Ordinary Insanity, page 7
The day we arrived in Mexico I was already refusing to let Elena touch any painted surface; I was dabbing the back of her neck with a repellent wipe from one of five jumbo-sized boxes of Natrapel I’d lugged with us. I dressed us both in long sleeves and long pants almost every day. In that country of scorching sun and sweet, dry heat, I bared my arms perhaps once or twice in the course of the year we spent there as a family.
Still, in the beginning, I enjoyed myself. I entered that honeymoon period when the world seems briefly benevolent, or at least harmless in its indifference, and as long as I was reasonably careful it seemed we could live a life somewhat approximating the one I’d nourished in my imagination. We took a trip to a village tucked deep into the Sierra Norte, three hours up a narrow, curvy paved road and another hour down an even narrower, curvier unpaved road, dust billowing up behind our back tires. I read Elena One Fish, Two Fish, Red Fish, Blue Fish, glancing up from time to time at fog-hugged cloud forest and mountains fringed in blue. This was joy. In the village, Jorge, Elena, and I slept together on a twin bed in a room full of the detritus of pueblo life: discarded egg cartons, broken pottery, books that looked as if they’d been whipped around in a hurricane, bits and pieces of toys, dust upon dust. We woke to the vaudeville sound of turkeys gobbling. It was the village fiesta, so the days were a madcap timeless whirlwind of fireworks and basketball tournaments and outdoor religious ceremonies heady with incense and flowers. I took Elena to all of it. I hiked with her to a shrine on a mountain path between villages, saying hello to the old couples who were trekking kilometers with mesh bags of oranges on their backs. One offered half an orange slice to Elena and clutched her hand with affection. This was the life I wanted to live.
My sense of joy disappeared in increments.
It began with clay. Most of the clay pottery in Oaxaca is lead-glazed, and can be quite toxic if it is old or the glaze has deteriorated. From time to time the government makes a half-hearted attempt to convince local artisans to use lead-free glazes or to fire in different kilns, although within months of the publicized initiative everyone more or less retreats to the status quo. Here is the conundrum of anxiety: it is rational not to want a child to eat from a dish glazed in lead. But what seems like a clear-cut and logical prohibition is quickly complicated by the million unknowns, particular contexts, and unique situations that make life life and not a simple equation solved by yes or no. The memela at the village festival: Was it cooked in barro? Was the barro glazed? Was it old? Was it chipping? What about the soup at the upscale restaurant in the city’s Zócalo? What about mole from the market? Quesadilla toppings? The salsas? What about horchata, the most fundamental of all Mexican drinks: where had the rice been cooked, where had the cantaloupe been stored, how traditional did the señora and the little street-side stand seem?
Trying to police this one seemingly straightforward threat—the ubiquitous local dishware—quickly led to a dense and extensive network of prohibitions that could never offer perfect security. I insisted we eat only at three restaurants: an upscale deli run by Spaniards and serving mostly sandwiches; a fancy courtyard serving dressed-up and Europeanized local dishes; and a café where the food was boring but the coffee strong and the staff friendly and tolerant of a toddler’s high jinks.
Still this did not placate me. Everything in my path was potentially dangerous. Everything carried risk. I didn’t see this as a sign of my own basic, human lack of control, a sign of the futility of trying to achieve perfect certainty. Instead, I became further entrenched. As another therapist would put it years down the line, I ceded more and more territory to my anxiety, until I was living a life the size of a postage stamp, restricted in experience, range, scope, and potential. This was not lost on me. I was often irritable. I sobbed suddenly and intensely. I wasn’t sure what was happening to me.
One day we went to eat at a restaurant on the city’s periphery road, a place Jorge and I had gone in the past for its traditional plates and its fried platters of snacks that went down perfectly with cold Victorias. My dad was visiting. There was road construction outside, and I could see the dust through the windows. By the time we got the check I wanted to throw up with worry at the thought of it coating our food, our plates. My dad and Jorge decided to go get ice cream. They took Elena. I went back to the apartment, curled up in a ball, and wept. My body shook with the force of the sobs. It was the one and only time I have cried so hard I choked.
I was miserable. I was making myself, and everyone around me, miserable. I was denying Elena a life. I should know better, I told myself. How had I let myself become this? I had no idea, and no way to make it stop.
JAMIE
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3
The Risk Society
The concept of risk emerged as part of political philosophy and theory in the seventeenth century, in association with gambling: it elucidated the probability of an event occurring, along with the potential gains and losses following that event. In the eighteenth century, marine insurance agencies used the notion of risk to determine the chance of a ship coming home versus being lost at sea. In each case, risk was a weighing of positive over negative outcomes: the possibility of success versus the possibility of failure. In contemporary language, however, risk bears a negative connotation: it has come to refer exclusively to unwanted danger.
Hypersensitivity to risk is not a specific feature of pregnancy and motherhood. Rather, it is the dominant characteristic of what German sociologist Ulrich Beck has called a “risk society.” The risk society is characterized by a tragic, ironic paradox: rapid industrialization has given way to a technocracy so complex, so beholden to science and expertise, that its successes ultimately end up becoming dangers it can neither predict nor control. The risk society is safer than any society throughout history, and yet its defining paradigm and organizing principle—indeed, its religion—is risk.
