DR MAY-19

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 It commenced in the waning days of September 2022. I was only just convalescing from a particularly virulent episode of COVID-19 when Hurricane Ian descended upon my hometown in southwest Florida. My wife and I sought temporary refuge in Miami, observing with rising disbelief the calamitous aftermath as broadcasted across various news outlets. Upon returning to our residence in Fort Myers after a week, we were met with a tableau of devastation so surreal it bordered on the grotesque: colossal fishing vessels lodged like playthings in the branches of mangroves and palms; entire domiciles adrift in San Carlos Bay; the iconic Sanibel Island causeway grotesquely sundered; and Fort Myers Beach reduced to little more than splinters and sediment. Miraculously, our own home, though rendered powerless, had escaped substantial structural compromise.

It was during one of those electricity-deprived evenings, seated on the patio and perusing a book by headlamp, that I began to notice a peculiar and involuntary tightening of my jaw musculature. Coordination between tongue, lips, and jaw faltered; a disconcerting suspicion of a cerebrovascular accident—more commonly, a stroke—arose. My life at the time was saturated in stressors beyond the dual catastrophes of illness and natural disaster. As a professor of philosophy, I had recently published a book attracting moderate academic attention, and invitations to lecture proliferated. A reluctant traveler by disposition, I was slated to fly from Madison, Wisconsin to Birmingham, England, then onward to Stockholm and Linköping in Sweden, and finally back to Stockholm—all within an unforgivingly short span. These obligations, juxtaposed with preexisting professional commitments and considerable upheaval in my personal affairs, seemed to overwhelm my physiological and emotional thresholds.

My initial hypothesis was temporomandibular joint disorder (TMJ), presumably exacerbated by chronic bruxism—habitual jaw clenching. Multiple consultations with dental professionals ensued, affirming this suspicion and yielding an occlusal splint for nocturnal use. Yet the aberrant movements persisted, and pain intensified. My tongue, seemingly possessed, moved incessantly, and my speech acquired a slurred cadence and an unmistakable lisp. I resorted to chewing gum as a means to occupy this restless organ. Eventually, the anxiety engendered by these aberrations reached such a crescendo that I rescinded all travel engagements and transitioned to delivering lectures via Zoom. A psychiatrist I consulted suggested increasing my dosage of Zoloft—an SSRI (Selective Serotonin Reuptake Inhibitor)—which I had been on for more than two decades. Unfortunately, this pharmacological adjustment exacerbated my symptoms, ushering in episodes of dissociation and alarming impulsivity. Ativan was subsequently prescribed to dull the edges, yet the descent into psychological disarray deepened, compelling me to consider inpatient psychiatric treatment.

In desperation, I presented myself at the emergency department of the local hospital. I was summarily dismissed as a case of occupational stress, perhaps requiring botulinum toxin (Botox) injections to quell the muscular activity. It was my wife who, through diligent research, proposed that my condition might stem from protracted SSRI usage—an assertion I initially rebuffed, citing the common narrative that tardive dyskinesia (TD), a disorder marked by involuntary movements, was primarily induced by antipsychotic and neuroleptic agents, not the seemingly innocuous SSRIs so ubiquitous in academic circles. Nevertheless, my own investigation uncovered rare instances of SSRI-induced TD. A return to the emergency room yielded normal blood work and CT scans, but a tentative TD diagnosis and a referral to a neurologist.

Thus began my foray into the dehumanizing labyrinth of contemporary biomedical institutions, where I collided with neurology’s so-called “blind spot”—conditions that exist neurologically yet defy structural pathological classification. The first neurologist I consulted conducted an exhaustive examination, dismissing the TD hypothesis due to the abrupt symptom onset, lack of neuroleptic exposure, and its rare association with SSRIs. Instead, she diagnosed me with Functional Neurological Disorder (FND)—once known as conversion disorder—where psychological conflict transubstantiates into physical symptomatology. Though formerly shrouded in labels such as hysteria, psychogenic disorder, and medically unexplained symptoms (MUS), FND now serves as a neutral descriptor that acknowledges dysfunction without asserting etiology, identifying the nervous system as operationally impaired but structurally intact.

Difficult Word Meanings:

  • Convalescing – Recovering health after illness

  • Virulent – Extremely severe or harmful

  • Tableau – A striking scene or picture

  • Domiciles – Homes or residences

  • Sundered – Split apart violently

  • Bruxism – Involuntary grinding or clenching of the teeth

  • Occlusal splint – A dental device to prevent grinding or clenching

  • Dissociation – A state of disconnection from reality or self

  • Impulsivity – Tendency to act on sudden urges

  • Transubstantiates – Transforms one substance into another, metaphorically used here

  • Etiology – The cause or origin of a disease

  • Pathological – Relating to disease

  • Symptomatology – The set of symptoms characteristic of a condition

Word Count: 799
Flesch-Kincaid Grade Level: 17


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