TW: self harm

For the first 12 weeks of pregnancy, a mother’s body produces a hormone called progesterone to keep the embryo healthy before the placenta, a temporary organ made of cells from both the mother and the fetus, takes over. It attaches to the mother’s uterine wall to provide nutrients and oxygen, remove waste and carbon dioxide, produce hormones, and pass immunity to the baby via the umbilical cord. The placenta is about 10 inches long and acts as a baby’s lungs, kidney, and liver until birth. Cells may migrate through it, perhaps finding home in the baby’s thyroid or muscles. As a mother gets closer to delivery, the placenta gives antibodies to the baby to jumpstart its immunity, which stocks them for the first several months of their life.  

*

When I was little, I just wanted to play with cups. When I try really hard, I remember their green plastic, the ones filled almost to the brim with tap water, that I would pour from one into the other, and back into the other again. My mother allowed me to play with my cups for as long as I wanted. 

There is a picture of me around this age standing in a shopping cart. It was back when my favorite grocery store was called “Henry’s” instead of “Sprout’s,” although the shelves were still wooden and they still sold those Red Mill oats, gluten-free. In the photo, I wore a green dress and my mother’s hair was blonder than it is now. Standing in the shopping cart, I was tall enough to lean my head on her chest.

Now, the picture lives in the People Magazine archives under the headline “No Wheat, No Worries.” The article started like this:

Sitting in a hospital room, Sarah toggled between tears and sighs of relief.

Finally, a diagnosis:

Her 3-year-old daughter Ellyse had Celiac Disease, a disorder triggered by the girl’s diet

That explained her severe anemia, her skinny arms, and tiny feet—

And a belly distended like a balloon.

Celiac is a digestive condition that damages the small intestine and prevents nutrient absorption from food. People with celiac cannot tolerate a protein called gluten, found in wheat, rye, and barley.

Before I stopped eating gluten, my speech and gross motor skills that should have developed were stunted by the malabsorption. I was filled up like my cups but without a modality to express what needed to spill out. It was only my mother who could communicate with me during those first two muted years, holding my hand in speech therapy as I learned to sound out my very first “R.” Now she says, “I always knew Ellyse was in there.” We improvised with signals—the rubbing of the chest, the patting of the head—our homemade vernacular. Sometimes, I still feel like she is the only person who understands me. 

I watch my mother as she tells my celiac story to other people and I shrug my shoulders, unable to remember anything from this period of my life except the green cups. I can try to imagine my grandfather's blood leaking through a needle into my small arm, but it hurts more to imagine my mother sobbing over my hospital bed into my dad’s shoulder—motherhood still so fresh, and suddenly, so tenuous. 

* 

It was the summer before my mother’s senior year of college when she was knocked unconscious by a broomstick. The broomstick held up a stuffed clown, the type of toy they give Brahman rodeo bulls to fetch. The bull charged into the toy, making the broomstick ricochet into the ground and fly into the right side of my mother’s face. There were 2,000 people in the rodeo crowd and nobody else was injured. 

As the doctor operated on the part of her jaw hit by the broomstick, he nicked a nerve. I wonder if he realized it immediately, if it still haunts him. My mother is cross-legged on her bed on a Sunday and bent over, her head in her hands, for the pain in her jaw that—because of him—throbs in her temple, too. I imagine nerve endings like tree branches being dragged on concrete, although I know I can’t understand it. I linger in her doorway and watch her body rise and fall, then walk away.  

I don’t know how to think about my mother’s chronic pain. I usually just get angry—at the doctors, at the world, at her self-proclaimed “accident-prone” body. I remember when my mother sliced her palm open during the pandemic, the blood dripping in the trash can. I remember frowning and speaking harshly, as if she was a child with a paper cut. The anger dilutes the empathy, making it hurt a little less.   

This summer, we moved from one house to another for the first time. On the second day of the process, my mother came down with a terrible headache. I have never experienced a headache that paralyzes; mine are fingers that tap the inside of my forehead. Perhaps my mother’s are fists. She flinched suddenly, stopping in the middle of her new bedroom’s dark wooden floors. 

“Does it hurt?” I asked, quietly. 

“I took a really gnarly pain medication,” she says. “It’s not helping.” 

I wonder if she is ever numb to the pain or if it is always surprising. 

When several pain control methods fail, doctors have the option to perform a nerve ablation, a procedure that destroys nerves to treat chronic pain in the neck, back, and other areas of the body. A small needle with an electrode on top is inserted into the nerve, which sends radio waves to the place that is causing pain. The heat causes a lesion that prevents the nerve from sending pain signals back to the brain. 

My mother told me that her body “freaked out” during her last nerve ablation procedure. As if her body suddenly realized what was happening to it—that there was a needle piercing its injury. Her stomach rose to her chest and she squirmed, beads of sweat stinging her corneas. Matter seized mind. The doctors now know to give her extra pain medication to calm her down.

* 

“Did you cut your hair?” my mother asked, mortified. My hair was pulled into a high ponytail for volleyball practice, but there was a shorter tail of hair resting on the back of my neck, not long enough to fit into the rubber band. I had forgotten to bobby-pin it up. I had just gotten into the car, finally old enough to sit in the front seat. 

I don’t remember how the conversation went, except that I thought my mother was going to cry. I had been pulling my hair, I told her. Twirling it into knots so big that I pulled them from the back side of my scalp. I remember storing the knots in the pockets of my jeggings or the waistband of my volleyball spandex. I liked saving the dark wads of hair, bundling my feelings into something I could hold between my fingertips and shove away in my desk drawers. 

