories of the Pseudoleporist)

There is a couplet written by the American poet George Starbuck, which is perhaps discovered by one new reader every three years. “The man is dead./ Turn to another.” Not the most heartfelt of elegies, is it? It does gain a certain resonance and reach now that the author is a figment more thought about than read—and one not often thought about. This may be considered a willful coupling of one idea to another, but this couplet of Starbuck’s, and the sentiment it charts (charts more than navigates), could be understood in greater detail if considered in light of another art form—song. Specifically a form of Irish a cappella, Sean-nós. The custom and technique of Sean-nós singing requires a room and a singer and an audience (if there is no audience, the singing is not Sean-nós but just singing). Facing away from the audience towards a corner of the room, to capitalize on its acoustic properties, the singer belts sound at the force of both lungs. Sound waves ricochet off the walls past the body of the singer towards the waiting ears of his or her audience. A song more powerful than if the singer turned to face them. Comparisons to Plato’s allegory of the cave, while stale, would not be inaccurate. What are sound waves but shadows of a self, as concentrated in the expression of its own particular voice? Never mind the melodies and lyrics are hundreds of years old. Leave it to the Irish to give that sort of primitive amplification a name. Leave it to the English to conquer them and accurately describe such techniques in the crown of their language. A handful of centuries later, a poet named George Starbuck. Who, writing in English, follows the play of its sounds like an Irishman. “Turn to another.” An interesting concept, more a directive than an appeal. That man, you found him, there he is, no explaining it, no forgiving it, dead. What to do? Bury him? Wring your hands over him? Well, perhaps for a little while. But while doing so, begin to edge the shoulders slightly away. Achieve that three word directive: “turn” and then “to” and then “another”. “An” and “other”, but no space between them. Turning so quickly so as to catch them standing there as one thing. Seen that way once, they will never quite separate. So, one could ask, what does this have to do with the poor devil who took to a ferocious revulsion at the scent and sight of his own flesh? One could say that, in the play of these ideas, one has written his whole biography.

Semper Fi (Theories of the Quantified Self Movement)

Weakness is a dream of strength. That is, considered from a certain vantage point, isn’t it true—weakness is useful insofar as it helps define those means through which strength can be achieved. What is the Marine motto? Not “Semper Fi”, the other one. “Pain is merely weakness leaving the body.” What’s left behind then, once a body has been drained of the many cries of its nerve endings? A system, with inputs and outputs, with interdependent synergetic processes whose efficiencies can be maximized. Food consumption, caloric intake; blood oxygen levels; insulin and cortisol levels; skin temperature, heart rate, quality and frequency of sleep: these can be monitored, analyzed as data. By means of body tracking technology (QardiCore, FitWalker, Lifelogger), data can be gleaned and integrated via Biohacking software to provide a real-time map of a subject’s many inputs, states, vital signs, etc.. A holistic simulacrum of a subject’s total self can be produced. Using this as a model, adjustments to diet and exercise, to any number of personal habits can be made, with the belief that ultimate maximization of efficiency in bodily processes might lead to feelings of well-being and potency. Once a positive self-regard has been achieved, only then can it be said: weakness has left the body. So should there be a malfunction in this system that causes, say, a subject to suffer ideations of self-loathing via olfactory and ocular hallucinations, it will most likely be due to neurological imbalances of some sort, perhaps insufficient secretions of dopamine or serotonin. The subject is convinced his skin has begun to decompose; and though his skin would appear not to agree with this diagnosis, there is the matter of his distress, at believing it so. Diseases of the flesh begin in the flesh. Their causes and symptoms are known. Leprosy, though incurable, can be treated; all but the worst cases can be worked back into unbroken states of remission. Such disease is attributable to the corruption of flesh by microbes. Its origins and habits of growth have been defined, analyzed, and for the most part, contained. Certain obsessive ideations, then, which, while horrible to the sufferer, fail to produce actual deterioration of the epidermis, are, then, unreal, immaterial. Patterns of electrical brain activity can be monitored: movements of distress and fear can be seen and studied. But these terrors, so much as they are subjectively real, are not wholly answerable to the structures and processes that produce them. They are not, in the parlance of the Quantifiable Self, knowable, containable. Genetically developed strategies of self-protection, of preservation, of expelling foreign agents of contagion, are of no use here. For there is no real threat, it would seem. Nothing a body could isolate in itself, to expel, to protect itself from. The fear is a fantasy, the fantasy lacks metabolism.

