Illustrations by Colleen Frakes

A few weeks ago, I found myself strolling through Hyde Park with an English friend. It was one of those rare, glorious, sunny London days. The water of the Serpentine glimmered as people lounged along its banks, having low, murmuring, exceedingly civilized conversations. My friend, who grew up in this city, took a deep breath and closed his eyes. “Do you smell it?” he asked. “That smell—such an English autumn smell, sweet and woodsy and damp. I’ve known it since I was five. Isn’t it lovely?” When I inhaled as he did, I found myself unable to share his delight. I suddenly remembered the joy of hiking in a park or forest of the northeastern U.S., breathing in the refreshingly crisp, almost biting fall air, gazing in rapture at the fiery elms and oaks as dry leaves crackled underfoot. Before I could smile back at my friend and continue the day, I had to shake off a pang of sorrow at having abandoned the country of my birth.

For someone like me, the daughter of Indian immigrants, it hurts to let go of America. It is the country that, after all, saved my father. He grew up in the southern Indian city of Chennai, caught between warring factions in a chaotic post-independence atmosphere. The old Brahmin elite, which his family was a part of, vied with the newly elected socialists, who saw Brahmins as evil co-conspirators with the British Raj. As a child, my father had stones thrown at him on the street, and, later on, saw his older brother denied entrance to medical school solely on the grounds of caste. In 1970, when he was twenty-two, my father left for America, hoping to avoid such nightmares.

At that time, the United States only allowed select Indians who showed quantifiable academic or entrepreneurial promise to obtain visas. When he got his, my father rejoiced at joining this golden set who had the chance of living in what he and many of his peers perceived as the most powerful nation in the world, where social class did not matter and talent and hard work could allow a person to transcend any kind of difficult circumstance. When he arrived at the University of Tulsa in Oklahoma, where he had been granted a fully funded master’s degree in chemical engineering, his first impressions surpassed his expectations. He fell madly in love with America. The frank warmth of the American people and the youthful energy of the hippie movement charmed him. He donned bellbottoms and grew a handlebar moustache, and soon found himself enjoying the attentions of Oklahoma women who told him he looked like Omar Sharif.

He also took full advantage of the meritocratic system. By the late 1970s he had finished graduate school, found a stable job as an executive at AT&T, and was able to go to India to marry (an arranged match, as per tradition) and bring my mother back with him. She finished her graduate degree in the States, too, and started working as a software developer—a harbinger of the Indian IT wave to come. A few years after my parents arrived in America, I, their first child, was born in the U.S.A. It gave my father great pride to know that I was a full-fledged, natural-born American citizen. As he guided me on my training-wheeled bicycle in our suburban New Jersey neighborhood, or threw a Wiffle ball to my bat, he would often tell me, with great zeal and optimism, about the endless possibilities I had. I admired my charismatic father and as I grew up under his influence, I began to feel his same devotion to the quintessential American values of freedom, individuality and hard work. I applied these values fervently to my own life, and, as I got older and discovered in myself an inclination for writing and an insatiable wanderlust, my version of the American dream became clear to me. I would become a journalist who worked for a major newspaper or magazine, and traveled the world as part of her job.

My faith in America convinced me that as long as I worked hard enough and with integrity, nothing would block my path. It was only in my early twenties that I was forced to question whether America was really going to support my aspirations as it had supported my father’s. After I graduated from Brown University in 2006 I took my first job as a general assignment reporter for The St. Petersburg Times (now Tampa Bay Times) in Florida. It is a well-regarded paper with multiple Pulitzer Prizes to its name, and for young reporters, it is considered a stepping stone to a job at the Washington Post, whose editors are known to scout for talent there. I felt thrilled to have landed this position.

When I arrived in Florida, I found that my apartment building stood right across from a store selling Bibles and Christian fundamentalist paraphernalia. Just down the road was a strip club called Kissin’ Cuzzins. This was a far cry from the liberal Northeast I had left behind, but I knew that dramatic scene shifts were to be expected in the life of a journalist. I looked forward to that sort of adventure.

