This Is The Conversation We Should Be Having About Carrie Fisher’s Death

courtesy of wikipedia
Assigning a binary of good and bad to sober/not sober ignores Fisher’s complicated relationship with her varying and intersecting illnesses.

When the news broke Sunday morning that sleep apnea had been a contributing factor in Carrie Fisher’s death, it didn’t make much of a ripple on social media. It was almost anti-climactic, in a way. After the wild, brilliant life she’d led, it turned out she might have died of the same disease that makes your old uncle Howard in Idaho strap a strange-looking mask to his face every night. Nothing too glamorous about that, is there?

Then on Tuesday morning further details of Fisher’s autopsy were released, including the information that she had cocaine, ecstasy, and heroin in her system.

And then the internet, predictably, blew up.

Never mind that the amounts of ecstasy and heroin were miniscule. Never mind that the autopsy report stated that they could have been consumed as early as 72 hours before Fisher died — meaning it’s unlikely she died of an overdose, as some have assumed. People had discovered a narrative that suited their image of Carrie Fisher — the beleaguered star who, though she had periods of sobriety, could never quite tear herself from the death-grip of addiction — and they weren’t going to let go of it.

Some people felt a furious sense of betrayal, as if Fisher’s claims that she was “no longer using drugs” were a lie that she had told them personally. Some people turned to victim-blaming, claiming it was Fisher’s own actions that led to her death. Some were just quietly disappointed, sighing that they still loved her — as if her drug use somehow made her less deserving of their love.

Carrie Fisher was never shy about anything, least of all her addiction and mental illness. She spent most of her life actively working to break down the stigma surrounding both of these things, not to mention artfully explaining how the two are often inseparably entwined. Whether or not an addict dies sober should not be any kind of metric for how much we respect them or how successful they were in life. And to assign a binary of good and bad to sober/not sober ignores Fisher’s complicated relationship with her varying and intersecting illnesses.

As her brother Todd Fisher said in a statement made shortly after the autopsy results were released:

“We’re not enlightened. There’s nothing about this that is enlightening… I would tell you, from my perspective that there’s certainly no news that Carrie did drugs. Without her drugs, maybe she would have left long ago.”

Personally, I don’t feel any sadness or sense of betrayal — or even surprise — about the fact that there were drugs in Fisher’s system when she died. What saddens me about the release of this information is that it has effectively shut down any discussions that might have been happening after the revelation that she died of sleep apnea. Because now that we’re all so focused on wringing our hands over the evils of illicit drugs, we’re completely ignoring a potentially deadly disease that affects more than 18 million Americans.

Assigning a binary of good and bad to sober/not sober ignores Fisher’s complicated relationship with her varying and intersecting illnesses.

Sleep apnea is a condition that causes a person to repeatedly stop breathing during their sleep for anywhere from seconds to minutes, sometimes up to a hundred times per night. It’s a frightening disorder to live with, and a frightening one to witness: partners of those with sleep apnea report seeing their loved ones gasp and choke and struggle to breathe as they sleep. But as awful as sleep apnea is to witness, the effects on the person suffering from it are much, much worse.

Because those living with sleep apnea can stop breathing for up to several minutes, that means that their brains are deprived of oxygen during that time period — something that can have disastrous effects on the rest of the body. On top of that, chronically disturbed sleep means that sufferers are not reaching the deeper levels of sleep, and consequently are not well-rested even after spending hours in bed.

Sleep disruption and oxygen deprivation can lead to heart disease (including heart attack and heart failure), high blood pressure, stroke, pulmonary problems, mood and memory problems, and even psychosis. It can also cause drowsiness — in fact, sleep apnea is the leading cause of daytime fatigue — which can be disastrous if the sufferer is driving a car or operating any kind of heavy machinery.

It’s unknown whether Carrie Fisher was ever diagnosed with sleep apnea, but if she wasn’t, she would certainly fit a known trend where women are severely underdiagnosed with the condition. According to Grace Pien, a sleep specialist with the Johns Hopkins School of Medicine, there are about nine men for every woman diagnosed with the condition. Pien adds that physician-held stereotypes about sleep apnea — that its sufferers are mostly middle-aged, male and overweight — lead to under-testing for it in patients who don’t fit these criteria. But the truth is that anyone, regardless of age, gender or body size, can develop sleep apnea.

We don’t know what exactly killed Carrie Fisher, but we do know that she abhorred stigma and shame. I’m hopeful that the presence of illicit drugs in her system will further many conversations, especially those surrounding sobriety and relapse and the illness of addiction. I also hope that Fisher’s autopsy results might launch a larger discussion about sleep apnea. The irony that Fisher — who refused to be silent about any of her illnesses — died of what many call the “silent killer” is not lost on me. With Fisher gone, let’s follow her lead and make sure that we’re not silent about it anymore.

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