What I'm Doing Differently After My Doctor Said, 'You Look Great!' When I Felt Awful

As I sat in the cold, sparse exam room, waiting for the doctor, I was hopeful he would have answers for why I still felt so bad. My legs were weak, my body was going from hot to cold and back to hot again. My skin felt creepy and sensitive. I was exhausted and lightheaded. It was as though I had air in my veins. My head was spinning and I was coughing sporadically. I had initially been diagnosed with tuberculosis and then nocardia wallacei, a rare lung infection. After four months of TB meds and massive doses of antibiotics, the infection was improving, however, my symptoms were not. I had sporadic fevers, extreme fatigue and zero stamina. It took all the energy I could muster to get to the doctor’s office.

After waiting for what seemed like an eternity, the doctor bounced in, sat cross-legged on the exam table across from the chair in which I was sitting and pronounced, “Your CT scan shows you’ve improved! You look great! Go back to work!”

What?! I look great?! What does that have to do with anything? I felt awful. But, as doctors sometimes do, he dismissed what I was telling him. He couldn’t or wouldn’t think outside the box or past how I looked, to hear that I wasn’t well. All he was focused on was the tangible. He couldn’t or wouldn’t address the intangible — my physical symptoms.

There was no possible way I could go back to work (which I desperately wanted to do). My job required that I be on my feet for an average of nine hours in a 12-hour shift, three days a week, and drive up to 200 miles in a day, going to various hospitals. As a crisis counselor for a major hospital group in Dallas, I dealt with very serious situations and had to be mentally sharp. I could barely concentrate on a half hour TV show. How was I supposed to be focused enough to help someone in a psychiatric crisis?

My body was betraying me on the inside, yet on the outside, I was the picture of health. I now realize that my upbringing was getting in the way. My mother taught me to always look my best — to always be presentable. I can still remember watching her get ready in the mornings. She never left without “putting on her face” as she used to call it. It didn’t matter whether she was going to the grocery store, to the doctor or out to a fancy restaurant, my mother put on a dress, her pantyhose, her heels and her full face of makeup. She was always put together.

And now, here I was, doing the same thing. I made sure I “put on my face” every time I went to the doctor. I was taught that you are judged by your appearance, so I wanted to put my “best face forward.” I needed to be credible. Somehow I believed (and still do to a degree) that the more put together I appeared, the more respect I would be given. But by doing so, I was masking how sick I really was. In hindsight, I realized that it was working against me.

It was then that I resolved to do it differently. I couldn’t bring myself to go completely without makeup. I’m a little insecure that way, but after that doctor’s visit, my makeup routine changed. I no longer put on my “whole face” — just enough to be presentable — but not totally.

There’s something about being told “you look good” when you feel awful. It’s invalidating, although I know it’s not meant to be. However, when facing an invisible illness like chronic fatigue syndrome, that was once thought to be a psychological manifestation and not a physical illness, one can feel a bit defensive. “I’m not faking this!” I wanted to shout at the doctor. “I wish I could go back to work! Why would I want to pretend to be so sick, give up a career I loved, that I worked hard to attain, and have no income?!”

But instead, I just sat there and listened to him ramble on about how my lungs were getting better, how good I looked and how I should get back to work. He couldn’t explain my fevers, my weakness, my fatigue, my night sweats, my tremors, my lack of appetite, my dizziness, my inability to stand for more than 10 minutes — but I looked good.

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