Years ago now, when I was an undergraduate, I shared an apartment with four medical students. The guys and I would play Ping-Pong a couple of nights a week, with whoever wasn't holding a paddle calling out questions for the endless exams they had to take. By the last game I was inevitably convinced I had the disease of the night—bubonic plague, check; diabetes, check; Still's disease, check plus. If you had any kind of imagination (and as an English lit major I liked to think I had plenty), you could see yourself as a candidate for the direst diagnosis, because symptoms are often mundane to the point of ubiquitousness. What woman doesn't occasionally have "muscle and joint pain," "fever," "headache," and a "rash"? (That's classic dengue fever, by the way.) And so I joined cynicism about an individual's ability to self-diagnose accurately with an innate preference for denial, and spent the next 20 or so years pretty much ignoring whatever messages my body was trying to deliver. The one exception to this ostrich approach happened on a beautiful late August night at a party. My then husband brought me a glass of white wine, and as I lifted it to my lips, a wave of revulsion washed over me. "The wine is off," I whispered to him. He took a sip and said it seemed fine to him, but he would get me some red and see if I liked that better. Same story with the red—a few centimeters from my lips, the smell revolted me and I put the glass down. Minutes later, a little voice in my head said, "You're pregnant," and it was right, I was, so early into the pregnancy that it would be weeks before the home test confirmed what my body knew. After that news blast, however, I went back to completely ignoring the mind-body continuum, finding it hard even to say with any accuracy if I was tired or hungry.
The wake-up call came in the dentist's office a month ago, when I happened to read a report about the "silent killer"—ovarian cancer. The article, in a nursing magazine, noted that a study of almost 2,000 women who had been diagnosed with ovarian cancer found that virtually all of them had had symptoms, many for as long as a year before diagnosis. I was stunned, and while I realized that the symptoms (bloating, pelvic pain, etc.) perfectly fit my "mundane to the point of universal" theory, I was shaken that patient and doctor alike could have failed to heed so many warnings. People tell stories all the time about being saved by their gut: I heard one recently about a woman who dreamed she was in a prison camp, pressed up against the barbed wire. She was unnerved by the dream, and when it kept recurring, she had a premonition that she knew what it meant; she went to her family physician and asked to be tested for colon cancer. Her doctor resisted—a colonoscopy is an invasive procedure, the woman was young and in seemingly excellent health, there was no family history of cancer. He said no, she pushed, they danced back and forth until her determination won out and he scheduled the test. As you'll have guessed by now, the dream was right—she was in the early, symptom-free stages of colon cancer.
But the predicament of the women with ovarian cancer was different—they didn't need a supernatural prompt; they had hard evidence tapping on the glass wall of their consciousness day after day after day. I trust my gut, but I don't trust my ability to heed that polite little tap on the brain. The magazine story ended with a call to women to Listen to Our Bodies. It was advice I'd read many times before, but it occurred to me that I'd no idea what it meant. How do you listen to your body? Where do you start if, like me, you've spent decades ignoring it? Can you listen too intently and topple over into hypochondria as I did all those years ago around the Ping-Pong table?