The Chief Complaint

by Austin Hopkins, MS1

He is anxious.

Or rather, he has anxiety. He is afraid of a complete reversal, one where he’s pulled back into the world he’s worked so hard to escape. He wakes up with a tightness in the base of his throat, a tightness that can crawl through his chest, into his shoulders, and into his lungs. He finds that he’s not breathing more often than not. His heart beats perceptively; he feels every beat with the magnitude of a great stampede. A rope pulls his temples together, tugging his insides from down within a deep crevice of his torso; if he allowed his body to follow the trajectory, he would fold in upon himself, a black hole, le denoument.

He is afraid. He is afraid of the reemergence of the clinical depression that plagued the past five years. He is afraid of the hypothetical day when the four-drug cocktail finally fails to deliver. He’s afraid of people misunderstanding him, of not really understanding it himself. He’s afraid of defeat, of being conquered a final, ultimate time. He is afraid of what they did, those men whose faces will never truly fade, that somehow it can’t be fixed. He is afraid of people, because he fears that he can no longer engage with them in the world outside of an internal cacophony. He is afraid of loss, of losing the most intimate relationships and friendships that he has been able to carry with him to this moment. He is afraid of what people will think of the past and current lists of diagnoses: anxiety disorder/post-traumatic stress disorder/trauma induced addiction/chronic depression.

He is proud of where he is today. In his mind, he sees himself smiling and dancing, despite the sky raining kerosene above a field of matches primed for illumination. But he is afraid that the sky will catch fire, that the night sky will be consumed by flames. So he worries, somedays more than others. There are good days, ones where he only takes one pill. But there are the days where he can barely keep his body from flying apart into a million unresolvable shards. He is sometimes afraid that the promises he made to himself in black ink across his body won’t form a strong enough anchor for those days. But somehow he is here, he is no longer in the past, today he is here. But something still lingers, an elusive, trailing, tempting, striking, constricting, faceless, boundless entity whose echoes you can hear if you know when to listen. He’s getting better, he’s much better, he can see what it would be like to be healed, to be a derivative of an idealized whole self that sits at the base of the altar littered by his body’s dutiful sacrifices. But the healing process isn’t yet complete, so he still worries. His body has erected a magnificently intricate and damning defense system to prepare for the worst-case scenarios that sometimes play in an ever-intensifying loop in his head. He worries because his body has taken the brunt of the fall and can’t relax, not just yet.

He is anxious.