Heat

CW: medical descriptions of the human body

I don’t feel good. I haven’t for days. In Chinese you say you feel uncomfortable, bushufu, 不舒服. This is exactly what it is. Discomfort, a nail poking through the mesh of the status quo, snagging constantly at my attention.

I’m not sick, not in a viral, bacterial, or infectious sense. I could be sick, but I’m most likely not. I have heat. This is a concept from traditional Chinese medicine that describes nearly lifetime of discomfort for me, and one of the reasons I came to China.

Growing up I’d get colds. Horrible, two-week long colds, every few months, like clockwork. First, a sore throat that lasted several days, then all the typical cold symptoms. Congestion, fatigue, despair.

And, for me, the addition of guilt and shame. My mother hyper-focused on my colds, blaming me for getting sick so often and punishing each episode as a personal failure. I got sick because I didn’t wear a scarf, didn’t cover my throat, didn’t wear my thick wool stockings under my jeans to school. I let the cold wind touch me. My carelessness. My fault. Taking care of me was a burden. She could lose her job, she threatened, we might end up homeless. I learned to go into deep denial over the initial symptoms, then, invariably, crash into a wall of sobbing wretched tears when forced to confront reality as my symptoms worsened.

I learned to associate stress of any kind with feeling sick, especially with throat discomfort. Sometimes, in moments of high and sudden stress, my throat would seize with pain — my own little canary in life’s coal mine. I had heard of tension headaches, stress induced muscle pain, stomachaches from anxiety, even death from grief. I had never heard of stress induced sore throat. No one I’d ever met had it. It was just me, alone and strange in the world.

I envied people who walked around in cold weather without scarves and turtlenecks. No one had put it in their head that cold air can make them sick, so they didn’t get sick from it. I didn’t want it in my head, but there it was, a belief so strong that even though I knew it was false, I couldn’t break its effect.

So, I bundled up, and still, I got sick. All the time, every few days it seemed. My body and brain heavy and tired, my throat not in pain so much as general discomfort, an off-feeling, the sense that something inside me was brewing and about to go horribly wrong. 不舒服.

In my early adult days I ran to the pharmacy every other week, stocking up on anything claiming to boost the immune system. Vitamin C, elderberry, zinc, tonics and pills and potions from every shelf. A friend teased me for “throwing money at the problem”. If money was all I had to use as a weapon, I thought, I’d use it. I couldn’t sit at home, wrapped in a blanket, helpless, imagining my body succumbing to an army of invaders. I wanted to do something about it, to fight back.

Even I didn’t believe half the tonics I bought were anything more than placebo, but I convinced myself that placebo was better than nothing. I had to give myself hope, manufacture progress, take control in some way.

Trauma does funny things to our bodies. When I left home at eighteen, my mysterious high-frequency colds immediately went down by half. Both their frequency and intensity reduced. But I was still quasi-sick most days, catching brief respites of air before going under again.

Slowly, over the years, my so-called colds reduced in intensity, though the frequency stayed about the same. Three days of feeling like a normal human being, free, then back in the realm of the undead. I slowly realized that perhaps these colds were not really colds, but psychosomatic manifestations of my experiences growing up, the neglect and downright abuse I withstood in my home, a private hell that was so normalized and minimized I didn’t think to look at it twice until much much later.

I forced myself through so many days of work and social situations feeling truly miserable the entire time. Had I allowed myself to rest when I truly felt I needed it I would have had to go on disability. The thought honestly never occurred to me until now, just now, as I write this. This has been the air I breathe. Who stops to question if they are not breathing air well enough?

In 2015, I failed a routine tuberculosis screening for a new job. While my chest x-ray was spotless and I was asymptomatic, public health authorities believed I was a risk and convinced me to take a broad spectrum antibiotic for months on end to clear the dormant infection they believed I had. In reality, the tuberculosis vaccination I got as a child in Belarus, known as the BGC vaccine, will yield a false positive on future TB screenings. So, I took a drug known to be toxic to the liver without anyone disclosing that fact to me. As a result, my liver was injured.

After my course of that drug, called Rifampin, I began developing mysterious symptoms, all located in my genitals. Vaginosis, yeast infections, bacterial vaginitis, vulvar irritation and pain. As you can imagine, this was deeply troubling and isolating. While coworkers were free to whine about their achy backs and knees at the office, I couldn’t say anything about the stinging, itching, raw feeling pervading my consciousness emanating from my groin. Awkward.

