A Tough Pill to Swallow

It felt like I was a ghost, floating through the gathered people: friends, family, colleagues, well-wishers … they all had a similar response to seeing me. Women would give me a sympathetic look and then divert their eyes. Men would pat me on the back and squeeze my shoulder reassuringly. Others would mutter a few pre-prepared words of support. I appreciated their presence, the fact that they had all come together to support me, but I could not help but feel frustrated that nobody would take account of what I had been trying to tell them for months. These people had come to say goodbye. The Doc had made his call and that was all that mattered.

It was June 1979, I was twenty-nine years old and it had been a routine checkup. I’d arrived at the GP in good spirits, feeling great. I was young, fit and healthy and did not feel the need to be in the slightest bit concerned. Even the doctor had treated the appointment as of little consequence: a formality, required by my company’s medical insurance scheme. My vitals had been fine. He took my bloods and said that he would telephone me with the results, only if there was something on which to report – which is why my heart sank when the office phone rang, a week later, and I heard his voice on the other end. I greeted him tentatively, hoping for something minor. Perhaps, it would just be an imbalance of sorts. His words were serious and to the point.

“Sir, I’m going to need you to come in as a matter of priority. I’ve picked up something of dire concern. It may yet be a false positive. But, that’s unlikely. I’ll want to run a more conclusive test, to rule it out. Please …”

“What is it, Doc? Cut to the chase! What’s wrong with me?” I interjected.

“Please, just come into my offices. We should talk in person.”

The drive across the city was agonising, as various uneducated possibilities ran through my mind. I’d never had anything worse than the flu. What now? Twenty-five minutes after hanging up the telephone, I found myself sitting across the desk from the Doc.

“Your hematology tests showed me that you have an abnormally high white blood cell count, together with very low reds, which lead me to conduct further tests. The standard suspects were eliminated, so I started testing for the rarer causes. I’m afraid, sir, after having tested for everything else, that I think that you may have Galem’s Disease.”

“What?! That’s ridiculous! I feel fine!”

“As you would do, Sir. I think that I’ve caught it early. You’d not have felt unwell yet.”

“Great! Thank goodness! How do we treat it?”

“We don’t, Sir. I’m afraid that there is no cure. We can only try to make you feel comfortable, maybe delay the inevitable by a few months.”

Was that really it? Was I just to sit back and allow myself to be killed by this thing? According to the professional, there was not much more to it. I was to slowly deteriorate and hopefully manage to get in some good moments before it was all over. He would give me drugs to slow the onset and to ease the pain, when it finally set in. I was told that it would be exponential: that I would feel only slight unease at first, but that the symptoms would accelerate and become worse as the end approached.

I was faced with one particular decision, amongst many. It was whether, or for that matter when, to tell my friends and family. I’d decided to take the path of waiting for my illness to become obvious. Until then, there was really no need to explain anything to anyone. I would live my life as though nothing had happened, making minor tweaks, here and there, to reinforce and repair relationships and to complete unfinished business. Some might be angry, to not have been told, but it was better that way. They would have less time worrying for me and would just have to mourn my passing, without much time to prepare. It was my life and my death. That’s the way that I wanted it and the way that it would be.

However, the plan had not worked. I got drunk one night and confided in my good friend, Carlo, who had thought better of not telling anyone about it. He’d later apologised, saying that he had just wanted me to have the support. But, at the time, I struggled to forgive him for it. I should have known better than to expect anyone, other than myself, to keep such a thing hush-hush. Regardless of blame, Carlo’s news had spread like wildfire in my social circle, so that, before I knew it, I had my sobbing sister, girlfriend, mother and all manner of other people phoning me to find out whether it was true, how I was coping etc. Very fast, I was forced to not only deal with my own, but also the emotions of all those people, close to me, who had found out. It was draining and did not help the situation at all. I wanted to run away to a quiet place, to be alone. But, that would have been selfish. They were involved now, for better or worse. They would need their chance to come to terms.

Through the grapevine, I was able to establish that we were dealing with an outbreak of sorts. I found and made contact with two other sufferers of the disease. On learning of them, I became extremely concerned. How was Galem’s spread? What kind of risk was I posing to my friends and family? Should I have been in quarantine? I approached the Doc with these questions. The man was clearly on top of it. He assured me that, if anything, it was an environmental trigger that was causing the problem and that there was no evidence to suggest that I avoid personal contact. He had notified the health authorities, who were conducting a thorough investigation. I was asked to maintain a level of confidentiality, so as not to cause city-wide panic. Not wanting to be a fox amongst the hens, I did what I was told and kept my mouth shut. He also refused to tell me the names of the other sufferers, claiming doctor-patient confidentiality.

