**Housekeeping** — I’ve decided to give myself a bit of breathing space for a while by dialling down my Substack offering to fortnightly rather than weekly essays (scroll for the full expliqué). If you’re new here and DESPERATE for more, my entire archive is free and unpaywalled.
The news that Kate Middleton has been diagnosed with cancer comes as a shock to hypochondriacs everywhere. To lots of other people too, of course, not least Kate herself, and her family, and the general public, and all those now feeling sheepish after weeks of speculation as to her whereabouts. But I’m thinking in this post of the chronically health anxious: those for whom the news of someone else’s diagnosis triggers dark clouds of worry, a deep-seated mistrust of their own bodies and bouts of frantic symptom-checking.
It feels to me like people in positions of power and influence are announcing their cancer diagnoses with frightening regularity. This could just be confirmation bias, because news stories of this nature have a horrible sort of magnetism for me. It could also be because people are increasingly open about such things in a spirit of solidarity and awareness-raising. Or it could be because there are genuinely more people getting cancer these days, which unfortunately is not solely a figment of my fearful imagination: the other news stories I find horribly magnetic are the ones about rising rates of cancer in younger people. It seems that millennials can add ‘less likely than their parents to make it through middle age in good health’ to their list of generational woes. And even royalty, with all their unearned advantages, aren’t immune.
The scary thing about this sort of news is the reminder that cancer strikes wherever it pleases, undeterred by the usual cushions of wealth and apparent health. The fact that Kate is protected from many of the stresses that plague us plebs and will be supported throughout her illness by privileges that shouldn’t actually be privileges — accessible and consistent medical treatment, unlimited help with childcare, the ability to stop work for as long as necessary without fear of financial repercussions — doesn’t change the brute fact that she is as subject to the unfathomable whims of her body as everyone else.
In her recent post ‘the kingdom of illness’,
quotes Susan Sontag’s book Illness as Metaphor:Everyone who is born holds dual citizenship in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.
I’d heard these words before and forgotten about them, but I’m incapable of forgetting the sentiment. The ‘bad passport’ burns a hole in a hypochondriac’s pocket. We’re always aware of it and of the fact it will one day have to be used — so why not next year? Why not today?
You hear of people diagnosed with serious illnesses wondering: why me? I wonder: why not me? The first time I read David Nicholls’ modern classic One Day, I was floored by a sentence towards the end, about two thirty-eight year olds: They expected to stay healthy for a little while yet. It was a revelation, actually. Was this how other people’s minds worked? The expectation of good health, as opposed to wondering how on earth you’d managed to make it this far without something going horribly wrong?
I have friends who claim to have been cured of their own health anxiety by having had to deal with actual health problems, whether their own or those of people close to them. I know my health anxiety is fear of the unknown, at least in part, which also makes it a skewed kind of privilege. I’m lucky enough to have almost always got around on my good passport, but I know that luck will run out one day. I don’t want it to. I don’t want to lose my privilege. Who does?
The other day I saw a guy on an electric scooter weaving recklessly in and out of traffic, and thought: wow, he thinks he’s immortal. The preciousness of existence is presumably not foremost in the minds of people who behave in this way, or who, say, practise free solo climbing, or take a lot of cocaine. And it occurred to me that health anxiety is really just a misdirected love of life. It’s rooted in a profound, visceral understanding that life and health are fragile miracles and should not be taken for granted. It’s something lovely gone bad, like rotten fruit. Death and decay exist at the heart of life; fear of death and decay exists at the heart of enjoying that life.
The conundrum, of course, is how to prevent this appreciation for one’s existence from mutating into its ugly alter-ego and thus, ironically, making that existence extremely difficult to enjoy. In recent years I’ve mounted a three-pronged attack on my health anxiety. The first: cognitive behavioural therapy. The second: meditating (inconsistently, yes, but the hours add up). The third: a dose of magic mushrooms. None have been a miracle cure, but I think they’ve contributed, collectively, to a period of personal growth that has blunted hypochondria’s sharp edges.
What I really want, though, is to get right to the heart of the matter and stop being afraid of death. It’s quite a big project. I’m working on it.
In the meantime, I’m no royalist, but I really hope Kate Middleton gets well soon.
‘Til next time,
Kx
**Housekeeping cont.** — The hawk-eyed among you might have noticed I didn’t post last week. Apart from planned breaks, it was the first Sunday I hadn’t published an essay since I joined Substack in September. I’d taken the preceding week off work to focus on writing and was planning to devote some quality time to my novel, but in the event a new writing project dropped into my lap from some unknown place and said ‘write ME!’ I’d be annoyed with my own fickleness and lack of discipline but for the fact it has been all-consuming and feels, in many ways, like what I’m supposed to be writing right now. Sometimes you have to follow your intuition, even when it derails your plans. On a practical level, though, I’ve accumulated an entirely ridiculous number of creative projects for a person who also has a full time day job, hence my decision to scale things back on Substack for a little while. Normal service may well resume once I’ve got this other thing out of my system, but in the meantime your inboxes will thank me, I’m sure.
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I think one way of approaching the idea of death is the Eastern view that sleep is a small death and death is a big sleep. Or Yogananda's view: death is Nature's way of telling you to slow down. I don't mean to seem to trivilalise our concerns, but there's no doubt in my mind that worrying about illness and death is bad for our health.
Very good to have you back!