KAYLA PICA WILLIAMS

In My Blood

Help me, it’s like the walls are caving in
Sometimes I feel like giving up but I just can’t
It isn’t in my blood.

-Sean Mendez

You are younger than one and you do not know what amoxicillin is and you nearly die for the first time. You are a part of the 60% that does develop the allergies that are genetically passed down from your relatives. When your immune system attacks the allergen, your blood flows with histamine and the white skin you got from your father is pinkened and blotchy with hives. It is likely that your tongue is swollen and your airways could be blocked. Your mother recounts the goodness in the world by stating how - towing a 11-month-year old into the emergency room an hour before a flight to see her family in Peru - the other mothers had stepped aside and allowed her to go first. Back then you wondered nothing, you merely screamed. Now, you wonder why your sister never experienced the rush to the hospital room because she took a common antibiotic.
As you grow up you listen to your mother. You know you cannot take amoxicillin and wear a bracelet that says so. When your class goes swimming and are told to take off all jewelry you stand off to the side and explain about the bracelet with the snake. You do not know about histamines or 60%, you only know that it’s because of your body that you wear the metal bracelet that sticks to your skin uncomfortably and you never take it off.
“What is that?” every classmate asks and you explain.
“Can I touch it?” They grab your wrist and pull.

* * *

* * *

You are seven and you are not good at swallowing pills. You get sick. So you take pills and so you often miss things. You miss the dance classes you are taking because you are Peruvian and so dancing is in your blood. You miss regular classes but you do not fall behind because you are the daughter of an engineer and a nurse, so you are smart. Every time you get a new pill and every time you cannot swallow it.
For the softer pills, your mother cracks them open and mixes it in Trix yogurt. Two colors swirling together with the bit of white powder mixed in. It tastes vile. For the hard pills, you swallow and spit and swallow and spit and swallow. It will work eventually.
Your best friend is Kaleena. You fight over the best dandelion to give to your mothers and make plans to grow up and own a farm together. The first pill you are able to swallow is a Lactaid and you run across the lawn with a pill and water to show her. She applauds appropriately then runs to her mama and asks if she can swallow pills too. You find the best dandelion to give to your mama who swallows Lactaid pills just like you.
Kaleena is a year younger than you and is not there when another student brings in ice cream for the class. You first explain to the teacher who lets you run to the office where you explain to the nurse who lets you swallow your Lactaid pill and then run back to class. By the time you return the other students do not applaud for you swallowing your pill. They have finished their ice cream and they ask you where you had gone and you are given your ice cream cone and they make you explain. Your ice cream drips down your fingers and onto the floor.

* * *

* * *

You are seven and you are not yet used to being hypoglycemic. It is a condition you get from your grand-mother on your father’s side, low blood sugar. You have to eat every two to three hours and you cannot have sugar on an empty stomach. Back home, with your nurse mother, this was not a problem. At school, you begin to adjust. You are used to the way your stomach gurgles and begins to gnaw at your insides. The light headed accompaniment that keeps you from getting up from bed most days. When you do stand, everything spins, and you feel the urge to vomit but nothing comes out even when you gag.
It is often by the end of school when you start to have trouble. Between lunch at school and snack at home it is four hours. It was easier when you were younger, when you were always at home and could eat whenever you wanted to. Now you have to explain to the other students why you cannot run at the end of classes. Why you no longer have the energy to walk home, let alone play. You try to teach them to say “hypoglycemia” but it comes out as variations of “hyper”, “glee”, and “dema” and after the fourth try you give up.
At field trips you have to bring a snack and sit away from the other students while you eat it. They get to pet the rat, look at the painting, touch the globe that makes your hair stand on end. You get to eat crackers and peanut butter. Again.
It’s not fair. They say while they glare at you. I want to eat too.
You always tell them that you will trade. As you grow older and the snacks become more frequent and larger, your friends say how great it must be to be able to eat so much and not gain weight. You are twenty pounds under weight and eating twice as much to maintain it. You want to participate in after school plays and sports but you’re too hungry to stand. You always tell them you will trade. They would get to eat as much as they want, whenever they want, would have a doctors note for it and everything. You would get to know what it feels like to not have your head spinning, your stomach gurgling, be able to do things after school.
They always laugh, point at your stomach, and say how envious they are.
You grind your teeth and try not to say how weak you are.

