What Would Susie Say by Susie Essman
You know Susie Essman as the sassy Susie Greene on HBO's Curb Your Enthusiasm. Now, she's turning her hilarious bouts of withering sarcasm into a book that delves into love, life and comedy.
I'm perimenopausal, and I know that I am because I have the symptoms, and I know I have the symptoms because I spend 80 percent of my free time checking out the myriad of medical sites online. I spend the other 20 percent looking for lumps.

I feel so blessed to live in an age where medical information is available on the internet. Internet info is a hypochondriac's wet dream and a doctor's worst nightmare. I spend a lot of time on these websites checking symptoms for illnesses and conditions I'm certain I have. So far, this month alone, I've had Lyme disease, hysterical blindness, and an enlarged prostate. Whenever someone I know, or someone I know knows someone who has an illness—minor, major, or terminal—I immediately assume I have it too and plan accordingly. Much to my delight and chagrin, almost all of the commercials on TV these days are for some kind of pharmaceutical treatment for diseases I've never heard of but am sure I've contracted. One after another, fifteen-, thirty-, and sixty-second spots for pills and ointments that must be taken at your own risk. I know I'm not alone in this. Otherwise there wouldn't be so many goddamn commercials for this stuff. I've even thought of starting a symptoms checkers support group. I'll call it Dead by Tuesday Anonymous.

The beauty of the internet is that there are so many choices. There's WebMD, MayoClinic.com, MedicineLine.com, Medicine.net—plus hundreds of specialty sites, too numerous to mention. Let's say I go on WebMD to check a symptom of a disease that I suspect I have, and they inform me that I'm in good health and have nothing to worry about. Needless to say, that prognosis doesn't sit well with me, so I can simply dismiss it and check out the other sites until I find one with an outcome that pleases me, one, that if not fatal, will certainly be very dramatic. The sheer volume of medical websites gives me hope that somewhere, somehow, I can find a site that lists my symptoms and will reinforce my belief that I have something that I most probably don't have a chance in hell of having. A lot of symptoms are universal. So many diseases have symptoms I can easily have. Fatigue. Who's not fatigued? Lethargy? Isn't she the twin sister of lazy? Or bloating? I'm bloated twenty-nine out of thirty-one days of the month! And you can fake yourself out on some symptoms and convince yourself that you have them even when you don't. Dizziness, for example. Dizzy is my middle name. I can easily convince myself that I felt dizzy because I lifted my head up too quickly the other day.

I don't mean to trivialize the pain and suffering of people who are really sick, and it's not that I really want to be sick, but the hypochondria is something that is out of my control. Illness is frightening. If I gain weight I'm convinced it's because I have a tumor growing inside of me that weighs a few pounds. If I lose weight, it's because the tumor is causing a diminished appetite. I can't win. To ease my fears I tell myself that if I'm vigilant about my health, then I'll remain healthy. But there is anecdotal evidence everywhere I turn that proves that this approach doesn't necessarily work.
Honestly, I'm not that bad, comparatively speaking. I've got a few friends that are pathological hypochondriacs. They make me seem like the bastion of mental health. Their hypochondria colors every moment of their lives, whereas mine simply informs it. You can see the movement behind their eyes the moment someone sneezes in their presence. By the time the sneezer says, "Excuse me," they've already been on the phone with the Centers for Disease Control, three immediate family members, and the head obituary writer for the New York Times. The gripping fear makes them incapable of really being a friend, because when you tell them about something wrong with you, all they're really thinking about is whether or not it's going to happen to them. They ask you about your symptoms as though they're being empathetic, but their motives are so transparent.

We all play these games. You hear that a friend has lung cancer and know that they're a smoker. That's an easy one because the cause and effect are so clear. But then another friend has lung cancer and they're not a smoker. Now we're into different territory. Is there a family history? Were they exposed to asbestos? Secondhand smoke? Do they live near a power plant? Did they ever spend a summer with Erin Brockovich? And when there doesn't appear to be any reason for them to have gotten lung cancer, when it's random and arbitrary, then that is proof positive that I, and my severely hypochondriacal friends, must have cancer too.

I grew up in a household that loved disease. Not like, loved. Sound weird? My father was a doctor and made a living off it, and my mother, according to her self-diagnosis, has been dying since 1963. My father always had medical paraphernalia around the house, syringes and tubes of blood in the refrigerator, and promotional items from drug companies in drawers and cabinets. I remember the pad next to the phone for writing down messages was in the shape of a colon. I'm not kidding. Disease was discussed at the dinner table with regularity. Between the soup and salad we usually had botulism, stroke, and retinitis pigmentosa. Someone in the family or extended family always had something.