The risks that haunt this society are not the result of ignorance but of an excess of knowledge, and of an understanding of knowledge as partial, contested, and suspect. In the risk society, which Beck first defined and outlined in the 1980s during the peak tension of the Cold War, trust in science and expertise has fallen. No longer do we depend on them to explain our realities to us. In the period from the early twentieth century through World War II, new technologies and scientific developments were celebrated as consummate improvements in quality of life: Frozen foods would save the housewife so much time in cooking. DDT would spare American soldiers the mosquito-borne scourges of the jungle. The affordable car would allow the middle-class white family to get a house with a backyard in the suburbs and vacation at Niagara Falls.
After the apocalypse at Hiroshima, breakneck scientific and technological “progress” came with scare quotes. Now I am become death, destroyer of worlds, thought Robert Oppenheimer as he watched a test launch of an atomic bomb in the New Mexican desert: the risk society had created, by virtue of its own dogged efforts of human engineering and intelligence, the ever-looming potential for its own demise.
Nuclear weapons offered the clearest illustration of this new principle, but it crept into everyday life as well. The plastics that give us an infinite variety of affordable toys, toothbrushes, T-shirts, containers, and furniture also poison the oceans and, to indecipherable and varying extents, our bodies. The cars that enable our work and leisure emit chemicals that give us cancer and might eventually smother our planet. The technology that detects deadly diseases in the fetal genome could create superbugs or a eugenic dystopia. Polish sociologist and philosopher Zygmunt Bauman wrote: “[Risk] is now dissolved in the minute, yet innumerable, traps and ambushes of daily life. One tends to hear it knocking now and again, daily, in fatty fast food, in listeria-infected eggs, in cholesterol-rich temptations, in sex without condoms, in cigarette smoke, in asthma-inducing carpet mites, in the dirt you see and the germs you do not.”
All of these threats can be identified, and all manner of experts can attempt to measure, qualify, minimize, emphasize, and anticipate their impact, but they all share the fundamental quality of hiding in the scrim of uncertainty and unknowability.
These risks are cultural and subjective: different societies and subsets of these societies envision them differently. In Europe, chemicals are carefully monitored, limited, and sometimes banned; in the United States, the regulation of chemicals is desultory at best and often requires significant evidence of harm, but widespread and extensive action is taken to prevent terrorism. This is reflective of one of Beck’s central, ironic principles: in a risk society, “acceptable risks are those which are accepted.” The risks that are most effectively highlighted by government, activists, organizations, and/or mass media are the ones most likely to be accepted as valid and organized around. Others are ignored or discredited or minimized, especially if they largely affect the poor. An “objective” risk is really a product of the staging of public perception. Beck explains, “The risks which we believe we recognize and which fill us with fear are mirror images of our selves, of our cultural perceptions.” This is not to say that these risks are either more or less real than others that go unrecognized; rather, it is to show that in the risk society, values and beliefs and priorities are expressed in terms of risks.
Risks exist as possibilities, as worst-case scenarios, as unknowable catastrophes, and we expend great societal and individual energy in our generally boring lives trying to anticipate and prepare for them. We have made what turns out to be a terrible peace: unparalleled levels of safety and longevity in exchange for constant anxiety. Without tradition, religion, a spiritual or deeper connection to the natural world, or even “faith in the redemptive powers of utopias,” we turn to risk: it becomes the cognitive and perceptual framework around which we define our lives.
“In God’s absence,” Beck writes, “risk unfolds its fateful and terrible, inscrutable ambiguity.” Individuals are left to themselves to negotiate it, and those with the most knowledge are often the most afflicted. They recognize the fallibility of science and mass media and yet must live within these institutions’ judgments, frameworks, and rules. They must ask themselves, as Beck put it, “What concerns should one have and in what situations? What are the boundary lines between prudent concern, crippling fear and hysteria?”
The anthropologist Mary Douglas has suggested that in order to understand how risk works in the contemporary Western world, one has to substitute the word sin for risk. The concept of sin was used to homogenize Christian cultures, to keep potential rebels and iconoclasts in line, and to separate the pure from the soiled. Now, Douglas argues, risk operates in much the same way.
Risk offers a secular cosmology that delineates appropriate behavior, maintains moral order, and prescribes a precise set of values. In the United States, these values include the sanctity of the child, the perfectibility of the child, the sacrificial nature of motherhood, and the responsibility of the individual for maintaining his or her own “wellness.” Risk is a way of policing and reinforcing these values. We chart the lines of social purity and transgression with the chalk of risk, and when disaster strikes, we blame the individual for not hewing closely enough to them. Douglas writes of risk as “scor[ing] on [the individual’s] mind the invisible fences and paths by which the community co-ordinates its life in common.” Risk, masquerading as impartial knowledge available to anyone willing to simply make the effort of education and prevention, is actually a moral order whose censuring of unbelievers and rebels is harsh judgment, banishment, and shame.
