We’re the Last Good Girls Alive

Who will remember a girl’s pain when the evidence disappears?

When they took out my thyroid I wanted to die. It’s not that I was mourning the loss (or already wishing for death after spending no more than eleven minutes in a hellish Facebook group titled something like “Thyroid Warrior Sisters”)—it was actually much more straightforward than that. I had been prescribed levothyroxine, or synthetic thyroid hormones, post-surgery, and because I was on a high-estrogen birth control, the hormone cocktail in my brain was telling me to bow out.

I was raised in North Dakota, where someone could walk into an emergency room with their arm dangling out of its socket, spewing blood onto the tile, and they would still be like, “Hey there, no rush at all, honestly no big deal, but I was hoping, if it isn’t too much to ask, that I might be able to get this thing checked out.” So I didn’t go shouting to my endocrinologist that something was off with my recovery, and that that something was my will to live.

I took what I remembered from my high school anatomy class and my access to the internet and got to work. I googled “birth control and depression,” “levothyroxine and depression,” “can estrogen birth control and levothyroxine cause depression.” I was always careful not to use the word suicide because I have been terrified of being admitted to a psych ward ever since catching Girl, Interrupted on Lifetime in middle school.

Eventually, I told my endocrinologist that I thought something was wrong. He ran some blood tests, but my levels were fine. There was no evidence on paper that something was wrong, no numbers to back up the way I felt. Then, one day, I was waiting for the el train to get to work, and I remembered riding the red line in college once when it hit a woman. As I stared down the tunnel waiting now for the blue line, I pictured myself as the woman, metal hitting bone, immediate relief. I suddenly understood that if someone didn’t believe me then I was going to die.

When Eleni died, they buried her in the prom dress she didn’t get to wear. We were practicing for our senior play when she complained to me that she had a headache. Not a regular one, like, a really bad one, but she didn’t want to make a fuss. I suggested she get an Advil. A few hours later I held my dear, funny friend’s hand in a hospital room while a nurse told me I could try talking to her, that she’d maybe hear. Her boyfriend stood on the other side of her hospital bed, begging her to come back, and I turned my focus to God, who didn’t seem very present.

She had a brain aneurysm and no one really knew why. Seventeen-year-old girls don’t get brain aneurysms; they mostly happen to menopausal women. Something to do with sex hormones. They kept her body alive for the night so that her dad could take a red-eye from Texas to say his goodbyes.

When Eleni died, they buried her in the prom dress she didn’t get to wear.

It will be one of the greatest regrets of my life that I didn’t realize the severity of the situation, and that she had lived long enough as a girl to feel like her pain was an interruption or an inconvenience. If she had made a fuss, maybe it would not have made a difference in the end, but sometimes I think about her lying scared and embarrassed and alone on the floor of our high school lobby’s bathroom, and I think at least I could have been there, tucking her hair behind her ear.

I don’t have the light pink, puffy scar that most people get with a thyroidectomy. Mine is indented, jagged, hard-core. In my first weeks of recovery it began to appear where my stitches had been. It very obviously frustrated my surgeon, who was well-known for leaving no trace. Given his reputation, he insisted on regularly putting a needle in my throat and injecting calcium in the site. I’d sit up straight and fixate on a spot on the wall. He’d insert the needle laterally into the scar and push out a little bag of calcium. I could feel the cold liquid squish into the space between old and new skin.

I didn’t have the good sense to ask what the calcium was for until maybe the sixth injection. It was entirely aesthetic and had no real effect on my health. I didn’t show up for our next session. People were always telling me about some cream or oil that would make my scar heal faster or go away. My mom’s best friend sent me a gooey mask from a spa she’d been to that would help “rejuvenate the cells.” It leaked through the envelope she’d mailed it in and I threw it away. I worried that once my scar was gone there wouldn’t be any evidence of what had happened to me.

Every so often I feel a prickly tickle drag itself across my scar, the same feeling I had as the surgeon would pull the needle out, replacing it with that puffy bag of calcium. A pain that’s there, but isn’t, but is.

The term phantom limb was coined in the late 1800s. Back then they thought the phenomenon was caused by irritation at the site of amputation. But that couldn’t be correct, because even people born without certain limbs would report feeling the ghost of one. Instead it was concluded that maybe the sensation of a phantom limb came from the reorganization of the somatosensory cortex, the part of the brain that processes touch, temperature, and pressure. But maybe something else. It’s hard to get to the bottom of these things.

I came across a video of a cat trying to scoop litter with its left leg, which had been amputated. The cat scoops its shoulder through the air, watching the litter go unmoved. He tries with the right leg, watches a hole form in the litter. He tries the left again. Nothing. He stares at the space where his leg should be, licks at the place of amputation. Tries again.

I have a hard time trusting my own pain. At my first appointment with the surgeon, he took a biopsy of my thyroid. He directed a long needle sideways into the base of my throat. Once in, the needle pulled tissue and fluid into what looked like the handle of a water gun. I don’t remember if it hurt. But it must have, right?

Breasts, teeth, eyes. Phantom pain isn’t reserved for limbs. People have reported feeling the ghostly phenomenon in all kinds of ways. A few weeks after Eleni died, I kept seeing her at the edge of my bed. I didn’t know if I was dreaming or hallucinating, so I just started filling her in. You’ll never guess who was caught having sex in the stairwell! and The winter musical would be so much better if you were here. When my prom date dumped me just a few weeks before prom, I dreamed Eleni and I were running through the hallway and she decked him right in the face. I missed her terribly. Thinking of her felt like pressing on a bruise.

