What follows is a mystorical[1] text. Though it appropriates freely from a 1953 novel, Savage Night, by pulp fiction writer Jim Thompson, the mental and psychic framework of this piece resonates less of the age of Eisenhower than of Reagan/Bush. My own take on hypochondria is that it represents a paradoxical denial or repression--paradoxical in that the hypochondriac's obsession with symptoms seems precisely opposite to the way so many of us stoically (or perhaps just numbly) ignore our symptoms. The hypochondriac uses illness to avoid dealing with issues that would come to the fore otherwise--specifically, I think (speaking from personal experience), issues pertaining to emotional maturity; the hypochondriac has a deathly aversion to making decisions in life. Hence, all his activities are de facto arranged by the self-consciousness apparently demanded by his symptoms. And for the committed hypochondriac, the spectre of AIDS represents the ultimate fear/bliss/jouissance: AIDS, an umbrella term rather than a disease itself, could indeed be masked/revealed by any and all symptoms--ultimately every readable symptom refers first to a response by the body's immune system, and only secondarily to a so-called causal agent.

Lacan, in discussing paranoia, once said something to the effect of "Just because Mr. X is a certifiable paranoiac and terminally suspicious of his wife's fidelity, doesn't guarantee that his wife isn't really cheating on him." Afterall, he explains, if you had to live with the stress and abuse of a spouse's chronic delusions, you might well find yourself growing further away from that person to where an affair might become more likely. And so with illness, perhaps. Little Bigger, Thompson's hypochondriac narrator in Savage Night, actually does suffer from a terminal case of tuberculosis. And in our day and age, for all the hypochondria undoubtedly inspired by the media event known as "the AIDS epidemic," quite a few of those fears no doubt have some sort of rational basis; and some percentage of those will ultimately prove well-grounded. As for nearly all the rest of us, I see little choice but to cling to our anesthetizing pattern of consumption: stories, explanations, more stories, further explanations, and so on.

I dropped the suitcases and stepped off the curb.

"You stupid pissant," I said. "What's the idea?"

"Temper, temper." He grinned at me, his eyes narrowing. "What's your idea, sonny? Your train got in an hour ago."

I shook my head, too sore to answer him. I knew The Man hadn't put him onto me. If The Man had been afraid of a runout, I wouldn't have been here.

"Beat it, Fruitjar," I said. "Goddamn you, if you don't get out of town and stay out, I will."

"Yeah? What do you think The Man will say about that?"

The truth was The Man would likely say very little. Not 'cause he's a dummy or a slacker or something; far from it. Just 'cause it's not really his style to say a whole lot about anything. No, The Man doesn't specialize in lengthy explanations, just orders--crisp and to the point.

After I gave Fruitjar the slip, I continued on down the street, lugging my suitcase, looking for the Winroy rooming-house. In a couple of blocks I came to it: a sagging gate, rickety fence, the house painted a crappy green with puke-brown trimming. Not a pretty sight, but then I spotted her. I couldn't let on that I knew who she was. Even in a jersey and jeans, her hair pulled back in a horse's tail.

"Yes?" she called, while she was still several steps away. "Can I help you?" She had one of those well-bred voices, voices that are trained to sound well-bred. One look at that frame of hers, and you knew the kind of breeding she'd had: straight out of Beautyrest by box-springs. One look at her eyes, and you knew she could call you more dirty words than you'd find in a mile of privies.

"I'm looking for Mr. or Mrs. Winroy," I said.

"Yes? I'm Mrs. Winroy."

"How do you do?" I said. "I'm Carl Bigelow."

I admit it's sort of a funny name for a guy who's only a shade over five feet and weighs 105. But what the hell; if the good Lord saw fit to arrange my birth to an Okie couple named Bigelow, then I can see my way to put up with the inevitable nicknames like "Little Bigger." Besides, there's a whole lot of things the good Lord saw fit to do that make a lot less sense than my name. Like giving someone in my line of work a preacher for a father, for instance. During the Depression my old man was on the itinerant revival circuit. And people always assumed that 'cause we were from Oklahoma, we had to be Baptists. "Not!" as the kids like to say these days. No, my dad was a Southern Methodist, but that sure didn't stop him from speaking in tongues and preaching the old fire and brimstone. No sir. And he and Mom's faith didn't stop two of their five kids from dying in the measles epidemic that swept through northeastern Oklahoma in 1937. Or keep a third one from coming down with a case of tuberculosis that he suffered from his entire adult life, as well as becoming a two-bit hoodlum.