For as long as I could remember, each of my parents would pull me aside, individually, to tell me that the other one was deathly ill and dying and then they'd go for a million tests, which they loved, and then there'd be nothing wrong. It was kind of a wish and a fear all rolled up in one.

For example, my mother would pull me aside and say, "I think Daddy has a brain tumor." And then he'd have tests tests tests and there would be nothing wrong. Or my father would say to me, "I think your mother has rickets," and then she'd have tests tests tests and there'd be nothing wrong. It was nutty. Maybe they needed the distraction from the realities of life, I don't know. My father did ultimately get cancer for real and died in 2001, but my mother is still frequently telling me that she's about to die. She's eighty-three, and while she's not in perfect health, she's nowhere near death. She's got lots of aches and pains and trouble with her eyes and ears, but none of her maladies are life threatening. Still, she told me just a few weeks ago that she'll be dead within a few months.

"Really? What from?" I asked.

"Oh, lots of things."

"Name one."

"Well, I've got a heart murmur."

"I've never heard of anyone dying of a heart murmur. And besides, you've had it for years."

"Well, I could drop dead of an aneurism."

"Yeah, well, so could I!"
So you see, I come by my own issues honestly. I get my mammograms and sonograms and pap smears and blood workups and even the dreaded colonoscopy on a regular basis, and I have the dermatologist check my moles and everything is just finefinefine and then I read about some flesh-eating supervirus and I'm instantly convinced that I contracted it on my way home from my checkup. How the hell am I supposed to protect myself from that kind of deadly scourge? By eating more broccoli? You have no idea how much broccoli I already eat, and carrots and beets and even kale, and I don't think a trans fat or anything with corn syrup has crossed these lips in a very long time. I wash my hands frequently, not sick OCDishy frequently, although some non-vigilant types may think so, but I can't deny that antibacterial hand lotion and I have become the best of friends.

Allow me to offer you a little hint about antibacterial lotions and gels. To me, they're one of the greatest inventions of all time, right alongside fire, the wheel, and ribbed condoms. Now I know there are naysayers out there who claim that they do nothing, and some say they actually foster bacterial growth. Bullshit. I don't believe a word of it, and I don't care to see the evidence. I choose to believe that these products work and that they're effective and protecting me. A placebo effect perhaps, but whatever gets you through the night.

There are germs everywhere. Go to the ATM and use that touch screen and the chances are that the guy who used it before you had the flu virus all over his fingers. What are the odds that not one person who touched those buttons before you was a nose-picker? You'd better get that gel out, because a sink with soap and hot water is not part of the operation over there.
Hand shaking is also a lightning rod for the spread of germs. People make you out to be crazy or antisocial if you don't want to press the flesh, but I think it's simply self-preservation. Do you know how much crap is spread by hand-to-hand contact? Donald Trump and Howie Mandel do. They don't shake hands with anybody—in fact their hands are probably in pristine condition, clean enough to perform major surgery. On Deal Or No Deal, not only does Howie not shake the players' hands, he doesn't even touch those freaking briefcases. A number of years ago, when Donald Trump was running for president, a big deal was made over the fact that he wouldn't shake hands. To me, that's the smartest thing he could possibly have done. I'd vote for him on that issue alone. I roasted Donald Trump at a Friars Roast a couple of years after he ran for office and said, "Everybody thinks that Donald doesn't shake hands because he's a germaphobe, but the truth is, he jerks off so much that he considers anything else cheating." Okay, that was a joke at a roast—and a good one, I might add—but in reality I admire his convictions about hand shaking. I'm too chicken shit and afraid of offending to make that rule, although I should follow his lead. Sometimes when I do a meet and greet after a show and have to shake literally hundreds of people's hands I feign illness and tell them that I have a cold or getting over the flu so I don't want to shake, as though I'm actually protecting them from my germs. My altruism is never-ending.
One of my greatest bacterial challenges is the fact that I travel a lot, which exposes one to all sorts of germs from all over the world. I mostly travel for work, not adventure, which means I'm usually in the comfort of the Pacific Palisades, not on a deserted island in the Pacific Ocean. But even when I'm on vacation, I'm not particularly adventurous. I have no interest in climbing Mount Everest or bungee jumping or sky diving or any activity where I can suffer bodily harm, like breaking my neck, or losing a limb, or tanning unevenly. I take enough risks onstage and onscreen that any further adrenaline rush is totally unnecessary. Do you know how high I feel every time I yell at Larry David? What more can I ask for? Why test the fates? Hiking through the woods exposes you to all kinds of bug bites and poison ivy. The beach is nice, but only under an umbrella, where you're protected from those evil UVA and UVB rays.

