If you’re reading this, chances are I’m in the tub.

If you’re talking to me on the phone, chances are I’m in the tub. If I say I’m reading, or writing, or highlighting back-issues of The New England Journal of Medicine, or sipping tea, or rapping Jay-Z for my dog — chances are I’m doing these things from a hot bath.

I’m in pain all the time. Every single day I wake up and my pelvis is heavy, a giant, throbbing ache. No matter how I sit, or lay, or walk, or stretch, it feels like there’s a jagged rock hanging from the fibrous hinges inside of me, the ligaments overstretched, tearing with white-hot pain.

It twinges and stabs, it nauseates me and exhausts me. It’s been part of my life for five years. Five years. For five years I’ve been dragging it around with me, reluctantly having to introduce it as part of myself.

Because even though you might not be able to see it, sooner or later, if you’re part of my life in some capacity, you’ll meet it. It might show up as a sudden grimace while we’re having coffee, a gripping of the edges of the table, an apology, cancelled plans, pushing away a barely-touched entree at a restaurant we’ve been wanting to try for months, silence when our jam comes on the radio. My hands pushing your hands away. My head turning away from your lips.

You, waking up one day and thinking — I haven’t heard Abby’s voice for weeks. Me, waking up one day thinking, I haven’t spoken in days.

Before I ever write a single word I think for days on end. So, writing a book is a lot of mental writing. Writing a book that contains a narrative about pain that I am still IN, about a disease that I STILL HAVE that has been PROGRESSING with each year that has passed me by — that, by the time this book hit shelves will have no doubt stolen even more of my life — well, that requires a lot of thinking.

I do this thinking, more often than not, in the tub.

Because the only kind of heat that gives me even momentary relief is the penetrating kind. It’s trading a moment of internal clenching for external burning and bruising. It’s trading one pain for another; a ruthless balancing act that makes your legs shake and your head spin.

Sometimes you just give up and you give in to the pain that rules you.

Fighting it requires something that you don’t have, energy that you can’t dredge up — so you sit in a steaming, scalding, punishing bath and you wait.

Reading in the tub is always a precarious affair. All the yellow legal pads I have are damp, the textbooks water-stained. Maybe when the book goes to the publisher I’ll ask them to print me up a special water-proof galley, since I’m certain that, as with the writing of it, the editing process will likewise be completed submerged in a tub.

Lately I’ve found myself there long after the water’s gone cold, because it’s a struggle to push myself up and out. My once-strong dancer’s legs are weak, the muscles of my upper body atrophied. Bird arms and legs that are perpetually bruised, black toes from standing several hours giving a lecture a few weeks ago. Whenever I go from one position to another my head spins wildly, I get short of breath — orthostatic hypotension, it’s called. When you get up and your blood pressure goes down — then, sometimes, you go down too, dead weight hitting the floor, bruising and bleeding again.

Like most chronic illnesses, Endometriosis doesn’t like to be lonely; women with Endometriosis are more likely to have an autoimmune disease.

Excruciating conditions like interstitial cystitis, bowel disorders and infertility may even be caused by Endometriosis.

I’ve long suspected an underlying autoimmune process in my case, as does my doctor, who thinks the root may be in my adrenals, Addison’s maybe.

As if the Endometriosis on its own wasn’t significant enough; especially with the new research that links the disease with increased risk of heart disease.

Something that I’m already genetically predestined for: my great-grandmother, her mother and her grandmother all died of heart disease at exactly 70 years old. My great-grandmother had her first massive heart attack in her early-forties. Of course I had my motherfucking genome sequenced — and, as you might suspect, the genes associated with coronary artery disease are impressively fucked up.

As you might suspect, that news about Endometriosis + heart disease fucked me up pretty bad. Then I thought. . .you know, there’s something oddly sedating about this kind of certainty about your own death.

Like, yeah — I’m probably gonna get heart disease and die like a lot of Americans, but not because I eat like a frat boy. My genes just suck. Hell, I might even die relatively young. My grandmother’s brother died of a heart attack when he was quite young.

It was never any secret that hearts were our familial weakness, but I always thought of it in a more philosophical sense. Maybe we all struggle to love because our hearts beat with evolutionary hiccups.

Next week I’m turning twenty-five. Not old at all, I know. And despite how ill I feel, despite how tired I am, there are parts of me that still feel young. My heart, even if it’s weak, still flutters from time to time. I still try to sing along with the radio. Eating a slice of birthday cake will nauseate me, just the same as any other food. I have a pill for that, so it will still be sweet.

I reach for joy, I grasp at chances to be happy.

And there’s always a voice somewhere telling me none of this is real, that disease isn’t real, that pain is manufactured by pharmaceutical companies, that all the things that make me unwell could be solved if I ate this or drank that or poked needles here or took capsules of powders and potions.

And then there are the doctors who frown at my blood work, my ultrasounds, my surgical scars — look at my organs, my chemistry, my brain — and I am sick, yes, but there are so many unanswered questions, and they hate that. More than I hate being sick, they hate not knowing why.

Did I suck on too much plastic as a kid? Did my early-twenties satisfy a ticking genetic time bomb that had just been dormant inside of me since I was still in utero? Were there too many hormones in my cereal’s milk?

Is all of this the beginning of something more sinister? Is this early stage of something with a finite end stage? Twice now they’ve said, “cancer” and twice now, we sighed with relief when nothing was found. But for every time they said “it isn’t cancer”, they came up with more labs that didn’t make sense, a new symptom after six months, crossed another drug off the list.

The last time I saw my doctor was a couple of weeks ago. She told me I’m not healthy enough for another surgery to stage my Endometriosis.

It made my throat burn and I blinked back tears — one, because the words too sick are terrifying.

And two? Because after years of being told it was all in my head, or that I was crazy, or whining, or attention-seeking or drug-seeking or even that, worst of all, pain in a woman was normal — a medical professional validated that I am, in fact, as sick as I feel.

What a horrible thing, that validation.

Because now I can no longer hope that maybe they’re right — maybe I am crazy, maybe I am making it all up. Five, almost six, years have passed and this whole time I’ve known deep down that I am very, very ill. Each year I have lost another facet of my life. Each year, my list of acquaintances whittles down, my “good” days fewer and fewer, my pills piling up.

All these years I’ve only wanted one of two things: to be well or to be wrong.

Now all I want is a hot bath.