i. Segment One: A View of the Iceberg

You can imagine me on the tall side. I have fairly even and ordinary human features, and most of the usual insecurities about how they all go together. I also have what I assume to be the usual amount of acrimony, compassion, dread, exhilaration, awe, and an overdeveloped sense of self-depreciating humor. Like most, I have always rather thoughtlessly relied on my capacity for tears being endless, my ability to feel joy, immeasurable. It never occurred to me that some emotions could be finite. 

As far as setting goes, imagine me in the Emergency intake waiting room of the Jubilee General Hospital in Victoria, B.C., a place of chipped paint and pilled fabric seat cushions. It’s the winter of 2010, about to turn over into 2011, and I am holding in one hand an orange, and in the other a bottle of Adavan. I leave the species of orange up to you. In my memory, it’s a clementine. 

This is day thirty-six of my self-imposed exposure therapy regiment, and, as usual in such grandiose (if slightly ill-advised) undertakings, reviews are mixed. Some might argue that in simply leaving the house today, purchasing this presumable clementine, and coming here to this sterilized, if not exactly consecrated ground, my achievements for the day are piling up. I, on the other hand, am more concerned that I have lost all feeling in the hand holding the orange. This numbness signals to me that, as usual, I am about to have a massive panic attack. 

As I’m sure most people would in this situation, I blame Sigmund Freud. He was my introduction to theories of interaction and conflict between different levels of awareness. My gateway drug into self-analysis; my first aerial view of the iceberg, where conscious, preconscious, and subconscious thoughts and feelings inhabit different strata of a structure that extends so far underwater none of us can see the bottom. The only thing we know for sure is that there be monsters down there. Reading Freud taught me that there are many metaphors available to describe how little we know about brain function, how difficult it is to say for certain why even holding something you are afraid of, an orange for instance, can make your arm go numb for hours at a time. 

Paul MacLean was a neuroscientist and physician who worked at Yale Medical School. While there, he developed what has come to be called “MacLean’s Evolutionary Triune Brain Theory.” Which, I think we can all agree, is pretty catchy. MacLean suggests that the human brain is really three brains in one: the neocortex, the limbic system, and the basal ganglia. You can also say: the neomammalian complex, where we store everything we need to navigate driving, and automatic doors, and knowing which fork to use when trying to impress our prospective in-laws. The paleomammalian complex, where we access our instincts to nurture and procreate, not simply for reasons of the personal, but the sociobiological. Last, the reptilian, or primal brain, a layer of us that has nothing but teeth. This stack of grey matter is how our brains sift and control the impulses that dictate not only what we will wear to the club on Saturday night, but how we will ensure our own survival once there, and the survival of our species. 

Whichever image you ascribe to, both Mclean and Freud agree that the closer you move towards the bottom, the further you get into territory where anger lurks. Pain lives here, as does anxiety and killer instinct. This deep underwater, there is no such thing as personality. The only thing that exists here is the instinct to survive, by tooth or claw if necessary. In terms of importance, our night of clubbing comes in a very distant second.

ii. Segment Two: The Problem With Oranges

For me, the problem started with oranges. They are what led me here to the Jubilee, on day forty-seven of my personal interpretation of rehabilitation, holding a navel orange under my nose and sniffing cautiously. There is a family sitting in the seats kitty-corner to me, father cradling his daughter in his lap while she cradles a sprained wrist. They’re looking at me with that cautious look we all reserve for the unbalanced. Which is understandable. I’ve been here longer than they have. 

The orange that started it all was just a regular orange. One of the midsized ones that comes in the plastic net bags from the grocery store. I was holding the peeled sections in my hand while I spoke to a co-worker, and I remember placing one of the segments in my mouth and a flush rising in my face. A nervy tingling started and a hotness that felt unnatural. It had been happening regularly for the past few weeks, so I ignored it and continued chatting. I put another segment in my mouth, but never got a chance to swallow it. I bit down, the juice rushed down my throat, and I stopped breathing. Or at least, I thought I did. That same co-worker was good enough to rush me to the hospital in their car. 

 I learned later from one disinterested doctor or another that it’s quite a common reaction. People who have never experienced a panic attack will end up in emergency, thinking they are in a state of anaphylaxis, even if they don’t know what that means. And once all the doctors have established that you really are fine, just one of those types, you get left alone to enjoy the dry air being piped into your nostrils through a tube, and, by and by, a sedative will show up in a Dixie cup, and you will be invited to leave. 

I was twenty-eight in December 2009, when I took my dramatic make-shift ambulance ride, and I had never suffered a panic attack before. I remember contemplating the retreating back of the doctor who had given me the Dixie cup and wondering what on earth sedatives had to do with being unable to breathe. 

