Reco Reads: “Sick” by Porochista Khakpour

Addiction is such a devastatingly common disease that it has been explored in literature from almost every angle. But if you’re looking for an insightful examination of the intersection between addiction and chronic illness, you may want to check out Sick by Porochista Khakpour.

This illuminating memoir chronicles the author’s arduous battle with a mysterious illness that is eventually diagnosed as chronic Lyme disease, as well as the addiction to psychiatric medication that she defines as a “complication” of her physical illness and its many misdiagnoses. 

As an Iranian immigrant whose family moved to the US when she was a young child to escape her home country’s political turmoil, Khakpour had always felt a certain sense of displacement.

“My first memories are of pure anxiety, buses and trains and planes with my two parents, who I was cognizant were just two clueless beings—a twenty-six-year-old, a thirty-three-year-old, both often in a panic, occasionally in tears. Furiously, I told stories to distract them, books the only toys we could fit into our two suitcases. Whenever I could, I took pen to paper and drew images and had my father dictate my narrative. It was not much, but it was something; storytelling from my early childhood was a way to survive things,” she writes. 

This early coping mechanism spawned her passion for writing, which would eventually turn her into an acclaimed novelist, but did not erase her sense of never being at home in herself. 

“My body never felt at ease; it was perhaps battling something before I knew it was. It was trying to get me out of something I could not imagine,” she writes. 

A childhood experience of awakening during a surgical procedure in an anesthesia-induced altered state also left Khakpour fascinated with such states, which, along with a permissive 90’s counterculture, fueled some alarming experimentation with substances while she studied writing as an undergraduate at Sarah Lawrence College.  

Though during this period there is still some glamour to drugs for Khakpour, she also glimpses their dark side. She loses friends to overdoses and then winds up having a close call herself after contaminated marijuana leaves her hallucinating orange cats and then struggling to breathe in the ER. Afterwards, she cries “like an animal in pain” while a worried friend clears her room of her remaining stash. 

“There are ways drugs can coat all sorts of problems. You can think of drugs as pain relievers, and most of them are in some way or another. The body is asking for something, and drugs deliver something, but rarely that thing the body needs. In the end, the needs of the body are unheard and another need opens to be filled. Drugs make holes so they can fill them for you later,” she reflects on her substance use during that period. 

But it isn’t the street drugs of Khakpour’s wild college years that are the culprit behind her life-altering addiction; it’s the Ativan and Xanax that she is prescribed by a psychiatrist for her chronic insomnia, itself only one of many troubling psychological and physical symptoms that are slowly taking over her life.

At first, the drugs do at least give her brief periods of relief. But it isn’t long until she finds she needs to keep taking them during the day to stave off withdrawal as well as at bed time. Though they do not seem to be helping with her underlying condition, she is horrified to realize how much she has come to rely on them.  

“Instead of words, her life was pills,” she writes of the broken girl she has become.

Things become so dire that she resorts to snorting her Ativan in a concert bathroom to make it feel more like a party drug before her psychiatrist finally decides she should be weaned off. He prescribes Neurontin to help her tolerate the withdrawal, and, miraculously, it at first seems to alleviate her other symptoms as well. 

But this remission doesn’t last; Khakpour’s illness once more becomes crippling a few years later, and, again, her psychiatrist prescribes benzodiazepines even after she warns him of her previous dependence on them. Though Khakpour tries to argue, he is insistent, and she too worn down by her illness to resist. 

“I put the prescription he’d written into my purse with no intention of filling it. But it took less than twenty-four hours until I did,” she writes.

Soon, going without the pills gives her “horrendous” panic attacks, and they are only getting in the way of figuring out what is actually wrong with her, as she goes to doctor after doctor to no avail. 

“I couldn’t believe I was there again, after all the bad experiences I had had. Back to a life of pill bottles and pill cutters and days measured in dosages,” she reflects. 

At this point, she is desperate to detox, but finds that even treatment centers are baffled by her insistence that she is under a doctor’s care and yet still a drug addict, or were unequipped to deal with her dependence.

“Almost every rehab I talked to, they sighed at the word benzodiazepine, some also sighing at Neurontin. They never seemed that hopeful; they could never guarantee me any sort of relief. No promises, they always seemed to say, even at a place called Promises,” she writes. 

It takes months of false starts, wrong turns, and excruciating symptoms before she finally gets an accurate diagnosis for her mysterious constellation of symptoms; chronic Lyme disease, which is known for being as notoriously difficult to identify as it is to treat. 

Before moving from Los Angeles to Santa Fe to pursue treatment with a doctor who specializes in the disorder, she undertakes the excruciating task of weaning herself back off benzos. Even when she has managed to cut her consumption down to only a tenth of a pill at a time, the substance still torments her.

“If there was one enduring image of the end of my LA days, it was this: me at the foot of my bed, curtains drawn tight, wondering should or shouldn’t I? At a tiny crumb, incandescent white, as if white was always pure, as if a pill was always medicinal, as if health was always treatable, me sitting there, hours upon hours going by, should I or shouldn’t?” she writes.

But when she begins treatment, things do finally begin to improve, with the array of “good pills” that Khakpour is given for her disorder eventually pushing the awful “bad pills” out of the picture.

Still, Sick doesn’t have the clean, happy, ending that Khakpour hoped it would, as she experiences yet another severe Lyme relapse a few years later that has yet to fully abate by the book’s end, though at least this time her condition is not further confounded by a benzodiazepine haze. 

There’s a whole lot more to Sick than the addiction-related aspects that I’ve focused on here, as Khakpour delves as deeply as she can into the whys, wheres, and whats of her Lyme disease, adeptly exploring issues of identity and the ups and downs of an artistic lifestyle along the way. She offers us an invaluable dispatch from the front lines of chronic illness, and, in her raw recounting of her experience, a reminder that addiction is no less valid, and no less sinister, just because it begins on a prescription pad. 

Whatever the roots of your addiction, don’t be afraid to forge a new path forward with Reco Intensive. Our comprehensive treatment program can help you to understand what hole drugs may have been filling in your life and to find your way towards healthier ways of coping. Call RECO Intensive at (561) 464-6533 today. Let’s get back to a brighter future.