Today is my birthday — hooray! Except that this has also come to mean that I’ll receive about eight birthday form emails from medical practices I no longer visit.

Today, my inbox is basically a list of doctors who no longer accept my health insurance plan and/or suddenly became “concierge only.” Subject lines include “Happy Birthday from Broadway Gynecology” and “Let’s celebrate YOU at Eastside Dermatology Group LLC.” One email includes an AI-generated graphic of dentists who also don’t take my insurance wearing party hats and holding balloons.

Perhaps the saddest part is that I opened each email to see if there was a birthday discount. Spoiler: there was not.

This was written by Emmy Blotnick and illustrated by Mads Horwath.

Push your leg straight up against my hands. Don’t let me push it down. Push your arms out against my hands. Now, don’t let me pull you away. Squeeze my fingers for me. Squeeze as hard as you can.

I have mastered this routine by now. The push and pull against my muscles, the shiny glint of the reflex hammer, and sometimes the doctor’s hand outstretched to me — or the walker claimed from some nurse in the hallway — to see if I can still take a few shaky steps.

This is the neurologist’s office, the place I have visited every three to six months for the past two years.

The doctor clasps my hand in his and gives it a sharp jerk back. My hand bounces up and down, up and down, in a rhythmic oscillating movement called clonus. It’s a sign that the central nervous system damage has now spread to affect my arms.

“Your reflexes are a neurologist’s dream,” the doctor says.

I live with spastic paraparesis. Spastic describes the slow “velocity-dependent” stiffening of all of my muscles as a result of central nervous system damage. Paraparesis describes the way that this stiffening has led to a partial paralysis of my legs. I use a wheelchair full-time.

And yet, neither of those words describe the spasticity and accompanying weakness that has spread, in more recent months, to my shoulders, my hands, my arms. Nor does the diagnosis describe the profound fatigue I experience as a result of another condition, or acknowledge the gaping sense of loss—the invisible wound—of having to put my dreams as a writer and sequential artist on hold, perhaps indefinitely.

I would do anything to get it back. But these days, when I try to force my way through the multi-step process of story creation, thumbnail sketches, and ink drawings, I am so cognitively exhausted that I can only stare with glazed over eyes at my paper. On the days I can draw, my hands shake. My lines take routes out of my control. My muscles tire after drawing just a few leaves on a tree or a simple human figure.

When my neurologist says my reflexes are his dream, I can only assume his own love for the complex workings of the nervous system makes him feel an intellectual thrill to see such clear evidence of disease.

Maybe I would have shared his excitement if my dreams didn’t diverge so significantly from his. I would’ve liked to know how much time I had left to do what I still dreamed of, rather than me now having to grieve the loss of all the stories I was just starting to tell— remaining stuck in the middle, untold.

This was written and illustrated by Rachel Litchman. She can be found on instagram (@racheldlart) and on her website, racheldl.com.

NO SOLIDS’. Written in capital letters on a whiteboard above my hospital bed. Along with other signs like ‘GLUTEN FREE’ or ‘LACTOSE INTOLERANT’ these were put in place to ensure the lunch service - not delivered by medical professionals - would make no patients suffer any dietary…‘misadventures’. I had just had a tumor removed from my bowel and my colon and brand new colostomy bag needed monitoring to make sure they were functioning properly with liquids first before putting any strain on my bowels with actual food. So when the Day Nurse came round to offer me painkillers in tablet form, I thought to ask whether this counted as a ‘solid’ and should I not be taking pain relief by some alternative method, like injection or fluid.

The nurse looked flustered, understandably exhausted, and potentially embarrassed by having their expertise questioned by this gastrointestinal upstart. He looked around as though to check whether anyone else was hearing this flagrant insubordination, then in an annoyed manner said he would check. He walked briefly out of the room - so briefly it seemed to me and my partner that he literally hid around the corner for thirty seconds - before returning to say it was fine. “You checked?” I asked. “Yes, yes, I checked.” I looked at my partner then, somehow submitting to the nurse-patient power dynamic, I dutifully swallowed my pills.

What followed was a bout of ludicrously intense hiccuping which didn’t end for over twelve hours. Which may not sound like much but, when every lurching hiccup sent an intense jagged pain to fresh surgical wounds, I was in agony. I pleaded with several nurses and candy stripers to help me stop the hiccups but the only advice they could give was to suck on ice chips. So I sucked. And sucked and sucked and sucked. Sucked so many ice chips in fact that my catheter overflowed, leaving not only more disgruntled nurses but a crystalline residue that caused prostatitis on removal. For weeks afterwards any painkiller instantly brought back a knee-jerk response from my body of hiccups, hiccups and more hiccups.

When the surgeon checked in on me the next day, I had to explain why the nurses had switched my painkillers to morphine (which slows down bowel activity and thus is not conducive to recovering from bowel surgery). “You know,” he said, with a smirk that was a fraction more comforting than you’d expect it to be, “they’re not supposed to give you solids.”

This post was written and illustrated by Alex Brenchley

When I was 21, I was diagnosed with medulloblastoma, an aggressive type of pediatric brain cancer that can turn deadly within months. After enduring an eight-hour craniotomy to remove the tumor, I was parked in the neurology ICU to recuperate. My head had been cut open, and most of my vital organs had been run by a machine for a few hours. I was exhausted.

I’d been extubated, and my throat felt like it had been scraped raw. I could barely talk above a whisper, and even that hurt. The morphine kept me euphoric, yet suspended in a strange half-awake fog where time stopped making sense. I drifted in and out of consciousness while machines beeped and blooped around me in the dark, except for the blurry red glow of the EXIT sign.

At 3 A.M., I heard someone pull back the curtain, and my eyes struggled to focus. It appeared there was a priest holding a Bible — he looked like the guy from The Exorcist — standing there. Now, I’d had enough pain meds to tranquilize an elephant, but I knew what I saw, and I understood why he was there: to give me last rites. Unfortunately, there were two things wrong with his plan.

1. I am not Catholic.

2. I was not dying.

I managed to summon a raspy voice, sounding like Harvey Fierstein on meth, to cast a spell of sorts:

“I’m Jewish. I’m Jewish. I’m Jewish!”

That made him go away. I found out later he’d chosen the wrong gurney, as he was there for the man next to me, who didn’t make it through the night. (In hindsight, I could have used all the help I could have gotten.)

The next morning, I told my mom about my late-night visitor, and it simply did not sit well with Roz Greenzweig. She went all Shirley MacLaine in Terms of Endearment on the nursing staff, shouting, “You let a fucking priest talk to my fucking son after fucking brain surgery?”

Somehow, she didn’t hit anyone, and that was the real miracle of it all.

This was written by Matthew Zachary , author of “We The Patients,” a book about surviving the American healthcare system.

This was illustrated by Delaney Gibbons, a writer and cartoonist based in central Iowa whose work has been featured in McSweeney’s and the New York Times among many other places.

I spent ten years working inside some of the best hospitals in the country. Let’s not name names, but these were places where people routinely do things that could only be described as miracles — if miracles came with a $$$ facility fee.

