PERSONAL ESSAY: “How She Suffered,” by Sarah Orman

Illustration by Maura Walsh / Black Nail Studio.

PERSONAL ESSAY
How She Suffered
By Sara Orman

In fifth grade, I was the new kid in school, an outsider, teased by other girls for my unusual height. It didn’t help when our class read the novel that won the Newbery Award that year: Sarah, Plain and Tall. In bed at night, I would bring myself to tears, recalling the day’s indignities. Inspired by Tom Sawyer, I would imagine that I could attend my own funeral, where my callous classmates would weep over how they’d mistreated me.

“Poor Sarah!” they would say. “If only we’d known how she suffered!” One night, my sadness led to action. I had seen an episode of Magnum P.I. in which a blonde woman emptied the powdery contents of a handful of capsules into a tub of vanilla ice cream, then tearfully spooned the ice cream into her mouth as the credits rolled to “Rich Girl” by Hall & Oates. When I reached for a bottle of pills on my mother’s side of my parents’ bathroom cabinet, I didn’t know what the pills were for. I only knew that taking a lot of pills was something a person could do to stop hurting. I poured all the pills into my hand, swallowed them, and went to bed.

The next morning my pee came out bright red. Surprised, I ran to tell my parents that I’d gotten my period. They followed me into the bathroom where I showed them the toilet bowl filled with neon liquid.

Since everything I knew about menstruation came from Are You There, God? It’s Me, Margaret, I assumed my mother would go straight to the store to buy me a pink sanitary belt, like Margaret’s mother. It was 1987. I didn’t know about advances in feminine hygiene since Judy Blume’s 1970 novel.

“Sarah,” asked my dad, “did you take Mommy’s bladder infection medicine?”

“No,” I lied.

My parents looked at me with concern but did not press, and we went on about our day. I was lucky; technicolor pee was the only side effect.

Eventually, I stopped towering over boys and started dating them. Thirteen years later, I was 23 and living in Madison, Wisconsin, with my boyfriend, Hans, who was in his thirties. In the spring of my second year in grad school, we flew to Tucson for a weekend of hiking with Hans’s best friend, Dave. It was supposed to be a relaxing break from our normal life, in which I studied Russian literature, Hans built bookshelves, and we were both beginning to question our relationship.

Dave did not try to hide the fact that he would have preferred a guys’ weekend. Not that he said this out loud. He was a gracious host, setting up the foldout couch in his one-bedroom apartment and gesturing, without eye contact, at the single bathroom that the three of us would share. But I could sense his disappointment. I wasn’t in bad shape, but Dave correctly assumed that I would not be as strong a hiker as my fitness-obsessed boyfriend. Like Hans, Dave was in his mid-thirties, but unlike my boyfriend he’d stayed in school and gotten married. Now he was a recently divorced surgeon. On our first night together, he stared into his beer and said: “All I do is work and hike.”

The next morning, we left for a two-night camping trip in the mountains above Saguaro National Park. The cool morning air quickly burned off, and the day reached a heat that I hadn’t experienced since my childhood in Texas. My back was bothering me, but I figured it was PMS, exacerbated by my heavy backpack. I said nothing about my discomfort. I tried to ignore the knot of pain in my lower back and kept my eyes on my hiking boots, zigging and zagging on increasingly steep switchbacks. We walked mostly in silence. Hans—a stern, Germanic type on his best days—was even more dour than usual, perhaps self-conscious about bringing me along. Normally, I would have rejected the idea of putting on a fake smile just to please a man. But on that day I smiled and laughed more than felt natural, eager to counteract my two companions, whom I’d dubbed in my head “the brothers grim.”

We hiked for hours, barely stopping long enough to take in the gorgeous view. I tried to keep up as we hiked through sunset, grateful that my long legs gave me a fighting chance. That night, in a thin sleeping bag on rocky ground, I could not find a position that would relieve the tightness in my back. My skin crawled with fever. By the time daylight crept in through the flimsy walls of our borrowed tent, I had not slept and could not stop myself from writhing and moaning, though I tried to keep it down. Finally, Hans woke Dave, who quickly diagnosed the problem.

“I can’t believe you hiked seven miles up a mountain with pyelonephritis!” he said.

It was the only time I saw him smile.

Somehow, we made it down the mountain and to the nearest emergency room. It’s unlikely that Hans or Dave carried me and my backpack all the way down the mountain. But I can’t remember. I only know what transpired inside my body after realizing that I was too sick to go on with our weekend plans: pain, fever, exhaustion, alternating waves of embarrassment and relief. When we arrived at the hospital, which was also Dave’s workplace, he stayed long enough to check us in and then disappeared, wondering out loud whether he had time to make it up the mountain and back again before his next shift.