Luckily for me, the hospital called my father. He was the emergency contact listed on my file. To do such a thing would never have occurred to me, since, obviously, if I had died, calling would have been impossible. And since I wasn’t dead, it seemed unnecessary. Regardless of my flawless logic, he arrived sometime later and stuck his head in the door, giving me a quizzical look. We both agreed that it might be better if I stayed on his couch that night, just in case I needed anything. Neither of us knew at the time that I wouldn’t be leaving that couch for almost a year. 

That first night at my father’s house, sometime around three in the morning, my lungs really did fill with fluid. I ran a delirious fever of over one hundred and three and began experiencing spasmodic muscle cramps and joint aches. Back at the hospital, what was initially diagnosed as a very bad case of H1N1 got worse as the days passed. Within two days of my re-admittance, ventilators were wheeled in, heart monitors, IVs of various fluids and functions. I even merited a round-the-clock vigil, during which time I murkily remember someone squeezed my hand a lot and asked me if I could please stick around a while longer. I never wanted to ask, but I assume this someone was my father. It sounds like something he would say. 

iii. Segment Three: An Embarrassment of Symptoms

I did manage to stick around. I was released into my father’s care several weeks later. But as the symptoms of the flu decreased, other problems rose to take their place. Fear of going outside, for instance. Fear of being alone, even with someone in the next room. I couldn’t sleep or eat. I hated sitting, standing still, reading, watching anything; it all made me panic. All the usual symptoms were present: heart palpitations, shaking, a sensation of smothering, chest pain, dizziness, fear of dying, numbness, and tingling. But I also started intermittently losing the ability to speak, swallow solid food, control fine motor function, feel my left arm. At one point, the entire left side of my face went numb for almost forty-eight hours. Finally, I lost the ability to ingest fluids of any type, which landed me back in emergency the week before Valentine’s Day. 2010 was not off to a good start.

The hospital checked me in and did tests that felt like they numbered in the thousands. Blood, urine, saliva, spinal fluid, heart rate, CT scans, tests of cognition, reflexes, allergies, pain response, sight, hearing: name it, they tested it. Either by injecting, recording, bombarding with X-rays, pricking, slapping, palpating, gripping, and what felt like a hundred more intrusions that have finally faded from memory. They found nothing. 

And time was ticking. There is a certain pain that accompanies hunger that is unlike anything else. As the body starts to break down its own muscle tissue for sustenance, a chemical called acetone is produced. In an industrial form, you can buy it in any hardware shop. It makes a good paint stripper. As it eats your muscle fiber away, it creates a smell like apples or pears on your breath. Which could, I suppose, be considered a very minuscule positive to the otherwise tiresome reality of inanition. Luckily, threat of death due to starvation was not the most pressing problem for me. As a normally healthy first-world citizen with reasonable fat and muscle stores, it might have taken months for me to succumb to any of the usual deaths associated with starvation. In my case, it was the dehydration that was the real worry. I couldn’t keep any kind of liquid down. This being the case, life expectancy drops to hours and days, not months. Any mouthful I took was accompanied by a greasy, numbing feeling of panic manifesting in my mouth and throat, followed by vomiting. My weight dropped dangerously low, my kidneys began to ache and put out numbers like they might shut down. IVs were brought in for intravenous feeding and hydration, and all, it seemed, because of oranges.

iv. Segment Four: Team Operable Tumour

“I think we should hope for a tumour,” my father announced. We were crossing the parking lot towards the medical building where my neurologist worked. After months of waiting, my X-rays had finally made it to him, and I had undergone a number of in-person physical tests. Today we were headed for our final consultation. I allow myself this time jump forward by several months because, under the circumstances, I feel the mystery about whether I survived my brush with desiccation is a moot point. It must have been about July at this point. I remember the scorching heat from the hood of some stranger’s car, where I had to lean for a few minutes to catch my breath from the short walk. 

“Really? A brain tumour? Instead of MS or ALS?” I’ll admit to some surprise. A neurodegenerative disease was what most of the doctors in the hospital had settled on to explain away some of my not-typically-panic-related symptoms, but I had assumed my father would come down on the side of something non-fatal. 

“I was kinda hoping for a small hemorrhage or brain damage,” I told him. 

“No,” he said severely, “that’s dumb.”

“But a tumour is genius?”

He looked at me like I was an idiot. “Yeah. Because then there might be a possibility of cutting it out. If it’s MS or ALS, you’re completely…”

“…Fucked?”

“I was going to say out of luck.”