My job was Speech-Language Pathology: mostly, figuring out whether patients could safely swallow. The human throat, it turns out, is very easy to break and very hard to fix. The same goes for medical communication, but nobody hired me for that.

Here’s what a decade at the bedside taught me: hospitals are full of brilliant, genuinely caring professionals, each responsible for one piece of you. They communicate through the electronic chart, which functions like a group chat where everyone posts updates, nobody reads the thread, and the patient is the topic nobody has time to TLDR for you. The team rounds for five minutes when the patient is half asleep and the family isn’t there. “Any questions?” The questions come at 2 PM, when the doctor is nowhere to be seen.

What nobody asks anywhere in this process is, what do you actually want? What matters most to you? Do you even know you have options? You don’t know what you don’t know.

That’s the gap. Brilliant medicine. Bewildering handoffs. And a patient at the center of it all who was never actually asked.

So, I became an independent patient advocate. Today, I spend hours at the bedside, live and breathe the patient’s medical chart, and translate “multifocal pneumonia with septic physiology” into “his lungs are infected, and his body is working very hard.” I make sure the plan of care reflects what the patient actually wants — and that they know they have a say in it. I work with the medical team, not against or around them. The doctors are doing their jobs. I’m doing the job that fell between the cracks.

Sometimes that gap is clinical. One patient, recovering from a major medical event, was drowsy and underfed — too foggy from his anti-seizure medication to engage in therapy, and not getting enough protein or calories to have the energy to try. Nobody had connected those dots. Two conversations — one with neurology about adjusting his medication, another with the dietitian about strategizing to increase his intake —changed his trajectory enough that he qualified for acute rehabilitation (the highest level of rehab care) instead of a lower tier. That distinction made the difference between him eventually regaining his prior independence and quality of life, or not.

Sometimes the gap is just transparency. Another family kept hearing some version of “we’re doing everything we can” while their loved one’s time was quietly running out. What they actually needed was a straight answer about how much time was left. Pressing the medical team for a real, honest timeline meant her family could get on a plane and say goodbye in person instead of getting a call after it was already too late.

In a perfect healthcare system, this line of work would not have been needed. But, until then, it turns out independent professional advocacy can make the difference between an uneventful hospitalization and a tragedy.

This post was written by Shlomit Liberty and was illustrated by Mads Horwath.

To find a personal patient advocate you can browse Greater National Advocates.

In January, I tore my calf muscle. I tried ignoring it for a month and hobbling through the pain, but, surprisingly, this was unhelpful. In February, I called my PCP for a referral and finally ended up with an appointment at Prestigious University Sports Medicine in March. The doctor did an ultrasound of my leg and showed me a black void inside my calf muscle, which was actually a pocket of blood. Gross.

In April, I returned to the sports doctor. Despite the treatment regimen I had been (mostly) following of physical therapy, heat, and meloxicam, my leg was still weak and painful, and I was contemplating replacing the entire limb with a wooden peg.

Another ultrasound showed my hematoma—that pocket of blood—was still lurking in my muscle, unchanged.

“Well, we have some other interventional treatments we can try,” said my doctor, who claims to be an adult that went to medical school, but would not look out of place in this year’s Temple B’rith Kodesh bar mitzvah class.

“Sure!” I said, because I want people to think I am fun and adventurous.

The first option was to aim acoustic waves at my injury to stimulate better healing. The second one was to take some of my blood, spin it around in a centrifuge to create platelet-rich plasma, and then inject it into the hematoma in my leg. I liked the absurdity of this one--filling my pocket of blood with more blood, so that the old blood and the new blood could fight to the death. A microscopic siege of platelets laying waste to the red blood cells of Castle Hematoma.

“The only thing is,” he added, “they aren’t covered by insurance.”

Fun and Adventurous Rebecca was immediately replaced by my true self: Grumpy and Cheap.

“How much do these cost?” I asked.

“$200 a session for the acoustic wave therapy.”

I have three kids—if I need my leg bombarded with sound, I can just go in my own living room for free.

“And the blood one?”

“We charge $950 for that.”

“Hmm, no thanks,” I said, wondering where I could find a carpenter or pirate to carve me that wooden peg.

This post was written by Rebecca Saltzman (@rebeccalsaltzman) and illustrated by Ellen Lindner (@ellenlindna).

In my twelve years as a hospice volunteer, I have experienced this recurrent theme: nurses or medical facilities not allowing the patient to have things deemed “unhealthy” for them (like beer or soda) because it’s unhealthy for them, but the irony is insane. . . because if they are on hospice, they’re already dying! Who cares? Let them have whatever the fuck they want!

So, I once snuck a Stella Artois into my hospice patient’s room, and we shared a single warm beer between the two of us. I had never seen her so happy.

This was written by M.C. Huff who is the writer and director of the Golden Trail Project , a film which aims to highlight medical aid in dying, dementia. treatments, and normalizing discussion around death.

This was illustrated by Ella Scheuerell, a cartoonist who likes to talk about her anxiety and depression in her comics, which have become one of her most valuable tools in her quest to stop the stigma surrounding mental health.

This week, we’re delighted to share an entire chapter (and cautionary tale about ignoring abdominal pain in a McDonald’s) from Maeve Dunigan’s new book, Read This to Look Cool: Essays and Overthinkings.

When I was twenty, I thought about how to execute the “perfect messy bun” a lot. I also thought about laptop stickers. I thought about Lorde and Dua Lipa. I thought about “reclaimed vintage.” I thought about the practicality of wearing high-­ waisted jeans to an endless buffet dinner. I thought about friends, family, and crushes. I thought about fresh orange juice, McDonald’s coffee, and hard cider. I thought about which “going-out tops” looked best on me. I almost never thought about death.

It’s not that I thought I’d never die, it just didn’t seem like a pressing issue. Death felt like a final assignment due in three months—­ I’d get to it when I’d get to it! My body was lithe and resilient. Nothing was clicking or sore. My family history of high cholesterol hadn’t yet caught up with me. My gums weren’t yet receding. My skin wasn’t yet plagued with adult acne. I could push through any pain. If I ignored a problem, it went away. I hadn’t yet learned that sometimes, no matter how hard you try to act like everything’s fine, your body will force you to speak up. And so, when my friend Ryder asked if I wanted to get dinner the summer after sophomore year of college, I said yes. I said yes, and I assumed everything would be fine. I said yes, while my body screamed “No!!!!!” I said yes, even though it felt like someone was using a curling iron to style my insides into movie star beachy waves.

Ryder and I have been friends since elementary school. Meeting him on the playground, I immediately liked him because he had the body of a child and the interests of a seventy-five-­ year-­ old widower. He was curious in a way that’s usually reserved for fictional children who solve crimes. While most of us spent seventh grade cutting our vacation Bible school shirts into crop tops, Ryder was busy at various backyard excavation sites, using his mom’s gardening shovels to unearth antique perfume bottles, later documenting their historical significance in meticulously kept notebooks. Ryder and I were inseparable through high school, in large part because I was very nosy, and Ryder was very good at figuring out which teachers were hooking up.

