Which came first, fatigue or illness? Does it matter? Abstract questions for an abstract time, these months where poor health has interrupted your life more than you ever thought possible, you who have been in chronic pains since age seven.

First the headaches that no specialist could explain, no scan or image pinpoint. Process of elimination: no brain tumor, no cancer, no slow-moving rupture. Process of elimination: try this medication, now this one, now that one.

Then two surgeries, leaving scars on the hand and arm you have to look close to see, pale purple indentations of pale skin. Skin covered with hair after both operations, you despaired of it ever falling off, some vanity holds on tight, even though it had been years since you could style your hair, hold an eyeliner pencil, uncap a lipstick tube without pain. Cartilage torn, a bone too long — in retrospect causes so obvious you wonder why it took eight years and two surgeries to diagnose and fix. And in the meantime the same explanations again and again. Yes, there is pain. Yes, it is real. No, you cannot take notes, iron a shirt, carry grocery bags. No, you do not know why.

You just know, isn't that enough? Isn't it enough now, when in the wake of the surgeries you develop a chronic condition whose name sounds delicate, almost pretty — fibromyalgia — and whose symptoms leave you baffled, confused, grasping at straws. Too unknown for a treatment path already laid out, too new for the causes to be determined.

You begin to marvel at the idea of perfect health, to wonder how many people are as outwardly untouched but inwardly crumbling as you. You sit on the subway and watch the other passengers, wondering who has heart disease, who cancer, who HIV. The hidden illnesses, symptoms only discernible to strangers who look close. You wonder if you're becoming too morbid, too fixated. You decide not to care because there are too many other things to care about right now.

You have pill bottles lined up on your dresser and make Valley of the Dolls jokes to your friends. The friends joke back about how much your daily dosages could fetch on the black market. Your boyfriend finds it harder to make jokes but he's earned that right, your boyfriend who didn't complain when a scarily severe headache cut your vacation short, just drove eighty miles an hour back home, to the emergency room and the medication that flowed seamlessly from the IV line into you.

You wonder if you're doing the right things, with the pills and the doctor-ordered workout sessions even though you're underweight, with the frequent nights in and all the appointments. You wonder if your body really wants nicotine, late nights in bars. Or if it just wants to be left alone. You realize that you don't remember when you began to think of your body as a separate entity from you, but that is what it is. Your wrist stopped working without warning or injury; the headaches are not a result of trauma; the fibromyalgia is a mystery. You didn't get a vote.

You eat cold noodles with bits of barely-grilled tofu hiding in them, no seasoning or sauce to irritate the lesions which bloom in your mouth, circumstantial evidence of your immune system's minor malfunctioning. You drink more water than you ever thought possible and you try to believe your boyfriend when he says you will feel better, try to believe the doctors who promise magic in a little pill, try to wait to feel better.