There once was a girl who was me. When she was sixteen, in summer, her mother won an online contest and got two half-priced cruise ship tickets to Mexico. The girl had cancer. It had already begun to gather like fabric inside of her—first in her gut and then outward in crab-legs. That’s where the word comes from, the greek carcinos: the crab and his legs which dug into the girl’s stomach and then everywhere else. They served crab in the main restaurant the first night of the cruise. The girl didn’t like seafood. The housekeeper folded a towel in the shape of a crab with chewy mints lying on his head for eyes on the second night. The girl who was me ate both of them. This happened exactly and entirely: he appeared and she ate his sweet eyes even though he was already crouching in her belly.

The girl draped herself across a hotel-style bed and cried, clutching her ever-contracting muscle wall, thinking, as she often did these days, that she wished she were not a macroorganism. Cells, like children, shouldn’t be left unsupervised. The girl listened to her mother, who swallowed as she continued her telephone conversation. “Yes. You have to call us on this phone if you want to reach us. Uh huh, she’s alright. Yeah, I brought her Zofran.” After hanging up, she went to sit next to her daughter and rubbed small circles on her back. The girl felt deeply for her mother. There was so little in their life lately which was controllable. Illness was meant to be one of them, an easy call and response: fever, ibuprofen; fever, sore throat, and cough, doctor’s office for a strep test. This illness was proving to be a months-long beast. The mother ached for her child, she ached to have something easy to solve for once—a respite from shuffling around an autistic child and shuffling around money she didn’t have to pay the rent.

The mother tried to reassure them both, “I bet it’s a gluten in- tolerance. I read that those can come on suddenly. Dr. Goldberg should call us even before we leave the ship.” The girl already knew that this was not an intolerance. She knew that there were shellfish making room for themselves in her body. Don’t ask how, she just did. A microscopic metastasis had broken off from its sisters and traveled to take root in her consciousness. Her heart ached because she also knew that her mother couldn’t add a dying child to her roster. She could see, in horrifying HD clarity, the composition of the next year of her life when she’d learn how chemo blisters your mouth and prevents you from tasting things properly. When she’d learn that cancer has a smell. She saw her mother’s poorly hidden tears; felt the loss of income and attention which should have belonged to her siblings. She could feel the sinking and the bloating of her cancer-body, the ways it seemed to expand and shrink at the same time. The girl’s mother tossed her an itinerary to look through. Everything seemed exhausting enough to be thrilling. The girl who was me mustered her strength and rolled onto her side.

She didn’t make friends with any of the passengers while she was aboard, but she did find companionship amongst the crew. There was a Bolivian waitress who decided to take a cruise ship job knowing it was the only way she would ever be able to see the world. There was the Singaporian housekeeper who worked aboard because it meant a steady income to send home to his wife and five children whom he rarely got to see, being at sea for sometimes six months at a time. Her habits haven’t changed much since then. The woman who is me loves the staff at her college to a degree that she thinks she could never love the faculty. She doesn’t think it’s their fault. It’s only the nature of the beast; that type of academic environment is a place where it is taboo to talk about the composition of one’s knowledge. This is because speaking about how you came about learning something implies that you, at one point, did not know that thing which is a vulnerable sin to admit committing where the girl studies.

And so she makes friends with people who believe, as she does, that all of learning is a re-tracing—an acknowledgment of the steps of not knowing which eventually lead to some kernel of surety. But the woman who is me has an important difference in this respect: instead of having one set of knowledge, she has two. The first set is healthy, like yours, and requires evidence and experience to build upon itself. The other is sicker. It belongs to the part of her brain where her OCD-rooted illness anxiety disorder lives—a proper DSM-V name for that particular brand of craziness often caricatured by the neurotic young fool who spends too much of her time on WebMD. It’s easy to trace the girl’s healthy knowledge back to its source. First she learned to add, then multiply. She walked first, then ran. Her sick set of knowledge is much harder to understand and, therefore, much harder to live with (though she can assure you it did not come from WebMD). It comes to her in red string, cut and twisted up in hard-to-untie knots. She hopes that somewhere in there is reality, though she’s never been able to loosen the knots enough to tell. Knot number one: the girl has a memory, hard and true, of hitting her small head against the drywall in her house’s hallway till it gave way underneath her. She was three. She remembers blood running down her eyelashes so that she could see it, in a moment of horrible clarity, dripping in front of but not onto her eyelid. She felt a comfort in this injury because she knew its origin and here, in undeniable crimson, was its consequence. It had the clean margins that tumors lack. Even then, she had a bodily fixation. A sense of nonspecific doom lying dormant in her tissue. The fact is that she did not create that crater in the hallway. Her ex-stepfather ripped into it after one of his rampages. But this is a memory she carries. It may not be fact but it’s as true and thick as any splitting of her skin has ever been.