We went to different colleges and did our best to stay close. But after two years apart, I was still managing the realities of distance. We were no longer fixtures of each other’s lives. Our daily texts became weekly texts became monthly texts. It was a difficult adjustment, but an expected one. Unfortunately, I’d been handling our changing friendship with the stubbornness of a pottery student unable to accept that her increasingly misshapen vase was actually more of an avant-­garde coffee mug. It was a vase! If I just forced it to be a vase, it was a vase!

Home for the summer, I intended to replicate the carefree days of our youth. Things would be exactly the same. How I acted in those few precious weeks would be how he’d remember me when we were apart for the next six months. I planned to be fun, spontaneous, untroubled.

And so, in an effort to be chill, laid-­ back, and down for anything, I became someone whose appendix ruptured in a McDonald’s.

It wasn’t until I lost my appendix that I became obsessed with it—­ like an unemployed indie band drummer who breaks up with you and then, realizing you’ve moved on, texts, “Hey babe, I’ve done some thinking, can I buy you a High Life later?” I wanted to know everything about the one that got away.

I learned that in 1735, an eleven-­year-old named Hanvil Anderson swallowed a pin. Shortly thereafter, he became the first patient in recorded history to undergo a successful appendectomy, performed by Dr. Claudius Amyand at St. George’s Hospital in London. In his abstract, Dr. Amyand wrote that the boy’s problem involved “a fistula between the scrotum and thigh terminating into it, which for a month last past had discharged a great quantity of an unkindly sort of matter.” I have no idea what that means, but I love that back in those days, doctors could write stuff like “unkindly sort of matter,” and everyone was like, “Totally.”

Two hundred and eighty-­ one years later, in 2016, I swallowed a Chicken McNugget. Shortly thereafter, I became, approximately, the one billionth patient in recorded history to undergo a successful appendectomy, performed by a doctor whose name I can’t remember, but that my mom thinks was “Defrilio or Demilio or something,” at Howard County General Hospital in Howard County, Maryland.

One of the better bearded guys in history, Charles Darwin, hypothesized that the appendix was a functionless organ. He thought it was likely used as a mechanism for breaking down plants, left over from when humans ate mostly plants, but that it slowly shrank into obscurity as diets evolved. This sounded like a good guess, and Darwin, a famously huge nerd, seemed like a reliable person to trust. For years, his appendix theory prevailed. And so, the appendix developed its reputation as the body’s most inconvenient wallflower. An organ that sits dormant and rarely rocks the boat, too timid to speak up for itself, until, tragically, it’s too late.

In terms of places your appendix could rupture, the best would probably be within feet of—or even better, comfortably inside—­ a hospital. The worst would probably be in the last row of coach seating on a JetBlue flight during turbulence with a screaming baby and an annoying flight attendant, where the only in-­ flight entertainment options are nineties rom-­com named something like The Ella Question.

Compared to that worst-­case scenario, the fact that my appendix ruptured in a suburban McDonald’s seems almost optimal. At the time I didn’t see it that way.

Earlier that day, Ryder picked me up in his mom’s Subaru, waving from the window. I waddled toward the car, attempting to project Cover Girl while surely giving corpse.

Sitting through a bumpy car ride was an exercise in torture, but eventually we pulled up to our destination, and I managed a smile. It was genuinely comforting to see the iconic yellow and scarlet of my childhood. Our hometown is charming, but it’s also the type of town where the McDonald’s is a restaurant restaurant, if you know what I mean.

As we took our seats in one of the familiar, sticky red booths, we started gossiping, just like old times. Pretty soon, my worries about maintaining a perfect vibe began to fade, just as the devil reclenched his lava-­ hot fist around one of my organs.

If I could just suffer through this mysterious ailment and get to the other side, I’d know that I hadn’t wasted one of our few evenings together. It didn’t matter that I wasn’t having a good time. If I could force a feeling of joy into our hangout by maintaining this façade, it would eventually become a fond memory…right?

As my internal panic raged, Ryder filled me in on the twisted lives of every member of our graduating class. Through increasingly blinding pain, I tried to keep up.

“Remember Becca DeMalo?”

“Ummmm, no,” I sputtered.

“She moved back here and she’s dating the manager of Ship’s Cafe.”

“Oh, okay,” I said, barely forming syllables.

“Remember Cassidy Mays?”

“Is that the girl who wrecked a Jeep?” This was a guess—most girls at our high school had done this.

“That’s her older sister. Cassidy got fired from Dick’s Sporting Goods for being on drugs.”

“Gotcha,” I whispered, pondering who might give speeches at my funeral.

“Remember the guys who got high on Robitussin in the bathroom every Tuesday and called it ‘Tussin Tuesday?”

“Yes, but…I have to go to the bathroom!”

Fleeing before Ryder had a chance to react, I waddled into the bathroom, slammed the stall door, and began frantically Googling. “Stomach bad what happen??” “Stomach feel terrible—­ death???” Every search hit pointed toward the appendix, which I learned can become blocked, leading to a buildup of bacteria, leading to inflammation, which results in a rupture.

Still confused, I begrudgingly clicked on another one of the links and learned that while the “blockage” scenario is one possibility, it’s not the only cause of appendicitis. In fact, when it comes to appendicitis, much like my cat’s propensity to randomly vomit, there are so many potential causes that it’s hard to pinpoint exactly why it’s happening.

My first instinct upon realizing something might be really wrong was to follow the advice dispensed by so many of my youth soccer coaches—­ the tried-­ and-­ true method known as “walking it off.”

As I limped across the restaurant, I recalled a moment during freshman year of high school when I was plucked from the chorus of our spring musical, The Wedding Singer, along with two other girls, and promoted to a “special” role—­ we would now be playing ditzy prostitutes who had no lines. Despite having zero sexual experience, I did a good job. Such a good job, in fact, that the director told the other girls to “mimic what Maeve is doing.” This inflated my ego for years to come and is why, even as I dragged my body zombielike toward the fountain soda machine, I was positive my acting abilities were so convincing that no one noticed a thing. Sure, my organs felt like they were knotting themselves into an intestinal friendship bracelet, but that was no matter! A true actress can overcome anything!

I knew Ryder would be understanding if I told him what was going on, but I didn’t want him to have to be understanding. I wanted to prove to myself that I still had a handle on my body. I was the arbiter of the day, not some stomachache. To admit my pain would be to relinquish the control I’d sweatily maintained through my Oscar-­ worthy performance. And so, after walking it off didn’t work, I gritted my teeth and suffered through tiny bites of fries, anxiously awaiting the moment I could attempt my ingenious backup plan—­ a similarly foolproof method known as “sleeping it off.”

I resumed catching up, to the best of my ability, as if nothing happened. After what felt like hours but was realistically about forty-­ five minutes, Ryder and I headed home, promising to meet up the next day. Unfortunately, when the next day arrived, I was in a sweaty fetal position, feeling ten times worse. I finally gave in and did what any competent adult would do—­ I called my pediatrician, who sent me straight to the emergency room.