I was admitted to a makeshift cubicle with four cloth walls—a tent I was much happier to be inside. Stretching out on the cot, I felt like I hadn’t laid down in days. I closed my eyes and let my mind drift as I waited for the doctor. Behind the scrim that separated me from my neighbors, female voices conversed softly in an unfamiliar language. The nurse told me that they were speaking the language of a local tribe. I thought of a story my mother told me. After she gave birth to me, my mother was placed in a bed in the maternity ward next to a woman whose baby had died. The two beds were separated only by a curtain. My mother, whose labor was completely normal, could hear the other woman sobbing. As I listened to the comforting sound of women’s voices behind the scrim, I imagined how my mother must have wanted to erase herself, to shield her joy from the grieving woman on the other side.

When the doctor finally arrived, he told me that I had a high pain tolerance and should pay more attention the next time my back hurt. I felt special, as if “high pain tolerance” were a badge of honor. I took his words less as the warning he intended, more as an indication of what my body could do.

Back in Madison, Hans and I tried couple’s counseling at a sliding-scale clinic. Our counselor was a woman named Rebecca with softly waving brown hair and peacock feather earrings. I instantly loved her. When she asked about my childhood, I told her about the time I swallowed a bottle of prescription pills and thought I’d gotten my period. I meant to make her laugh: silly Sarah, the girl who thinks life is just like a novel. But Rebecca didn’t laugh. She asked if my parents had done anything after this event, which she called a “red flag.” I said no. We talked a little more, and Rebecca taught me the word “somatize,” which means to manifest psychological distress through physical symptoms. I said it reminded me of soma, the fictitious drug in Aldous Huxley’s Brave New World. And then we moved on to the real purpose of our meeting, which was to salvage a doomed relationship. I never talked to Rebecca about the pills again. But after that day, I no longer told the story of my attempted suicide as a joke.

After grad school, I moved to New York for a new boyfriend, Adam. I’d only been in the city for a few weeks when my back started to hurt like it had in Tucson. We looked in the yellow pages for doctors who didn’t require insurance and found one in Brooklyn, a few subway stops from where we lived. I can’t remember the name of the neighborhood, which is typical. I was forever trailing behind Adam back then, dodging other pedestrians on crowded sidewalks, jumping in and out of trains and buses. I never quite knew where I was.

We arrived at the address at the appointed time, and I stood on the sidewalk to catch my breath, staring up at the doctor’s name on a plaque on the brick wall. I had expected a clinic, but this was a basement apartment. I felt uneasy. Adam rang the buzzer, and the door opened just wide enough for the head of an ancient man to poke out, whisps of white hair flying up from his scalp. He scowled at us like Billy Crystal in The Princess Bride; I half expected him to tell us he didn’t want what we were selling. Then Adam reminded him that we’d called, and the doctor beckoned us in.

Inside, the doctor led us to the kitchen and indicated that I should hop up on the narrow counter, which I did. As I lay on my back, the doctor’s cold, bony fingers probing my pelvis, I distracted myself by wondering what was going on behind my boyfriend’s furrowed brow. Warm, funny, Jewish Adam couldn’t have been more different from Hans. But he was not smiling here. He looked like a man in a mechanic’s shop, waiting to hear if his car is a lemon. I feared the doctor’s conclusion: “I’m sorry sir, but your shiksa is kaput!”

Finally, the doctor completed his inspection and gestured for me to get down. As I stood there adjusting my skirt, he took out a notepad, wrote out a prescription for antibiotics, and muttered something about avoiding rough sex. Adam paid the bill. We stepped out into the sunshine, and I resumed my usual practice of trying to keep up with my boyfriend as we barreled down unfamiliar streets. I almost didn’t care about the burning sensation in my back. I was eager to get far away from the doctor’s fingers.

Both the doctor in Arizona and the doctor in Brooklyn had looked incredulous when I said that my kidney infection came out of nowhere. I hadn’t had a urinary tract or bladder infection; the pain simply flared up after one day of needing to pee more often than usual. Evidently, my urinary tract was a bacterial super-highway. When the doctors said germs could enter my body during sex, I imagined a gang of germ bikers on microscopic Harleys, squiggly clouds of dirt surrounding them, like Pig-Pen in Peanuts. I saw this filthy crew bust through the general vicinity of my urethra and blaze to my kidney on the Autobahn of infection, my body temperature rising as the contagion spread.