* * *

* * *

You are fifteen and you believe your mother that taking too many meds could hurt you and so you take too many Motrins. It is after the marching band carwash. Your mother was also in marching band and so was your sister. They delight in the “car wash” written in permanent marker across your stomach when you come home. You smile at them without your teeth. The pills are small and red and go down easily. They taste nothing like Trix.
You sit and wait and do not cry and wait and wait. At some point you notice that you have freckles from your time out in the sun just like your father. And the “car wash” has left a permanent imprint because you tan as easily as your mother. You make no decision and you walk over to your mother and tell her you took Motrin because you wanted to kill yourself. It is then you learn from poison control that Motrin could not and would not kill you. You are stupid. You learn the pills will make you sleepy and you tell yourself that is why you can’t get out of bed and why you pee yourself rather than move. It is warm and yellow.
“Think of it like cancer.” your mother’s chest is warm and her nursing scrubs are soaked as you lean against her from inside the tub. Her face is darker than yours will ever be. Your father will never know how to watch out for tan lines and your mother does not know what it feels like to peel sunburn from your nose. She makes sure to wash the flakes away.
“Would you be saying sorry if it was cancer?”
The therapists asks you questions and you sputter and swallow and try but fail. Your mother trusts you and so she believes you when you say you do not need to go anymore. The freckles you get from your father help hide the razor pock marks on your stomach. The sensitivity to pain you get from your mother keeps the scissors on your stomach and away from your wrists. When you see your family they talk about you.
“You are as skinny as your grandmother. Eat. Eat” in accents you barely understand.
“You are as picky an eater as I was when I was your age.” From one of your white aunts.
You draw the words “help me” over and over again on the skin of your stomach with the tip of the scissors. You wonder which relative will see it through your thin, white t-shirt.

* * *

* * *

You are seventeen and the pills they give you this time are small and oval and blue. You pull out the short list of phone numbers on a post-it to call your old therapist and make sure that you have not taken these ones before. These ones were new and not scary yet. Your mother doesn’t cry when you call her from the same landline and your best friend does not either.
“What happened chica?” this friend is Haylee. You met her through that one boyfriend that neither of you liked and you are glad she dumped him. Between music practice and changing lights backstage, you practice duets and walk to 7 eleven for slurpies that make your stomach gurgle. She shares snacks with you to help you handle your hypoglycemia. You tell her it was a mistake and how you will still be there for class soon and you will graduate on time and she should not worry. You feel stupid and do not tell her how sick and weak you are.
You stand in line for your medications behind the boy who held a gun to his head and in front of the one who tried to strangle himself when he was five. You do not argue with what they give you like you did last time and you simply clock back whatever is in that small paper cup. You have changed your medication. Your legs will grow restless and you will bounce. You will spend a lot of time wondering if you need to vomit as a side effect or if you just need to vomit because you are sick. You will balance precariously on top of your own two feet and the world will spin around you and you will wonder if this is just the transitioning into meds or if it is permanent. You wonder what the world would be like if everything was always flipped. You answer the same string of questions about symptoms and moods and thoughts and the doctors ask you why you had stopped taking the pills in the first place. You’d just forgotten.
“Do you know that you only took about two weeks’ worth in the past six months?” they ask.
You didn’t know. You had forgotten.
You are pulled out of lunch when you had been laughing with the others children about Motrin bottles and razor blades. You amaze the line of six male doctors when you explain how you had planned to tie yourself to weights and jump into the pool at or walk into the middle of the street and just let the cars come or how you had hid all those pills in your sock drawer. You are, after all, a planner just like your mother. They did not expect for you to tell them so quickly and you explain it is not your first time in the hospital. You explain how you decided to go to the hospital and was not dragged and had not done those things and did not want to really. You tongue feels heavy and so you do not explain how you are stupid and weak.

* * *

* * *

You are eighteen and this pill is small and white and looks tiny centered in plastic in an oversized box. This pill costs you more than the others and you can’t tell your parents and insurance wouldn’t take plan B anyways. You don’t tell your friends either. Your boyfriend doesn’t even know. The last time you had to buy it you told him and he told you how you were stupid. You want to argue with him, you want to tell him about your parents, about how you are smart, but you are so sick and so weak and so you let him call you stupid. So this time you buy it yourself even though you do not have a job.
When he has sex with you it hurts and you bleed. It drips down your legs like raindrops and makes a mess when mixed with his cum. You had stopped asking him to use a condom, he would point out how you are stupid again. You go to wash up in your friend’s house and hope that no one sees you going to the bathroom. This was why you didn’t want to have sex there. You said no but he said yes and you are weak and you are stupid.
Your boyfriend talks about the children you are going to have someday. How they will have his blue eyes but your black hair. You wonder if they will also keep scissors in their backpacks or razors in their purses. After all – you are just like your parents, aren’t you?
When you two break up you will blame it on your depression. How if you weren’t always going to hospitals, weren’t always drawing your own blood, maybe he would have stuck around. Later when you recognize the words “sexual abuse” you will blame your depression for not being strong enough to push him away. And you cry because you are sick and you are stupid and you are weak and he left.