Folks these days forget how TB used to be pretty much the same thing as a death sentence. When I came down with it I was a senior in high school, trying my damnedest to graduate. One day I'd finally scammed my way past the petty-ass gatekeepers of highschool diplomacy and gotten myself officially awarded if not enough credits to graduate, then enough for admission to junior college. It'd taken all my underhanded charm and sales abilities to pull this off, so I went home that afternoon feeling pretty good. I hadn't been home an hour when the good feeling rushed from me like water rushing down a drain. Then, after a long moment of absolute emptiness, my heart stuttered and raced, beating faster and faster until one beat overlapped the other. Blood gushed from my mouth and I fell to the floor in convulsions. Doctors came, although I was unaware of their presence. They attended to me wonderingly. I was eighteen years old, and I'd had a complete nervous collapse, pulmonary tuberculosis and delirium tremens. In my fall I'd bruised my kidneys and fractured my skull in three places. I had an incipient rupture. My shoulders were sprained so that the arms did not articulate properly in their sockets. Nothing about me was as it should be, physically speaking. As the doctors saw it, I had nothing with which to battle the diseases I was suffering from.

Susan Sontag writes of the mythological status of tuberculosis back before medical science discovered its "cause" in a particularly stubborn microbe and its "cure" in a combination of three different antibiotics. Though well-intentioned, she writes with the certainty of the zealot as filtered through the casual, innocuous voice of "common sense." Her certainty is grounded in medical science, positivism, hermeneutics. The germ theory is seen not as a model for understanding the real--is in fact not even seen as a theory at all--but rather, she perceives germs as objectively and verifiably real or present. Hence Sontag smirks at any model for treatment of tuberculosis that doesn't view the germ as ultimately causative. She goes on to note how, in the wake of TB's supposed demystification, cancer and later, AIDS, take on this mythological or metaphoric status in the absence of an understanding of their respective causes and cures. What Sontag couldn't have known then (though others predicted as much at the time) was the manner in which TB would make its astounding rebound in the early '90's. What she might've understood (had she listened to alternative medical voices at the time she wrote "Illness As Metaphor") was the manner in which microbes rapidly mutate when under antibiotic assault. The result of said mutation is the creation of a superstrain of microbe, one difficult if not impossible to treat by all currently known antibiotic therapy. The analogy to careless and over-zealous pesticide usage is hard to ignore here. As with antibiotics, pesticide advocates arrogantly assume that the problem lies "out there," in the environment's organic bugs and "pests"--note how the term "bug" carries over metaphorically to germ-born illness. And these "harmful" insects or "pests" must be killed at great cost to the larger environment, taking the "good" with the "bad," just as in antibiotic therapy within the body. And ultimately we end up with super-resistant strains of "pests" within a now-toxically stressed and hence highly vulnerable environment.

The tuberculosis example leads us directly into the 64-dollar question: "What does illness mean?" Note that this question pertains to a totally different level than the question "what does a given symptom mean?" A medical symptom is to an illness what an illness is to one's life. And the art of determining the meaning of a medical symptom lies at the root (and heart) of the semiotic.

It was a long time getting to sleep and thirty minutes after I did I woke up again. I woke up exhausted but with the feeling that I'd been asleep for hours. You know? It went on like that all night. When I woke the last time it was 9:30, and sunlight was streaming into the room. It was shining right on my pillows, and my face felt hot and moist. I sat up quickly hugging my stomach. The light, hitting into my eyes suddenly, had made me sick. I clenched my eyes against it, but the light wasn't shut out. It seemed to be closed in, under the lids, and a thousand little images danced in its brilliance. Tiny white things, little figure-seven-shaped things: dancing and twisting and squirming.

I sat on the edge of the bed, rocking and hugging myself. I could taste the blood in my mouth, salty and sour, and I thought of how it would look in the sunlight, how yellow and purplish, and . . . I swear, sometimes I think this sickness thing is all in my head. That's my problem alright: an over-active imagination. No kidding, like when sometimes I get so busy keeping up with what The Man wants done that I forget to pay attention to my lungs, and I'll have no problems with 'em during those periods, wouldn't you know. It's only when I realize it and sort of congratulate myself for starting to get a little better, that the fucking symptoms come on again. Like I'm getting punished for one of those deadly Christian sins--arrogance or something. I guess that's why people knock on wood and pray for forgiveness and do all that other superstitious, obsessive-compulsive ritualistic horseshit. I mean, can you imagine living your whole life afraid that something--something inside your own body, even--was out to get you, to do you in, and all you could do was try to hold it at bay with your sorry-ass superstitions? Of course I can; imagination's my problem, remember?