For me, a vacation involves great shopping and great restaurants and beauty and a bit of luxury. Not over-the-top luxury—I don't need a diminutive personal manservant to fetch me things and pumice my feet, but I don't think indoor plumbing, air-conditioning, and room service are unreasonable requests. And speaking of indoor plumbing, the thought of camping is horrific. No interest whatsoever. If God wanted us to be camping, she wouldn't have invented The Ritz-Carlton. And even though I'm enormously fascinated by other cultures, if it's a big schlep to get there or I have to be careful about drinking the water or eating the food, or if the visit requires shots beforehand, I'd rather watch the Travel Channel or Nat Geo or Robin Leach. My nephew and his wife and daughter live in Australia. I'd love to visit them, but the thought of sitting in a stuffy plane for twenty-two straight hours causes me such fits of anxiety that I don't know if it will ever happen. People tell me that they're dying to go to China, India, Vietnam, Africa. I say, "Enjoy yourself and send me a postcard. I'll be in Miami relaxing, shopping, and eating."

I'm not a big fan of flying. It's not that I'm afraid to fly, it's just that I hate it. I hate the packing and the airport and the germs and the confinement and the germs and the lack of control and, oh, by the way, have I mentioned the germs? Allow me once again to put on my "Susie, the Good" hat and give you some pointers on what to do when you do have to fly somewhere. First of all, always wear socks. Even in the summer. The grossest thing in the world (other than European men wearing brown socks with sandals) is to see someone going through security in flip-flops. They take their shoes off to go through and they're walking barefoot on that floor that thousands of people have walked on before them with all sorts of crap on their shoes. It's disgusting. No different than the horror I feel when I see someone walking barefoot through the streets of New York City. I fear for their life. And I read that the floor at the airport is loaded with staph infection. As is everywhere else. Being barefoot on the plane is even more disgusting, because now, in addition to the normal dirt, schmutz, and dog shit they have on their shoes, they've added to the mix whatever crap they picked up in the airport itself.
Next, sanitize! After I go through the security, I hand sanitize and moisturize like crazy. Always bring moisturizing lotion with you, because the sanitizer, thankfully, is pure alcohol and dries out your hands, so you need to moisturize afterwards. Remember, when you're in an airport, there are people who are passing through from every corner of the globe. They're coming from places with microorganisms and bacteria that you, or anyone in your entire gene pool, have never been exposed to. You have no immunities to this stuff! Try at all costs to avoid the airport bathrooms, unless of course you're a Republican senator from Idaho, in which case, by all means, set up shop. For the rest of you, only use them if you absolutely have to, and remember, don't assume other people are clean. They're not.

Once on the plane, get out your wipes and become your own cleaning lady. I use just plain antibacterial ones. My manager uses the alcohol wipes that are wrapped in foil that diabetics use before they inject themselves, which he proudly tells me are three dollars for a pack of five hundred. My friend Robyn Todd travels with a big tub of Clorox wipes. She also turned me on to the benefits of filling your nostrils with Polysporin ointment when you're on the plane. Yeah it's gross and looks like your nose is dripping goo, but at least when you breathe in all that bad air, it's being filtered through an antibiotic barrier. See, I'm not the only crazy one out there. Robyn and I are single-handedly putting the Walgreens' kids through college! Wipe down everything you can reach: seat, tray, table, headphones, the guy sitting next to you…Same thing in the bathroom. Wipe, wipe, wipe. Seats, counters, mirrors—if you can wipe down the actual paper towels, do that too. You think they clean those planes between flights? They don't. You have no idea who was lying on that pillow with God knows what kind of head lice or scabies before you.

