Thyroids, a Love Story

Nock. Nock. Nock.

"Aram noks but nobody seams home.” Beatrice Monahan, the writing instructor, read from the wrinkled manuscript in a flat monotone then waved the half dozen pages over her head at a young man in his early thirties sitting three rows back near the water cooler. "The verb, knock, begins with the letter 'k' and seams are stitches used to bind fabric." She directed her eyes elsewhere as she spoke.

Dressed in steel-toed work boots and a blue shirt with the Firestone Tire emblem stitched above the left pocket, Abi ran a thumb and index finger over a bearded chin in a repetitive, soothing gesture. A wild outcropping of curly black hair cascaded down over his ears. “Story is goot... yes, no?”

“I appreciate the fact that that English is a second language," The barrel-chested woman observed, "but still, you should consult a dictionary.”

“Computer have spell check,” he offered.

The writing instructor stood five foot three and weighed a hundred and sixty pounds. Like some displaced time traveler from the psychedelic sixties, she favored flowery, moo moos and wire-framed granny glasses. Under the best of circumstances, the woman with the orangey hair would never be terribly attractive, but Austin, who sat several rows back from the bearded immigrant, had the distinct impression that the writing instructor went out of her way to foster the image of a physical grotesque. He wouldn’t have been the least bit surprised to discover that Ms. Monahan never shaved her armpits or bothered with feminine deodorants.

Eight students signed up for the creative writing workshop. Among others, there was Carl, a sixteen year-old high school junior with a twitchy eye. Phyllis, the menopausal housewife, admittedly hadn’t written anything more challenging than a grocery list in years. A chubby girl, Sage Ostrowski, waitressed at Ryan’s Diner, and Abi, the Armenian, emigrated from Azerbaijan in central Asia.

“I liked Abi’s story just fine,” Austin blurted.

Beatrice lowered her head and stared at him over the top of her glasses. “How so?”

“Faulty grammar taken aside, he did well describing the tension between local Christian villagers and their Moslems neighbors.”

"Unfortunately, editors wading through a slush pile of unsolicited manuscripts at the Yale Review are looking for something a bit more polished." The rebuttal was accompanied by a glacial smile. Abi, who was unfamiliar with the Yale Review, grinned proudly and continued to stroke his lush beard. Nothing fazed him. His people had been massacred, routed from their ancestral homeland and dispersed to an unsympathetic Diaspora - what more could a mean-spirited Beatrice Monahan do to deepen the hurt? Retreating to the safe haven of the oak desk at the front of the room, Beatrice set the class to work on an impromptu, flash fiction assignment.

The previous session, Austin inquired about the mechanic's name. “Is short for Abimelki,” he explained. Abi meant father and melik king. The Assyrian variant was Abimelki, a name which was common in biblical times but not so anymore. The Armenian's stories contained a veritable junk heap of dangling participles, split infinitives, ill-chosen adjectives and other syntactical abominations. But everyone in the writing group, Austin included, was grammatically challenged. Phyllis, the grocery list lady, favored run-on sentences that gobbled up entire paragraphs before a period ever materialized to bring the verbal chaos to a thudding halt. Wearing his adolescent angst like a badge of honor, Carl, the child prodigy, suffered emotional diarrhea, and Sage wrote exclusively in short, choppy sentences. Abi, whose name meant 'father-king' in a defunct, thoroughly moribund language, was still grappling with the proper spelling of simple words.

“Wanna grab a coffee?” Sage was waiting outside the community college center when Austin emerged.

“That would be nice,” he watched as the other members filtered out into the parking lot. A Honey Dew just up the street stayed open until eleven. At the donut shop they ordered hot drinks. "Would you like something to eat with that?"

Sage shook her head self-consciously. "I'm watching my weight."

Austin sipped at his coffee and glanced out the front window. The last of the dusky, late summer light had bled out of the sky wrapping the town in wooly darkness. “Has Beatrice said a nice word about anyone’s writing?” The previous week Beatrice trashed one of Austin's stories, insisting the main characters were ‘not sympathetically drawn - little more than one-dimensional stick figures and talking heads’. Those were her exact words.