Somehow I got to the dresser and got the lenses and teeth into place. I staggered down the hall, kicked the bathroom door shut behind me, and went down on my knees in front of the toilet bowl. I threw my arms around it, bracing myself, looking down at the wavering water in the faintly brown-stained porcelain. And then my whole body swelled and shook, and I heaved.

There was a rap on the door, and Fay Winroy called, "Carl. Are you all right, Carl?" I didn't answer. I couldn't. And the door opened.

"Carl! What in the world, honey--?"

I gestured with one hand, not looking around. Gestured that I was all right, that I was sorry, to get the hell out. I felt so goddamn humiliated, a woman seeing me like that. I don't know why, really. A shrink could have a field day with me, no doubt about it. Here's a guy who's basically coughing up a piece of his right lung and what he's most concerned about is that nobody finds out. Go figure. The shrink would probably tell me that I was "castrated" by my mother, or else I'm holding onto "repressed grief" over when she "abandoned" me for my old man during the oedipal drama, or some crap-line like that. And speaking of the old man, he eventually gave up on the holy spirit and took up with plain old spirits, mostly Jim Beam when he could afford it. My mom stayed all over his ass, screeching that he was killing himself and such. Which he was. Bleeding ulcers and cirrhosis of the liver finally got him into AA about 18 months before the end of his life. By this point I'd moved on up to Chicago so I didn't see a whole lot of him anymore. The last time I saw him, though, he'd finally seen the light and he was spouting one of his AA slogans: "You're only as sick as your secrets." How 'bout that? Easy enough to say, but talk is cheap; he went to his grave holding onto a few secrets. For instance, his long-suffering wife got to hear all about his last day on earth from the bimbo he'd spent it with at the racetrack over in Tulsa. Mom ran into this whore at the morgue; she'd ridden over to the hospital with him in the ambulance after he'd been stricken with his fatal "cardiac infarction." Evidently dad had a penchant for both gambling and low-class working girls; in any case he'd just hit a trifecta for over 500 bucks--a lot of money in those days--and got so excited his heart couldn't take it. Or maybe it was really his liver that triggered it. Basically all his vital organs seemed to have failed at once. And the bimbo had the gall to demand half the money from Mom, claiming she'd helped pick the winning ticket.

"My God, honey!" . . . She was down on her knees in front of me; why she bothered to wear that nightgown I didn't know, because it didn't conceal anything. "You get that way very much, Carl?"

I shook my head. "I haven't had a spell like that since I was a kid. Don't know what the hell brought it on."

"Well, gosh, I didn't know what to think. You sounded worse than Jake does sometimes."

She was smiling, concerned for me. But there was a calculating look in the reddish brown eyes. Was I a sharp guy, a guy who could give her a lot of kicks? Or was I just a sick punk, someone good for a lousy fifty a week and no laughs to go with it?

Semiotician Carlo Ginzburg discusses "The Morelli method" for identifying frauds among paintings being passed off as originals during the late 19th century. The method, developed by one Giovanni Morelli, is still referred to by art historians and calls for a focus not on the most obvious characteristics of the paintings (which are most easily imitated), but on the minor details, the details "least significant in the style typical of the painter's own school: earlobes, fingernails, shapes of fingers and toes" (Ginzburg 82). The idea is that the marginal details would more likely escape the conscious attention of the copy-artist, hence it is here that his own style would unconsciously betray his forgery attempt. And elementary as it sounds, it bears repeating that in-keeping with the semiotic method, the forger's own style would stand out only in its difference from the master's known style vis a vis these details. Some, of course, would attribute the very notions of conscious and unconscious style to Freud's psychoanalytic model emerging at about this time. Ginzburg suggests persuasively, however, that it was Freud who was influenced by Morelli's work, and that he quite definitely drew upon it in formulating and theorizing psychoanalysis. Moreover, Ginzburg notes, another Italian art historian, Enrico Castelnuovo, drew a parallel between Morelli's method and that of Arthur Conan Doyle's Sherlock Holmes, which followed Morelli's work by only a few years. Holmes, Ginzburg explains, solved mysteries by way of "abduction."[2]

Ginzburg goes on to outline an analogy between the methods of Morelli, Freud, and Holmes. And what common element underwrites this triple analogy? The medical-investigator model; Freud, Morelli and Conan Doyle all had degrees in medicine, Ginzburg observes. "In all three cases we can invoke the model of medical diagnosis, though the disease cannot be directly observed, on the basis of superficial symptoms or signs, often irrelevant to the eye of the layman, or even of Dr. Watson" (Ginzburg 87). In other words, Ginzburg suggests that all modern sign-systems have their basis in medical symptomatology. And the symptom or clue that produces meaning does so in its dissonance from the norm or, loosely speaking, a state of health.[3] Hence, signification arises strictly out of crisis or conflict.