I started the job with the fresh enthusiasm of an ambitious post-graduate. Every morning at eight a.m. I greeted my bureau editor, ready to go out, “chase down” stories and write two, sometimes three articles per day. By nine I was out in my car, driving from one end of the county to another, frantically gathering details for these stories so I would have enough time to crank them out before the end of the day. My boss expected more output from his new hire than his more established reporters, and I soon found myself leaving work later and later in the evening. At first, I did not as much as cast a glum look when I found myself alone at the office at nine p.m. “It’s fine, I thought as I downed my third coffee of the day and unwrapped a health food bar, my substitute for dinner. “This is what you do at the beginning. Pay your dues.” Overtime, in my mind, was a normal aspect of life as a young professional in America.

I tried to keep up, but after three months on the job I started to grow exhausted in a way I had never been before. Even after eight hours of sleep I struggled to get out of bed in the morning, and I needed more and more coffee to get through the day. At first I tried to manage this energy drop myself. I took extra vitamins, tried to get to bed at a reasonable hour and waited to feel better. I didn’t. Instead, new symptoms appeared. A nauseous, dizzy feeling started to seize me at inopportune moments in the workday. The right side of my body started to tingle and go numb.

In spite of my desire to conceal my condition and get on with my job, I wanted to at least confide in someone. I hesitated at first, because I felt I had no safe confidant to turn to. My hardworking parents had made me feel abundantly lucky to have landed a salaried job in my field of choice immediately after graduating; I did not want to disappoint them by revealing that I was falling apart, somehow failing to take full advantage of this plum opportunity. I did not dare reveal my plight to my Brown friends either, who were now scattered around the country and world. Though creative and different from stereotypical type-A overachievers, they were all achievers nonetheless, and there was always a tacit understanding among us that we could find a way to prevail over any obstacle in our way. There was no way I wanted to out myself as the weak one, physically incapable of winning at survival of the fittest.

As I continued to work long hours with scant time to recuperate, my symptoms worsened to the point that I felt my ability to do my job would soon be threatened. I began to fear, as I struggled to walk for twenty minutes on the treadmill (I was previously able to run four miles at a stretch) that there was something seriously wrong with my health. Once or twice, I did try discussing my worn-down state with a few colleagues. Although I had never heard any of them talk about personal dilemmas even at off-duty house parties, I hoped they might be willing to comment in some meaningful way on the fact that I had dropped about eight pounds, that there were now blue-black hollows under my eyes and I had stopped being my usual fun-loving self, declining social invitations.

However, as soon as I uttered my woes to several of them at a dinner after work, I knew I had violated an unwritten code. My colleagues blushed. They looked uncomfortably down at their plates. One of them finally said, “The editors all love the work you’re doing. You’re making a great impression. Just keep it up a bit longer.” When I expressed my worry that I might not be able to go on at this rate, they looked at each other and kept silent. Some force of denial seemed to prevent them from acknowledging the very possibility of someone who was unwell and in dire need of a break, or at least a more reasonable regime.

After that dinner, as we all got into our separate cars and made our way home, I felt miserable, full of self-loathing for being an overly fragile wimp. But as I drove back home in the dark, a feeling of indignation slowly crept in and crowded out my despair. I felt I did not deserve to feel so miserable after confessing my predicament to my colleagues, and I was shocked that their reluctance to address my condition mirrored my own embarrassment about it. If it had been one of them to complain instead of me, I might well have acted just as they did. I would have felt I had no space in my busy life to accommodate another’s health problems. And, on some level, I would have judged the person for not being tough enough.

I had always seen myself as tough enough. According to the identity I had assumed from childhood, I was an invincible heroine who could handle whatever work was needed to pave the way to her own version of the American dream: a job at a major newspaper or magazine. My experience in Florida was showing me that I simply, physically, was not the person I had imagined myself to be, and for the first time, as I arrived home that night with my head pounding and muscles aching with fatigue, I began to realize I should not be ashamed of that fact. I sensed that something was wrong with how America had turned work into a cult-like religion that superseded care for the self and for others. I realized that in my current situation, the best way to be tough was to stop playing my part in the game, get over my fears, accept what I was going through and talk with my bosses about it.

I made a doctor’s appointment so that I would at least be able to give a concrete diagnosis to my editors when I spoke to them, but the doctor dismissed my symptoms as “just stress.” This perplexed me, and I determined to continue on in the job while deciding how best to broach the subject. I would not have the chance.

While returning from an assignment one evening a week or so later, about seven months into my Florida stay, I lost all navigational bearings while driving along a local highway. My brain had suddenly turned into a mess of misfiring synapses, and my limbs felt like they were moving through sticky molasses. I somehow managed to swerve to the shoulder of the road. When I shut off the engine, my hands were shaking, and I leaned out the window and vomited. I could not remember how to get back to the office.