Heading to the ER, my mom warned that the person at reception would ask what my pain level was on a scale of one to ten. The key, my mom said, was to tell the receptionist a number that was three higher than my actual pain level. This would ensure I didn’t sit in a crowded emergency room for very long. I hated this idea for all the obvious reasons—­ having to lie, potentially putting myself ahead of someone needier—­ but more than that, I hated it because, even with these new parameters, I still had no idea what to say. Sure, it was the worst pain I had ever felt in my life, but thus far I’d enjoyed such an easy life! What constituted a ten, anyway? Childbirth? Having your arm sawed off? A never-­ ending UTI? I needed more concrete examples of ones and tens. “On a scale from the feeling when a nail technician is ripping off little bits of your cuticles to literally being set on fire, where is your pain?” That would have helped.

Aside from the logistical nightmare of assigning a numerical value to my pain, there was also the social nightmare of having to admit that I was in pain at all. I mean, wouldn’t it be sooooooo annoying to everyone at the hospital if I told them I was experiencing a medical emergency? They’re busy! They’ve got a packed day of scrubbing their hands and yelling, “Scalpel!”

I only had one organ that was failing—­ surely, I thought, there were people here with three, four organs that were shutting down. What if someone accidentally got their hand stuck in a NutriBullet? How serious would my problems seem, a girl whose hand was still clearly affixed to her wrist, if I asked for help?

I’d never been taught to realistically evaluate my pain. I understood debilitating monthly cramps, bloating, and headaches to be normal things people with bodies (usually female bodies) just had to deal with. Period woes, no matter how extreme, did not constitute a sick day. Then again, if it was ever something more dire, I was taught that doctors wouldn’t believe me unless I exaggerated, unless I added three to the scale. On each end, my fate was determined by a performance. Either I pretended nothing was wrong so that I wasn’t a burden, or I pretended things were worse than they were so that I could be taken seriously. It felt like there was no middle ground. But as the agony intensified, I was forced to reckon with the fact that burdening the doctors with my medical issue was probably better than burdening them with my corpse littering their waiting room floor.

And so, tears pooling in the corners of my eyes, clutching my stomach, practically hallucinating, I looked at the receptionist and shakily said, “Seven?”

Fifty minutes’ worth of passive-­ aggressive glances from my mother later, they called me back.

They told me the pain was either appendicitis or an ovarian cyst. If it was an ovarian cyst, it would probably go away on its own. If it was appendicitis, I would have surgery that night.

“Please, please let it be an ovarian cyst,” I pleaded with any God who would listen—­ all of whom were probably like, “Ew, gross.”

McBurney’s point, which sounds like the name of a seaside vista where teens go to make out, actually refers to the location on the right side of the abdomen just above your appendix. McBurney’s sign, which sounds like a hand signal teens give to each other when they wanna sneak away to McBurney’s Point and make out, is used to describe the feeling of intense pain located at McBurney’s Point, and is a common indicator of appendicitis.

When the nurse pressed hard on McBurney’s Point, two things immediately became clear: I definitely had appendicitis, and I was going to murder the nurse.

I wish I knew that nurse’s address so I could send her one of the more expensive Edible Arrangements available for purchase. Because, after enduring blistering pain by her hand, I became, as the French would say, a huge cunt. She was only doing her job, which was saving my life, and yet the second she pressed on my abdomen I thought, Women shouldn’t be doctors.

I’d finally reached a pain threshold that forced me to drop the act—­ a level of discomfort that broke me out of the performance I’d been so adamantly maintaining. With one press on my abdomen, I went from “No worries if not!” to “I’ll chat with your superior later”—­ rocketing to the opposite end of the white-­ lady spectrum.

“I don’t understand why I can’t have any water,” I fumed, the first time all day I’d complained about anything. She calmly explained that I wasn’t supposed to drink fluids before surgery, but that she would give me water through an IV so I wouldn’t feel dehydrated. “It’s not the same,” I said, in a tone that implied I genuinely believed this medical professional didn’t understand the differences between drinking water and having it pumped into your arm.

To be fair, I can’t imagine the nurse felt particularly offended. It’s hard to take anyone in that much pain very seriously—­ never mind a girl who, at this point, had sweated through her college sketch comedy group T-­ shirt and was high on Percocet for the first time, repeating over and over that she was “just like Lil Wayne in that Chance song.”

I never actually asked to speak to that nurse’s superior, nor did I say or do anything to her beyond rolling my eyes and melodramatically asking for my cot to be pushed closer to where my phone was plugged in. But, in an albeit misguidedly annoying way, I was finally speaking up for myself. I was finally telling people what I needed and how I felt. I had finally stopped caring about how I was coming off to others. I was also still being pumped full of drugs and beginning to think my skin was made of baked potato.

The thing about telling people how you feel is that it allows them to help you. (Groundbreaking, I know!) I’d been working so hard to navigate this no-man’s-land, somewhere between the selfishness of worrying what others thought of me and the altruism of worrying about being an inconvenience, and I wasn’t getting anywhere. I would never have stopped if my body hadn’t forced me to.

It turns out, my appendix was also doing more work than anyone thought. In 2007, researchers came up with a compelling theory for its role in our bodies. The appendix, they hypothesized, doesn’t just collect bad bacteria, it also acts as a storage space for helpful bacteria, thus aiding our digestive and immune systems. The appendix doesn’t just sit around, twiddling its thumbs—­ it tries to keep us alive.

The appendix, in its own way, serves its larger body by doing the little bit that it can. As I learned more, I felt a strange empathy for this organ that’s trying its best. This organ that keeps doing its job even at the expense of its own functionality, that naïvely believes it can keep going and going and never burst. That eventually gives up, does a complete 180, and burns everything down.

I like to think my appendix had six Gibsons served by the hot bartender who works in my intestines and then, cocktail onion crunching in her teeth, enlivened by an intoxicated, violent complex was like, “You know WHAT? YOU KNOW WHAT??? I HATE being here! No one respects me! I’m not getting any work! In another body, I’d be a STAR! So that’s it, I’m LEAVING!” And then she stumbled her faux leather booties toward the door, never to be seen again.

God, I miss her.

Staring at the bright lights of the operating room, I had the urge to ask if they could put my appendix in a jar for me to take home. But then I remembered this was Howard County General and not medieval Europe and there was no way they’d let me do that.

Plus, I was so high that I couldn’t think of the word “jar.”

“Imagine you’re on a beach,” the anesthesiologist said. “Which beach are you thinking of?”

In a drugged haze, I closed my eyes and tried to find a beach. But the only location appearing on the fuzzy map in my brain was the one where my best friend Jackie had just studied abroad.

“Madrid,” I said, confidently.

“WAIT!” my eyes shot open as my last brain cell worked overtime, realizing that Madrid is not a beach at all, but a landlocked city in Spain. This anesthesiologist was going to think I was an idiot. “Actually, I meant—”

And then everything went black.