Each time I saw a doctor about a kidney infection, I wanted to share the story about how I’d taken all my mother’s medicine. By my mid-twenties, I had been prescribed the same medication. I knew its name, Pyridium, and was familiar with the little red pills as a helpful analgesic that relieved painful urination. Could I have swallowed so many pills that I’d permanently numbed my entire urinary system? I was too embarrassed to give voice to this idea. It sounded insane. But I kept thinking about it.

In 2003, Adam and I moved to San Francisco, where I’d gotten into a decent law school. My master’s degree in Russian literature did not suggest a legal career. Even my lawyer father predicted that law school would not bring me happiness. But by that time, I’d been wandering restlessly for years, from relationship to relationship, state to state, paycheck to paycheck. A stable salary and health insurance sounded pretty sexy. I was offended by my father’s advice, which I interpreted as a lack of faith in my abilities.

The fall of my second year was the frenzied season when big law firms would come to campus to interview students for summer jobs. The firms would seduce their summer associates with light workloads and fancy meals. After graduation, an associate was all but guaranteed a six-figure salary and a partner-track position. I applied to several firms, but none of them invited me to interview. On the first day of on-campus interviews, the sight of my classmates in their identical black pantsuits made me nauseous. I finished my classes and went back to our apartment in the Mission. The next thing I remember, I woke up in bed next to Adam, soaked in sweat, a familiar pain stabbing my lower back like a sharp rock.

We went to the clinic at school, where a young person at the front desk took my temperature and left. We waited for what felt like an hour. I was shivering and sweating, burning up but freezing. Finally, a medical professional arrived and examined me. We heard him admonish his assistant: “She has a fever of 104. She needs to go to the hospital right away.” We were afraid of what an ambulance might cost on my student insurance plan, so we took a cab to the nearest emergency room, at a private hospital in Nob Hill.

Later, after this story had taken its place under the “in sickness” clause of our marriage vows, Adam and I would marvel at the minor miracle of his remembering to grab the New York Times as we left our apartment that hectic morning. He read the entire newspaper to me while I lay waiting on cots, first in a busy corridor of the E.R., then in a small exam room. He started with the book section, for me. Then he turned to his favorite: the sports section, in which, for no particular reason that we can recall, a journalist had written his regular column in the voice of Howard Cosell. I lay trembling with fever while Adam sat beside me and executed a perfect Cosell Brooklynese. We kept having to stop, either because Adam made himself giggle or because my laughter made me gasp in pain.

From time to time, a nurse came in to check on me and tell me to marry Adam. I wish I’d been lucid. I lost count of how many times they said, “He’s a keeper!”

I was admitted to the hospital late in the afternoon, but moving from a cot to a bed was not much of an improvement. My body shivered with cold beneath thin hospital blankets, but my back was on fire. My jaw ached but I couldn’t stop my teeth from chattering. I heard moans coming from me as though from a person in the next room. Adam jittered on a chair next to me, helpless to stop my suffering as the sky outside the window darkened, nursing shifts changed, and the hospital settled into night. The hours crept by in sameness, broken only by Adam’s excursions to the nurse’s station for blankets and attention. It was almost the next day when a nurse arrived with a new IV packet she said contained morphine.

Morphine reminded me of To Kill a Mockingbird. I thought of Mrs. Dubose, the old woman who weans herself from addiction and whom Atticus Finch calls “the bravest person I ever knew.” I was not much older than Scout Finch when I read To Kill a Mockingbird at my father’s urging. Mrs. Dubose had scared me; I remembered the old woman in withdrawal, her mouth opening and closing “like a clam hole at low tide.” Morphine still scared me. But I was in no position to turn it down. The nurse did her job quickly and left. The drug hit the base of my neck with a coldness like ice in my veins, and then it turned warm, climbing down my vertebrae and spreading through my whole body, loosening muscles that I hadn’t realized were clenched. My teeth finally stopped chattering. I slept.

The next morning, the daytime nurse said that I had been the sickest person on the floor last night and should have received more attention. In my memory, that nurse was a man. But was he really, or is my memory making him a man, like Dave in Tucson, because I wanted a man to see my grit?

