While self-isolating, I had an outbreak of dermatitis herpetiformis (DH), a form of celiac disease that produces an intensely itchy rash. Imagine the itchiest you’ve ever felt, then ratchet that up by a thousand times. I was first diagnosed 25 years ago, and managed it by eliminating gluten from my diet. Since I haven’t changed my habits, I can only surmise that there has been cross-contamination in the packaging of a gluten-free labeled product I’ve been eating. Meanwhile, I scratch away and wonder what use I can make of this experience. One possibility: I could write a story about somebody who develops DH. After all, what could be more timely than a story about somebody who becomes uncomfortable in his own skin?
Tom and George sat on the low stone wall and watched how the tear gas, looking for all the world like tufts of cotton, scudded along the street and vanished through the trees in the park. The chaos was thrilling, especially for George who had never been allowed to do anything like this before. Tom had always told him he was too young. Even tonight, George had expected Tom to tell him he was too young to crack heads but at the last minute, after begging for a chance to prove himself, George got his way. George could come but only to watch. So George watched white cops crack black heads and the sight of it got his heart pounding and brought a grin to his face, and before Tom could clamp a hand over his mouth, George was shouting: Lookit that nigga go down. Lookit. Awesome. Lookit that blood.
George didn’t like the way Tom reined him in. George thought the whole point of showing up to these things was to keep uppity people in their place by letting them know that only your kind has the right to be uppity. If there’s a hand over your mouth, how can you enjoy your right to shout loud and uppity proud about who you are. Tom told him: There’s a time and a place. George thought it was funny the way Tom spoke like an old man seeing as how he was only four years older than George and barely twenty at that.
George said he was old enough to get a driver’s license now. Tom wondered what the fuck that had to do with anything. Nothing much, really, was George’s answer, except it shows you ain’t the boss of me. Tom said he wasn’t tryna be the boss of George; he just wanted George to keep his front teeth. Mom sure as fuck can’t afford the dental bill. As if to prove his point, Tom turned to George and grinned so the whole world could see the missing tooth that no amount of pay checks from his job as a shipping clerk was ever gonna fix.
Tom and George leaned back on the low stone wall and basked in the mayhem. Sirens echoed off the downtown buildings. The alternating red and blue lights lit the night sky. The percussive sound of helicopter rotors seemed to fall in sync with the throbbing in their chests. Batons banged on shields while heavy black boots clomped in lockstep along the pavement. Cries of panic flew up into the night air. The boys especially liked the cries of panic. The police shot canisters of tear gas into the crowds. Sometimes people in the crowds picked up the canisters and lobbed them back at the police. More often than not, they couldn’t find the canisters for all the smoke, so they turned and ran away. Tom and George sat far enough from the commotion that the tear gas didn’t bother them, but close enough that they could still enjoy the squealing. It used to be that people called the cops piggies, but this time around it weren’t them that did the squealing.
George pointed at Tom’s thigh and asked: What the fuck man? Tom asked: Whadya mean what the fuck? George pointed again and said: Lookit.
A dark patch had soaked through the denim a hand’s width above the knee on the top of Tom’s thigh. It was a round patch about the size of the ring that a wet beer can leaves when the condensation pools on your old lady’s dining room table and she finds it later and yells at you.
It’s nothing, just a rash, started a coupla weeks ago.
But Jesus it’s oozing.
It’s nothing, I just forgot to put a band-aid on is all.
The boys watched a mounted police officer canter down the middle of the road on a gigantic horse that looked more like megafauna from prehistoric times than an ordinary horse bred in the local police stables. The police officer wore a round white helmet that almost glowed in the dark and he wore sunglasses even though it was nighttime. The boys agreed this was just about the coolest thing they’d ever seen. The only thing that’d make it cooler is if the horse trampled one of the protesters and left behind a battered body. The police officer with the glow-in-the-dark helmet waved at the boys and said: You boys behave yourself now.
George called back: Abso-freakin-lutely, sir.