The day after the surgery, Ryder came to visit me in the hospital.

“I can’t believe you made it through that whole dinner,” he said.

I couldn’t believe it either. I’d waited so long that my appendix, pushed to its limit, had unexpectedly burst open during surgery, forcing me to stay in the hospital an extra day. I’d made it just in time.

What would’ve happened if my body and brain had worked as a team? If I’d listened to what it was telling me, instead of insisting everything was fine? If I hadn’t been so afraid of maintaining this perfect act? If I knew how to tell people the truth? Maybe everyone’s day would’ve been easier if I hadn’t been so focused on shrinking my problems to make their day easier. Maybe I’d be home by now.

“Anyway,” Ryder continued, scrolling his burner Instagram. “Remember Julie Frank? I think she stole her ex’s pug.”

Maeve Dunigan is a writer, comedian, and frequent contributor to the New Yorker. Her work has appeared on NPR’s Selected Shorts, McSweeney’s Internet Tendency, Reductress, Mic, Mountain Gazette, and (to her great surprise) a high school textbook. She recently published her first book, Read This to Look Cool: Essays and Overthinkings.

Mattie Lubchansky is an American cartoonist and illustrator. She is the former Associate Editor of Ignatz and Eisner award-winning magazine and website The Nib. Her graphic novel Simplicity (2025) was a national bestseller and her debut, Boys Weekend (2023), was named a best book of the year by NPR and The Washington Post. She cohosts the No Gods No Mayors podcast with Riley Quinn and November Kelly.

As someone who loves a good bit, I have to admit that, after spending decades injecting myself on a weekly basis, having my body decide that “I have a chance to do the funniest thing” as soon as I make it into content is kind of perfect.

In short: during my little media blackout, I’ve been trialing a new medication in pill form to replace my Xolair. It quickly proved to work, but, out of an abundance of caution, I didn’t want to mention anything here until my insurance company cleared it.

Now that I’m holding my first Rx fill in hand, I can say it: no more needles — for now.

Obviously, this raises some questions about the future of this column, so please accept the first (and last) episode of the webseries “Amanda Takes a Pill” — immediately canceled on account of boredom.

What’s next?

• You can still expect periodic “Infusion Diaries" for the time being. In another wild development, I recently learned that I could have been self-injecting my infliximab THIS ENTIRE TIME instead of spending hours hooked up to a bag, but my current insurance company doesn’t cover the switch. Since I’m anticipating a change in coverage within the next year, there’s a nonzero chance that we may be back to “Shooting Up” in my bathroom instead of staring at my feet in a medical recliner. Watch this bureaucratically-determined space, kids.
  

• Out of respect for my craft, my meat-sack seems to be working on a one-in, one-out basis: while my medication regimen has streamlined, I’ve recently learned that I have hypermobile joints. While less than delighted by the announcement of Yet Another Thing, I’m also having the exciting, disorienting experience of realizing that I can mitigate types of pain that I thought I just had to live with — not to mention having an explanation for grab-bag physical qualities I’d dismissed as quirks. (i.e. always leaning on counters/standing on one leg, bizarre sitting postures, giant mystery bruises that make my legs look like a Rothko painting, and, of course, rapid-onset clumsiness.)

  

  So, if the idea of hearing about the humbling process of re-learning how to walk in your 30s appeals to you, I have good news.

Stay tuned for next week’s infusion! Until then, I remain bendily yours.

In March 2024, my partner Matt came home from work to find me lying on the floor, naked, writhing in pain, with my vibrator humming between my legs.

“Jesus Christ” he said. “You need to go to the hospital.”

“It’s fine,” I snapped. “I’m handling it.”

The pain had started as an ache in my mid-to lower back, on the left side, around 11 am. By 3 pm, the ache blossomed into waves of agony, numbing my sense of reality and forcing me down to the floor like a wounded animal. In hindsight, it should’ve been insanely obvious to me that I had another kidney stone. I’ve had them before. But, at the time, I figured it couldn’t be a kidney stone because I was still awake.

My first kidney stone had tore through my body the night of my 20th birthday. I ended up at the hospital, vomiting then passing out from the pain.

So It can’t be a kidney stone. I thought. That particular unimaginable pain was a vivid memory for me, even ten year later. I’m still awake. I’m not vomiting. I didn’t think about how the current blinding pain I was experiencing had rendered me naked and immobile. After all, I was still awake, damnit! It couldn’t be a stone if I was still awake!

Anyone who’s experienced intense pain will tell you it warps your mind. A kind of pain-logic takes over your brain, and at this point, I wasn’t thinking clearly.

It’s got to be, I don’t know, some kind of stupid muscle spasm. I told myself. Just turn on the heating pad, relax, and distract yourself by jerking off.

I figured, if I flooded my pain-filled nervous system with equal-ish amounts of pleasure, it would even out the extremes and make the pain tolerable. So for the next few hours, I “balanced” my nervous system by furiously jerking off, trying to follow intense waves of agony with the release of an orgasm.

By 6 pm, I was naked and feral, unable to handle the constraints of clothes or the softness of pillows. the hardwood floors felt solid, cool on my skin, as the burning spasms rode my body every few minutes, contorting me into new unwilling shapes as I tried to twist away the sensation. I kept trying to jerk off, even as it increasingly became impossible.

Matt found me like this.

“Jennie,” he said. “What the fuck?? Are you doing?”

“It’s not a kidney stone,” I said, in-between pain spasms. “It can’t be. Because I’m still awake.”

“Good,” said Matt. “So you can go to the doctor.”

“No, “ I growled.

Matt managed to drag me off the floor and into the emergency clinic. I could walk again, but just barely, by the time the doctors confirmed it was a kidney stone.

“But... I didn’t pass out,” I said.

“That doesn’t mean it’s not a kidney stone,” the doctor replied, talking to me the same way you would a slow donkey. “The pain can vary in severity. But in general, if you feel that much pain, don’t try to manage it at home.”

“But,” I said, still unable to think clearly. “But I jerked off? A bunch? For hours?”

“Um, that’s creative.” said the doctor. “I’m writing you a referral to a urologist.”

I passed the stone the next day.

That was my second kidney stone. A year later, I got my third, and hopefully my last one. This time, I called my urologist and went to the clinic for pain medication.

This post was written by Jennie Egerdie and illustrated by Emily Flake

The following is an excerpt from a short film, Good Girl Greta, written by Rachel Ross — and based on her lived experience of how it took decades and a near-death experience for her to finally be diagnosed with ulcerative colitis and endometriosis.

Read, follow the film on its socials, and, most importantly, click here to donate to the film’s crowdfunding campaign, which concludes on 4/23!

INT. EMERGENCY ROOM — DAY

Greta, a New Zealander in her 30s wearing a hospital gown, sits on her bed with her three-year-old daughter, Delilah.

Delilah’s drawings scatter the bed. Delilah blows into a latex glove. Giggles.

Greta hits refresh on her phone. No new mail. Another shaky breath.

The curtain RUSTLES. DOCTOR RUDY slides in with a tablet.

