This short fiction is true to my experience as a therapist stumbling on CFS while looking for something else.
To Find It, You Have to Listen
Adapted from the novel Going Along Together
By Frank Albrecht
"Allison is depressed," said Allison’s mother, Monica Huerta. She nodded toward her 13-year-old daughter slouched on the far end of Dr. Wolfe’s couch. A closed-off expression on her face, Allison stared indifferently out the nearby window.
Allison had prominent eyebrows, straight black hair, and cream-in-your-coffee skin. Her plump cheeks, short chin, and broad forehead combined with large, dark eyes to make her look cute but not quite real, as if she were an Hispanic babydoll. Ponytail and bangs combined with her Catholic school uniform to accentuate that impression.
Wolfe watched her for a moment. She seemed not to notice. "Allison," he said finally, "do you think you are depressed?"
She flicked her eyes at him for about a millisecond. "Yeah, whatever," she responded.
"Allison!" said her mother, her voice on edge.
The girl looked at her mother. Nothing much seemed to happen but Allison looked back to the psychologist, this time for a good half second. "I am depressed," she said in a flat, uninvolved tone, and looked away again. Her lack of interest pervaded the room.
Monica stared disapprovingly at her daughter. She was a slight, pale skinned, dishwater blond non-Hispanic white woman wearing what Wolfe’s mother would have called a "street" dress. High neck, calf length skirt, three-quarter sleeves, loosely tied belt, no frills or fancy features, not flashy enough for a party but too "good" for a house dress. She sat up very straight on the couch next to her daughter.
She looked back at Wolfe. "Allison was brought up with better manners than this," she said. He muttered sympathetically and asked for more information.
About eight months previously, sometime in June, Allison had started showing what her mother called "this bad attitude." Normally active, always on-the go, she had become quiet and moody. She stopped going out with her friends and stayed in her room most of the time, listening to music or watching TV. When the family went sailing she refused to go with them. The previous year she’d been an enthusiastic participant on field hockey and softball teams but this year she hadn’t even tried out. "She’s lost interest in everything," the mother concluded.
Allison looked around abruptly. "I’m interested," she said to her mother. "I keep telling you that. But I don’t feel like doing things."
"Oh, darling," Monica said, making a sad face. "Can’t you see that’s just an excuse?"
Allison’s face seemed set in stone, an angry mask. She looked away.
"Last year," Monica resumed, sadly, "Allison had perfect attendance at school, and she had all A's."
In a contemptuous tone, without looking around, Allison murmured, "I got a B in music."
Her mother stared at her and kept talking. "This year she’ll make up any excuse to stay home. And she’s so ingenuous about it! Today it’s a sore throat, yesterday it was some ache somewhere, it’s always something." She learned a little toward her daughter and put her hand on her thigh. "Really, darling," she said, "if you’d put as much cleverness into doing your work as in getting out of it, you’d be doing fine." Allison did not move a muscle. After a moment Monica straightened, withdrew her hand, looked around at again at Wolfe. "She’s flunking everything," she said in an almost conspiratorial whisper.
All this seemed pretty standard to Wolfe—depressed teens often feel angry rather than sad. Frequently their behavior is aggressively hostile. The stark contrast between mother and daughter in skin tone and hair color was unusual, but Wolfe already knew about that. He had a superficial, chatting-on-the-dock acquaintance with Allison’s black-haired, brown-skinned father, Angel Huerta, a Latino computer whiz. Wolfe had heard that Angel had a WASP wife but he had never met her.
He asked Monica to leave him alone with her daughter. Looking relieved she removed herself to the waiting room.
Allison sat unmoving, looking away, her body tensed against attack.
"Apparently something is wrong with you," Wolfe said to her.
"No duh," the girl responded, still apparently fascinated by the sky outside his window.
"You didn’t get into sports this year, " he went on, "because you ‘don’t feel like doing things.’ Is that right?"
An indifferent shrug.
"Could you tell me more about that?" he asked. "Explain it a little."
She almost smiled, though still she didn’t move. "Which word in the sentence, ‘I don’t feel like it,’ don’t you understand?" she asked him.
"’Feel like,’" he replied calmly. "I don’t understand what you mean by ‘feel like’."
That brought her head around. "Are you stupid"" she asked. "I don’t feel like it. What’s to explain?"
"Feeling like doing something, or not feeling like it, those are ways you are inside yourself," he told her. "But the words can mean different things. You might not feel like doing something because you don’t like it, or because you want to do something else, or because you’re tired or in a bad mood. So when you don’t feel like playing softball, what is that like inside yourself?"
As he spoke she had again looked away. He had to guess that she was actually listening.
"Is your feeling red, yellow, green, or black?" he went on "Is it big or little? Where inside you do you does it not feel like playing softball—behind your eyes, in your chest or belly, in your butt or your big toe? Where?"
She looked back and almost smiled. "Well it’s not in my butt," she said.
"So where?"
She thought about it. "Everywhere," she said finally. "Like when I try to do something I get weak. Sometimes I get weak just thinking about doing something."
"Weak?" he asked. "What kind of weak?"
Her tone was now almost conversational. "I get dizzy. Or my legs don’t work right. I can feel my heart banging."
These are not standard symptoms of depression. Maybe anxiety, Wolfe thought.
"Do you feel scared when your heart goes fast like that?"
"No," she said, as if surprised at the idea.
"Do you get short of breath when your heart goes like that?"
She looked thoughtful. "Sometimes I get short of breath going up a flight of stairs, unless I go real slow" she said. "But not just if my heart is going fast."
This is how you stumble on the possibility that someone has Chronic Fatigue Syndrome. You fall over it when you’re expecting something else.
Wolfe was silent a minute, looking at her. She was staring off to the side again but without the same rigid posture as before. She seemed to droop, like a wilted flower.
"You don’t really think you’re depressed, do you?" he asked.
She glared at him in sudden anger. "I’m not sad! I don’t cry much. I care. I’m not upset about anything. I don’t have problems with my friends. School’s all right, or it was till this happened. I want to do things. Once in a while I think about killing myself, but only because I feel so shitty all the time. Dr. Orris keeps asking me about those things and I keep saying no, no, no, I don’t have those things, I don’t have problems! Except I feel so bad. Why can’t anybody just accept that?" Suddenly she had tears in her eyes but her face was still stiff with anger. "Well screw them," she said. "Screw them all, all those doctors! I don’t care anymore what they think." She paused for breath and her gaze on him sharpened. "And you, too," she added with enormous intensity. "Whatever you think, the Hell with you!" Twisting her body away from him and staring down at the floor, she crossed her arms in front of her chest, as if embracing herself, and became motionless again. Her tears dried and her face was like again stone.
"Well," Wolfe said slowly, rather tentatively, "I don’t think you’re depressed."
For a moment she didn’t move. Then she raised her head a fraction of an inch. She was listening.
"I think you might have a physical illness," Wolfe said. "It’s called Chronic Fatigue Syndrome. Did you ever hear of that?"
Visit the site for Going Along Together.