What They Don’t See

ABSTRACT

The author is currently living with a chronic autoimmune disease known as Hashimoto’s Thyroiditis, which caused his hypothyroidism. Although this disease is most common in middle-aged women, he was diagnosed at age 23. This disease is unique, because it is not entirely visible to others. In this piece, he presents a personal narrative of his diagnosis process and utilizes poetic inquiry to demonstrate to readers what “they,” meaning individuals without an invisible chronic autoimmune disease, don’t see.

Acknowledgments

Thank you, Art Bochner, for sharing your story at BGSU in the spring of 2016; you inspired me to share my very own lived human experience. Thank you, Sandra Faulkner, for encouraging me to follow through with this piece, I appreciate your continual guidance more than you know. Thank you, Laura Ellingson and two anonymous reviewers, for your thoughtful feedback on this piece. Finally, and most importantly, thank you to everyone who has been there for me when “they” were not. Smiling never felt so good.

Notes

¹ Depression is a mood disorder that effects how you feel, think, behave, and it can lead to a variety of physical and emotional problems (Mayo Clinic, 2016a). Although appearance-based cues can help diagnose physical illness, mental illness is not always so visible to others (Daros, Ruocco, & Rule, 2016). Symptoms of depression may include sadness, loss of interest in pleasurable activities (i.e., sex, hobbies, and sports), sleep disturbances, fatigue, anxiety, slowed thinking, or even thoughts of suicide. There is not an exact known cause of depression, but some factors that may cause depression include biological differences, brain chemistry, hormone changes from pregnancy, thyroid problems, menopause, and even inherited traits. More women are diagnosed with depression compared to men, but this also may be because women are more likely to seek treatment (Mayo Clinic, 2016a).

² Dutta’s (2008) culture-centered approach helps explain the impact culture has on how we communicate about health. With the culture-centered approach to health communication, the intersections of culture, structure, and agency are all recognized. Culture is developed from cultural members who influence thoughts, values, and daily practices of other cultural members. Structures reflect on the culture and turn into systems that enable and constrain certain choices made by cultural members within those systems. Finally, agency is the capacity for cultural members and communities to cooperate with or resist against the structures that bind them (Dutta & Basu, 2011; Hodges, 2015).

³ Hashimoto’s Thyroiditis (HT) was first described by Hakaru Hashimoto in 1912, but the autoimmune aspect was not recognized until the 1950s (Pyzik, Grywalska, Matyjaszek-Matuszek, & Rolinski, 2015). Research shows the dominant form of thyroid dysfunction is Hypothyroidism (Bishay & Chen, 2016), and HT is the most prevalent cause of hypothyroidism (Costantini & Immacolata Pala, 2014). HT is diagnosed five to ten times more often in women compared to men, and the frequency of HT increases with age, where the peak is between 45 and 65 (Mayo Clinic, 2016b). Studies have shown that HT development depends on an immune defect in an individual with genetic susceptibility combined with environmental factors. There are still some aspects of HT that are not fully understood and these unsolved problems are often overlooked, since HT is so very commonly diagnosed today (Pyzik et al., 2015).