DOCTOR RUDY
(not looking up)
So. Diarrhea. Bleeding. Stomach pain.

Greta glances at Delilah . . . Not happy she’s in earshot.

GRETA
Yes. I’m happy to have you look me over but—

DOCTOR RUDY
Do you strain with your bowel movements?

GRETA
Not at the moment. . .

DOCTOR RUDY
Have you in the past?

GRETA
I guess. At some point.

Doctor Rudy scribbles on his tablet. Greta clasps Delilah’s hand. Looks at her phone — WIFI CONNECTION LOST.

DOCTOR RUDY
Have you travelled anywhere recently?

GRETA
Yes. I arrived from New Zealand a couple weeks ago. Which is what I’m trying to say, I can’t stay long—

DOCTOR RUDY
Because you’re traveling, you’ve likely caught a bug which would account for the diarrhea. And with straining in bowel movements in the past, that can cause hemorrhoids—

SWISH — the curtain flies open.

It’s Harriet, 30s, a brash New Yorker with an upper-limb difference, in the neighboring cubicle.

HARRIET
What’s this half-ass diagnosis? Huh?

DOCTOR RUDY
That’s confidential and, quite frankly, doesn’t concern you.
(to Greta)
I’ll prepare the discharge paperwork.

GRETA
Thank you—

HARRIET
It does if you’re not doing your job properly.

DOCTOR RUDY
Excuse me?

Delilah’s puppy-dog-eyes dart between the adults.

GRETA
(to Harriet)
Honestly, I’m—

HARRIET
Have you even performed a physical? Run extensive blood work? What’s her CRP, red and white cell count? Was her CT scan clear?

DOCTOR RUDY
That would be a complete waste of our time and resources.

HARRIET
Is it? Or is it standard care you’d give to a male patient with the same symptoms?

Doctor Rudy freezes. Medical staff nearby pause, suddenly interested.

This post is an excerpt from writer/director Rachel Ross’ film Good Girl Greta . She is raising money to help produce the film here.

This post was illustrated by Julie Mitchell. Julie is a comedian, writer, and artist and runs the Girl, Uninterrupted on Substack

I hate when I have to recount 20+ years of my medical history from memory because my records didn’t transfer — just because the new office uses a different portal.

This was written by indie animation filmmaker) Masha Ellsworth, a who can be found on Instagram at @masha_makes_movie and her website. She has a new film called Wishing Trees.

This was illustrated by cartoonist Rusty Epstein whose work has appeared in Times Luxury, Private Eye, Weekly Humorist, and others. He can be found on Instagram at @rustycartoons

I rarely spoke up in my doctors’ appointments. And, when I did, I spoke in “the good female patient voice.”

You know the one: the pleasant and accepting and grateful voice, the voice that wasn’t too assertive or too blunt or too cold, the voice that didn’t ask too many questions or follow up too frequently, and — especially — the apologetic voice.

With every doctor, I was just so sorry. I apologized for my unshaved legs. I apologized for bleeding all over the hallway when I hemorrhaged after a blood draw (and I tried cleaning up the blood before asking for help). I may as well have set apology reminders on my phone, but, it was so automatic, I wouldn’t have needed to.

This was written by Elissa Bassist, the author of the memoir Hysterical, a semifinalist for The Thurber Prize for American Humor.

This was illustrated by Animation Obsessive, a biweekly newsletter devoted to animation from around the world.

So, I am a transgender person who used to be on testosterone. I was living as a trans man for quite a while and passing as male. And I legally changed my gender to “male” in 2018, so all my documents are pretty lined up. For my care, the main clinic that I was interfacing with in Chicago was Howard Brown.

It’s the main queer clinic. They do a lot of free and cheap STI testing, as well as informed consent hormone replacement therapy (HRT). In some ways, they’re this really essential cornerstone of trans healthcare here in the city. But it’s also a place people endlessly complain about for all kinds of reasons.

So, one of the big frustrations for me was that, for years, every time I went into my appointment at Howard Brown — even though I would put down in my MyChart, documents, and paperwork that my legal gender was male — every time I opened up a portal link or a chart or they handed anything to me, even just my information to put on test results, it would still always list my legal sex as “female.” And I couldn’t figure out what was going on.

I would correct it every single time, and then it would revert back.

My actual provider (my prescribing nurse practitioner who gave me my hormones) was fabulous. She understood trans things. Almost all of the staff there understood trans things, and always affirmed me and used the right pronouns and language.

But my documents were also always wrong.

I complained about it once on social media, and somebody reached out to me and said, “Hey, I work at Howard Brown. What they’re doing here is absolutely not their policy. If your legal sex is male, it should say male on all of your documents. Let me know some info and I can go around and fix it for you.” And I said, “Thank you so much. That’s so awesome of you.” I talked to the person and gave them my info. They said they fixed it.

And then I reported to my next appointment — and it still said “female.”

A lot of little stuff like this continuously happened.

I learned to brush it off.

I know a lot of trans people who go to this clinic, and who are very upset about it and constantly criticize Howard Brown for these things. And I think that’s completely legitimate.

But, for me, at the time, I felt kind of worn down to the point where, well, I was getting my hormones and being treated right by my provider, so . . . I know that bureaucratic systems are transphobic, so I just rolled with it.

I kind of gave up.

Recently, I stopped taking testosterone and moved into a more feminine presentation.

I don’t pass as a cis man as consistently anymore.

But still I’d been going to Howard Brown not only for hormones but also PrEP (pre-exposure prophylaxis to prevent HIV), which requires STI tests every three months. I’m pretty sexually active, so I stuck to the testing schedule.

I rolled up for a recent appointment to get my STI test. And, all of a sudden, they handed me an anal swab, a throat swab, and a vaginal swab.

Again, I had been going to Howard Brown for STI tests every three months for years. And they had not once given me a vaginal swab before.

I didn’t even know they were still using vaginal swabs for STI tests. Normally I went in, did the anal swab, did the throat swab, peed in a cup, got an HIV blood test, and that was it.

I came to find out that if you have a vagina, you are supposed to get a vaginal swab for an STI test every single time.

So, that whole time, the super aware, trans-affirming queer clinic in the city was misgendering me as female in their systems, but also only ever giving me STI tests for cis men.

There was zero attention to what my anatomy was or what my actual sexual health risks were. (I could have been carrying gonorrhea, chlamydia, things like that in my vaginal area that whole time and not known.)

It pissed me the hell off because medical centers always act like they need to know about your so-called birth sex — actually your sex assigned at birth — because it’s critical for them to customize care, and they can’t just treat you, a trans man, like any other man.

But they were literally doing that: treating me like any other man, not looking at any of my specific trans healthcare needs, while simultaneously misgendering me as female.

So, fuck you, Howard Brown. I loved you. I depended on you. And I also hated you.

That’s just the nature of trans healthcare. If we’re lucky enough to get anything, we’re thankful for it.

But boy, did it come with a bunch of flaws.

