Facing the Grave

Recently I was looking at a picture of myself taken before a spring House formal I attended last year. My face looks flushed, I appear to have been sweating profusely and large, puffy bags surround my eyes. I seem to be forcing a weary smile.

Remember, this picture was taken before the formal.

Big deal, you might think. Tuxedos are uncomfortable, it was a warm May evening and Harvard students are working themselves to the bone during spring reading period. It's true that none of these detail seems outstanding at first glance, and when I first saw the picture I simply shrugged off my miserable looks to bad timing.

But over the summer, more and more often, I found myself sweating and red-faced at time when I should have been perfectly relaxed. I wasn't having trouble sleeping, and I was sleeping regularly, but I was much more tired than usual. This left me prone to several short illnesses--never pleasant, especially not in succession. Worst of all, I was still having trouble smiling.

There appeared to be no persistent problem with my health, but I had a sense something wasn't working correctly. Last September, I went to a doctor and told him to test me for every imaginable affliction. Finally, after six months of blood tests and consultations, the diagnosis came in March: I suffer from a mild form of Graves's Disease.

Now don't get all hepped up with flowers and sympathy just yet. It sounds very serious--Graves' Disease--and it can be, but it is rarely life-threatening, especially when diagnosed early. More than one million Americans suffer from the disease, among them former President George Bush, First Lady Barbara Bush, two-time Olympic gold medalist Gail Devers and women's golf champion Pat Bradley. As this small sample indicates, Graves' Disease tends to manifest itself in very active and energetic individuals. In fact, as journalists speculated in the aftermath of the Gulf War, President Bush's Graves' Disease may have been precipitated by the stresses of a new presidency and an escalating international conflict.

Graves' Disease is an auto-immune disorder in which the body unaccountably attacks itself. In such disorders, the immune system is hyper-vigilant, prepared to fight off enemy viruses at all times. But when no such enemies are present, the immune system turns against its own tissues. This in turn weakens the body's ability to resist viral infection, and the vicious cycle plays itself out ad infinitum. It's unclear whether the viruses cause the disease or the disease causes the viruses. It is known that Graves' Disease is hereditary to a certain extent, although there is no clear way to predict when it will develop, in whom or under what circumstances.

There are two primary components to Graves' Disease--hyperthyroidism and opthalmopathy. In my case, I have yet to develop the latter, a pronounced bulging of the eyeballs. Hopefully preventive treatment will keep this aspect of the disease from developing. I do, however, suffer from hyperthyroidism, and its mysterious effects were what triggered my initial visit to a doctor.

The thyroid gland controls the body's basal metabolic rate--the rate at which it consumes energy while at rest. When the thyroid hormone is produced in excess, the body consumes energy faster than it can be supplied. The result is a haywire combination of anxiety, tension and fatigue. The body wants to go, go, go--and it does, even when it isn't going anywhere. This type of things can wear you out, even if you haven't been exerting yourself at all.

Physiological symptoms of hyperthyroidism include heat intolerance, insomnia and loss of appetite, which, together, tend to result in weight loss. In my case, I lost almost 20 pounds in two months, and didn't sleep much during that time either. Yes, I was a thesis writer, but, as all thesis writers know, there is a point at which one's problems can no longer be blamed on the thesis alone.

Perhaps more disturbing are the psychological disturbances associated with hyperthyroidism--emotional imbalance, irritability, impatience, difficulty concentrating and fluctuating depression. In extreme cases, a hyperthyroid patient may appear schizophrenic, losing touch with reality and becoming delirious or hallucinatory. Such symptoms have led some hyperthyroid sufferers to be misdiagnosed, hospitalized for months and treated unsuccessfully for psychosis.

Detection of thyroid disorder and Graves' Disease has proved to be a difficult science: everyone feels anxious, tense, emotionally up-and-down, irritable, impatient, distractible, overactive and depressed to one degree or another. Especially on a college campus, especially at a school like Harvard, the average student probably feels any number of these ways to a large degree on even the most average of days. Add to this the fact that stress itself may be a precipitating factor in the development of hyperthyroidism, and overachieving Ivy League undergraduates suddenly become poster child candidates for Graves' Disease. In fact, the closest thing America has to a poster child for Graves' Disease, President Bush, is himself a Yalie.

At first I was uncomfortable talking about the fact that I have Graves' Disease, not wanting to inspire an unnecessary level of concern in others for my health. The gravity of Graves' Disease isn't that much to face up to, really, and it's given me a perspective I otherwise might not have gained for decades. It's not as if I feel like I have a new lease on life; it's just that I have a better idea of what life must feel like when it really does come to that.

Currently I'm on medication to suppress my overactive thyroid gland. The hope is that by taking my medication regularly and by doing my best to regulate my lifestyle, my thyroid gland will quickly begin to regulate itself as well. I figure my metabolism has to slow down eventually. After all, my Harvard experience will be going into remission starting in about two weeks. That might be just the thing my Graves' Disease needs to head into remission along with it.

Jim Cocola '98 is a history and literature concentrator in Winthrop House. This is his final column.