This was game over. I had no choice at that moment but to phone the bureau from my cell and mumble what had happened. A photo intern was sent to help me get home. I then rang up the editor who had hired me and finally explained that I had been feeling increasingly unwell over the past months. He was shocked at my tale of suffering, since I had been performing so well. I told him that as things stood I unfortunately would not be able to keep up that performance for much longer, and asked for a decrease in my hours, at least until I sorted myself out. Disappointingly, he said that it would not be possible to do that, since if he did such a favor for me he would have to do it for everyone. He did offer me a week of paid vacation to see if that helped set me right. I flew back home to Princeton, where I lay in bed, ate soup, and tried to read books. At the end of the week I felt no better. Even if I had been able to transfer bureaus, it would likely not have mattered by that point. It was too late. As my family finally understood when they saw me, I was in fact seriously ill. I had no choice but to leave the Times.

I remained home in New Jersey and threw the little remaining energy I had into figuring out what had gone wrong with my health. The first four or five doctors I saw continued to tell me I suffered from “just stress” and recommended anti-depressants and sedatives, which I did not take. I now actively resisted the labeling of my condition as “just” stress. I had been under severe stress, for sure, but since the stress had contributed to a breakdown of my physical health, I felt it was not something that could be passed off as “just” anything, or merely psychological. At last, eight months later, in October of 2007, a more comprehensive blood test validated my suspicions. High numbers of auto-antibodies were circulating in my blood. These antibodies were attacking my thyroid and slowly destroying it. This phenomenon is a sure sign of Hashimoto’s thyroiditis, an autoimmune disease. I finally had an explanation for the debilitating fatigue, brain fog, constant stomach discomfort and assorted aches and pains. The doctor who discovered my disease told me that it was certainly no accident that I felt my first symptoms in Florida, while working unreasonable hours and, as a result, eating poorly and irregularly. Most of the time, he said, autoimmune disease is triggered by a stressful event or poor work-life balance.

The standard treatment in the U.S. for Hashimoto’s is thyroid replacement medicine (typically a brand called Synthroid), which ostensibly makes up for the destroyed thyroid cells. When I discovered that this treatment did little to ease my symptoms, my parents insisted that I keep trying different doctors, believing that the American medical system would eventually solve the problem. I saw five more specialists who each tried different combinations, brands, and doses of thyroid medicine. Still no relief, and my thyroid antibody count was higher than ever. To rule out other possible causes, I consulted three or four highly rated New York City internists, who subjected me to endless blood work, multiple MRIs, a CAT scan and even a spinal tap. Two years after my initial diagnosis, one of them put me on a course of heavy-duty antibiotics to treat a possible Lyme infection that might have been triggering the autoimmune attack. The drug was too intense for my weakened state, and I ended up in the emergency room with a toxic liver. I survived, but felt more debilitated than ever before, and ready to quit doctors for good. In a last-ditch effort and an attempt to steer away from conventional medicine, I tried a cocktail of expensive vitamin supplements recommended by a well-known “holistic” MD. After that array of colorful pills and potions made my stomach revolt, I finally gave up. I threw out my pill bottles and told my family I was done. I was tired of punishing my body with drugs and procedures that cost thousands of dollars more than what was covered by my health insurance and only seemed to line the pockets of the doctors and insurance and pharmaceutical companies.

My father, whose black moustache had grown increasingly white, and whose eyes now had bags under them from worry, encouraged me not to give up—it was too painful to accept that his once-dynamic daughter had been reduced to a semi-invalid. But by this point, my eternal optimism was starting to fail. I did not want to give up hope, but I felt I had to accept that my life in the way I had envisioned it was basically over .

In the midst of such grim contemplations, a friend who had recently moved to Florence, Italy, invited me to visit her. A change might help you, she wrote in her email. I remembered a two-week trip to France a year earlier, and the slight energy boost I had felt by the end of my time there. That might not have been a coincidence, I suddenly thought. I sold my car and bought a plane ticket.

