A doctor told Sasha Abramsky that, in all likelihood, he had eaten a fish tainted with ciguatoxin. Suddenly, horrors and anxieties lurked everywhere
In early February 2015, two weeks after my family arrived in the atmospheric Chilean port city of Valparaiso to study Spanish for a month, I woke up in the middle of the night convinced I was about to die.
We were high up in the hills above the city center, in a compact neighborhood called Cerro Mariposa, staying in a small second-floor suite of rooms out back of our landlady Marisol’s house.
When I woke up that night, in our little bedroom opposite our even littler kitchen, I felt as if I were fading away. My blood pressure seemed to have disappeared; my heart was fluttering slowly, weakly. I stood up, and my legs took on a life of their own. They began walking frantically up and down the small apartment, back and forth, back and forth, faster and faster.
They seemed to be telling me to jump out of my skin.
I managed to wake my wife up. She started massaging my back; my heart gradually, gradually started returning to its normal pattern. After a couple hours, I fell asleep, sitting upright in an armchair- a 42 -year-old man who abruptly felt like a nonagenarian.
I was 6,000 miles from home and was more frightened than I had ever been, experiencing wobbles in my heart that I couldn’t imagine trying to explain in a language not my own. At the language school the next morning, my Spanish teacher, horrified at my condition, hurried me out of the school, bundled me onto a collectivo minibus, and took me to the central clinic.
There, after an uncomfortable await of a few hours- during which day, if I really had been having a heart attack, I would almost certainly have died- I discovered myself spread-eagled on a hospital bed, shirtless, the electrodes for an EKG attached to my chest and arms and ankles.
I wasn’t having- and hadn’t had- a heart attack, the doctors told me. Armed with a prescription for anti-inflammatories and another for muscle relaxants, and feeling somewhat sheepish at all the bother I had caused, I headed back to the language school to resume my late-afternoon studies.
For a time, I seemed to be on the mend. True, my energy levels tanked, and there were days in the week following during which I expended 12 hours in bed; but when I wasn’t resting up, there were also days I felt okay. Assuming I was getting better, we traveled south, to the Lake District, a place of huge, shimmering blue ponds and towering volcanoes- many of them active. A glorious place, I hoped, to recuperate.
Then two days in, however, my heart did the exact reverse of what it had done in Valparaiso. My blood pressure soared, and my heart started beating so hard and so fast I thought it was about to burst.
Within an hour I was having the second EKG of my life. This time my heart had locked in at about 175 beats per minute. All I could hear was the awful beating of blood in my head. But, again, the doctors and nurses told me I wasn’t having a heart attack, and released me back out into the quiet midnight streets.
For the remainder of our time in Chile, as we tried to navigate the Lake District and then Patagonia, my health was, at best, precarious: OK for a few moments and then exhausted, seemingly on the mend and then floored by another bout of pain.
Only once we were ensconced in our California home again did I find out that my cousin in Los Angeles, with whom I had shared a farewell sushi meal two months prior, had, over the intervening weeks, experienced the exact same define of symptoms as I had: low blood pressure and low heartbeat, followed by high blood pressure and a heart rate high enough to ensure her a couple nights in a hospital, followed by calamitous exhaustion over a period of weeks.
Since the only point of overlap was the sushi dinner, another cousin of ours, an infectious disease expert, began reading up on fish toxins to see if we could have been poisoned. A few days later, while I was beginning a battery of medical tests at the UC Davis medical center, he phoned to tell me his conclusion.
In all likelihood, we had eaten a fish tainted with something called ciguatoxin. It’s a neurotoxin present mainly in tropical fish, the symptoms of which were first described by medical personnel on Captain Cook’s South Pacific expedition in 1774. It does terrible things to the body’s systems controlled by electric impulses.
The good news, my cousin told me, was that it usually wasn’t fatal; the bad news was it could wreak havoc on one’s health for more than a year. And so began my months-long medical odyssey.
* * *
I don’t know for sure if I had ciguatoxin or some other, unknown ailment or food-borne poison. I’ll likely never know, since there is no way to generate a foolproof diagnosis in situations like this. I don’t know for sure how much of what I experienced was purely physical and how much was a mental reaction to a feeling of physical decline, of losing control over my own fate.
Above all, even though as I write this I sense that I am ultimately on the mend, and I feel healthy and well again, that well-being also seems appallingly fragile: I don’t know if tomorrow will bring another round of sickness and pain, another crisis in yet another part of my battered body.