This was written by Dr. Devon Price

This was illustrated by Mads Horwath

Since this was my first session without any premeds (i.e. the steroid/Benadryl appetizer meant to force my immune system to relax), I was thrilled and relieved to be boring.

Beyond some minor differences — facing a different window; spending less time in the chair; Marcel ending his obsession with a remote aristocratic woman, so he could obsess over a different remote aristocratic woman — everything else was familiar.

One aspect of the routine I’ve never mentioned, however, is the consult.

During each infusion, while I’m mainlining Fix-It Juice, a doctor or nurse practitioner stops by my chair to chat about how the treatment is working and if I’ve noticed any side effects. And, for the past few rounds, I’ve had to say, “uhhh . . . maybe?”

Chat, let me be frank. Inflectra (infliximab) has me following this Tracy Jordan credo:

Now, in a better, kinder world, this would mean that I’m simply using the (100% real) Sharktivity app to check on my boy, Fruit Loops.

But, while we can (and should) go look at Fruit Loops, what I actually mean is that, after I finished my loading doses, my period became — to use more medical lingo — “wack.”

For a while there, like a terrible houseguest, it showed up whenever it felt like it, then overstayed its welcome by up to a week while trashing the place.

The real kicker, however, has to do with a phenomenon called “(pre)menstrual exacerbation” or “magnification.” As anyone out there with a uterus and a chronic health condition likely has noticed, hormone cycles can have a dynamic effect on disease states, so the symptoms of your illness get significantly worse at certain points during the month.

While this effect applies to a wide range of conditions — ranging from diabetes to epilepsy to lupus to mental health disorders — I personally have to brace myself for a lot of inflammation, a creakier skeleton, and a higher risk of tissue injuries. And, since my Shark Week doesn’t come with a John Williams leitmotif, if my period gets irregular, I lose the ability to track it and to predict those pain spikes.

Now, before you stop reading, let me explain why I’m telling you this. One is paying it forward: I wish someone had told this to me. And the second is to point toward a systemic issue in medical research.

When I mumbled something about “erratic cycles” to the nurse practitioner at my infusion center, she started nodding before I even finished. “Ohhhhhh yeah, that’s a thing sometimes with biologics. Usually settles down in about three months.”

I was grateful for the clarity — because, despite infliximab being one of the oldest and best-studied drugs of its kind, the existing literature told me almost nothing about how it affects patients with menstrual cycles. And that’s because most clinical trials of drugs on today’s market were conducted exclusively on cis men.

In her book on data bias in medicine, Invisible Women, Caroline Criado Perez observes that, historically, women have been excluded from clinical trials. When they are included, they tend to be tested and observed in the early follicular phase when their hormone levels are lowest — i.e. more superficially like men.

It wasn’t until 1993 that the U.S. passed a law that required all NIH-funded medical research to include women. Yes, you read that correctly. 1993. “Compulsory medical research on women” has been around for less time than Home Alone 2.

Suffice to say, we know a lot less than we should about how drugs affect the menstrual cycle (and vice versa) but, even more concerningly, about how to adapt dosages to women for the purpose of safety. A 2020 research study demonstrated that women experience twice as many adverse drug reactions compared to men — many of which have been attributed to differences in factors like hormones, body composition, and metabolism.

So, while I’m grateful for the on-the-ground healthcare providers who can make observations about gender differences (like that awesome nurse practitioner), we all deserve research practices that are actively inclusive of women’s bodies, trans bodies, and intersex bodies — in other words, all of us who have been done the disservice of being lumped into the category of “imperfect men.”

Now, if you excuse me: I have to go check on Fruit Loops.

In the 1940s, a group of researchers at Cornell University was trying to come up with an objective method to use to measure pain. They suggested that a person’s pain threshold be measured in a unit they called the dol, which was short for “dolor” — Latin for “pain.” Once they had a name, they had to figure out what a dol actually was. The only way to do this was to design experiments that intentionally inflicted various types of pain onto human subjects, then scale them accordingly. So that’s exactly what they did: they came up with over a hundred different experiments using various pain-inflicting stimuli. As they reached the upper limits of pain, however, they were confronted with a very obvious problem. To understand pain at that level, they’d have to truly injure a subject, and the margin of error for something like that would have no doubt been very small. What they needed was a highly painful experience that wasn’t going to maim or kill anybody, and that they could easily observe. And that’s how researchers from Cornell found themselves in the obstetric wing of New York Hospital, burning the hands of laboring women . . .

The experiment went like this: as the thirteen women in the study labored, in between contractions, the researchers would burn one of their hands with a thermal device calibrated to deliver varying levels of intensity. The researchers had set the value of a dol as “approximately one-tenth the intensity of the maximal pain,” which they were hoping the experiment would help them establish. What they really needed was for the women to be able to compare not just the intensity of the two types of pain, but both their qualities. Of course, as the labor progressed, the women were understandably less communicative than at the outset, and so the researchers made inferences about their pain experiences by noting their behaviors, “such as crying, complaining, sweating and degree of alertness and cooperation.” Not surprisingly (to many women, anyway), the pain experienced by at least one of the women achieved the maximum value for the dol pain-measurement scale—a 10.5. what the researchers called “the most intense pain which can be experienced”

These experiments in calorimetry provided a lot of fascinating data about pain, and it scientifically confirmed what women had known for millennia: that childbirth can push beyond the perceived limits of the human pain threshold. It did not, however, provide medicine with the kind of objective measurement it needed in terms of pain assessment. As compelling as the dol studies were, they still relied on the patient’s willingness and ability to report their pain — which is inherently subjective.

This is an excerpt from Abby Norman’s book, Ask Me About My Uterus: A Question to Make Doctors Believe in Women’s Pain

This was illustrated by Cara Ziruo Wang

Whenever I go somewhere with my partner I find that, while she’s very excited for the views and the restaurants (which, don’t get me wrong, I do like. . . sometimes), I love seeing a working hospital in the area. It’s a beacon of hope that’s perfect for every kind of emergency, from bowel obstructions to heart palpitations to my belief that kidney stones will make a surprise cameo at any time. Knowing it’s there makes this IBD-ridden fellow very happy. — Ian

Until recently, whenever I booked a hotel, my make-or-break amenity was “do they have a mini fridge?” Not because I have a weakness for $15 bottles of Fiji water, but because if I was going to be on the road for more than one week, I’d be toting what looked like a purple insulated lunch bag with my biologic medication, which has to be kept chilled at all times. Mildly inconvenient, but at least I knew I’d have working legs at the beach!

What I don’t miss is carrying my little parcel through airports. A TSA agent would always swab it to check for explosives (in case I wanted to blow up the plane), then check the validity of my prescription (in case I wanted to blow up the plane against medical advice). Just let me carry my needles and string cheese in peace. :/ —Amanda


This was written by Ian Goldstein & Amanda Lehr / Illustrated by Helen Nesburg.

Enjoying the Out-of-Network and want to help us keep making it? Buy me a Coffee! (Your “coffee” goes directly to paying our illustrators.)

For me to get legs I could take for a run, I’d have to pay $27,000 out of pocket.