Muertos (Theories of The Lifelong Meditator)

It is a disease to blame man for those reasons that deny him a capacity to love. Consider the word ofrenda. “An offering, a gift.” No mistake the word “friend” is in there. “Oh”, “friend”, “ah”. Oh don’t the eyes roll at the coincidence! But consider its use in reference to memorials for the dead—Ofrenda de Muertos. Now it is truly significant. It is there, plain as love of self. An offering for who, for what, for why and when? Someone passed out of life and friendship to become something pure flesh, a corpse, an object, simply there. Not something wrapped around a gift so as to briefly hide it, and not, really, even the gift laid bare. The offering really, is nothing more, nothing less than the instinct itself: to give. An instinct not wholly attributable to primitive customs of tribute exchanges—what it opens between two people, a true kind of giving, so neither is held in the other’s debt. So if a body takes to the belief that it is rotting, perhaps that is a signal from the heart to the body, a small something given? Again the eyes rolling! Yes, it’s a dead metaphor, “heart”, but we both know it’s dead, correct, so using it posthumously, don’t we stand to employ it for purposes of its own resurrection? Sometimes a body is so strong and buoyant and healthy it doesn’t know how bad things are. It’s so young and self-contained, it doesn’t care to listen. It receives no gifts, and certainly doesn’t give them. So confident it’s of a piece, the thing itself, the gift. Why give itself away, when it needs nothing? In those instances who’s to blame the heart if it should fall sick, almost as if it had no choice but to will its own illness? Listen, it says. Feel me. Feel this. All the stuff you’re ignoring. Those nerve endings that map every inch of you, true, they’re agents of their own sensitivity and self-adoration. There is a greater wrong, though, and you’re within it. Your loving yourself to extremes of self-interest have made the larger body, the one you’re a part of, sick. Why the skin, then? Why illness there, and not elsewhere? Time to rot that all away, I think, and allow your better parts to rove. Heart is a dead metaphor but a cruel instructor. Its taste for flesh stronger than death itself. But to what purpose? To tease nerves further from their self-contained innocence. Grotesque as the image may be, what it illustrates is as vital as it is painful. Unspooled from fleshlessness, those threads out wandering, blooming and working forward though blind dark like mile-long hairs. So, if that’s the outcome, how could you not say: punishment is often the mind’s gift to the body.

Third Shift Nurse, Lemonhurst (Testimonial)

Yes, the night shift. Every night between ten and six the next morning. Yes, I knew him. I mean, watched after him. He was on heavy sedatives so he slept most of the time. A bed in a room of his own. In the evening while he slept took his meals through an I.V.. Nearly impossible to get him to take solid food. Just a little soup in the afternoon and, to supplement that, I.V.s in the evening. He was quiet, didn’t move. A pitiful, shriveled little thing. I’d seen late stage Alzheimer’s patients and that’s what it reminded me of. Even the symptoms were similar. Grinding of teeth. I mean, real bone on bone—like someone chewing a mouthful of molars. Yes, it’s true. I didn’t think there would be any objections to it, but I’ll admit I knew enough not to tell anybody. I did put a hand on his forehead sometimes, talk to him. I did turn on the television so no one in the hallway might hear me sing to him. Oh something old, a mountain ballad. Something my mother used to sing to me in bed when I was a little girl. “Lazy Bones”, “Froggy Went A-Courtin’”, that kind of thing. But slow enough to calm him down. Yes, it did. Rare that it doesn’t. Well, fine. Skinnier than anything you’d want to put your eyes on, but yes, it was true, the skin on him looked fine. Smooth as if it hadn’t had a day of use. I’ve seen that sometimes. People old enough they suddenly become soft and smooth again, like infants. Most dry out, but there are those few. He liked that, I know it, me touching, talking to him. And he liked that singing. It was the only thing that stopped him with the teeth. I’d pick up something and he’d stop, as if to hear better. Hours sometimes. As long as I could spare. Other rooms, other patients. Hard to leave, I tell you, could hear the grinding from the hall. It was nice, yes, I heard. Considering how he was most of the time, it was something. Don’t know when it started exactly. The easing up on the teeth, the humming. Low and faint and gentle as anything. Not sure. Hadn’t heard it before, same thing over and over. Something he heard, something he made up? It was relaxing, all the girls will tell you. Light and pretty as cigarette smoke. Each of us, we’d just sit there next to him and listen. Those busy slow movements curling over him. Can still remember it, even now. Could hum it, if you want. It starts high, quiet. Simple. One note. One long note. Then others coming upon it, to turn it like a wheel.

KYLE COMA-THOMPSON is the author of short story collection, The Lucky Body (Dock Street Press), the title story of which was selected by Ben Marcus for inclusion in New American Stories (Vintage, 2015).