What I do know is that something as amorphous as a possible ciguatoxin diagnosis saps one of self-confidence. I know in a way I never did before- at the most personal level- what fear of particular horrors and anxiety about unknown horrors lurking just out of sight feel like .
When you’re battling an invisible, formless foe- a hard-to-define enemy against which there is no easy fix, an enemy with the power to upend daily certainties and to inflict chaos out of the blue- it changes how you live. It changes how you make choices, how you interact with the world. It alters your emotional state, building moroseness something of a default state and optimism appear more akin to naivety. It is hard to stay upbeat if you always fear the worst.
Six months before the possible ciguatoxin struck, I had been commissioned to write a book on the culture of anxiety. It was to be a book about fears of unknown assailants, overseas terrorists, hidden germs, pedophiles, violent kids, negligent parents, immigrants, inner cities, and a raft of other bugaboos. And it was to explore the political implications of this epidemic of anxiety.
I had been investigating these ideas in my reporting for decades, looking to understand what things and which people frighten us, and why, and investigating how we fathom risk: how our brains interpret hazard and identify, rightly or incorrectly, perceived threats, both at a neurological level and at a conscious one. Some of what we fear is innate. But much of it is the result of social conditions- in the economy, in how community is structured, and so on.
Too often, I believe, we calculate risk not by the probability of an event occurring but by the number of news items or talk radio minutes or Facebook postings or movie scenes devoted to a topic. As a result, we fear terrorism far more than run-of-the-mill , nonpolitical gunmen, despite the fact that by orders of magnitude it is the latter who, year in and year out, kill the most Americans.
Similarly, the flu, tuberculosis, and malaria, despite these three diseases having killed millions upon millions of people over the course of recent human history, are seen as yawns, unlikely to generate the sort of sensational coverage that the Ebola outbreak produced in 2014.
Miscalculating risk comes with consequences. It influences the places we go and the medicines we take. It alters the way we parent our children and the interactions we have with our neighbors. It affects how we police our cities and how we think about our borders. And, of course, it skews our political preferences.
As I battled my own medical demons, and struggled to retain a sense of normality amid the chaos engulfing me, it struck me that in the book I was writing, I was exploring how, increasingly, large parts of our society behave as if under continual neurotoxin attack.
* * *
I remembered those scaring days after the 9/11 attacks, when it felt as if the pillars that hold our world in place were buckling. I remembered that feeling of nauseating horror when, weeks afterwards, envelopes filled with anthrax powder started turning up at random locations around the country- the sense that invisible forces-out, against which we, as individuals, had no real defense, were conspiring to destroy us.
In the wake of the anthrax scare, one in 20 Americans- roughly 15 million people -stocked up on powerful antibiotics, and about 3 million of them actually began taking the antibiotics as prophylactics, thus, paradoxically, massively increasing the likelihood of antibiotic-resistant strains of bacteria emerging.
I remember, too, the sense of disorientation when a few weeks later, a sniper team began terrorizing residents of Washington DC, shooting drivers and pedestrians seemingly at random. Nothing and nowhere appeared safe anymore.
The DC police responded by urging pedestrians to walk in” rapid zigzag patterns”, and to avoid open spaces. Reports soon emerged of drivers crouching down behind their vehicles while at gas station filling up their tanks, and nearly half of locals polled said they were now avoiding outdoor activities.
We are conditioned- by the way stridently ideological television and radio personalities cover events, by the manner in which ratings-conscious news executives prioritize stories, by the echo-chamber effects of social media, maybe even by an intuitive sense that the broad prosperity in which so many of us live our lives is deeply precarious- to fear unknown enemies.
And, with this conditioning, our brains come to be flooded with an array of stress hormones that physically alter the neural networks in key parts of our brains, reshape how we act and how we believe, build us more likely to inflate our sense of hazard and less likely to respond rationally and in a proportionate measure to events and people we confront on a daily basis as we go about our lives.
As a result of all of this fear and anxiety, our fundamental decisions around everything from parenting to gun ownership are, too often, constructed with worst-case scenarios as a psychic backdrop. Unable to fully identify the things and people we fear, we retreat into a state of chronic, omnipresent angst, waiting for the next foe around the corner, behind the hill, beyond the horizon.
Waiting for the next predator lurk in the shadows, ready and eager to take advantage of whatever weaknesses we build the mistake of showing.
Excerpted from Jumping at Shadows: The Triumph of Fear and the End of the American Dream by Sasha Abramsky. Copyright( c) 2017. Available from Nation Books, an imprint of Perseus Books, LLC, a subsidiary of Hachette Book Group, Inc