“Same thing. Okay, you can be team Operable Tumour, I’ll hold out for Minor Stroke.”  

“Okay,” he sighed. “Maybe we’ll both hope for that.”

This is one of my favorite memories of my dad during this time. His incurable optimism never faltered. I even considered having t-shirts printed that said: “Team Operable Tumor,” to remind us of those days. If I had such a shirt, I could have worn it for day fifty-three of my self-imposed exposure therapy, sitting in my usual spot at Jubilee. By day fifty-three, I had moved on to peeling . I stuck my thumb into the soft void on the arse end of the orange. Just for variety, imagine a tangerine. The thin skin gives with a satisfying tear. The air around me is suddenly perfumed with citrus oil that sits in tiny dark drops on the smooth skin. Almost impossible to escape, it hangs around me like Christmas, clings to my fingers, and for a split second, has absolutely no effect on me whatsoever. Success. I breathe deeply. I can feel the tension simmering, right there under the surface of my inner monologue, balanced on a fulcrum I have no idea how to control. The waiting is eternal. So far. So good. I pull off the first long thin strip of peel. Oh, shit. It feels like a hole opens up in my palette, through which all the air in my lungs escapes. 

I remember some of those days in the Jubilee better than others. How on that day I actually got up and walked to the intake window and leaned against the wall just out of sight of the on-duty nurse, as if needing her sympathetic participation. My assumption of her ability to do something helpful for someone dying of an overactive imagination kept me upright. 

On the day my father and I decided to explore the power of prayer to manifest either an operative tumour or minor stroke, my final meeting with the neurologist was a comparatively short one. 

“You present as extremely healthy,” he told me. I felt a slight tingle of disappointment at that. I mean, after all the work I was putting in, I may as well have something. 

“I think you just got attacked by multiple problems at the same time. A really bad flu covered the symptoms of the onset of a severe panic disorder, coupled with migraine variants, which would cause asymmetrical numbness. It’s not something I’ve seen happen before, but that doesn’t mean it’s not possible,” he intoned, looking more at the paperwork than me. 

“What about being suddenly allergic to oranges?”

“You’re not allergic to anything. You’ll have to confirm with a psychologist, but your allergy tests are clear. I’d be willing to bet on the oranges being a psychosomatic occurrence.”

“You’re telling me that because I believe I’m allergic to oranges, that I’m allergic to oranges?”

“No. I’m telling you that since you believe you’re allergic to oranges, your body is manifesting the symptoms of an allergic reaction, when none really exists.”

“Your body can do that to you?”

“Your body just does what your brain tells it to. If your brain is convinced on a subconscious level that oranges are going to kill you, then it’ll release chemicals into your system that mimic those symptoms. It’s a self-fulfilling prophecy. You should read Freud. You seem like the type of person who’d enjoy his writing on subconscious cause and effect.”

 “So…how do I convince my brain that oranges are back on the fly list?”

“Again, not my line, but if I were you, I’d ask a psychologist about exposure therapy. All I can tell you is that your brain is showing normal function on every test we’ve done.”

“Exposure therapy? So if even thinking about oranges makes me panic?”

“You need to start spending time thinking about oranges.” 

v. Segment Five: Nothing Rhymes with Orange

It turns out that the chakras have colours assigned to them. Orange is the colour of the Svadhisthana, or sacral chakra. Religions like Buddhism and Hinduism believe the chakras are energy centers inside the body that help it function properly. Keeping these chakras open and receptive helps maintain good health. There are seven primary ones, the Svadhisthana being located under the navel. It’s linked to the sexual organs, sexuality, and emotions. It’s also linked with creativity. 

For many cultures, oranges symbolize the reward for hard work. Orange trees are extremely difficult to cultivate and require years of labor before they produce fruit, so the orange is physical proof of diligence and consistent effort. Some Asian cultures view oranges as good luck and use them extensively in ancestor worship, while others, like some pre-Islamic groups in North Africa, use them as offerings to pray for a reprieve from ill-health or anxiety. 

Scientifically, it’s been discovered that the colour orange has one of the strongest measurable physical effects on the body. It is linked with increased appetite, metabolism, and energy levels. 

I also discovered, during my exhaustive orange research, that the fact that “nothing rhymes with orange” is untrue. Sporange is an alternative name for the spore-producing part of a plant. And the Welsh have a mountain called Blorenge. Because of course they do. 

And all of this knowledge seems to have led me directly to the pilled cushions of the Jubilee waiting room, where, at twenty-nine, and more than halfway through a now-abandoned BFA, I am sitting, some time in the very early spring of 2011, furtively licking peeled orange segments and hoping that no one I formerly knew needs any triage tonight. As one might guess from the pattern starting to emerge here, it was not going well. Today was day seventy-five of my self-imposed exposure therapy, and I was deep into the licking phase. 