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Jamie grew up in the “typical, white-picket-fence American family” in Sumter, South Carolina, with a stay-at-home mother and a soldier father. After college, she married one of her brother’s closest childhood friends. He took a position at Heinz, and together they moved to Pittsburgh for the job. They knew they wanted kids someday, but they weren’t in a rush. They delighted in being far from home, doing what childless twenty- and thirty-something couples with means do: eating out at restaurants and zipping off on spur-of-the-moment trips. “I didn’t have a care in the world,” Jamie told me. When they started talking about a baby it was mostly because of her age—she was nearing the zone of the “geriatric pregnancy,” and she thought perhaps they should get moving.
She got pregnant immediately. They were delighted. “We didn’t think anything could go wrong.” Jamie pauses. “It”—the “it” being the possibility of a descent into all-consuming fear—“didn’t even register.”
What did register were the damaging effects of nitrates and the dangers of aspartame. Jamie poured all of her occupational and educational energies into the project of the uber-baby. “I was laser-focused on, like, I wasn’t going to destroy my baby by eating a turkey sandwich! I didn’t even think to worry about anything with like, me.”
It started somewhere in the second trimester. She began to notice herself engaging in strange behaviors, almost as if they were independent of her. She read an article about women who go in for an exam in late pregnancy only to discover that the baby’s heart is not beating, and then have to deliver the stillborn baby. Stillbirth became the terror at the center of her world. She fixated on her son’s kicks, and he never seemed to kick enough. The doctors would tell her he was fine, but she never believed them. My baby is going to be born strangled, with the cord around its neck, she thought. I’m going to give birth to a dead baby. She lay awake at night thinking this over and over, then running through the conversations she would have with doctors if and when it happened. She wondered how she would react. How she would get over it.
Jamie started going into her OB’s office several times a month, and then several times a week, just to listen to her son’s heartbeat. The office employees got to know her so well that a nurse would let her bypass the typical check-in and go straight to an exam room to listen. No one thought to pull her aside and mention anxiety as a potential problem. Nobody said, “This isn’t normal.” Sometimes they would roll their eyes, telling her, “You’re fine, sweetheart! You have a healthy baby, a healthy pregnancy.” It was never enough. Eventually, she bought herself a heartbeat monitor on Amazon in order to listen at home whenever she wanted.
Jamie was constantly collapsing in panic. She had a half iced tea/half lemonade from Subway after a doctor told her caffeine intake really didn’t matter, and then she read on a blog that caffeine was terrible for her baby. She could barely function for days. She adhered to all the rules—not a sip of alcohol or a slice of lunch meat—feeling like that should quell her anxiety. If I can just do everything right. She thought if she executed her pregnancy meticulously, perfectly, obeyed every command from the medical pantheon and every warning on Google, checked and monitored and devoted her total cognitive capacity to her unborn child, she would be okay. But her anxiety reinforced itself, solidifying within her.
Jamie’s pregnancy crept past her due date. The anxiety of those final days was excruciating, and finally she went into the hospital late one night with a concern and they agreed to induce her. They broke her water, gave her an epidural. Unfortunately, it didn’t seem to work: each time she had a contraction, an electric pain flared in her butt and rocketed down her leg to her foot, as if a long bone there was being forcefully broken over and over. They gave her another epidural. It had no effect: the pain ignited with fresh force whenever a contraction kicked up. At one point she screamed, “I’m being electrocuted!”
No one took her seriously. Her baby weighed nine pounds, eleven ounces, and faced the wrong way, bearing down on her sciatic nerve: the longest and largest nerve in the body, running from the lower back down the legs. This was causing the brutal electric jolts, but no one thought to investigate further: “Everyone thought I was just a snowflake.” Her husband told her at one point to settle down.
The baby would not come out. After twelve hours of labor and incandescent pain, she was finally given a C-section. Her baby was born. “The best way I can describe it is: when they took out the baby, they took out my joy. If joy was like a color or a cloud, you would just see it sucked right out of my tummy.”
They handed Jamie her son, and she could not have cared less. She had no energy or emotion. “I was a zombie; I was completely empty.” After coming home from the hospital, she cried constantly. Three or four days postpartum, she called her gynecologist and said, “Something is seriously wrong with me.” The gynecologist said it just sounded like the baby blues but prescribed Zoloft. She said they’d only give Jamie thirty days’ worth, and then Jamie would have to meet with a therapist to get more. “What dose do you want?” the gynecologist asked. “I want all of it,” Jamie said. It took weeks to take effect.
That first month was an experience of breakdown. She was hysterical every day. She was not producing enough milk, but she refused to bottle-feed because she’d read something that insisted it would harm her son’s development. He started losing weight, and Jamie went to the pediatrician’s office over and over. A different doctor saw her for each visit, and during each she sobbed. She sobbed when they weighed him. She sobbed when they checked him for jaundice. She sobbed when they took her milk. Her husband or her mother accompanied her for every appointment, because she would not travel alone with the baby; she was terrified to be by herself with him. What if she got in a car accident? What if she had one of those after-pregnancy strokes, what if she was one of the women who have blood clots after cesareans? Finally her mom asked the doctors, “Do you see a lot of women like this? Crying all the time?” Most of the doctors shrugged. One pediatrician said: “No.”