Once the mounted police officer was out of earshot, George started up again about the patch of ooze leaking through Tom’s jeans. Tom told George to let it be, it was nothing, probably an allergic reaction to something in Mom’s casserole.
That night, Tom slept with the covers down so the ooze from his thigh wouldn’t stain the bedsheets. He could have covered his thigh with an extra wide band-aid but chose not to because he’d read on the internet that a little air might help the rash heal. His night’s sleep began pleasantly enough with dreams that were an obvious extension of his wakeful evening at the protests. He rode on the back of a great mastodon, stomping on cars and skewering protesters on the beast’s white tusks, coaxing it to sweep its snout back and forth across the road so that it knocked people down like bowling pins. Tom held the reins in one hand and raised his other hand high overhead, making a fist and letting out loud whoops. The mastodon answered by lifting its snout and trumpeting.
Before Tom could shift his dream into high gear, he started awake. An intense itchiness radiated from the rash on his thigh and now gripped his whole body, red spots everywhere, and each spot crying out for attention. The spots had scattered around to the inside of his left thigh, then jumped over to the inside of the right thigh and up the leg from there. They had popped up below his kneecaps and spread downwards, gathering in a ring around his ankles. His elbows were rough with them. They appeared like an infestation of tiny red spiders, swarming up the backs of his arms, across his shoulder blades, and meeting at the nape of his neck where some jumped to his earlobes and the rest settled onto his back and upper buttocks. As much as he scratched, it was never enough. After he finished with his ankles and started in on his kneecaps, the ankles screamed for him to come back. Meanwhile his neck and elbows screamed just as loudly.
In the morning, Tom stumbled into the kitchen bleary-eyed and grimacing. Without looking up from her cup of coffee, his mother asked how he’d slept. He whimpered but she didn’t notice. Tom held his hands together, fingernails of one hand scratching the palm of the other, scratching absently, unaware that he was drawing blood.
Dude! his brother shouted. George stood from his bowl of cereal and his chair whacked the wall behind him. He grabbed Tom’s hands, pulling them apart and holding them tight against his own chest. Tom tried to free his hands so he could go on scratching other parts of his body but he’d had a sleepless night and was no match for George who had already finished his first power drink of the day. Instead, Tom dropped to the floor and pushed his back across the linoleum to relieve the itching between his shoulder blades. George stood over him, still holding his hands. Together, they looked like partners in a modern dance routine, not that either of them knew anything about modern dance, and not that they would have danced with one another, that was just gay. A yellow pus dribbled down either side of Tom’s left thigh and dripped onto the linoleum.
Jesus, what’s wrong with you.
Itchy.
It almost sounded to George like his brother was on the verge of tears.
When their mother looked up from her coffee and saw the weeping sore and the red spots that had run riot over her oldest boy’s skin, she shook her head and let out a guffaw. This was the worst rash she’d ever seen. In her recollection, the closest to this was when Tom’s father broke out after he caught a dose of the clap. It was on account of that rash that she became a single parent. But Tom didn’t have the clap; that was for goddam obvious. Whatever Tom had, it was of a different order altogether.
We need to get you to the doctor, she said.
Tom lay in the back seat, squidging to and fro to get some relief from the itching. George saw this as a chance to drive the car so he pestered and pleaded until his mom gave in and handed him the keys. He had exaggerated when he said he had his driver’s license; he only had a learner’s permit. That meant his mom had to come along, too, and remind him to put his foot on the brake whenever the traffic light turned red.
At the doctor’s office Tom scraped his spine up and down the door frame like a cat on a scratching post. It wasn’t much of a visit. As soon as Tom pulled off his shirt, the doctor knew exactly what was wrong with him. DH, he said, then noting his patient’s blank expression, he elaborated: Dermatitis Herpetiformis. He shooed Tom into the reception area where Madge, the woman with big hair, would arrange a referral to a dermatologist.