My mother hugged me too tight and I realized for the first time what it felt like for her to worry about me. I hated it. 

* 

After the rodeo incident, my mother found a lawyer through a college friend. In court, the defense brought up her history of depression. They leveraged her record of mental health struggles to discredit the pain that she experienced after the rodeo tragedy and probably what she said in court altogether. The rodeo company did not end up paying for any of her medical bills. After graduating from college, she immediately went to business school so that she could remain a student and stay on her father’s medical insurance. 

I was visiting New York last summer when my sister called to tell me that my mother was in the hospital for seizure-like symptoms. She had forgotten to bring a certain medication on a trip, and was experiencing the side effects that come with an abrupt stop in dosage. When the doctor performed a scan, he found a blockage in her right side carotid artery unrelated to what she went to the ER for, funnily enough. I cried to my boyfriend and asked why some people are more unlucky than others. 

*

My mother’s male doctor tells her to do cardio in the morning and strength training at night. I wonder if he knows about her Hashimoto's diagnosis, an autoimmune disease that causes her immune system to attack the thyroid gland, which leads to persisting fatigue and unpredictable hormonal fluctuations. Does he know about the nerve damage? That sometimes she can’t move her neck? I want him to have needles in his nerves and know what it feels like when several strong medications mix together inside of him. And then I want him to do cardio in the morning and strength training at night. 

Chronic pain, as a stress state, is one of the critical factors for determining depression. In a study conducted by the University of Arizona, adults with chronic pain were approximately five times more likely to report anxiety or depression symptoms compared with those without chronic pain. On top of that, although 70% of chronic pain sufferers are women, 80% of pain studies are conducted on male mice or human men. One of the few studies to research gender differences in the experience of pain found that women tend to feel it more of the time and more intensely than men.

*

I have always picked my toenails off. When I was young, it was usually my pinky toe. Upending the nail with my fingers and pulling, I felt in control. I placed the tiny toenail on the shelf beside my bed in triumph. I remember wrapping tissues around my toe and watching scarlet swell on white. I swaddled another tissue around so I didn’t stain my sheets. 

At 21, it’s the bottoms of my feet or the ingrown parts of my big toenail that are my addictions. Sometimes I wonder if I do it for the artfulness. But then I am there again and I don’t remember how I began, and the sharp part of the cuticle cutters is dug into the bottom corner where my big toenail meets skin. I suck up the blood with my lips and I can finally see the rawness that’s almost pink, the way the small ridges in my skin are the same, even layers deep. Later this summer, I ask my mother to hide the tweezers and the cuticle cutters. For a moment, I believe in myself. The next day, I find my sister’s nail kit in the top drawer of her bedside table. I lick the blood off her tweezers before I put them back.

I know my mother feels something when she sees bandaids on my big toes. It is just like how I feel something when I walk past her room and her head is in her hands. I hate it when she worries about me, but I reckon that she must hate it when I worry for her, too. Neither of us wants our pain to intensify what the other already feels. 

Some people have said that my mother and I are enmeshed. Enmeshment is a psychological concept introduced by Salvador Minuchin. To him, enmeshment within a family unit causes personal boundaries to be diffused. Over-concern for others leads to a “loss of autonomous development”—as if you hug someone so tight that your insides start leaking into theirs.

I am confused about how one avoids enmeshment. After all, we are most related to our mothers. According to Dr. Jennifer Cohen of Duke University, the DNA in our mitochondria, the “powerhouse of the cell,” comes from our biological mothers, not fathers. “The mitochondrial DNA comes through the egg, not the sperm,” she says on a podcast for NPR. “All people, women and men, are more genetically related to their maternal line, I would say, not just their mother but their whole matrilineal line, essentially—so their mother, their maternal grandmother and so on and so forth.”

Inversely, fetal cells migrate into the mother during pregnancy through the placenta. Fetomaternal microchimerism, according to the journal Cell Adhesion & Migration, probably occurs in every pregnancy. The fetal cells can be found in maternal blood, bone marrow, skin, and liver, and can persist for decades. In mice, fetal cells were even found in the brain. She is inside of me, just as I am inside of her. How can we not feel for and with and instead of one another? 

*

My ex-boyfriend thought it was weird that I fear motherhood. “You’ll be a great mom; what are you talking about?”

I don’t doubt that. After all, I learned from the best. The buns gelled so tight that I thought I may actually be a princess. The letters from the North Pole typed in red and green cursive whose edges rolled back toward one another when I opened them, like real medieval scrolls do. I believed in magic for too long because I couldn’t help it. I now know that parents can create this magic if they try. 

My mother sent me a graphic that said, “Moms can push all their kids’ buttons because they installed them.” I think this is what I fear—the knowing and the loving, how intensely it will all hurt. The way my mother can feel what I feel from thousands of miles away, knowing even over the phone that I’ve been crying, and no, that I’m not just congested. 

This summer I dreamt of a photo. My daughter wears a beaded white dress and holds flowers. Purple, like the ones my mother had on the tables of her 2001 wedding, where she also wore a beaded bodice. My mother and I stand on either side of her. Everything is blurry except the three sets of crow’s feet, lines splaying out from the corners of each of our eyes like tiny sunrays. Wrinkles from smiling, like my mother always tells me.