The Hardest Pill to Swallow

Kneeling on the ruthlessly cold, travertine bathroom floor, lights off, abdominal muscles convulsing, lungs heaving, and hands holding her hair back as she purges her own stomach of boluses that once looked like her mother’s famous Mac ‘N’ Cheese, Morgan O’Hara is truly in her darkest hour. The air is foul and her tongue burning with acridity. She is alone. She is fading. There is no proper way to explain the degradation of the body, mind, and spirit that occurs with Cyclical Vomiting Syndrome (CVS).

Now, Morgan O’Hara is far from that ugly scene describing where she spent most of her senior year of high school. She is seated across from me, looking sweetly excited with vibrant pink hair, green eyes, a brilliant flare of personality as we enjoy some ritzy drinks reeking of Scottsdale and Boss Coffee. We’ve been friends since middle school, and this is the first time we’ve seen each other since we began university.  

Morgan knows, generally, what I came here to interview her for. She takes a few moments of silence as she sifts through her film of memories and casually begins, “I was twelve. Pretty much what would happen is I would have to sit in a dark, black room, no TV, no light, nothing. My mom couldn’t even come into the room to give me anything. We would have to shove pillows in the bottom of the door so no light would come in. For my dad, throwing up would relieve the pressure of the migraine but for me…I just threw up all the time and it was always around October 30, every year, like clockwork…there are certain triggers to it. It’s called Cyclical Vomiting Syndrome (CVS). It’s a really rare condition, but it’s a thing.” 

I imagine Morgan’s prone form, a calendar in sight across the room, and as the date creeps closer to October, to fall, to what the normal kid knew as new school years and old school friends, I think Morgan must have been too entirely aware of the ticking time bomb that was her health, a little annual alarm in her head saying “Your time is up! Your CVS episode is now!” 

She recounts, “Doctors had one of two responses: I can’t help you, go to this person, or they would give medication without ever fully explaining all the side effects to me and the consequences were brutal. I would suffer for the next few months–even if I got off the medication–from the effects.” Morgan told me even after her diagnosis of CVS, she would have to re-explain herself to every new specialist because they would question the validity of her diagnosis. 

It was almost arbitrary to ask at this point, but I did it anyway, “Did you ever feel like doctors did not take you seriously?”

Morgan traces the rim of the cup with her finger, her long inhale is audible, my ears not straining in the least to hear it when she finally says, “Oh yes, especially when I was 18, because that was the only year I had actually lost a significant amount of weight. I can’t tell you how many times doctors thought I was bulimic. My own dad thought I was bulimic. That was hard.” 

The doctors thought she was bulimic. In school, her friends thought she was bulimic. At home, her own father was convinced she was bulimic. Was it because she was a teenage girl? Was her mental health the only possible explanation for her physical ailments? At least her primary care doctor didn’t think she was bulimic; her PCP thought she was pregnant. Morgan cried as she was forced to take a pregnancy test and contemplated if it was possible to be pregnant without ever having had sex before. I almost spit out my drink as the hilarity, the absurdity of the situation, and now, we are both chuckling at fifteen-year-old Morgan who worried if she was next in line to experience immaculate conception. I wonder if we are laughing because it would be too awkward to cry about it instead. 

The apathy to Morgan’s situation could perhaps be justified for doctors. There needs to be a professional level of distance and disconnect so a doctor can do their job. But when Morgan was sick, her own friends and members of her family seemed emotionally and physically unavailable to her ordeal too. 

I think of a time when we were both in high school Spanish class. Morgan had been gone for weeks and had just returned looking like a ghost wandering through our halls. 

She asked me, “Could you tell Señora Raught I’m going to the bathroom?” 

Of course, I would. I remember being entirely undisturbed by this announcement, this new normal Morgan who pukes her guts out at school and does so by slinking out the door. I asked to check on her and found her at the last stall of a desolate bathroom. Between heaves and gasps she told me I did not have to stay and hear the morbid sounds. Instead, I plop down on the floor outside the stall covering the visage of my hurting friend, the stall door shielding me from a harsh reality I would never understand. I often wonder of that day; wonder how many times Morgan O’Hara has put stall doors between herself and others to ease their discomfort at the cost of her own. 

But today, Morgan is currently as free from CVS as one can be. She is eighteen and this year, she has entirely skipped a cycle of CVS, the first since she turned twelve. She is off the anti-seizure medication, Topamax; her only method of treatment for years because as she describes it, she feels “sharper in every capacity.” She is a top student and stronger than ever. I remember that Morgan is at once both defined by her challenges and separate from them. 

I look up at Morgan and ask her what she wants everyone else who deals with their own version of personal, medical hell to know now she is “recovered.” I begin to see a grin take over her visage, her whole smile expanding, her body enlarging itself until her existence seemed larger than my eyes could perceive. This is not someone who can be contained within a stall, within bathroom doors, or unfounded labels and she says, “Don’t listen to what anyone else says and take care of yourself. If you need to stay home every single day, then fucking do it. Don’t let other people or the guilt get to you. I let life get in the way of my health.” 

I think of the difference it would have made if, instead of being skeptics of Morgan’s pain, we had been beacons of support instead. I reach across this iron table that has held the words we’ve exchanged over the past hour and put her hand in mine. I feel a lump in my throat as a realization overtakes me; this is the hardest pill to swallow. Where were we when Morgan O’Hara was in her darkest hour?

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Natalie Nabaty is a medical student from the class of 2025 at UACOMP with so many passions she struggles to juggle them all. Between playing guitar, dancing traditional Assyrian line dances, learning about global health, and serving the community, writing is a skill she is happy to refine while in medical school. She graduated from ASU with a Bachelors in Biology and a minor in Psychology. Natalie also spent time doing research in molecular oncology with the Mayo Clinic and Alzheimer’s Disease with Banner Sun Health Research Institute. When she’s not busy with her hobbies, work, and school, she enjoys spending time with her family and friends, exploring the world, and contemplating her existence.