I never did actually get to see a psychologist. The waiting lists were years long, and I couldn’t really afford it anyway, so I consulted the internet, oracle of all knowledge, and determined that I was already a past master of exposure therapy anyway. I mean, if all it consisted of was identifying something you were illogically afraid of and repeatedly and incrementally doing that thing, then I had been engaged in it since the beginning. Everything scared me. Ergo, doing anything qualified as recovery. It was how I managed to avoid death by dehydration in the first place. In order to be released from the hospital back into the wild (of my father’s one bedroom apartment), I had to be able to drink water. An action which, unsurprisingly, caused me to have a panic attack. So I drank water and had panic attacks. And since I had so much incentive to practise and so little else to do, I got creative. I discovered that if I was moving, I paid less attention to the actual act of drinking. I began to take a sip of water every time I turned over in the hospital bed. Later, I’d sip water while shuffling up and down the hallway of my hospital floor. Gradually this turned into being able to do the same while standing still, sitting down, and, eventually, whenever I wanted. Since it had worked with water, I tried it with solid food. It took longer but followed the same pattern. Same for going outside once installed back at my father’s place. First touching the doorknob, then stepping outside the interior apartment door, then the elevator, then the exterior door. It was terrifying, and arduous, and ridiculous, and sometimes, oddly hilarious. 

In fact, I remember very clearly the day when I realized that it just might be possible that I wasn’t going to spend the rest of my life sleeping on someone’s couch. I was taking one of my walks around the block when it suddenly struck me that all of this was funny. All this shuffling along with cups of water and jogging around a one-room apartment in hopes of choking down a salad and wandering the neighborhood with my father on speed dial in case I panicked and forgot which way to go. It was definitely agonizing. But it was also funny. For the first time in what felt like forever, I wanted to laugh at myself. I didn’t then, because I couldn’t, yet. I hadn’t even managed a smile in almost seven months at that point. But I wanted to. And to me, laughter is everything. Not just a coping mechanism, or my favorite activity, or my favorite way of communicating with others, but survival. If I can laugh at myself through an ordeal, I can survive it.

vi. Segment Six: One Hundred Days' Worth of Vitamin C

When you bite into an orange, all the juice runs down your throat. There’s almost nothing you can do about it. It’s all or nothing. And every time I tried biting into my orange (Seville), sitting in my now well-worn seat at the Jubilee, I had a panic attack. For days ninety-seven, eight, and nine, my panic attacks had been enhanced by the urge to throw up about halfway through. And may I say, vomiting while short of breath, is an experience both horrifying and even more horrifying. But what else is there to do? It seemed a shame to turn back now. 

I had originally chosen to do this in a hospital because, unlike many people who dislike their sterile atmosphere, hospitals are a place of comfort for me. I was a first aid attendant for many years. I was a rescue diver before that, and before that, a lifeguard. Having the knowledge to help those in a state of suffering had defined so much of my life up until this point, when it became obvious that I could no longer take care of myself, the hospital gave me the feeling of connectedness to other people with the same drive. 

I had come to accept that somehow, someway, a seed of an idea had planted itself deeply in my primal brain, and every time I force-fed myself this single stupid piece of fruit, that part of me screamed that I was going to die. In an ironic twist that is not lost on me, my panic attacks were my subconscious trying to save me. Because I was killing us right now, me the university-educated know-it-all, me the nurturer of the wounded, me the animal that refused to die without a fight. It seemed the only way to drive the idea out was to keep dying, day after day, until all three levels of me were beaten back into agreement. It’s just an orange. So I swallowed the juice and waited for the panic. I wasn’t disappointed. 

By the time I had this ninety-first self-inflicted panic attack, I had sat in the same chair in the same waiting room for one hundred consecutive days, and not a single staff member ever bothered me or asked me to leave to free up the chair. No one asked if I needed any help either, but I suppose you can’t have everything. I never spoke to a single staff member. Never tried to check myself in, never did anything but sit and try, with varying degrees of success, to eat a single orange. 