* * *

* * *

You are eighteen and the doctor piles boxes in front of you on the desk and you do not even attempt to keep track. It was during martial arts at your new college, Kaleena and Haylee all the way back home, that you felt odd and puked up the food you ate and then became too dizzy to stand. These friends tease you when you cannot come to practice because you puke after eating. Four months later they stop teasing and you still can’t train and they stop calling. You tell your therapist it is their fault but you do not try and you let them leave and you are sick and you are stupid and you are weak.
You spend six months puking and you visit five doctors and you find this one. You give him seven vials of blood in three different locations and a tube filled with spit and a hormone test after many awkward bathroom trips. He gives you a binder filled with all the ways that your genetics are wrong. He explains all the ways in which you are sick and weak.
MTRR A66G and MTRR A664A. MTRR helps recycle B12. You recognize B12 as being connected to mood from talks with your therapist, how not having enough of it could increase your depression. You think about all the mood stabilizers you have had to take.
MAO-A R297R. A critical enzyme involved in breaking down important neurotransmitters such as serotonin, norepinephrine, and dopamine. Mutations in these can potentially lead to neuropsychiatric conditions and symptoms. You underline the part where it says “such as Obsessive Compulsive Disorder, mood swings and aggressive and/or violent behavior.” You think about your mood stabilizers, all the times you tried to kill yourself.
COMT V158M and COMT H62H. COMT is important to areas of the pre-frontal cortex, the area of the brain involved with personality, inhibition of behaviors, short-term memory, planning, abstract thinking, and emotion. You underline the portion where it describes how mutations “can lead to irritability, hyperactivity, or abnormal behavior. They may also be more sensitive to pain.” You think about the small pock marks you would press on your stomach all day long, how you felt no need to slit your wrists because the other pain was severe enough. You wonder which of your behaviors would be labeled “abnormal.” You are not sure how to feel about that one.
VDR Taq. This encodes the nuclear hormone receptor for vitamin 3. Low or low normal vitamin D values are often seen in those with chronic illness. You underline how it “is related to a lot of neurological and immunological conditions.” You remember all the times you were sick as a child, all the pills you had to swallow.
BHMT-08. This acts as a shortcut through the methylation cycle helping convert homocysteine to methionine. You have no idea what this means. You only underline the portion that says “it is common to see elevated gycine in someone with a homozygous BHMT 08 mutation.” You recognize the second part of hypoglycemia. You rub your stomach which is already growling even though you just had lunch an hour ago.
Then he gives you the pills.
“The best way to treat your stomach disorder is to follow our diet and take these medications.” The doctor who says he can fix you talks and points “For the diet we have more details listed out in your paperwork but really you will stick to organic vegetables, chicken, and water. With the meds: first there’s the Vitamin D, we will have to slowly increase your dosage until your hands start to turn red and we will go from there. Then there’s these three pills you take once a day. And there’s the drop which you put on your tongue twice a day. And there’s the supplements which are protein powders you’ll add to water and take instead of a couple of your regular meals. They’re pretty gross at first but you get used to them. And of course, please remember to take your other medications and vitamins regularly too.”
You are not listening. You are looking at the genetic testing results and the list of mutations you got from your mother’s and father’s sides of the family. You think about all the times you were sick as a child. How you missed so much class, how you always seemed to be vomiting. You think about how your entire life you’ve had to watch what you eat and could not participate in activities because you were getting hypoglycemic. You think about all the pills you’ve taken for mood swings and abnormal behavior. You think about all the times you tried to kill yourself. The bottles of pills you swallowed, the roads you walked out onto, the pool where you tied weights to your ankles. You think about how stupid and weak and sick you are. You sit there and nod to the doctor and take home the binder listing all the reasons for all your problems and then you take a pair of scissors and try to bleed them out.

Kayla Pica Williams is finishing up her MFA at CalArts in California, working on a short story collection about depression. She has a King Charles Spaniel named Addie.