So, let’s recap where I’m at at at this point. I now not only have fake-colds that are all in my head almost constantly, but I also can’t cross my legs, wear pants, or wipe after I pee, and my crotch hurts. Life, as you can imagine, was rough.

I went to a lot of western medicine doctors. A lot. Half of upstate NY saw my vulva in 2016. I was given steroid creams, ointments, gels, and even injections. That’s right, needles in the labia. 0/10 do not recommend. Nothing worked.

In desperation, I turned to eastern medicine. I went to an Ayervedic doctor, a doctor of Indian and Chinese medicine. He took my history, felt my pulse in both wrists, and looked at my tongue. After seeing me once, he gave me his diagnosis. Liver heat.

This was my first introduction to the concept of heat. He didn’t explain it, leaving it hanging in the air as a concept whole unto itself, foreign and self-sufficient, existing in a parallel world to my western understanding.

He gave me pills of compressed herbs to take and tonics of concentrated herbs to drink, diluted in water, on an empty stomach three times a day. My life became a medication schedule. I could take medicine twenty minutes before a meal or an hour after a meal. I had to carry pills and tonics with me everywhere.

At first, I wasn’t getting better. I saw him every week, and every week he would say “wow, you’re a hot tamale”. Heat, trapped inside me, making me miserable. He would put acupuncture needles in my feet and legs to let it out, twisting the needles to cause pain and activate the stuck points. I imagined clouds of heat pouring out of me as I laid on the table and he wrote out his weekly prescription to be filled at the pharmacy downstairs.

When my heat wouldn’t relent, he changed my diet. No more foods that are energetically hot in Chinese medicine. No acidic foods, tomatoes, citrus, garlic, green onion, spicy foods, fried foods. I ate carefully, swapping butternut squash sauces for tomato sauces, apples and pears for oranges and lemons, onion powder for garlic powder.

I saw him for five years. Over that time, slowly, my symptoms improved. Would they have have improved on their own anyway? Maybe. But they hadn’t for a year after my course of the antibiotic, and were only getting worse. I believe that he saw the missing piece that western medicine doesn’t see, and he saved my life.

In 2020, I hurt my knee doing yoga. A year into my injury, having gone through several rounds of physical therapy, I was, again, desperate for help. A friend referred me to her acupuncturist. This turned out to be another life changing connection for me.

In my first session with her, while she was fighting with trigger points in my shoulder blades she believes are connected to my hip and knee, I told her, through sharp intakes of breath, what I’ve just told you. “Oh my god”, she exclaimed, “they cooked your blood”.

“Blood heat”, she said. And, with this, came my second introduction to heat.

She explained that my liver, damaged by a medication injury, might have been cooled off sufficiently by the herbs I had taken prior, my blood is likely generationally hot, carried down by my genetics and epigenetics, and further heated by my childhood trauma.

She gave me a classic blood-cooling traditional Chinese medicine formula to take called Qing Shang Fang Feng Teng, 清上防風湯. “Take one every day morning and night”, she instructed. “For the rest of my life?” She shrugged, stating it as a matter of fact. “Some people just need their blood cooled. It’ll help.”

Let me tell you, it helped. For the first several months of using it, my psychosomatic colds went away. Completely. I finally got a taste of what life must be like for regular people on a daily basis. How in the movies people just get up and do things, have energy, walk around, smile, go out to bars, live life. It was a revelation.

Then, slowly, the colds returned. Perhaps my body became acclimated to it, perhaps I need to take more or take something stronger, perhaps I’m playing it fast and loose with too many hot foods. This is a real thing. Sweet potatoes, oats, grapes, chocolate. These are all hot. I need cold foods. Pork, cabbage, potatoes, mint, bitter melon, bitter tea. What’s in the food I’m eating in this new world I live in? Perhaps I’m in a new country where I can’t even figure out how to do daily tasks like send mail and life is just a bit stressful right now.

I will likely have to manage my blood and liver heat for the rest of my life. I can now sense it in my body, especially my throat. There’s a reason I struggled for so long determining if my colds were “real” or not. Pathological colds are an overabundance of heat, but so is a general feeling of being unwell when the only thing wrong is too much heat.

So, I take my herbs, I eat a cold diet, I drink my bitter tea, and I wait for the heat to clear. It always does.

We all have our burdens to shoulder in this life. Mine is heat. I bump into the sides occasionally as I learn to navigate my little car down the road, but there’s one thing I have learned. Life is not an all or nothing game. I do not have to wait until conditions are perfect before I allow myself to experience the thrills, joys, and adventures of life. A couple deep breaths, a bit of cabbage, a few herb tablets, and I can still live my life, hot or not.

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