vii. Segment Seven: The Topmost Village

Imlil is the topmost village in the High Atlas Mountains, a range that runs from the royal blue Atlantic coast of Morocco to the endless Saharan sands of Algeria. The village is used as a supply station and rest-stop by anyone intent on hiking some of the highest summits in North Africa. The narrow aluminum sheet and cinderblock buildings are strung out along a single muddy road that leads towards the trailhead into the vast mountain range. From there, you can hike for a day, or twenty. The only deciding factor is when you turn back. A few hours' hike from Imlil is a pre-Islamic shrine, Sidi Chamharouch, the King of Jinns, on Jebel Toubkal, the highest Mountain in North Africa. The shrine is one of the last of its kind, and the locals will guide you out there for a small fee. Nearby the shrine is a small gite, a waystation, where you can sleep on a plank bed and eat from a hastily furnished kitchen. There are stone huts like this dotted throughout the mountains, maintained by Berbers, that offer carpets to sit on and drink tea when the endless terrain becomes overwhelming, or the excruciating muscle cramps in your legs from hypoxia due to the altitude can’t be ignored any longer.  

On the night before I hiked into the high Atlas, our group opted to continue past Imlil, with its wandering mules and children, all sending dense plumes of breath into the freezing air, and stay at this tiny gite. It was two days before Christmas, and the deep purple gorges around the village were full of walnut and apple trees, the blossoms invisible on the snow except for the pale pink flush at the stem. 

Outside the gite, the air is thin and sharp, the snow surrounding the small building insulates it against the dangerous pre-dawn cold. I could feel the familiar tickle at the back of my throat. The tightness I had come to recognize as a tell-tale sign of an impending anxiety attack. The trail to Sidi Chamharouch was not a hard one to find, thousands of feet have trod it before. It’s the remoteness that’s setting me off. Even now, four years after my last visit to the Emergency room, I’m still surprised how terrifying I find it all. To get here, for instance, I wasn’t able to come alone. There is a group of four others still inside the gite, and our fearless and intrepid leader, Mustapha: a Muslim Amazigh born in the Sahara’s Valley of Roses to a family of camel traders. He has been the one to guide us across the country up until now, and barring mishap on some rocky ledge, will get us back home again as well. He has been teaching me about Islam as we go, and how to program my new cell phone. 

It ended up taking me to day one hundred and fourteen before I was able to eat an entire orange without suffering an immediate panic attack. I then moved with my new trick farther down the hospital hallway. Then I ate oranges at the rate of one a day sitting in my car in the parking lot outside the hospital. Then parked several blocks away. By the time I could eat oranges wherever and whenever I wanted, I was already well on my way to finishing the degree I had dropped out of. The year after I finished my degree, I moved across the country to take a job in St. John’s, a city I had never even seen before. One of the first things I did when I got there was identify where all the hospitals were.

By the time I arrived in Morocco, I had finally given up on what I had stubbornly and naively considered a full recovery. The years I spent hoping to go back to the person I was before my diagnosis were disappointing ones. No matter what milestone I achieved, I always remembered that I would never be as carefree or thoughtless in my actions. I’d never be able to just drop everything and travel. I have to plan for it now, ensure I have enough of my prescriptions, set myself small goals to get somewhere, leave myself an escape route. I have to fail a few times first. Like anyone after surviving a trauma, I couldn’t go back. I used to assume this was weakness, a sign that I wasn’t healing. Eventually, I let that idealized version of me go. I came to think of memories of my old self like meeting someone from a different country, one that has different beliefs than my own. I enjoy seeing them, but I can’t be them.

Spending a night in the Sahara Desert and hiking in the High Atlas were adventures I’d always wanted to do alone, but I eventually let that go. Instead, I found a way to get there that was possible, if slightly more crowded than my initial plan. 

So after the dawn had settled into the cold grey light usual for these climes, my group hiked the last hour through the mountains to a small indent on the side of a slope that housed Sidi Chamharouch. The shrine was a giant boulder that sat on a low platform, the large stone painted white. Around the far side from us was a shelf used for daily sacrifice. Offerings were made to heal mental illness, exorcise spirits, or solve everyday problems. The view was amazing. We were right in the middle of a valley that had a view of the jagged mountain ranges that stretched off into the distance. Circling to the other side of the shrine, I came to a sudden stop when I noticed one of the offerings left there. Sitting in the blue shadow, the shrine pitched over the snow, under the blue and white of the sky, and the white and grey of the mountains, someone had left a bowl of tangerines. 

The orange fruit was so bright that I could only look at it for a few seconds at a time. I walked up to the bowl, laughing to myself at the very cheek of fate some days, and took one of the oranges off the pile. I didn’t break the skin. I didn’t inhale the familiar scent. I had no wish to disrespect any old Gods or people around me. I just hung onto that orange for a few minutes, looking around at the view, watching the visible evidence of my own breath billowing out of my mouth and nose into the sharp air, cradling the small fruit in my palm, thinking that from a distance, it may have looked like I had created fire in my own hand.