There’s another memory which often runs hot down her face. She had a persistent delusion, her growing up years, that she was terminally ill and that all of her family knew how ill she was but kept it a secret because they wanted to spare her the sorrow. Every kind word was proof of their acceptance of her dying and of an obligation to make her final months gentle ones. Within that delusion, she finds a knot—she remembers the day her ex-stepfather left his station at the computer. Her clumsy hands reached up and gripped the polished wood on his desk. She began to read the words on the screen. She saw her name, over and over. An email message: “Eliza doesn’t have much time left. Eliza will be leaving us soon. You should come to visit.” The truth is that it was a message to her teacher about a missing report card. But you must understand, to the girl, they were the same thing—a tight knot covered in memory-ether and set fire. These knots are burnings. There is no tracing them because this set of knowledge doesn’t walk or run. It sprints. The woman who is me aspirates obsession, fear, and memory. They bond like chemicals in her lungs and come out as what she knows to have happened. Please understand, for the sake of this story, all of these things she remembers happening are true, as was her cancer. If this were a narrative about how the body reacts to illness—if this were a cancer ballad with loops of tubing stuck inside her veins—she’d encourage you to ask to see the scars inside her elbow crease. She would tell you her burnings were just that: something ordered caught fire. But this is not that story and your skepticism is not welcome here. This is a story about knowing and being. The woman will not tell you how her arm stung when the nurses pricked it but she will tell you that they were two prisons, the needle and the vein, and that they were speaking to one another. She will tell you what they whispered because, like Broyard, she is intoxicated by her illness. She doesn’t need a diagnosis for it to give her vertigo. If this feels like a riddle, then good. Help her to solve it. Please.

All you really need to know is that the girl who was me did have her cancer summer and it was as ripe of slow-rotting smell as anyone else’s cancer seasons. I ask you to suspend your disbelief for the moment, knowing, as you now do, that the girl has a habit of believing she is suffering from nonexistent illnesses. Harsher ironies than the hypochondriac falling ill have happened—the optometrist who lost his sight or the girl’s aunt whose husband was a pastor and an adulterer, busy buying prostitutes and singing hymnals on the weekends. So imagine, for a moment, that this happened exactly and entirely: when the girl who was me exited the boat in Cozumel, people were instantly grabbing and shoving her, sticking cheap toys in her face for purchase. She felt a rocking and almost tipped over. The girl’s mother steadied her and soon they both became practiced at saying ‘no’ quickly, clearly, and forcefully as they moved on to their destination: Cozumel City. The next interaction they had was with a taxi driver who didn’t want to take them to their destination. “You want to go to the resort, not the city,” he’d say. “No,” said the girl who was me, “No, we’re here to see the city. That’s why we’ve come.” She was frustrated and a little bit flushed. Being severely ill and knowing how ill you are is revelatory, intoxicating. The girl who was me felt as weak as she thought she’d ever be and as energized as anyone could become. Her body, deprived of basic nutrients, forgot its own weaknesses in a desperate attempt to push itself towards an ability to hunt, forage, and eat. The girl had no appetite and a level of nausea that could take down a fully grown steer. She had teeth without flesh to sink them into. She wondered, much later, if she looked as radiant to her mother as she felt during moments like this. I think she did. She let the girl sink her teeth into taxi drivers who thought they were shallow, silver-spoon resort children.

When they arrived in town, the girl began to lose the halo of fever around her. Her skin sunk, paying toll for its exaggerations. There were women and children begging on the street. The girl couldn’t finish her breakfast. There were shantytowns and streets with animals sinking low into the pavement. The girl passed by a scrawny man reaching out his hand, offering beads in exchange for a dollar. The girl’s mother’s instincts from earlier in the day kicked in, saying “no” rudely and curtly, speeding up her pace. “Please. I’m so hungry. I need money for lunch.” She stopped abruptly when she heard him. She had a rude vision, clear like revelation, of the decadent buffets aboard ship. She turned to the man, the tint in her cheeks a manic fire, made to reach for money in her pocket, and instead felt a jerk of nausea before she emptied the contents of her stomach onto the tips of his shoes and kept gagging after there was nothing left as if to say, “See, I gave you all I have.” Cancer lacks tact.

The girl’s mother took her back to where the ship was docked. She asked if the girl was alright to make it back aboard on her own, eyeing the customs-free wine bottles in a shop as they approached the dock. The girl answered yes and set off, walking a couple of yards before the heat started melting what was left of her body’s tact and she nearly fell tumbling over the side of a narrow boarding bridge. A staff member helped her, gripping her arm and leading her back towards her room after the girl insisted that she did not want to be brought to sick-bay. After an hour of lying in bed and listening to her headboard-neighbors fuck over and over, the girl’s restless energy came back, and even though she didn’t have the strength in her cells she got up to wander the boat. As she took her feet everywhere, the girl began to have a vision of being a passenger aboard a train. She took a brief pause outside the ship’s spa to catch her breath. Foreboding, she thinks, is worse than imminence. When she’s on the train and she gets a gut feeling that something’s amiss, that a tree root may be growing in the tracks right in front of her engine’s path, it’s catastrophic how many catastrophes lie in the minutes when there is no impact. The longer the ride, the more time she has to see these catastrophes, marbled and multiplying in her head: death on impact, no help comes, succumbing to the elements. It overwhelms her completely. A woman with pristine nails and clear, commercial skin walks out of the spa, offering her a services menu.