Now that I was stable, Adam took short trips home to check on our cats. I stayed in bed. The view from our hospital room window was spectacular. I had never seen sunsets like that in San Francisco, where fog envelopes the sky on most afternoons. This was before smartphones. Once my pain was managed, my veins flowing with antibiotics, I had nothing to do but think. Time slowed down, three days stretching out like the pink and orange clouds that I could see from my bed. Aside from Adam, nothing from the outside world reached me. My disappointment over on-campus interviews, my classmates in their polyester pantsuits—all of that nonsense faded. I remembered that I’d wanted to be a lawyer to feel safe, not to get rich. I decided that I didn’t need a big firm job after all.

I had a CAT scan before leaving the hospital. The doctors found some scarring from my previous infections but nothing that could explain why my kidneys kept getting infected. Their solution was a low-level antibiotic that I was supposed to take after sexual intercourse. The antibiotics worked—I never got another kidney infection. But I had terrible stomach aches for years, and there was a more insidious side effect: every time I took a pill, I thought of my kidney troubles, which reminded me that I was, at my core, a dirty girl. This invisible shame festered in the early years of my marriage.

The next time I saw the inside of a hospital, I was there to give birth. When the labor pains started, I was surprised to recognize the knot of pain in my lower back, between my hips. I won’t write that I welcomed the pain like an old friend. But there was gratitude—I remember that. I remember thinking, I can live through this. I labored all night, and Adam was a true partner: rubbing my back, feeding me ice chips, massaging my shoulders. He never flinched, not even when I emptied my bowels on the bed—an event that did not seem to surprise anyone in the delivery room besides me. I was glad that I’d listened to the nurses and married a keeper.

The bills from my hospital stay in San Francisco arrived in the mail for years, following me from San Francisco to Austin, where Adam and I moved to be closer to my family after the birth of our son. Miraculously, my student health insurance plan paid for everything. The total cost added up to the equivalent of a fourth year of law school, which I found perversely pleasing. It took three years to learn the law, but without those three days in the hospital, I might not have figured out what kind of lawyer I wanted to be. Poetically, the two experiences were the same.

Years passed. We had another child, bought a house—the “full catastrophe” according to a line from Zorba the Greek that my dad loves to quote. Adam opened an Italian restaurant, and I worked as a staff attorney at an education nonprofit. I stayed home with the kids on nights when Adam worked. After work, to relax, I drank a glass of wine while I cooked dinner. Or at least that is what I told myself. In reality, I drank multiple glasses of wine while cooking, and then more wine with dinner, which I often could not taste, and sometimes even more wine after putting the kids to bed.

Alcohol was a regular feature of my twenties, but I was not known for drinking too much or getting drunk. In my late thirties and forties, weighted down with work and family responsibilities, I began to drink more and differently. I drank quickly, furtively, beyond and outside of social gatherings. I drank before meeting friends for drinks. I drank before going out to dinner. I drank to mute the voices that crowded our small house every evening, to make me forget that I was barefoot in the kitchen again, roasting a chicken or assembling homemade lasagna for two children who would have been thrilled to eat boxed mac and cheese in front of the TV. I drank because I felt trapped. I couldn’t wrap my head around how I’d become so domesticated, so different from the adventurous girl I used to be. I loved my family, but at some point I convinced myself that all they needed was my body in the house. Alcohol provided a temporary mental escape. Once I felt the first hint of a buzz, I was both there and not there.

I didn’t hide my drinking from Adam. He brought home wine from his restaurant whenever I asked him; he saw how quickly it ran out. He told me once, in the lockdown summer of 2020, that I was drinking too much, and we never talked about it again. He says now that he felt helpless. I didn’t believe that I could ask him for help. I wrote about drinking in my journal, but I told no one that I was struggling.

On the nights when I drank too much—the one or two glasses I had intended somehow turning into a bottle or more, I fell asleep quickly after putting the kids to bed but would startle myself awake a few hours later, metabolized sugars coursing through my veins alongside the guilt. I tried progesterone, melatonin, CBD, and Tylenol PM. My old fear of Mrs. Dubose and her clam mouth kept me from taking anything stronger. I lay awake on those nights like I had when I was in fifth grade, except that now I didn’t imagine cruel classmates crying when they realized how I’d suffered. I had learned something along the way to becoming a woman. Now, I wanted to hide my pain.

On mornings after the bad nights, I felt sick, depressed, unable to work. I wanted to wallow in my hangover, but I never did. I would not give in to feeling sick and exhausted. I pictured my husband finding me wrapped up in a blanket on the couch—or my son, which was even worse—and I willed myself to get up and work through the pain. No one, I believed, could possibly love me if they saw me like that.