Apparently she'd made up her mind. She stood up and locked her arms around mine, holding them. I didn't want that. Yet. I wasn't up to it. So I started a little rough-house, and that broke the mood. I've gotta admit, it wasn't just the prostate problems or even the bug in my lungs that stopped me, though they figured into it alright. It's just that in this day and age you can't be too careful about who you play around with. I mean, a broad like Fay Winroy--no telling where she's been and who with, and so forth. We're not just talking about a friendly case of the clap anymore, you know. And someone like me has gotta be especially careful. I've been reading how there's this new strain of TB going around that can't be fixed at all. And they say it's all because of The AIDS. After everything I've been through I guess I thought I wasn't scared of much anymore, but I gotta confess, the thought of wasting away to nothing because of jumping in the sack with the wrong broad sure don't do a lot for my desire. I mean, it's one thing to die quick, even if it's a messy job; but to have to be around for months, even years maybe, while a goddamn virus saps you and leaves you more and more open and less and less there . . . hell, I've been through as much of that with the TB as I ever want to go through. Still, Fay's a pretty swell-looking babe. And she keeps going on about how she hasn't had any in almost a year, ever since Jake started in boozing real heavy again. And she sure doesn't seem like the kind of broad that just falls for the first slick talker that comes along. So she's probably okay; as okay as they come these days anyhow. And I could break down and use a sack, just to be on the safe side. If I let things go that far, that is. Shit, for all I know The Man's already brought Fay into the game and she's just stringing me along, letting me think that I'm in charge and she's just a helpless, desperate broad looking for a way out.

. . . .

Well, like I said, she said it'd been over a year since you know what, and I kind of think it must have been an understatement.

And, then, finally, she gave me a long good-night kiss, about fifty kisses rolled into one, and turned on her side. And a minute later she began to snore.

It wasn't a real snore, one of the buzzsaw variety. It was as though there was some small obstruction in her nose where the moisture kept gathering and cutting loose in a little pop-crack about every tenth breath.

I lay there, stiff and tense, counting her breaths, wishing to God that it was a faucet, wanting to grab her by the nose and twist it off. It reminded me of a time when I was a kid, about fourteen, but I guess I looked closer to eleven or so. I was with my younger sister at a sinkhole near Joplin, Missouri. We were staying with our Aunt Pruda (I swear that was her real name) for the summer while our folks went on the road. Luke had already gone off on his own by this time, though technically he was still a minor. Anyhow, during the afternoon we came across some other kids, a boy of about twelve and his two sisters, both younger. We all got to skimming stones, or trying to. And at one point I guess he thought I'd deliberately tried to splash either him or his sisters, I don't quite recall which anymore. So outta the blue he picks up a good-sized rock and chucks it at me hard, hitting me in the gut, knocking the wind clean out of me. I was down panting on my hands and knees for a minute or two just trying to catch my breath. He thought he'd put me out of commission, no doubt. Unfortunately for him I always carried a Boy Scout knife around with me, and I eased it out while looking like I was still rubbing my stomach. When I'd gotten it open I rushed the little bastard and stuck him right in the side, just like a pig. Of course he collapsed and his sisters started squealing, but in the midst of all the noise and excitement I can still remember hearing his breathing, sputtering and crackling as though he had some sort of obstruction up there; probably just a case of asthma that acted up when he got excited or something. With Fay Winroy, though, there was nothing I could do but lay there counting her breaths, getting set for the little pop-crack that stabbed through me like a hot needle. And just when I had the damned thing about timed, she broke the rhythm on me. She started pop-cracking on a seven count, then a nine, and finally a twelve.

It went up from there to a point where she was taking twenty breaths before it came, and finally--God, it seemed like about forty-eight hours later!--finally it stopped. By that point it was useless even trying to sleep; I'd already begun my familiar routine, mentally going over all my symptoms: numbness in both arms now, as well as some creeping into my jaw and cheeks--I figure it's either the beginnings of multiple sclerosis or else what I've heard doctors call "neuropathy," another thing my old man suffered from during his decline. A fancy name for nerve death. Apparently that can also be a symptom of diabetes. And bloody sputum. And the prostate (though after you-know-what it doesn't feel too bad). Christ, I'm falling apart. If I seriously thought I had anything to worry about I'd think it was The AIDS for sure.