“For what it’s worth,” Sage noted, “I thought Abi’s story was rather touching.”

“What she said earlier was a cheap shot,” Austin observed glumly, “but if Abi can’t spell any better than a second grader and doesn’t understand - ”

“The guy's lonely... homesick." Sage interjected, "so he writes about his mountain village and, in the process, comes to terms with the loss.” Sage made a thoroughly disagreeable face. “For Abi, Getting published in the Yale Review isn't the point,… never was.”

A mother with two freckle-faced children entered the doughnut shop. They bought an assortment of donuts and disappeared back out into the street. “How’s your thyroid condition?” The question caught Austin totally off guard. In response to his baffled expression, she added, “When I got to class, you were shaking one of those distinctive, butterfly-shaped pills from a plastic prescription container into your palm.” She blew on the coffee before raising the Styrofoam cup to her lips. “I took Synthroid for six month. Gave me the goddamn heebie-jeebies... almost had a nervous breakdown.”

“You don’t take the medicine anymore?”

Sage shook her head in the negative. "It's an exclusive club... more like a carnival freak show," the fleshy girl added almost as an afterthought.

"What is?"

"You know,… people with thyroid conditions. We're always looking for something better… comparing notes."

"You certainly have a colorful way of putting things."

"You get brain fog?"

"Some days worse than other," Austin confided. He took a bite of his jelly donut.

Brain fog - you couldn't think straight, remember simple things. It was like being diagnosed with Alzheimer's disease sixty years prematurely. How did you explain such nuttiness to 'normal' people? Brain fog - what a stupid expression! You got to be kidding me! "Some days," he noted, "I can hardly think straight, I'm so screwed up."

"What about the heebie-jeebies?"

"The jitters, the creeps… all the time. Some days worse than others." The Levoxyl stabilized Austin’s illness but created a whole new set of vague symptoms that Dr. Balcewicz, his endocrinologist, dismissed of with blasé humor. He finished his donut and dabbed his mouth with a napkin. "What are you on now?"

"An all-natural, desiccated supplement made from pig thyroids. Most traditional MD's won't prescribe it so I switched to a naturopath."

"My doctor says its voodoo medicine."

"Yeah, well it works just fine for me." Reaching into her purse Sage located a pen, scribbled some numbers on a clean napkin and handed it to him. "There's my telephone. Like I said, it’s an exclusive club and us thyroid freaks got to stick together.”

The endocrinologist initially started Austin on a regimen of seventy-five micrograms levothyroxine. The first week he was bushwhacked by a panic attack in the lobby of the Brandenberg Public Library; a few days later while climbing a short flight of stairs, Austin felt an erratic flurry of palpitations mimicking angina. Then he broke out in hives. Dr. Balcewicz’ response to Austin's concerns was to increase dosage.

"Why are you giving me more, if I don’t feel good?"

Dr. Balcewicz, a pear-shaped man with a florid complexion and bristly, salt-and-pepper moustache, grinned affably. "Your TSH levels are still much too high. The temporary unpleasantness will subside over time. Trust me."

What good was trust when a person found himself in worse shape than before he sought medical intervention? At their next meeting Austin said, "If you don't take me off this dog shit, I’m gonna go nuts."

“You aren’t giving the pills enough time to work properly.”

“What about the desiccated hormone?” Austin learned about the controversial therapy on the internet.

"Wrong percentage of T3 versus T4," the older man in the clinical white jacket replied authoritatively. "What works for pigs and bovines is ineffective for humans. The chemistry is all wrong."

"But I read where a lot of people swear by the stuff."

"Mostly older people," the doctor said, "who were took the stuff a century ago, before there was any sensible alternative." Leaning forward, he patted Austin lightly on the shoulder. "Look, you're a reasonable kid. You want the best that modern medicine has to offer, not some outmoded, nineteenth century snake oil." Actually, Austin did want outmoded, nineteenth century snake oil. Outdated, outmoded, poppycock, bunkum, quackery - what the hell did he care as long as it made him feel half-human again?

