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  The term hysteria derives from the Greek word for “womb” and is a diagnosis at least as ancient as the case documented on a scroll of Egyptian papyrus in 1990 B.C. describing an affliction of the uterus, which caused irregular movements of the mind and body. Hippocrates traced hysterics to “wandering” wombs, nonconformist wombs, wombs that refused their prescribed role, refused wifedom, motherhood, a life dedicated to the perfection of modern housekeeping and Jell-O salads.

  Diagnoses of hysteria in the Christian era linked the condition to witchcraft and satanic possession, so the association between hysteria and femininity naturally persisted, perpetuated by the witch archetype and by medical science, whose stance generally concurred with Fabre’s. Not surprisingly, in the Hellenistic and medieval eras, anorexia was also often linked to witchcraft, with documented cases suggesting that the onset of the disease stemmed from ritualistic fasting the patient started, but, like a miscast spell, couldn’t stop. In the nineteenth century, medical science shifted to considering anorexia nervosa less as witchcraft than hysteria (although the two are covertly linked), but it was not formally named until Sir William Gull, personal physician to Queen Victoria, published his seminal study Anorexia Nervosa (Apepsia Hysterica, Anorexia Hysterica) in 1873.

  With the rise of the psychoanalytic doctrine of Sigmund Freud, the term conversion was added to hysteria to connote the patient’s conversion of sexual impulse and emotional trauma into physical symptoms. This repressed impulse or trauma might also, according to Freud, convert itself into anorexic behavior. In his 1896 essay “The Aetiology of Hysteria,” Freud suggests that hysteria may be decoupled from female physiology (although later in the essay he qualifies this claim) and linked instead to one’s upbringing, making men susceptible to hysteria and broaching the concept that hysteria could be a social disease—although, as I learned in Women’s Studies 101, in Freud’s practical work, the patient was almost always female.

  Then came feminism to suggest that isolating women from nature and each other, confining us to the kitchen, convincing us we were competitors rather than allies, calling us crazy if we strayed from prescribed roles, had been a ploy of the patriarchy all along. Dora was right to abandon her treatment, many feminist scholars proclaimed; she was right to claim Freud didn’t understand her because she was a woman. Besides, women weren’t more vain, jealous, dependent, or submissive than men, as was argued in Freud’s famous (and somewhat disastrous) lecture on femininity. Nor were they less moral or less loving. Nor did they harbor a collective and poisonous penis envy.

  These complaints fed a movement pointed at reclaiming hysteria, a movement best summed up by theorist Elaine Showalter, who writes of hysteria “as a specifically feminine protolanguage, communicating via the body messages that cannot be verbalized.” But though Showalter’s attempt to take ownership of this protolanguage was mirrored by many other academics, outside the ivory tower the trope of the madwoman, the hysteric, persists. In fact, we’ve dedicated a whole genre of reality television to the schadenfreude of watching her enact her hysteria. In this genre, “real housewives” of various cities wage brutal war against each other, often devolving into shouting matches and physical violence. These women have become celebrities. But they are also cultural laughingstocks, dismissed for their unstable behavior on screen and their obvious addictions to plastic surgery. But what if, like the anorexic, these women are searching for freedom from their bodies? If they can achieve the impossible, if they can cheat time, cheat genetics, they’ll be free.

  Even if the real housewives are more radical, more empathic, than they seem, the cultural response to their “hysterics” was just the response the girls of LeRoy would refuse in 2011, when they insisted their illness had a real source, a physical source. Of course, my mother and I both agreed, the reason for the girls’ illness could be anything. But physical or not, it would always be real. “This is exactly what happened to me when you were a little girl,” Mary said, remembering how she fought for the surgery that saved her life. “No wonder they want there to be a physical reason for their symptoms; it’s the only way anyone will take them seriously.”