The girl smiles and takes it. A deep-tissue massage costs $300. She goes back to her train. This time she can see the root with her own eyes. She is approaching it quickly; there is nothing to be done. The impact is made. No more multitudes of hurt, just one. Once she strikes the root, she either is or she isn’t. It happened or it didn’t and her solution is to put her head down and grind out what labor is required of her. OCD is living in foreboding. Her particular root is cancer. Why? The short answer is she doesn’t know. The woman who is me learned from online support groups—one of the few places where her wildness may come into contact with someone else’s—that everyone’s obsessions and compulsions are hyper-specific and uniquely ritualized. She met a man there who was wracked with worry that he would one day kill his mom. Horrified, she wrote a comment: “Have you ever wanted to hurt your mom?” “No. Never, I love her more than anyone,” he replied. “Then why? Why are you worried?” She hoped he’d answer her own questions for her and he did. “Because fear and reality are making love in my serotonin-deprived neurons.” She didn’t like the answer, though it was true. There’s nothing more biological than anxiety. Survival of the fittest is sometimes just survival of the one who is afraid of the right things. It wouldn’t be hard to extrapolate that a small genetic slip could cause an anxious fixation. Instead of worrying about most things, sick-brain stones like the girl’s fear one or two things in full force, all of the time. All of the time they are compelled to act in preparation for the nonexistent danger. The woman who is me is still trying to understand why it is cancer that gripped her so forcefully. She knows that understanding, in this instance, may not ever be possible. “Psychiatry,” said someone on the group page, “is twenty percent recognized patterns and eighty percent marveling at all the ridiculous ways the psyche can go belly-up for absolutely no reason at all.” She knows this, but, some days, putting her illness into context is the only thing that takes it away from her.

Her therapist thinks it’s cancer because it was the first thing that hit the girl squarely in the death spot. Her neighbor had it when she was five—stage four, incurable. They found it during a routine surgery. “It must’ve been horrifying to you,” said the therapist, “to suddenly realize that you could be terminally ill for no reason at all and that it could lie secret inside of you until it was too late to do anything about it.” As Ross Gay puts it, “I had the stark and luminous and devastating realization—in the clear way, not that oh yeah way—that my life would end.” That’s the death spot—the place the therapist thinks the girl who was me landed, graceless and tumbling. Her mind had a skeleton of a hypochondriac’s train, it just needed a coal-fire to set off its momentum. But the woman can’t explain away her bloody head at three or her childhood delusions which came about before she could even pronounce the word ‘tumor.’ But it’s all she has for now, and so she’ll take neighbor Teresa and the death spot. She’ll take it and sprint with it, trying, as she always is, to catch up with her sick knowledge. There’s a cleansing charcoal face mask on the services menu for the spa. Sure, she’ll take the coal fire mask. Sure, she’ll pay the $45 for it, and she’ll tip the woman who applies it to boot.

The girl was and still is obsessed with the train-impact, the cancer. She is stranded forever in the moments before the crash inside of which she has had one thousand deaths and recoveries. She is compelled to reach the tree, to cut it off at its roots. She must warn someone that her body is losing itself even though it might not look like it. She knows you can’t see the cancer with your machines, but you must trust her, she knows her body after all. She tries explaining that you only see the root on the tracks once it’s too late. Docking in Galveston is at seven, they exit in an orderly fashion. She is disordered, she knows that, but what if this time she is right? There is one cell phone message from Dr. Goldberg. After all, ironies harsher than a hypochondriac with cancer have happened. He speaks quickly, “Everything’s come back normal. I don’t know what’s causing Eliza’s difficulties, she may just have irritable bowels.” The mother smiles and pats the girl on her back. “Isn’t that great news?” The girl smiles back but it doesn’t reach her dermis. But she smiles still because she knew then and she knows now that the mother is the hero of this story. They walk off, the girl with a shellfish stowaway stuck inside her. The woman who is me takes a medication now that helps her to sprint and catch up with her unhealthy set of knowledge. There are times, though, when she can’t keep up the pace. Each time this happens, the mother is there to remind her of what the vein and the tube whispered to one another. The woman feels awful, she knows the mother has better things to do than fielding her three AM phone call— a soft whimper, “Mamma, it’s real this time. It’s lymphoma. I… I can feel it growing in my throat. Oh god, mamma, I’m going to die.” The woman who is me sincerely wishes the crash would come. There is more crying. The mother gives her time. She knows how to offer the woman rest. “I know. I’m here.” The prisons, they said, “It was nice being here with you.” Before meeting one another inside skin and breaking free. I feel my mamma’s skin over and inside mine and yes, it is okay despite the cancer of it all.