Subduing the Body

Subdue v. to overcome, quieten, or bring under control (by force)

Subduing the body: Tarot ‘The Hanged Man’ Free CCO image from Rawpixel.

Healthism is the idea that our health is entirely under our control, and that our health or lack of it, has a moral dimension. So a healthy person is a ‘good’ person, and an unhealthy person is a ‘bad’ person for having caused - or failed to prevent - their health issue. Its been popping up of late in Rae Katz’ Inner Workings, Virginia Sole-Smith’s Burnt Toast and Gina Jacobson’s Strive for Five.

I recently had an exercise stress echocardiogram, because my average resting heart rate has been gently increasing over a few months, without a clear reason apart from ‘blame it on the ME/CFS’. Interesting experience. Good news, I am alive, despite the Informed Consent explaining I had a 1:10,000 chance of death due to that test.

I did a quick google to understand the actual risk of that statistic, and it’s about twice the chance of a fatal motor accident… unlikely but not wildly unlikely, not ‘struck by lightning’ unlikely, or ‘win the lottery’ unlikely. WTAF. The hair on the back of my neck rose as mild medical anxiety kicked in. I consoled myself with the thought that the test is used to measure recovery from heart attack, and surely those souls up the odds for the rest of us? Comparison is not always the thief of joy, it seems, but I digress.

So, I have a new symptom: EBPR Exaggerated Blood Pressure Response (to exercise). EBPR is a symptom that is found in both healthy athletes and people with current or future heart health problems. I was sent off to a cardiologist for some professional medical advice, in the meantime there was Google.

Sensible sources of online information (like Healthline) suggest that it will be important to exercise but stay well below maximum peak heart rate for my age. That’s already recommended for ME/CFS, but I was startled to find that I had noticed no symptoms, other than being puffed out and feeling like I was working ‘quite hard’, harder than I have since becoming ill, but not systolic BP considerably north of 200 hard, not heart skipping beats hard. I felt like I could have kept going, if required. (I am a recovering people-pleaser.) Good thing they stopped me. One heart attack in the family this month is enough.

After talking with my GP (aka primary care doctor) I caught myself evolving plans for bootstrapping my body into health. I tried to find advice for how to prevent EBPR slipping into a more general heart disorder, and couldn’t find anything specific other than look after your heart, and get check ups. Frankly, science/medicine isn’t actually sure why it happens. There are some ‘associations’ but that is not the same as ‘causation’.

After some vivid and unpleasant dreams of running races and car crashes, I lay awake at 1am my tired and vaguely alarmed mind returned to the dodgy base programming: mortification of the flesh via punitive diet and exercise. I was a Bad Person, who had made Bad Choices and this was the inevitable outcome. This is where Internal Family Systems is useful.

I listened, with as little judgement as I could manage, while my anxiety held the floor. Then a calm internal voice, I call her Wild Woman, said, “That’s all very well, but you don’t actually understand how your heart works, and certainly not enough to tell it what to do.” I felt flooded with relief as the truth of that hit. Wild Woman often turns up with a part I call Healing Lion, he seems to be a representation of how my immune system is feeling on any given day. It’s good if he’s a rich emerald green, bad if he’s washed out or dark green. Yep, its a bit woo, but paying attention when he turns up seems to help.

Now I started writing this post a fortnight ago, since then my Mum had a heart attack - she’s recovering well, thanks for asking. I’ve seen the cardiologist because he had a cancellation - is that sinister, or just someone with COVID who had to reschedule? - and I’ve started the lowest possible dose of an ACE inhibitor (blood pressure medication) “because there’s clearly some genetics there” and because without blood pressure medication he couldn’t recommend I do any exercise. Gulp.

So far, it seems to be helping, despite my slight wince at “you should take blood pressure medication for the rest of your life”, which feels a little like I’ve stepped on the escalator to old age (hello internalised ageism). I realise, in retrospect, that I had been preening myself, a little, for being mid-50s and not on BP medication (hello internalised ableism). Taking pride in something that is not in your control would be the very definition of privilege. Sometimes we’re out to conquer our own biology, and that doesn’t end well for anyone, though it can take decades to realise it.

Thank you for reading, your time and attention are a gift.

Over to You

• Is there something about your health or body you take pride in? A little or a lot?

• How might you feel if that aspect of health or your body went away? If you became fatter or less muscled, or deaf, or bald, or cognitively impaired, or injured so you couldn’t walk? Whatever is the removal of your pride point.

• Do you know people who don’t have that pride point? How does their bodily difference affect how you view and/or relate to them? Try to get past your first response of:“It doesn’t!”. Dig a little deeper, turn over a few mental rocks.