  My mother was frustrated that twenty years after her first diagnosis, people were still telling women that their suffering was imagined. But I was frustrated by the girls’ inability to accept their own trauma. “I really don’t think that any of us had that traumatic of a life before,” Katie Krautwurst insisted. But Katie’s mom, Beth, a patient with a facial nerve condition called trigeminal neuralgia, was often in agonizing pain. By the time Katie awoke from her nap in 2011 with her own face in spasm, her mother had undergone a total of thirteen brain surgeries. At the time I wondered how Katie couldn’t see in her body what I did as it ticked and twitched—the depth of her pain; her mother’s illness, the fear and helplessness it had imprinted upon her and the legacy of loss she’d inherited simply by being born a woman.

  Now, though, I think her radical. Her mother, too. I think all the girls of LeRoy, in insisting they be heard, in insisting they not be passed off as crazy, were radical, even as I think them subject to that unspoken legacy. I know my daughter, the mothers insisted. She’s happy. Not damaged, not bad, not malingering or rotten on the inside, like today’s real housewives, or the instigator of the Salem trials, at least in Arthur Miller’s version. In The Crucible, one of literature’s most popular explorations of female hysteria—and one cited an awful lot in relationship to the LeRoy girls—conversion disorder is presented as a revelation of women’s true nature when left in the pressure cooker of oppressive culture for too long. The girls in Salem easily turn feral in Miller’s play, accusing each other wildly to save themselves. And at the root of it all? A man. Abigail Williams, obsessed with the already-married John Proctor, incites mass hysteria and hangs half the town, all in an effort to take him for herself. The other girls follow along like lambs. So no wonder the girls of LeRoy resisted their diagnosis: to accept it would only take their story from them, cast them in the same mold as the Salem girls, brainless and boy crazy, in need of masculine rationalism to diagnose and cure them. Rather, they wanted to be seen for what they were; they wanted to be believed on their own terms.

  25

  Autumn. Leaves falling, rattling as they blew. This was my first Thanksgiving in years spent with my mother, and we were joined by Judy and a slew of other family friends. I’d spent the last holiday alone in my dorm room, eating ramen noodles, the nutritional content of which I knew exactly. What did I give thanks to then? Freedom to stand at the microwave and count, to know exactly how many calories I consumed. Just a year before, that had seemed more important than being around people or feeling wanted and loved. I was self-conscious about my problem, which was obvious, visible in my bony body, which ticked and twitched at the height of my illness, the height of my silence, with everything I wanted to confess but couldn’t yet articulate.

  So here I was, a year later, in recovery, wearing the winter jacket Mary had bought me, stepping off the train in Connecticut and wheeling my suitcase toward the beams of her headlights. “Don’t you look pretty,” she said when I got in. We leaned across the gear stick to kiss each other’s cheeks.

  “Let’s park for a minute,” she said.

  “What’s wrong?” I asked, already bracing myself against the familiar sense of disappointment and loss rising up inside me.

  “Well, it’s about the CT scan I had the other day?”

  I nodded, already knowing.

  “The tumors,” she said, “they’re back.”

  For a moment I didn’t speak, just searched her face for how she might be feeling. “How can this be happening?” I finally managed. It had been only a year and a half since her surgery.

  “I don’t know,” she said, and we were quiet again, stretched across the console of her car to hug, unable to get close enough. “But I just got you back,” I said, starting to cry.

  “We’ll figure something out,” she said into my shoulder, “we’ll fix
it.”

  I didn’t ask how. Just lingered close to her warm body, unwilling to let go first. But there were people waiting at the house, and she broke away.

  A week later, we went to the specialist together, carrying binders of bloodwork and medical records. The office was on the Upper East Side, the surgeon inside it white-haired and small. Mary had fought for a referral to see him, and he sat across a cluttered mahogany desk from us, shuffling paperwork and sighing as if our presence exhausted him. When he unearthed her charts, he examined them, saying nothing, and I thought nothing, not knowing to be afraid; my mother’s voice had been so sure that night at the train station. We’ll fix it, she had said.

  “These aren’t operable,” the surgeon finally said. “It’s too risky.”