But it itches like crazy, Tom cried as the doctor was retreating into his office. Can’t you give me something for the itching?
The doctor paused and turned: Shit, I dunno; that’s why I’m sending you to the dermatologist. He turned away and shut the door behind him.
The earliest appointment they could arrange for Tom was in two days, two excruciating days of sores oozing a runny yellow pus that stained all his favourite white T-shirts, two excruciating days of scratching the palms of his hands until he drew blood. He did the same to the arches of his feet. Everywhere he walked he tracked behind him red splotches, like stigmata. Alone in the middle of his second sleepless night he thought he saw a light hovering above his bed and wondered if maybe he should be venerated for his affliction.
On the morning of his appointment, Tom put on his last clean shirt, but by the time he stumbled into the dermatologist’s waiting room, the shirt was mottled with red and yellow blots. After he spoke to the receptionist, he took a seat with the rest of the patients, noting that most of them were women of an indeterminate age, indeterminate because they moved as if they were old but had tight-skinned faces and plump lips as if they were young. A couple of the women had lips so prominent Tom wondered if maybe they were the product of interspecies breeding—half human, half duck. That thought made him laugh to himself and, for a brief moment, he forgot his itching. One by one, the duck-lipped women were summoned to the dermatologist’s inner sanctum, then went on their way, until Tom sat alone and itchy in the waiting room.
The dermatologist stepped up to Tom, white-coated and armed with a clipboard. You must be Tom, the dermatologist said. Tom thought the answer was a little obvious but answered yes all the same. Am I the last one? Tom was trying his best to be sociable. He hadn’t used the f-word once. The dermatologist looked all around the room as if to verify that Tom was indeed the last one, then smiled cryptically and said: Tennis. He ushered Tom into the examination room where he peered at various blotches through a magnifying glass equipped with a special light.
He said uh-huh repeatedly then stood upright and proclaimed that Tom’s doctor was probably correct in his diagnosis.
Derma-whatever?
DH.
OK.
But we can’t be certain until we’ve done a biopsy.
A what?
We’ll take a small sample of your skin tissue and send it off to a lab where they’ll apply a definitive test. We’ll have the results in about a week.
Tom ceased to be sociable. He explained to the dermatologist that he couldn’t wait another fuckin’ week. By then, he’d’ve put a gun to his head or jumped out a window or thrown himself in front of a moving train.
Better that than a stationary train.
What?
If you want to harm yourself …
Never mind. The point is: this thing is driving out of my fuckin’ tree. I can’t wait a week.
The dermatologist explained that there were protocols for DH. There was a treatment that would relieve the itching but it included serious potential side effects, damage to the liver, that sort of thing, which meant that once he got a positive result from the biopsy, he would have to get blood work done to establish a baseline for his liver function. Only then he could start taking medication to relieve the itching. Realistically, it would take about ten days.
You’ve gotta be fuckin’ shittin’ me!
The dermatologist was not fuckin’ shittin’ him.
Tom went home and did his best to keep from scratching himself. His mom made him wear gloves she kept in place with duct tape. This worked well until Tom tried to change channels on the TV. He was tired of trash-talking reality TV shows and wanted to pass a few hours binge-watching cartoons from the 50’s and 60’s back when they really knew how to put together a good show. But his Mom had stepped out to run some errands. By the time she came back, Tom had gnawed through the duct tape and pulled off the gloves. Which was fine. He got to watch his cartoons. But it also gave his fingernails easy access to his skin. When his mom got home, she found his forearms drenched in blood. After she soaked up the blood with paper towel and cleaned up Tom’s arms, she discovered that he had scored his forearms from elbow to wrist, deep grooves that channeled the blood to his fingertips where it dripped onto the floor. Kneeling on the floor, she gathered up little chunks of her son’s skin, and rising again, she held them to his face.
What are you doing? she asked.
I can’t stand it no more.
But if you do much more of this, you’ll flay yourself.
I know, Mom, but I just can’t help myself.
Tom wept.