Dr. Balcewicz stared at the morose young man sitting on the opposite side of the desk. His pokerfaced expression never wavered. The impasse was broken only when the doctor reluctantly reached for his prescription pad and began scratching out a new order. "Levoxyl is a safe alternative to the generics." He pushed the script across the desk. "Let's see how you make out on this new medication." Before Austin could collect his thoughts, the endocrinologist was already racing out the door toward an adjacent examining room.

Austin and Sage strolled back to the community college parking lot. Everyone having left for the night, all lights were extinguished. Directly across the street, the Brandenberg Bowlarama was still doing brisk business with the tacky, neon sign flashing in pulsating rhythm. The lanes closed at ten o'clock on weeknights. A couple of grungy teens dressed in black and sporting chains and body piercings were sitting under the electric bowling pin sign. The boy, whose dark hair fell down in his eyes grabbed playfully at the girl. She let out a squeal, punched him viciously and ran off to the darkened far end of the lot with the boy in pursuit. A minute later they were back sitting under the sign again puffing on a shared cigarette.

How old could they be - sixteen,… seventeen tops? Austin felt ancient, positively prehistoric by comparison. It was the damn disease. When his thyroid shut down, went AWOL a year and a half ago, his whole life turned upside-down.

“Beatrice trashed my short story.”

“Yes, I know.” They were standing next to Sage’s blue Toyota. “She didn’t like the main characters.” An eighteen wheeler lumbered down the street, pulling up at a set of traffic lights with a screech of hydraulic brakes. Sage had her car keys in hand and was reaching for the door but leaned away. The waitress was dark complected, certainly not a beauty but modestly attractive. Unlike Beatrice Monahan, she exerted rigorous effort to make herself prettier. “In your story there's a scene where the girl’s boyfriend kisses her. They're in a public place, but he doesn’t care. The guy’s testosterone is flowing so he just acts on impulse. That’s the sort of thing Beatrice Monahan can’t wrap her spastic brain around. It’s too spur of the moment."

"Irreverent and honest," Austin blurted.

"Yes, that too." Sage turned fully around and stepped closer. She was smirking, a cheeky expression. “Would you like to kiss me?” There was no immediate reply. “I see the way you look at me sometimes in class, and don’t you dare deny it.” “I guess it's just fictional characters,” she inserted the key into the driver's side door, “who wear their emotions on their sleeves.”

Austin had never met anyone quite like Sage, and, in part, that was her appeal. She was self-assured but without any of the cocky, false bravado of the preppy types he knew from college, whose fathers underwrote their personal finances soup to nuts. These pampered yuppies were shipped off the best schools with their Louis Vuitton handbags, iPods, kindles and American Express Platinum Cards, where it was assumed that they would find suitable partners and marry well.

Before Sage could crack the door, Austin slipped an arm around her waist and pulled her close. Leaning up against her, he pinned her against the car with his body and kissed the girl deeply on the mouth. The scruffy teens across the street began hooting and jeering at the top of their lungs.

"Would you like to go out some time?" Austin pressed.

"Yeah, that would be swell, but what do hypochondriacs do on a romantic soiree?"

"We're not hypochondriacs." He kissed her on the neck softly and felt her curl to the side as his lips tickled the smooth skin. "We're hypothryroidiacs."

"There's no such thing. You just made that up." Sage broke free and got into her car. She lingered a while longer before firing up the engine and driving away.

One, two, three, four, five… Later that night before going to bed, Austin sat in a straight-backed chair and counted his breaths. He sat with his feet planted firmly on the floor and, breathing through his nose, followed the thin column of air as it came and went. At a certain fixed point - usually about twenty minutes into the exercise - he would stop counting and just sit in meditative silence feeling his body, trying to gauge where he stood visa vie his loused-up thyroid.