  Mary leaned forward. “There’s nothing we can do?”

  He shrugged. “I’ve seen worse,” he said. “I’ve seen tumors like this go on without growth for years.” We must have looked hopeful, because he held out his hand. “Judging by this chart, though,” he said, “I’d give you three years.”

  “Three years until what?” I asked, looking at my mother, who was looking at him. Nobody answered.

  We left the office in a blur, and she began to walk downtown, but I caught her arm and said, “Hold on a minute. Let’s just take a breath here.” We faced each other. We hugged. “Fuck him,” she said.

  With surgery off the table, Mary chose a course of chemotherapy suspected, but not proven, to shrink neuroendocrine tumors like hers. I would spend winter break in Connecticut, we decided. I would give her the daily shot.

  On a Friday afternoon, sitting in an empty chemotherapy infusion room just before the office closed, we were shown how the shot was administered. The sky outside was already dark blue, the color of despair. But we were optimistic. It was the only bearable response.

  A blond nurse rushed in with a pillow and a syringe. “Look,” she said, demonstrating with quick efficiency how to pull from the vial and clear air bubbles, before poking the needle unceremoniously into the pillow’s bulk. When she leaned in to trace exactly where on my mother’s thigh I’d inject the drugs, I could see the spots where lipstick had stuck to her dry, flaking lips. Maybe I was imagining it, but up close the nurse seemed warmer, maternal but firm, toward both Mary and me. She could see we were both childlike around the needle. She guided our hands over the pillow prop with careful patience, demonstrating how to hold the syringe, how to shoot the trigger. “Not so bad,” I said when we were done, emboldened by the nurse’s lesson. I looked at my mother, who looked back, worried. Eventually I’d have to return to school, and she’d have to give the shot to herself. The importance of this self-reliance was stressed by our teacher-nurse. “It’s really not hard,” she said, and we agreed obediently, unwilling to say what we both were thinking: the shot was poison, but it was poison my mother needed to live. At home Mary wrestled with her fear of the venomous chemicals, sitting on the edge of her bed and holding the syringe over her leg. Her breath would shorten. “I just can’t do it,” she’d gasp, fear fuzzing the edges of her voice.

  Eventually she opted for a less invasive regime, given weekly at her oncologist’s office. “It’s just not worth the torture,” she said.

  Friday afternoons I came in from the city to sit with her in side-by-side chemo-ward armchairs, surrounded by gray bodies hooked to infusions, and the nurses who circulated with snack bags and juice boxes, little plastic cups of red Jell-O. Then we’d go into a small room, and she’d bend over an exam table with her pants around her ankles, holding my hand and making bad jokes while a nurse pushed a long needle into the bruised skin of her ass. Each time I watched this process, I felt the contorted pain on my mother’s face in my own body. It lodged beneath my breastbone, a dull breathlessness. But the sensation passed quickly. She was always resilient. She’d stand, give herself a little shake, and smile. “Glad that’s over,” she’d say.

  Months and then a year passed quickly. My mother traveled—trips to Guatemala, Morocco, and Spain, where she sat with her sketchbook, always surrounded by crowds of children, angling to get a look. I graduated, got a job. Mary gave me a puppy, and he grew. The tumors did not. “I made a deal with them,” she said. “What was your deal?” I asked. She ignored the question, and I didn’t push. I wanted to believe it was possible to barter for her survival.

  When she began to limp, wincing with each step, her pain took up residence in my body, too. For her it was raw nerve, slipped disks, not cancer but the sensation of constant sciatica. For me it was the pain of preemptive grief, a pain I’d live with for years to come. But, we were assured by a new team of doctors, the back was fixable. “We’ll cut here,” the lead surgeon said, holding his pen like a pointer to show us how he’d make two incisions, peel the skin back and fuse what he found broken. Mary nodded. She was eager for mobility, and freedom. “I have places to go,” she said, and I thought of her, four years before, lying like a husk of herself in the hospital bed, hopped up on painkillers and telling me she wanted me to know that she’d never do that again. I just want you to know this, she had said. It’s important you know this. She was crying, and the artificial lights above her bed made the tears crease her face like laugh lines.