So, you've arrived at your destination with no new diseases or infections that you know of, and are ready to check into your hotel. Before you even say hello to the concierge, once again, wipe, wipe, wipe. Hotels, even the five-star variety, are a hotbed of germs and bacteria. In five-star hotels you'll get five-star bacteria. Every doorknob, every light switch, the phone, the toilet handle, needs your sanitizing attention. You think the maid is cleaning the toilet handle? NO! And most important of all, clean the remote control. Who knows what movies some businessman from Cincinnati was watching before you got there...which leads me to the bedspread, which may reflect the aftermath of the movie he was watching. Eeeeeewwwwww. Hotels wash the sheets and pillowcases, but they don't wash bedspreads or pillow shams between guests, and you have no idea who the prior guests were—not that it matters; just assume they're all pigs. The bedspread is the most disgusting thing in the room, so take it off immediately, throw it in the corner, and go boil your hands. Or better yet, use a hand towel to lift it off the bed so you don't even have to touch the damn thing and ask housekeeping to get rid of it and never bring it back. This goes for duvet covers, blankets, comforters, or anything else that sits on top of the top sheet. Ahh, the top sheet, one of nature's little miracles. Make sure you fold it all the way over the duvet, like a sausage casing, so that no potentially unclean thing is touching any part of your body! Also, bring slippers or flip-flops (the ones you shouldn't wear in the airport) so you don't have to walk on the carpet. Athlete's foot or fungus or crap that dropped off of another person's body could be lurking in those fibers. Similarly, this is why you shouldn't sit naked on the big fluffy overstuffed chair. And speaking of the overstuffed chair, there's a worldwide epidemic of bedbugs in even the swankiest of hotels. Check for brown dried blood spots on the sheets. And don't ever put your suitcase or clothing on the bed or any other piece of upholstered furniture.
The suitcases are a hygiene issue themselves. It's always amazing to me that people will come back from a trip and take their suitcase, which has been in the cargo section of the plane, and put it on their bed to unpack. That thing is filthy! I wipe down my suitcase in my hallway before I even allow it in my house. My sister Nina has a spray bottle with bleach and water in it and sprays the luggage before she allows it in the apartment. Maybe it runs in the family, because my sister Nora is a vigilant germ freak as well, but the truth is, I do think all of these things make a difference. When I walk into a hotel room and take out my wipes, it takes me under a minute to wipe the room down to my satisfaction. Why not play it safe? Sixty seconds of diligent cleaning is well worth gaining sixty years of your life.

Sadly, I'm just one woman, and I can only do what I can do. The reality is, I can wipe surfaces till my heart's content and there are still a million and one other things out there that can wreck havoc on my body. Things like antibiotic-resistant staph infection and spider bites and auto emissions and tainted food and, as I said, I'm perimenopausal.

What exactly is perimenopause? It's the period of time before menopause. They have a name for it now so now it's a condition, when in the past it was just life. Actually, when women say that they're going through menopause, they're really going through perimenopause. Menopause itself lasts for just one day, the day after a woman has not menstruated for one whole year. Then you're officially in menopause. And then it's just life again. There's no "pause" involved. The perimenopause can start at any time and can last for years. And there's really no "pause" involved in that either. It can start as early as thirty-five, but most women begin in their early forties, and it lasts all the way up until that one day when you're finally in menopause. A lot of the symptoms for the perimenopause are the same as for the menopause. For some women the symptoms abate after menopause, but for many, they don't. They go on and on and on. So again, where the hell is the "pause"? I have a friend who went through menopause thirteen years ago and is still suffering from frequent hot flashes.

There is so much to look forward to. I of course went online to check the perimenopause and the menopause symptoms to see what I do and do not have. Interestingly, there were almost no variations of symptoms from website to website, and believe me, I checked them all. So, here are the main symptoms of perimenopause. I'll tell you what I have, and you can check it against yourselves.
I. Hot flashes and/or night sweats
Luckily, I don't have the hot flashes yet. But I do have the night sweats. (Addendum—since I wrote this a couple of months ago, I've been inundated with hot flashes.) It's wild. I'm going along doing whatever, la la la la la, and then suddenly, I'm on fire. It's like spontaneous combustion with no rhyme or reason to it. I'm not a sweater, but now, several times a day, I'm drenched. I say to Jimmy, "Feel the back of my neck." And he invariably responds, "Honey, I felt it an hour ago." He doesn't seem to be as fascinated with my fluctuating body temperature as I am. The night sweats have increased. I wake up every few hours in a pool of fluid and not the good kind. I'll have the A/C set to Ice Station Zebra and still my body is hot and clammy. Jimmy wanting to touch me in those moments is not a good idea. As a matter of fact, it's an act punishable by death. The last thing you want when your body feels like it's in the middle of Dante's inferno is to be touched. And I think there's an adrenaline rush too, because once you're up, it's impossible to get back to sleep. My heart and head are racing a mile a minute.

2. Trouble sleeping
See number I. I've been awake since November 25, 2006. But I do know how to buy real estate with no money down. So you've got to take the good with the bad. Besides, I get a lot of work done in those wee hours of the morning. Not meaningful work, but I keep busy. My files have never been so organized and my liquor cabinet never so bare.

