Diagnosis

“A well-marked case of pseudo-leprosy or ichthyosis, a scale-like affection of the skin, unsightly, obstinate, but possibly curable, and certainly noninfective. Yes, Mr. Holmes, the coincidence is a remarkable one. But is it coincidence? Are there not subtle forces at work of which we know little? Are we assured that the apprehension from which this young man has no doubt suffered terribly since his exposure to its contagion may not produce a physical effect which simulates that which it fears?”

--from “The Adventure of the Blanched Soldier” in The Case Book of Sherlock Holmes by Sir Arthur Conan Doyle


Hello, my name is Katie, and I am a hypochondriac.

There, I said it. I admit it, okay? It’s not really that I always think I am sick. It’s more that as soon as I have the tiniest, most insignificant unfamiliar symptom, I automatically jump to the worst possible conclusion.

For example, a week or so ago, I felt a mild stinging pain on the back of my left shoulder. I looked at the offending spot in the mirror, and saw a raised bump about the size of a dime. It was the same color as the surrounding skin, with a tiny reddish dot in the middle. All signs pointed to some kind of bite, perhaps from an insect of some kind, or perhaps from a spider.

I tried to just forget about it. Really, I tried. But the thing didn’t go away like an insect bite should. It’s still there. And even though it does not itch or hurt or otherwise bother me, I can’t stop thinking about it.

Maybe it’s a burn because I have some sort of terrible allergy to the detergent I used to wash my pajamas. Maybe it’s some sort of cancerous growth underneath the skin that is going to spread. Maybe it is in fact an insect bite, and the insect is something like bed bugs and my apartment has some sort of infestation I’ll never be rid of. Maybe one of the sites of my mole removals is swelling because I have a mysterious, incurable infection!

All of those things actually entered my brain at some time this week. And while the rational part of my brain knows that none of those explanations make sense, the irrational part of my brain keeps screaming, “But it could be true!”

I wasn’t always like this. In fact, for most of my life, I dealt with injury and illness mostly by ignoring it. I kept most ailments a secret from everyone, because I didn’t want anyone to force me to do anything about them. So, this is a relatively new development. I’ve been thinking a lot today about what made me start obsessing over my health, and to my surprise, I was able to pinpoint the incident.

I blame running. And I blame the internet.

In March of 2009, I went on a 9-mile run. Approximately 4 miles into it, I started to have some pain in my left hip. It really hurt to run uphill, even on the very slight inclines of curbs. Yet, being the dumbass I am, I just kept running. I finished the 9 miles and limped up the stairs to my apartment, telling myself that everything would be fine in the morning.

It wasn’t fine. My hip hurt a lot for a week or so, until I finally went to an injury screening at a local running store. The physical therapist listened to my symptoms and winced as she told me that she thought I had a stress fracture in my hip. As I was my pre-hypochondria self, this did not faze me; I had no idea what a stress fracture was. But then the physical therapist did some tests, moving around my leg and hip, and told me there was a chance that it wasn’t a stress fracture after all, but a bad pull of the psoas muscle.

And this, my friends, is where the trouble started. I was bewildered that the therapist could not tell me exactly what was wrong. Aren’t doctors supposed to have all of the answers? I thought. I must not have told her enough information. I’m sure I could figure out what the real problem is if I knew a little more about the two possible injuries. And with that, I went home and googled “stress fracture,” “hip running injury,” and “psoas.”

I think back on this sequence of events, and I wish I could tell pre-WebMD Katie not to do it. But alas, I cannot stop her. And as you can imagine, it’s been all downhill from there.

Turns out that according to the internet, stress fractures are the worst possible thing that could ever happen to a runner. They bench you for weeks or months. And hip stress fractures are the worst of all, because the hip has a delicate blood supply that can get really messed up if a fracture occurs. Augh! I was going to have a messed up blood supply, I just knew it!

For the next six weeks, I could not stop compulsively looking for more sites about hip stress fractures. I was trying to both convince myself that I had one, and convince myself that I didn’t. Since there was not enough evidence either way, I automatically assumed the worst.

I’ve been like that ever since. I have a really bad headache? Well, it could be the sinus problems that run my family, but it also could be a brain tumor. (The internet says so!) I have some pain in my abdomen? It could be indigestion or a common stomach bug, or it could be appendicitis! (No, really, the internet says the location of my pain is consistent with it!) I have pain in my shins? Well, it could be the incredibly common running injury, shin splints, or it could be (bum bum bum!) a stress fracture! Or, it could be (bum bum BUM!) compartment syndrome, and that can sometimes lead to (ominous noise) amputation of the leg! THE INTERNET SAYS SO! (I had to lie down when I read the amputation thing. I was a hair’s breadth away from passing out.)

There were some isolated incidents prior to my psoas injury (yes, it did turn out to be my psoas) when I leapt to ridiculous medical conclusions. While I was in graduate school, for instance, I pulled a muscle in my neck and eventually convinced myself that I had meningitis. But that time, I went to the doctor and she told me definitively that it was a muscle pull. But now that I realize that sometimes, doctors don’t know for sure what’s going on, no one can convince me that any medical malady is not the worst-case scenario. Even the doctors don’t know for sure!

The doctors don’t know which possibility is the true one. But the internet knows ALL the possibilities! And I have the internet, so clearly I am qualified to diagnose myself.

That bump on my shoulder could be a slow-healing but harmless spider bite. Or it could be a precancerous cyst. I’m not sure which, because I stopped googling it once I read about precancerous cysts.

At least I know when to stop.