All this time, I rarely thought about my kidney infections. They seemed like a relic of my old life, before career, marriage, and kids. Then one day in 2022 I read an essay by a friend about pain. She suffered from chronic endometriosis, and once she’d had an emergency appendectomy. But during both incidents, even when the pain was severe, she had never stopped going to work, picking up her young daughter, loading heavy grocery bags into her car. I noticed my friend’s militaristic language: “I kept soldiering on,” “I figured I could tough it out,” “I powered through.” Her essay reminded me of my kidney infections.

The next day, I sat down at my kitchen table and wrote about my kidney infections for ten pages without stopping. The afternoon sun shone through the windows across from me, illuminating my notebook and warming my hand. When I reached an end, I felt satisfied and sort of empty. I poured myself a glass of wine, and the evening took its course.

Less than a week later, I woke up at 3:00 a.m., hungover and miserable again. It was the week after Thanksgiving, the holiday season providing even more excuses than usual to drink to excess, but I couldn’t blame holiday spirit for this feeling. It was my usual 3:00 a.m. state of unrest. As I lay in my bed, careful not to disturb Adam, I thought about what I’d written.

I remembered how I’d wanted to impress all those doctors with my ability to tolerate pain. I thought about how I’d tried to impress my father by becoming a lawyer. I realized that there was a pattern. I was doing the same thing I’d done at other times in my life: suffering in silence. I was biting the bullet, soldiering on like my friend, through night after night of misery, rather than admit that I had a problem and needed help. All because of a story that I had told myself about men not wanting to see a woman in pain.

I wasn’t raised in a family like my husband’s, in which illness is looked upon as an interesting puzzle: something to be examined, considered from all angles, and eventually solved. My parents, especially my father, didn’t seem to believe in people getting sick. Poor health was something to be conquered by the force of positive thinking. Talking openly about one’s body was a sign of poor manners, like speaking of scatological functions at the dinner table.

My mother said that my father could not bear sickness or hospitals because of his mother, Catherine, whom I never met. I know five things about Catherine. She played piano. She loved baseball. She was funny. She drank. And she died of cancer when my father was 16.

When I imagine my grandmother, I see her looking small and frail, wrapped in blankets on a couch. Then I see my father as a child coming home from school. Catherine extends an arm to beckon him closer, and my father recoils with disgust. I’m not sure how this image implanted itself in my mind. My father never told me he found his mother disgusting. But when I think of a sick woman, I picture Catherine on her couch, my father running away.

As I lay in bed, I realized that I’d been telling myself this story about my father. It struck me that my father’s belief in conquering illness through positive thinking was also a story—not necessarily true or false, just a story, no more reliable than the idea that an overdose of pills could have resulted in a series of kidney infections more than a decade later. I saw now that the story I told myself was not even about my real father, who loved me, or the grandmother who I never knew; that imaginary father and the woman on the couch were as fictional as Atticus Finch and old Mrs. Dubose.

Meanwhile, here was Adam, who had not left my side when I was in the worst pain of my life. He had held my hand while I gave birth to our two children. He was real, and he had never shied away from my suffering.

Something inside me loosened.

I got out of bed, went to the bathroom, and splashed water on my face. When I came back, I could tell from Adam’s breathing that the sounds had woken him up. I didn’t know what I was going to say until I said: “I need to quit drinking.”

“I know,” he said.

“I’m afraid I can’t,” I said.

“You’ve never really tried,” he said.

I nodded and leaned into his hug.

“This is the best Hanukkah present ever,” he said.

I didn’t drink that day, and I haven’t had a drink since.

At 47, I am still the 23-year-old girl who walked for seven miles up a mountain without admitting that she was in pain. She is still part of me. But I am also the woman who married a kind and loving man. Who bore two children. Who went for years without sleeping through the night. When I look back at my kidney years now, I’m grateful to have learned so many surprising lessons from illness in a body otherwise blessed with good health.

If I could go back in time, I would tell my younger self not to try so hard to hide her pain. The ones who were impressed with her tolerance didn’t matter so much in the long run, and the ones who loved her never rewarded her for suffering. She—I—just read them wrong. I thought that if I quit drinking the pain would destroy me, but I was wrong about that too. In my life now, the feeling that threatens to undo me is joy.

Sarah Orman writes personal essays and poetry. Her work has been published in Narrative, Witness, Stonecrop, oranges journal, and elsewhere. She lives in Austin, Texas, with her family, and she is working on a memoir about reckoning with her wayward youth. Find her at sarahormanwrites.com and on Instagram @sorman33.

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