Before He Died, I Told Him I Loved Him. Do You Think He Heard Me?

                                                         Majid Ali, M.D.

                                                                   A True Story

Marie, a thin woman with an intense face, walked into my consultation room and eyed me suspiciously. I stood up to greet her and invited her to sit on a chair. She thanked me nervously and sat at the edge of a chair. She was distraught and obviously depressed. I decided to give her a few moments to compose herself while I read through her clinical questionnaire. After I finished reading, I gently asked her if she wanted to add anything.

“I’m frightened for my job,” she blurted. “I’m a senior laboratory technologist. I had a photographic memory. I would read a long procedure for a complex new experiment, then complete the experiment without once looking at the written procedure. Nobody believed my memory. In the laboratory they said I must play some sort of game and memorize the whole procedure the night before without letting anyone know about it.”

“And now?” I asked softly.

“Now I read the procedures, but I cannot understand any of it.”

“How did this happen?”

“I don’t know.”

“I mean did it happen suddenly after some chemical exposure or after a severe viral infection, or did the change occur slowly over months?”

“Slowly over months.”

“Do you recall the beginning? Is there a specific time to which you can trace this problem?”

“Not really.”

As I wrote earlier, such drastic health problems rarely develop suddenly—as bolts from the blue. The exceptions, of course, are cases of sudden massive exposure to chemicals. I then moved to other clinical features of her illness. In the companion volume, The Canary and Chronic Fatigue, I describe many such case histories of chronic fatigue sufferers—the human canaries, as I call them. Extensive experience in caring for human canaries convinces me that all their complex case histories can be reduced to one basic element: unrelenting oxidative fires that burn out their digestive-detoxifying-receptor-energy enzymes. The patterns of illness look different only to uninitiated eyes.

I wondered what events might have set Marie’s enzyme pathways to oxidative flames. She sat on the edge of the chair, leaning forward, holding herself tight, as if to keep herself from falling on the floor. Her neck and upper torso were stiff. Without touching, I knew her neck muscles were hard as brick. Several moments passed. Yet there was no sign of her softening up. We spoke for about half an hour, mostly with my asking questions and her giving short, cryptic answers. She remained suspicious, yielding no significant clues to the onset of her illness. I began to wonder why she had bothered to come see me if she had decided not to open up to me. I ordered some diagnostic tests and said many things to create and sustain some hope for her recovery, but to no avail.

Weeks turned into months, but she showed no sign of improvement. At the Institute, my colleagues and I are blessed with a large group of extraordinarily compassionate, devoted and diligent nurses. They often tell me when a patient doesn’t show satisfactory progress following a reasonable period after beginning our programs. More than one nurse told me that something was holding back Marie’s recovery. No matter what therapies we tried, we saw no response. Finally, I asked the staff to schedule an extended visit—a long visit when I spend twice as much time as I usually do—for Marie. I had to learn where the block was.

Between held-back tears and loud sobbing, Marie finally told me the story. Several years before falling sick, she had gone through difficult and prolonged divorce proceedings. She won the custody of their only child, a handsome boy she doted on. With time she recovered from the trauma of divorce and for some years had a good life caring for her little boy. There were some superficial relationships along the way. When her son grew older, his American teenage ways began to clash with her European upbringing. Their conflicts grew in intensity and frequency. Along the way she had troubles with her boyfriend. His insensitive demands for sex, even during her health difficulties, bothered her greatly.

Some time later, trouble began between her son and her boyfriend, which fanned the flames of her anguish. Her son threatened to leave the house on several occasions. Then came the fateful day. The woman and her son argued intensely. The boy used foul language and repeated his threat to leave the house. Holding a basket of laundry, she angrily told him to go ahead and do what he wanted, then walked upstairs. At the top of the stairs, she stopped and looked back. Her son stood at the door, holding his motorcycle helmet in his hands, his eyes blazing with hatred. “I hate you,” he yelled. “I hate you too!” she shot back and entered her bedroom.

Several hours later, she received a call from the police asking her to come to the local hospital. The boy died in her arms a few moments after she reached the hospital.

“I wish someone could answer a question for me,” she spoke, holding back her tears.

“What?” I asked.

“Before he died I told him I loved him. Do you think he heard that?”

“Yes, I’m sure he did,” I replied, choking on my words.

I managed Marie’s case the best I could. I tried therapies that I knew worked, and a few I wasn’t so sure about. Nothing seemed to make any difference. She diligently took instruction in autoregulation. Sometimes it seemed it might work, but then she reverted back to her punishing thoughts. Every time I mentioned the subject of bereavement support groups, she recoiled and related her unpleasant experiences there. A year later, Marie still showed no signs of improvement. Once, when her sister visited from Europe, it seemed she might get some relief. But that didn’t pan out either.

The Theory of Secondary Gains

“Are there any hidden benefits there?” Choua asked, after she left my office one day.

“What do you mean?” I asked, puzzled.

“Why isn’t she getting better?”

“What would

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