Two weeks in Tuscany became three, then four. In that month, something happened which at that time I could only explain as a miracle granted by a benevolent Italian saint. I began to feel better. My stomach stopped reacting with cramps and pain to nearly everything I put into it. My brain was markedly less foggy. I felt sparks of creativity again—the beginnings of an idea for a short story. I flew home and presented myself, bright-eyed and five pounds heavier, to my family. My father viewed my refreshed countenance with satisfaction, but also a bit of chagrin. It was a slap in the face of his beloved America. “Go and live in Italy,” he said, shrugging his shoulders. “What choice do you have?” I subletted a tiny room in an old Florentine building overlooking the Arno and started working as a private tutor, using the Italian I had learned in college to teach English to high school students. Slowly, as my strength continued to build, I started freelancing for magazines. I also began to understand more concretely why I felt so healed in this new country.

First there were the tangible reasons. It was clear to me that the rapid improvement of my stomach troubles, which had been a major aspect of my illness, had to do with my new Italian diet. Unlike the U.S., Europe has very strict laws when it comes to genetically modified foods (GMOs), pesticides and hormones in food. After a year of eating Italian foodstuffs, my rogue thyroid antibodies had dwindled to the normal range. I still had significant fatigue, but I felt once again that I had a chance at life. I would later learn from a German doctor that autoimmune disease is closely linked with gut trouble, which is often triggered by stress. Healing a weakened gut with a high-quality, GMO-free diet, he said, is the key to healing, and possibly even cure. It was not only an unhealthy attitude to work and a drug-happy, expensive healthcare system that threatened my well-being in the U.S., but also a loosely regulated food source: America had failed to heal me, and to nurture me.

There were also many cultural intangibles that helped me heal. Landing in Italy felt like switching from a splintery, unforgiving wooden chair onto a velvety divan. Italians understood illness. They wanted to nurture you out of it, and it did not make them squeamish. If ever I mentioned that I was battling a health issue, my Italian friends clucked sympathetically and were quick to suggest age-old, medicine-free remedies. Even strangers helped. I must have looked pallid one day as I bought my meat, because the butcher said, “Il brodo…fai il brodo!”—Broth…make broth!—and handed me a sack of cow bones. He then gave me his recipe for an exceptionally soothing beef bone broth, which I make to this day.

If I looked a bit harried as I walked down the street, a vigilant signora would sometimes stop me and say something like, “Stai tranquilla, cara,”—keep tranquil, dear—in a soothing, musical voice, or “Vai con calma”—go on your way with calm. Excessive stress and overwork were by no means considered de facto aspects of life in Italy. They were understood for what they are: serious threats to health. In Italy, I began to see more clearly the serious problem with American culture’s tendency to make work the supreme value. There may be some people who can withstand long days, all kinds of environments, and being available by text or phone at all hours, but there are plenty of people who cannot—or don’t want to—withstand such conditions. Unfortunately, American work culture does not offer such people an alternative. It’s true that the stress-phobic attitude of Italy, taken to an extreme, may have led the country to a recession much deeper than that of the U.S., but for me, the refreshing contrast of the Italian way was crucial to my recovery from chronic disease.

After two years in Italy I felt sturdier in my health and began looking for a way to stay in Europe that was more financially viable than tutoring and freelancing. After several months of searching, I found a job as a script editor for a U.K.-based film company and moved to London. Here I enjoy the same regulated food source as I did in Italy, a culture that is also less work-crazed than the U.S., free national health care and the additional benefit of a community of writers who speak English.

My family supports my decision to live abroad, but they themselves have not stopped living in the frenetic American way. Both of my parents continue to work long hours and take little to no vacation. This does not mean that their opinion of America is as rosy as it was when they first arrived. In a recent conversation with my father, he told me that my experience has shown him problems with America that he never fully grasped because he did not have to face them himself. The difficulties I ran into have made it clearer to my father that people and companies are often over-obsessed with their own success and profit, without realizing deeply enough that their own well-being is linked up with the well-being of others. I agree with my father on this, but at the same time I still believe, as he does, that there is an inexplicably magical quality about America. I look forward to a time when that magic can thrive again, in a country that is more balanced and supportive of the foundations of health. Until that happens, I will keep building my life on other shores.

* * *

Sheela Raman is a writer and a singer of jazz and classical Indian music. Her articles and essays have appeared in Art in America, Forbes, the Boston Globe, and the Indian Quarterly. She is currently at work on a collection of short stories.

Colleen Frakes is a Xeric and Ignatz award winning cartoonist living in Seattle. 

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