3. Vaginal dryness
Although I know that male readers are now closing the book and heading to the plasma TV, I must persist and address it. If we have to deal with it, then so do you. This symptom annoys the shit out of me. Who wants a dry, crusty vagina? Not me. As of this writing, mine is still moist and delightful, thank you very much. It's like a vaginal wetlands down there. Jimmy Hoffa may be buried in my vagina, for all I know. To me, KY still means Kentucky. But for how long? Will I wake up one day and have to file a drought report? Is it in my future? I ask my postmenopausal friends and some of them say they have it and others say not. Are they lying? Some tell me that they don't have dryness, but rather a thinning of the vaginal walls. What the f**** is that? It doesn't sound like something I have any interest in. What's behind those walls? And how thin does it get? Can it disappear altogether? Should I call Bob Vila in to build an addition? So many questions and so few answers. I'll have to wait and see. But one thing I know for sure, I'd rather have vaginal dryness than erectile dysfunction. At least with the dryness you can use a lubricant or salve and maybe it gets a little drippy but it's all external and harmless. With erectile dysfunction, however, you have to take a pill that screws with your biology, and there are all sorts of side effects. The four hour erection, for example. The thought of anyone—even Clive Owen, hot as he is—coming after me for four hours is frightening. The thought of Bob Dole, packin' wood, on the prowl...I don't even want to think about it. It's too disturbing. I wouldn't know what the hell to do with it for four hours. Four minutes is about my limit. Besides, I don't even want to do anything that I like for four hours!

4. Mood swings
**** you.
I've had mood swings since I was seven. Nothing new here.
5. Weight gain
If I want to lose weight at this point, I have to eat absolutely nothing. I'm not exaggerating. Nothing! Recently I tried to take off this four pounds that I can't seem to get rid of, so I had 1,200 calories a day and worked out daily and I gained a pound and a half. I even cut out red wine, which is not easy for me because I enjoy my glass or two of wine at dinner, but I cut it out and still I gained weight. Can someone explain this to me? I'm thinking of drinking alcoholically, because if I'm going to keep gaining weight no matter what I do, then I might as well be hammered and not give a shit about my appearance. If I'm going to be bloated, I might as well be loaded. (Oh, and by the way, cutting out the wine did nothing to alleviate my hot flashes either, which is one of the useless pieces of advice I found online.) I used to be able to eat anything and stay thin. And then when I hit thirty that kind of ended, but I was still able to take it off when I had to. Now I gain weight eating carrots. Whatever. I don't want to make myself crazy, but truth be told, I'm making myself crazy.

6. Trouble focusing
I can't remember a goddamn thing anymore, and you know what, it's made absolutely no difference in my life. There isn't much worth remembering anyway. And if I repeat myself because I don't remember that I said it before, too bad. You'll just have to listen again. My kids roll their eyes, like anything that they have to say could be half as interesting as what I'm saying for the second or seventh time.

6. Trouble focusing
I can't remember a goddamn thing anymore, and you know what, it's made absolutely no difference in my life. There isn't much worth remembering anyway. And if I repeat myself because I don't remember that I said it before, too bad. You'll just have to listen again. My kids roll their eyes, like anything that they have to say could be half as interesting as what I'm saying for the second or seventh time.

7. Less hair on head, more on face
What is that? Less hair on head, more on face! That's almost as annoying as vaginal dryness. Actually, I think hair reassignment is worse than the dry vagina, because nobody sees your vagina in public on a regular basis, at least not mine, but your face and head are on constant display! I've seen these women with their whiskers and comb overs on the streets of New York. I always thought they were mentally ill. How horrible of me. Someday I will be them. When is it going to happen? Is it slow? A whisker here, a five o'clock shadow there? Or does it happen all at once so that by July, I'm going to look like Rob Reiner?
I don't know. There's not much I can do about any of it anyway. I guess I just have to accept the fact that I'm going to end up a bald, fat, sweaty, irritable woman with a dry vagina and a full beard, who never sleeps and has memory loss so I won't even be able to remember how hot I used to look! The only comfort I take in all this is that I'll be dead soon anyway. Hopefully heart murmurs are genetic.

Why Susie Essman enjoys being a broad  

Susie Essman has played the sassy Susie Greene for all seven seasons of the critically acclaimed HBO comedy series Curb Your Enthusiasm . She has been a veteran of the world of stand-up comedy for 25 years and has appeared in her own half-hour HBO comedy special and made numerous appearances on Late Night with Conan O’Brien, The View and Crank Yankers . She also has acted in numerous films, most recently co-starring with John Travolta as the voice of Mittens the Cat in the Disney animated movie Bolt. To learn more about her work and her book, check out  SusieEssman.com .
Excerpted from What Would Susie Say? by Susie Essman. Copyright ?? 2009 by Esswoman Productions, Inc. Reprinted by permission of Simon & Schuster, Inc, NY.


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