  Now she was adamant. The pain was too great, the back must be mended. So she scheduled the operation for January, and I quit my job and moved into her attic to serve as caretaker during the months of recovery the surgery required. “Are you sure about this?” she kept asking. I was sure. Something had shifted. I wanted to stabilize, to release the compulsions that had kept me from her side. My mother had protected me by urging me into recovery. Now I wanted to protect her.

  It snowed. The surgeon cut. Mary’s friend, my beloved “unkie” Richard, arrived, and we sat together in the waiting room, which emptied as the hours passed, first six, then eight, then twelve. It was after midnight when we were allowed to see her, covered in Betadine stains and pallid yellow bruises. “She looks like she’s had the shit beat out of her,” Richard said, and I thought about seeing her after the liver resection three years before, how she looked like she’d been skinned, segmented, and pieced back together. Now, having been cut to the bone, she looked worse than before.

  She woke the next morning angry and confused, then drifted away again. She clicked the Call button by her side to summon nurses she then eyed with suspicion. “They’re poisoning me,” she said conspiratorially, as if she knew she could trust me to understand her paranoia, her fear of being silenced. But I wasn’t yet ready to bear her helplessness. I wasn’t yet ready to assume the mother role. I guessed it was the drugs, removing my mother from herself, ferrying her into darkness. But what if it wasn’t? I needed her to tell me, and because she couldn’t, I brushed her off, packed up my things, and left for the night.

  Later, after I’d gone to her house and walked her dogs, made myself soup and gone to bed, she called. I felt the phone buzzing from underneath my pillow where I’d tucked it, close enough to wake me should an emergency arise. “Mom,” I said, sitting up in bed, “what’s wrong?”

  “It’s in my IV,” she said unceremoniously.

  “What is?” I asked her.

  “Strychnine,” she whispered matter-of-factly. I felt myself spring from the residue of a dream, as she had each time I went to her as a child, frightened by a nightmare and unable to return to sleep. I pictured Midge in her housecoat, reaching for her daughter, my mother, begging Hide me as the ambulance approached. I wanted to take my mother seriously, to hear her fears, her voice. So I called the nurse’s station on her floor and explained that my mother wasn’t feeling well. “She’s expressed concerns,” I told the first nurse I spoke to, whose voice was thick with sleep and annoyance. She’d look into it, she said. I hit Redial repeatedly, talked to whoever I could. I knew I was getting a reputation on the floor, one to match my mother’s. I wanted to tell each person I spoke to, each pink-scrubbed nurse at the desk, the story of the last time my mother saw her mot
her. I wanted to tell them that it played in my head, an endless reel of regret that colored Mary’s life. This is why, I wanted to say. This explains it all. But instead I compulsively apologized, said sorry like a tic, verbal evidence of my girlhood.

  It was cold and quiet and lonely on her floor, which seemed, unlike the cancer ward we’d grown used to, abandoned. Days passed, and then a week. She woke from her opiate dream from time to time, long enough to pick out the cute nurse and call me to report his shift times. “McDreamy is on tonight,” she’d say, and I’d smile in the mirror before I left the house because she was getting better.

  We giggled each time McDreamy rushed past her room, a blur in his blue scrubs. When he came inside to do vitals or check Mary’s IV, she batted her eyelashes, and I asked questions about what the ticking orange numbers illuminated on the screen above her bed meant, what they promised. She was often happy when I left, clearheaded and content, but would call me later, after I’d gone home and she’d fallen asleep and awoken again. I’d look at the clock. Listen to her complain. “Let’s face it,” she said once, “I’m all alone.” I could hear the morphine in her voice.

  “Not true,” I said. “Don’t say that.”

  She sounded angry. “But I am,” she insisted. “I am I am I am entirely alone.”