Perhaps the most untenable thing about AIDS for someone given to hypochondria is that essentially any symptom you can experience could be a sign of AIDS, as evidently all symptoms of illness are generated by one's immune system, not by the disease itself. That is, an immune system under the stress of bacterial or viral infection generates signs, commonly known as symptoms, as a healthy response to the stress. So we have here the basis for an interesting semiotic problem: if the symptom is a signifier which refers to a signified--the disease or "invasive" agent--but the symptom is all we ever directly know and witness, doesn't it take a leap of faith (what Derrida would call metaphysics) to believe in some essential yet inevitably conceptual "cause" of the symptom, the same leap as is required in our everyday language process with the same deferral of the signified?[4]

And even if Fay Winroy really hadn't had sex in over a year and had been tested for HIV just prior to her involvement with Little Bigger . . . considering what the "experts" say about HIV--that it could take five, ten, even 30 years by latest speculation, for antibodies to the virus to show up in a test--well that sort of admonition leaves plenty of room for paranoia, even in one not abnormally given to it (which Little Bigger happens to be: there's a long history of hypchondria on his father's side of the family). Of course this ten or 30 year stuff is what the prominent retrovirologist, Peter Duesberg, refers to as "moving the goalposts." That is, since the AIDS establishment is stuck on its theory of HIV causing AIDS but in order to do so (according to available evidence) HIV would have to behave in a manner here-to-fore unheard of in a life-threatening virus, rather than rethink their posited causal relationship, they simply change the rules about this particular retrovirus to fit the apparent facts. We've seen this type of reaction before, of course. In pre-Galilean times when it was widely assumed that the earth was at the center of the universe, all appearance of movement in the sky was attributed to the heavenly bodies "out there." Which was only partly correct, of course. What was faulty was the assumption that the earth constituted the one stable, ground-zero point in the universe. Even when Galileo came along and drove home the implications of Copernicus' solar system model so as to explain previously mystifying and abberant movements in a far more coherent manner, the Christian establishment held its ground (so to speak) by "moving goalposts" all over its earth-centered universe in order to prop up its beleaguered dogma. And when this failed to silence Galileo and his fellow-travellers, the Church resorted to terror.

So with AIDS we have a particularly slippery semiotic equation: the presence of HIV is, we're told, an irrevocable sign of AIDS, or at least eventual AIDS, which is itself an irrevocable sign of death. But HIV, which even the AIDS establishment admits infects only about one in a thousand cells in an AIDS-ravaged body, can generally be detected only through the presence of the body's antibody to it. And more and more cases are being documented wherein someone who once tested positive for the virus now repeatedly tests negative. (Guccione 95). Nevertheless, the AIDS establishment grants this very slippery antibody a status equivalent to that of the earth in pre-Galilean Christian doctrine. The antibody occupies a position of utter centrality: that of the referent to which all of the 25 or more officially-recognized diseases in the AIDS catalogue refer. Demonstrating that "AIDS" itself is not even a disease, but rather an umbrella term intended to cover a myriad of symptoms (or are they illnesses?). And the symptoms or conditions recognized as AIDS comprise by no means a stable group, but are subject to change (inclusion or exclusion) through political lobbying by women's organizations, gay men's organizations, the NAACP, the pharmaceutical industry, and so forth--this so their clients can benefit from federal monies designated for "AIDS research." The point, of course, is the slipperiness of the signifier "AIDS." That condition or thing referred to by "AIDS" would also be the thing indicated or pointed to not only by all these symptoms--chronic yeast infections, pneumocystic pneumonia, Kaposi's sarcoma and so on--but also by the signifier "HIV," which in turn is the referent for the antibodies which show up in an "HIV test," or as much of the media and public now carelessly call it, the "AIDS test." And what is AIDS anyway but a legal and linguistic category? As Duesberg points out, there are nearly 5000 officially-recognized cases of apparent AIDS--cases meeting the CDC's medical and legal definition of AIDS and indiscernible from "legitimate" cases in all ways but one: they don't test positive for HIV--which are simply given a different name by the CDC. They call it "Idiopathic CD-4 lymphocytopenia" or ICL. Presumbly, though, the CDC would still counsel caution over having sex or sharing a needle with the sufferers of this new non-AIDS condition.