Because she was only seventeen, she hadn’t left behind any instructions on what to do in case she died. There was no green tick on her driver’s license to show she’d like to donate her organs, so the decision was left to her mother. I caught her in the hallway with a form indicating which organs they’d like to give up. My mother stood with Eleni’s in the hallway outside of her hospital room while she went through the list. Lungs, heart, skin, all viable. “I can’t bear to give up her eyes,” I overheard her say. Her own eyes, the big brown ones she’d passed to her daughter, hung heavy with exhaustion.

I remembered sitting on the lid of Eleni’s toilet one morning before middle school while she layered fresh mascara on top of dry mascara, clumping her lashes together. It was very in, she assured me, pointing to a magazine cover of Kate Moss. She wasn’t big on blush or foundation, but she wore that chunky mascara look for years. It was the dead of winter, and the wind had picked up so that on our walk to school we had to face forward, heads down, not talking. When we got to the entryway and could look at each other again, her mascara had frozen and her eyes were lined with frosted icicles. I am not sure if she was buried with her eyes.

Scientists can’t really agree on where these phantom limbs come from. Ultimately, the conclusion is that there is none. The body and the brain are unable to understand the space between what should be and what is.

The tumor made itself at home on the front of my thyroid, and I was lucky for that. The signs were there long before I knew I was sick, but thyroid disease symptoms are easy to ignore. I had them all: exhaustion, fatigue, night sweats, insane sex drive, digestion issues, mood swings. I chalked it all up to being twenty. By the time the tumor started to poke out from my throat I was in my junior year of college. Most of my nights were late, drinking Old Style in bay windowed Wrigleyville apartments, or in the library writing essays about aspiring stand-ups who’d hurt my feelings, and all after long days between classes and internships and two on-campus jobs. Of course I was tired and moody.

Sometimes I’ll walk into a store and get a waft of Eleni’s signature fakey cupcake perfume and it will seem like she was there and I just missed her. On the tenth anniversary of her death, I laid awake in bed and thought about the church where her funeral was held. She probably would have gotten married and had beautiful olive-skinned babies and opened a restaurant in an up-and-coming city by now. If I had just followed her into that bathroom.

When I got sick I thought I was being punished. At Eleni’s funeral I wondered: Why her? Why not one of the kids who was always drunk driving home from football games? Why not me? When the tumor appeared I thought maybe it was a delayed punishment, and maybe I’d die on the table. People don’t die very often from thyroid tumors. It’s called “good cancer” for a reason, but there are always risks. I woke up from surgery with a chronic illness.

She doesn’t sit at the edge of my bed anymore, but she haunts me.

A few months before surgery, I’d started seeing a guy from my poetry class. We were twenty-one and keeping things casual and a tumor is the least casual thing in the world. I didn’t know how to say it, so I just blurted it out in the hallway one day on our way to class. He avoided me for about a week. Just a few nights before, he’d pulled me onto his lap to read me a poem he’d written about a banana that was of course really about his dick. I thought he was just about the most romantic person who’d ever walk into my life.

No one knows what to do with words like tumor or surgery, but especially not twenty-one-year-olds whose second date included spiking a 7-Eleven slushie before going to his place to do hand stuff. The day of my surgery he sent me a naked photo with the words “good luck today” typed over his torso.

She doesn’t sit at the edge of my bed anymore, but she haunts me.

A few weeks before she died, Eleni and I snuck off during drama rehearsal to practice lines. Only we didn’t practice our lines; we just sat and reminisced about all of those days we walked to school together. On particularly cold mornings, she’d wait until I got to her house, then hop out of bed at the last possible second. I’d trade places with her, taking refuge in her still-warm bed while she layered on Abercrombie T-shirts and pulled on her Uggs. Toward the end of our conversation she got sort of solemn and quiet and she looked at me and said: “We’re the last good girls alive.”

I thought that was really funny. I wasn’t good. I cheated on my anatomy homework and sometimes I bought handles of Smirnoff from Kelsey’s brother in the Hornbacher’s parking lot. But I loved her, so I went along with it.

Before my thyroidectomy I read a statistic that women tend to downplay their pain levels in hospitals and that they are given longer wait times and lower pain-med dosages than male patients as a result. I did not want to accidentally downplay my own pain. How was I supposed to know the difference between a seven and an eight, and could I really trust that this nurse could understand what a seven felt like to me specifically? There is no definitive threshold for pain. It is a subjective experience. I can tell you it’s the dull ache of pressing on a bruise or the startling sharpness of a wasp sting, and you can say you understand. But my bruise and my sting are entirely my own.

As I was coming to from surgery, a nurse came in to administer pain meds. She handed me a chart with ten faces on it. The faces did not seem to progress in pain to me. The first face was a smile that faded by the fifth face. Faces five through ten had mouths that drooped from a straight line into a deep frown. It would have felt more accurate if maybe around number six the face bit down hard on the inside of its cheek. If by eight, it curled up into a ball focusing entirely on trying to breathe. I told the nurse a ten because I wasn’t fucking around. She pumped me full of morphine and I drifted into a hazy sleep.

When I say wanting to die felt like nothing, what I mean is the pain was so far beyond a ten it circled back to zero.

Eleni’s funeral was open casket, even though her head had been cut open. Someone told me before I made it to the front of the church that she wouldn’t look like herself. Her face was puffy and her lips were swollen. An incision snaked across her hairline from the emergency brain surgery. It looked like it hurt. I felt so much, I couldn’t feel anything at all.

They buried her with too much blush. I wanted to put my hands on her overly pink face and say it back to her, that declaration from that stolen moment during drama rehearsal. I wanted so badly for it to be true.

“We’re the last good girls alive.”