Nonetheless, I did look to make friends with Marlene and James, the two who I had independently established had also been diagnosed with Galem’s. They were both being treated by the Doc, who seemed to be something of an expert on the subject. We had all been asked to remain quiet about there being others suffering from the disease. It was turning out to be less challenging than anticipated, considering that none of the three of us had seemingly infected anyone else. We looked to each other for support and an understanding ear. Sometimes, we just sat together and cried.

James was the first to display symptoms. He woke up one morning with a cough, which, after a week had still not gone away. He then started with headaches and eventually constant nausea. He knew he was going to die and so resigned from his employer, to spend the rest of his days with his wife and three children, in the comfort of his own home. Although Marlene and I had not begun getting sick, James’ sudden decline had seen both of us badly shaken. We now knew what kind of suffering to expect in the near future.

As the weeks passed, paranoia set in. If I woke up tired, I attributed it to the illness. This applied to anything: stiffness, irritation, constipation, headaches etc. But, the symptoms did not become worse and stayed sporadic. I soon started wondering whether these were just normal events … things that I had always occasionally had, but never linked to any underlying cause. I started to wonder why the disease was taking so long. It had been months since the Doc had predicted the onset of regular symptoms and, yet, they had never come! I had exceeded James’ onset by seven weeks and, yet, I still felt quite healthy. Even Marlene, who had been diagnosed within a week of me, had started with a regular cough. I contemplated whether this meant that I would survive the longest.

As my paranoia slowly passed, it became apparent in all those close to me. A bead of sweat on my forehead would draw a worried glance from my receptionist and a nasal sniff would send my mother crying to her room. Reassurances did not work either.

“Really, Matt, I feel just fine.” I’d say to a close friend.

“Okay.” he’d say, his expression betraying that he thought me to just be playing strong.

It had become a most confusing situation. I wondered if, perhaps, I had been deluding myself. Was it possible that my mind could deny reality, to the point where I did not notice things that were there? Could everyone around see me deteriorating, whilst my reflection in the mirror looked back, just as it had months before? After all, the Doc’s expression was growing more solemn on each visit, whilst James and Marlene were on the steady decline. My doses were constantly being upped and he would tell me, on each visit, that the situation was slipping out of control. He ignored my protests of feeling fine and told me that the tests did not lie. He would give me the special medication from Sweden, I would settle accounts at the receptionist and be on my befuddled way, to return the following week for more tests and stronger medication.

Marlene died twenty-two weeks after she had been diagnosed. She had accelerated quickly past James, whose condition had only worsened slightly, to include fever and violent mood swings. I attended her funeral and spoke to her family, who had no idea of my relation to her. I had simply described myself as an old friend. I had to swallow a lump in my throat, as her niece described her last couple of weeks. She had suffered from endless vomiting, weight loss, pounding headaches, delusion and festering lesions all over her skin, amongst other horrible things. She had died a most terrible death. I wondered if I would allow matters to get that far. I went to visit James and told him of Marlene, but spared him the gruesome details. He did not need to know. He was doing badly all on his own.

On my final visit, as I walked into his office, the Doc’s expression said it all. He told me that I’d be lucky to have another four weeks to live. He sold me a month’s supply of his strongest pain medication and told me to go and make peace with all of my loved ones. I popped a handful, because it’s what the Doc had told me to do, and went home to break the news to my family. There was a shocked silence and my mother began to sob hysterically. My sister held her tight, as tears began running down her own cheeks. My older brother said nothing and simply put his hand on my shoulder reassuringly. I felt one of his tears land on my arm. When I looked up, he was looking away, avoiding emotional contact.

The event was organised by my brother. It was a chance for all who knew me to see me for a final time, before I retreated to the mountains to sit, think and eventually die. I was still sure that I felt fine, but had accepted that this was my mind’s coping mechanism. It was the only thing that made sense. The reactions of friends and family must have represented reality, as did the final words of the Doc. I was unsure of what to say to everyone, just as each person was unsure of what to say to me. So, the evening went by very quietly, people standing around, not knowing what to do or where to look. I made sure to say a few token friendly words to everyone, but avoided the obvious topic of my imminent departure. It was clear to all: the elephant in the room. They had already been briefed. As they slowly filed out of my old family home, each would offer another sorrowful look, or pat on the back and usually leave without saying any more. I was glad to have seen them. Now I could face up to the finishing line, satisfied that I had left a clean trail behind me.

Despite my family’s protests, I had taken the old Jag and driven myself up to our mountain cottage. I wanted to be alone at the end. It was well-stocked and had all the comforts. I assured everyone of a daily phone call, so that its absence would tell them when it was all over and when the hearse should be dispatched. My mother’s voice on the other end was always hoarse and quiet. She would say very little, other than “I love you”, just before hanging up. The rest of the family was equally talkative.

