Written in my skin

I wear my heart on my sleeve, although it’s not quite as simple as that. Because I also wear my life on my skin.

2016 has erupted on my body. Angry red bumps cover my shoulders and upper back; here and there they appear along my spine, my side, my coccyx. I have a tattoo on one upper arm, and I can feel the bumps concealed by the ink.

On my face, it’s no longer just hormonal acne on my jawline. It has crept up over my cheeks, below my ears, into my hairline, appearing on my forehead.

I have acne because I have epilepsy. The medication I’ve been taking for nearly 12 years to control my seizures (Epilim, or sodium valproate) can cause adult acne. Medical options not available to me, for various reasons: antibiotics, the Pill, Purbac, Androcur, Roaccutane.

It’s been up and down for over a decade, but this year I have to acknowledge that my appearance is a reflection of inner distress. My physical skin has become an extended metaphor of my psychological skin.

After my girlfriend left me in the middle of January, I felt like my skin had been flayed off. I was raw and bleeding. I would sit on the couch for hours, not daring to move for fear of the molecules in the air causing me pain. Perhaps, if I sat very still, I could stop myself from thinking or remembering or feeling anything.

(This is not an effective long-term strategy.)

Within a few days, my skin had gone berserk. What had been a few pimples on my shoulders spread down my back and upper arms, and this breakout has stayed consistently bad in the eight months since. I swim for exercise and feel self-conscious in my training kit. I haven’t worn anything sleeveless since the beginning of the year.

In the six months I spent grieving (and dealing with a myriad other disasters, because 2016 has been The Year From Hell) I felt exceedingly vulnerable. When your psychological skin has been stripped away, when you are nothing but bones and flesh and nerve endings in a world full of sharp edges, you become fiercely protective. While I was careful not to isolate myself, I was incapable of socialising as usual. I could have coffee or lunch with one or two close friends; the thought of going out for dinner with a group of people made me physically ill.

The loss of that internal barrier also meant that I was constantly aware of my feelings and what I could and could not do. All of my emotional energy went into holding myself in the shape of a human being. There was little left for anything else. I said “No” a lot. I said “maybe” to Facebook events and never showed up. I withdrew from friends who needed too much from me, even though I had always been the person who was there for everyone, who mothered my friends. I had to mother myself.

I have two tattoos. The first one, which I got last year, is the silhouette of a flying Canadian goose just below my elbow and is a reference to Mary Oliver’s poem “Wild Geese”. It begins:

You do not have to be good.
 You do not have to walk on your knees 
 for a hundred miles through the desert, repenting.
 You only have to let the soft animal of your body love what it loves.

The second one I got in June, the face of a mountain lion on my right bicep. To me, it represents boundaries, a visible reminder that I am able to protect myself. I had to write that into my skin.

Your skin is your body’s largest organ. It breathes; it is a living thing. It is both a protective barrier and the organ that gives you your sense of touch, allowing you to move through the world.

In July, I finally shook off my depression. My senses came back to life. I was a human being again, no longer merely the shell of one. I’m better! I thought. I’m going to be okay!

My doctor suggested that I change from Epilim to lamictin (Epitec), which is better for acne. Some people develop a rash, he added, but it is quite rare.

Naturally, I developed the rash.

My entire body was covered in red spots, including my palms and the soles of my feet. It involved a trip to the emergency room, a cortisone drip, adrenalin shots, multiple doctor’s appointments, antihistamines that knocked me out, a two-week course of prednisone. For a week my skin was itching so badly that once I started scratching, I physically could not stop. Getting in the shower was the only way to make the worst of it subside. I would run to the bathroom, opening the tap and removing my clothes with one hand while the other was clawing at my back.

“I haven’t seen a lamictin rash in three years,” my doctor said to me. “I just tell patients about it as a standard warning. Of course it would be you!”

I made an appointment with my dermatologist. We haven’t run out of options yet, she told me, she’ll put me on another medication.

For leprosy.

I could only laugh. For much of the year I had been a hermit, might as well have been in a leper for the oozing sores on my internal skin, and now I was on fucking leprosy medication.

In August, I went to Cape Town on holiday. It was in many ways a cathartic and profoundly healing trip. I went out, I socialised, I faced a hell of a lot of demons.

I also met a lovely woman with whom I spent a couple of nights. If you’ve ever felt self-conscious about your body, I don’t need to tell you how nervous I was about taking off my shirt. I felt like I really did look like a leper.

She didn’t even notice.

As we went to sleep, she held me with my naked skin against her chest, and I very nearly cried.

When I returned to Johannesburg, I felt incredibly emotional. I cried about everything. Elizabeth Gilbert came out on Facebook, explaining that she was in love with her best friend who had cancer; I sobbed like a baby. Sia released the video for her single “The Greatest”, a tribute to the victims of the Orlando shooting, and I cried while watching it over and over.

The barrier between me and the rest of the world had disappeared. My skin had gone and I felt everything, everything. It was just too fucking much.

This week, I went to my dermatologist’s office for a chemical peel, part of my treatment regimen. While doing the peel, the skincare therapist became concerned about some blemishes which hadn’t healed properly. She called my doctor, who took one look at my face and said, “You have a staphylococcus infection.”

She prescribed a strong course of antibiotics. No further peels until everything has healed.

That same evening, after a long conversation with someone I trust, I realised that I need to put dating on hold for a while. I have too much baggage; too many skeletons rattling the closet door. I have to do the work of healing first.

I don’t pay much attention to real life symbolism; I’m too skeptical for that. But this one I can’t ignore: My physical skin has suffered so much damage that it became infected. My largest organ, my living body. I have to heal it with medicine and protect it from things that can harm it. I have finally acknowledged the damage to my psyche, to my living heart, that I have to heal with therapy.

And I have to protect that psychological skin too. Until it regrows.

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