The kiss in the parking lot notwithstanding, today totally sucked. His brain fog had worsened and energy level plummeted so low the boy felt absolutely geriatric. Lately, Austin found himself nodding off in the middle of the afternoon like some addle-brained, nursing home patient. And he was constantly cold. The issue with cold was fairly commonplace. People with thyroid conditions heaped their beds with extra blankets and dressed in layers even when it wasn't particularly chilly. They weren't neurotic or attention seekers. Being hypersensitive to the slightest change in temperature, they were always cold - cold and physically exhausted. Austin could sleep twelve hours straight and wake up feeling like he chugalugged a quart of scotch the night before! If anything, he was losing ground. And the new medicine, the silver bullet that was supposed to rectify everything, was a total bust!

At the previous meeting of the writers' group, Abi told a funny story. He traveled back to his homeland to visit relatives. As the Beechcraft King Air twin-prop landed in Baku, the plane badly overshot the runway by several hundred feet, running off the asphalt into an open field of barley. The Caspian Sea was visible out the grimy passenger window a short distance to the east. "Was not so good the brakes," the Armenian immigrant noted with a goofy smile that belied his anxiety over the ordeal. As Abi explained it, the region was desperately poverty stricken, the government feudal and corrupt. When a domestic plane had mechanical problems or needed routine maintenance, spare parts were often purchased on the black market. They were third rate, the substandard metal either too soft or brittle. It's just the way things were. The provincial country was one of six independent Turkish states with Russia to the north and Iran due south.
Abi desperately wanted to get it all down on paper, to chronicle his bizarre experiences. "I go home for Christmas, not for to swim in Caspian Sea," he chuckled and rubbed good-naturedly at his hairy chin. Abi was just Abi - a grease monkey heartbroken over the immutable loss of his spiritual homeland. So he joked in fractured English and, as best he could, jotted down his life story. Nok. Nok.Nok.

Prickly ash bark, sarsaparilla, oat seed, shizandra berry, ashwaganda and maca root.... Before leaving the community college parking lot, Sage fished about in the glove compartment of her Toyota. “Here try this.” She handed him a smallish, opaque bottle.

“What is it?”

“An adrenal support herbal formula. I got a spare bottle at home. Just follow the directions.”
Later that night, Austin dribbled ten drops of the rust-colored herbal solution into a tumbler of water and tossed down the bitter solution. Sage was seeing a naturopath. Maybe he would make an appointment with the holistic practitioner to discuss a non-pharmaceutical alternative. An hour after taking the herbal remedy, he already felt a hundred percent better, although he realized, full well, that the euphoric sense of well being was probably just wishful thinking. Still later that night as he lay under the covers, Austin felt warm, too warm. He removed one of the blankets - just one as a precautionary measure. The heebie-jeebies weren't completely gone, but manageable. And his brain fog had lifted ever-so-slightly.

What if? What if? What if? Beatrice Monahan, the ungracious troll who managed the community college writing program, had a favorite exercise. Students chose a theme and then asked a series of recurring questions, each of which sent the work-in-progress spiraling off in an, unanticipated direction.

What if Austin fell in love with the chubby, dark-skinned girl with the satchel jaw and thyroid condition who waitressed over at Ryan's Diner? And what if she returned his slavish devotion? Sage Ostrowski was no fashion plate - not the sort of girl most red-blooded guys gave a second look. But still the girl possessed nice breasts - not overly large but 'substantial' - and that was definitely an asset when you climbed into bed slightly horny and wanting to snuggle in the middle of February with a foot of snow carpeting the New England landscape.

Sage was surly and kind, sullen, churlish, defiant, loyal and a dirty street fighter. Austin was passive-aggressive, hard-working, low-keyed and dull. He had no sense of adventure, no wanderlust, no desire to set the world ablaze. In his third year at Bryant College he was leaning toward a degree in accounting. In a few short years, he would be earning decent money and searching about for a significant other. What if? What if? What if?

What if he stopped by the diner this weekend and brought Sage a small gift - nothing ostentatious - by way of appreciation. Perhaps a bouquet of cut flowers or dozen roses. No, that was out of the question, since it would certainly set gossipy tongues to wagging and give the employees at Ryan's the false impressions.

But, on second thought,...