I took regular walks and was surprised at my ability to complete even the tougher trails. Mind over matter was clearly something to be taken seriously. Who knew that denial could be such a strong force? Many hours were spent on the tops of hills, looking down into valleys, thinking, meditating and sometimes just throwing stones at random targets. I had begun with anger, sometimes screaming into the wilderness, but had eventually made peace with the fact that I would die. I still struggled with being unsure as to when. Back at the cottage, I wrote lengthy letters to the most important people, sealed them, marked them and left them in a pile that would obviously be found. I did not know when the delusion would stop and the pain would start, but, if it came quickly, I did not want to be unprepared. I did not want to leave important things unsaid. I still felt well and almost wished that my mind would give up with its games. I had prepared myself for the reality. It just needed to present itself to take me away.

After three weeks in the mountains, two weeks beyond my ‘best expected’, I could not take the wait any more. I lit a blazing fire in the hearth and sat down on the shagpile rug with a bottle of whiskey. With each sip, I resigned myself more and more to what I was about to do. I was three-quarters through when I began to feel sick and drowsy. I almost hoped that it was the illness and not the booze, but, I did not care very much, either way. With the final quarter, I washed down an entire bottle of pain medication, lay back and went to sleep. Dreams came for a little while, vivid dreams, but those soon ceased to exist. I’d done it. The pills were in my stomach. It would now all be over.

But, it wasn’t. I woke up the next day, sprawled face-down on the shagpile carpet, drooling and with a beam of light shining through the dirty window and directly into my crusty eyes. My head hurt, my eyes itched, my stomach turned and I was desperately thirsty. As I pushed myself slowly to my feet, I felt every muscle ache. I knew that I wasn’t sick. This was a regular bad hangover: something I’d had on many an occasion before. I stumbled to the bedroom, drew the curtains and collapsed onto the soft bed. It was only after nursing myself for a few hours that I emerged back into the living area and noticed the empty pill bottle on the floor. Again, I was confused. I’d clearly taken enough to kill an ox. Something was very wrong. I staggered to the bathroom and vomited. As I washed my face and looked into the mirror, I was met with my usual hungover face. What the hell was going on? Neither the illness, nor an overdose, had done me in. I needed answers.

I rang my mother, told her that I was fine, went outside and then climbed into the old Jag. I flew down the snaking dirt path, caring little for my own safety. More than once, I had to fight the steering wheel to avoid flying off into the trees. The engine whined in protest, as I slammed the accelerator pedal to the floor, skidding, as the road transitioned from dirt into potholed tar. I was soon on the highway towards the city, dodging between hooting cars and ignoring the angry gestures of their drivers. I cut onto the off-ramp, narrowly avoiding an old lady in a sky-blue Datsun. Skipping two stop signs, I finally screeched to a halt outside of the Doc’s. Even when turned off, the Jag’s engine ticked and hissed, as though complaining about what I’d done to it.

I burst through the front door and found the rooms empty. Looking around, I realised that the place had been recently abandoned. Loose papers lay haphazardly on the floor. Only a sliver of light could be seen shining through a slightly ajar side-door. I heard a throat being cleared. I crept up and looked inside, then pushed the door open and went in. Behind a desk, the only piece of furniture that I had seen since arrival, sat a familiar face, nose down in paper work. It was Captain Davies, from the local police station. He looked up at me, clearly exhausted.

“Come to get your Swedish pills, have you?” he asked from behind his thick black mustache.

“Ummm, yes.” I replied, “Where is the Doc?”

“You’ve been one of a few unlucky victims of an elaborate fraud, by Dr. Phineas Lacebo, Sir. The good news is that you’re probably in perfectly good health.”

I fainted on the spot.

The Doc had scammed over twenty people, from all across the city, having been careful to make sure of the sparse geographical dispersal and ample cash of each. The Captain had no idea of his current whereabouts, only that his “Swedish” sugar pills had pulled him in a fortune over the last few months, with which he had disappeared. I later found out that Galem’s Disease had not affected anyone, outside of a small Amazon forest tribe thirty years prior, and had never spread beyond that small village. For all intents and purposes, the Doc had made it up.

As it turned out, his victims had reacted differently. Most had suffered from the expected symptoms, despite having had no underlying disease. The Doc had made quite sure to inform them of what to expect. Four, including Marlene, had gone beyond the call of duty, suffering additional pains and eventually dying, because their minds had told their bodies that it was the appropriate thing to do. I was one of only three people who had suffered no symptoms. The other two had successfully committed suicide, unlike me.

After hearing the revelation, James had recovered with amazing speed, but had never quite managed to wrap his mind around what a lie and some sugar pills had done to him. A few years later, after having lost touch for a while, he contacted me and we drove out of the city to visit Marlene’s grave. We left some fresh flowers and then went to lunch together at a nearby pub. We never were able to settle on whether it had been the Doc, or Marlene’s own mind, who had caused her death.

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