Ain’t nothing like being told that the legs you want are not “medically necessary.”

This was written by Jamie Schanbaum and illustrated by Lia Strasser

Enjoying the Out-of-Network and want to help us keep making it? Buy me a Coffee! (Your “coffee” goes directly to paying our illustrators.)

The first thing I do when I book a flight isn’t pick a seat or pack my luggage.

It’s sigh and roll my eyes... A DEEP AFRICAN-AMERICAN ANCESTRAL SIGH/ EYE-ROLL COMBO.

Because I live with a permanent ileostomy due to severe Ulcerative Colitis, and every time I get on a plane I already know I’m about to be disrespected by architecture, engineering, and “efficiency.”

I’m a 38-year-old woman living in Fort Worth, Texas. I’m married; I’ve got four teenagers, three dogs, and over 600,000 people online faithfully watching my life like the latest episode of Euphoria. I survived ulcerative colitis. I’ve had a total colectomy. I’ve survived learning to love my body with scars and a prosthetic device that comes with a lot of stigma and shame. I’ve rebuilt my whole life from scratch.

But the airplane bathroom?

That’s my final boss.

Airplane bathrooms are designed for people with one problem: needing to pee. Ostomies come with several problems, most of which require space, stability, consideration, and the ability to move your arms without hitting three surfaces at once. (Eye roll)

People with ostomies need space. Not luxury. Not a chandelier. Just enough room to care for ourselves.

And then there’s the cabin pressure. Changing cabin pressure makes ostomy bags expand like a bag of chips overinflated with air.

My ostomy doesn’t do “travel size.”

It expands like it paid for its own seat. . . and, now, at 35,000 feet, I’m panicking in a bathroom the size of an iPhone box, thinking about every possible bathroom scenario that leaves me with liquid poop all over my clothes. . . the shitty walk of shame back to my seat. . . the passengers asking “what’s that smell?” . . . old ladies gagging, babies crying . . . and everyone realizing it’s me . . . How many more hours do we have on this flight? Will the pilot have to turn the plane around or make an emergency landing, all because we hit rough air while I was using the restroom? The anxiety is SO REAL.

No matter how short the flight is, my bag is like, “Now seems like a good time to show off.”

Just imagine me in a tiny little sky closet during turbulence, trying to empty a medical device full of liquid stool, holding my bag closed with one hand, bracing myself with the other, knees touching the door, elbows touching the sink, hovering over the toilet (cause, you know, girl code), praying to God and Beyoncé at the same damn time.

And of course, somebody is waiting outside.

Breathing all heavy and impatient. Shifting their weight from left to right. Acting like I’m in there scrolling Instagram and laying my baby hairs before we land.

Baby. I am in here doing advanced trigonometry with my appliance trying not to set off a poop bomb in this sky torture closet.

The anxiety isn’t even about just being embarrassed. I’ve been naked in front of entire medical teams. I have HUNDREDS of rectal exams. I’ve lost all shame.

It’s about knowing there is no room for error.

No space to fix it.

No space to breathe.

No space to maintain dignity.

No space to hide.

And one time. . . it did go wrong.

My ostomy exploded on a plane.

Not a leak. Not a “little situation.”

A category 5 crisis.

It happened right when my husband and I landed in Dallas after a vacation, and I felt it instantly. That warm, unmistakable feeling of, “Oh. This sh!t is happening to me right now, in public — on a plane”

I grabbed my purse, covered my body with my blanket, grabbed my carry-on and whatever confidence I had left, and walked off that plane like a woman who absolutely did not have the time to explain herself.

No eye contact. No small talk. Just straight ahead.

This is not rare.

Millions of people live with ostomies. We work. We travel. We vacation. We exist.

Other countries have ostomy-friendly bathrooms on planes. Real space. Real shelves. Real consideration. Real dignity.

Meanwhile, I’m on a billion-dollar airline being asked to perform a medical procedure involving human feces in a space designed for a lip gloss touchup, a selfie, and maybe a prayer.

I talk about my ostomy online. Loudly. Proudly. Publicly. I’ve built a whole platform on Beyonce’s internet around telling the truth about this life. I’m not ashamed of my body.

I’m so tired of my body being treated like it’s an inconvenience to OTHERS.

I survived my disease.

I survived the stigma.

I survived the shame.

I survived losing my colon.

I survived learning how to live again.

I should not have to survive the American Airlines (or Delta or United or Spirit) bathroom.

This was written by Victoria Tyler and illustrated by Mads Horwath

My face burns. It always burns. The left side feels like zombies on fire are chomping down, and yet I feel nothing if warm water touches my cheek. I can feel the cold. Cold water and air and touch make the fire zombies angry.

Anesthesia dolorosa, numb pain, is what the doctors call it. Sometimes I can’t say the name, when it hurts to move my lips.

7 days minus 7 hours, 15 minutes, and 5 seconds before my brain surgery is set to happen, I broke down sobbing when I learned The Insurance Company was going to cover the surgery. The surgery to install wires that change the electrical currents in my brain and a battery that powers the wires in my chest. The surgery that won’t cure me, but will make me 75% better.

I would be happy with 10%.

For 5 months, 2 weeks, 4 days, and 33 seconds, I fought The Insurance Company. They called my condition a “suicidal disease” in one sentence and deemed it “medically unnecessary” in the next. Maybe it would be cheaper for The Insurance Company if I lived up to the name.

It was almost 250,000 dollars if they kept their promise not to cover my brain surgery. That’s more than a funeral.

I’m not going anywhere.

I’m a dependent on my dad’s Insurance Company plan at age 28. The age limit is 26 but The Insurance Company allowed me to stay on. An act of kindness I wonder if they regret.

December 30th, 1 month, 10 days, 19 hours, 57 minutes, and 6 seconds ago, Richard from The Insurance Company told me the surgery was approved. He made a mistake. My medicine that does nothing was approved. The surgery was not.

I didn’t change Richard’s name. Richard is nice. He felt bad and cried when he told us he was wrong.

I hate Richard. I hate The Insurance Company.

I’m scared I lied when I wrote 6 minutes 47 seconds ago that I’m not going anywhere. There’s a chance of stroke. There’s a chance of coma. There’s a chance of death. There’s a chance it doesn’t make me 75% or 10% better. There’s a chance it doesn’t work at all.

I need it to work. I have a therapist and a backup plan and like I promised I’m not suicidal. But I NEED it to work. Or I’m even more beholden to The Insurance Company.

Richard wished me good luck. I hate Richard.

The fire zombies don’t know what’s going to hit them. Neither does my brain. I do. I’m awake for the surgery. I’m scared I’m going to sneeze or cough or get an itch. I’m scared of making my doctor laugh.

That was a joke.

I’m scared I’m scared I’m scared I’m scared, but don’t let The Insurance Company know. This’ll be our secret. This brain surgery is GOOD and HELPFUL and I’m HOPEFUL. I am.

Really.

My brain surgery is 2 days, 20 hours, 36 minutes, and 35 seconds away.