Even medical people are treating you like a second-class citizen. Is this really about ringworm or is this reminding you of what it’s like to be a person with addiction?
So one day I see this pink round patch on my forearm. It itches. I immediately start Googling eczema and psoriasis. Nope, looks nothing like that. But it does have that distinctive red ring so I look up pictures of ringworm and voila, there it is, my new friend.
When I was smoking meth and shooting cocaine, I never got sick. I never got staph or scabies despite lying around with a bunch of gutter punks. But at six years sober, out of nowhere, I get ringworm. I don’t deal with children. Colonel Puff Puff, my cat, doesn’t have it. What the fuck is going on?
Despite its grotesque and misleading name, it has nothing to do with worms. Ringworm is a type of skin fungus akin to athlete’s foot and jock itch. Trying to make light of the situation, I tweeted: “I was super depressed and smoking again but suddenly I got ringworm and that cheered me right up.” I was hit with a bunch of questions like “Is that the one that makes you skinny?”
No dear, that’s a tapeworm, but thanks for the concern.
I’d heard ringworm was very contagious so I went straight to urgent care where they confirmed it was indeed ringworm. I was prescribed a cream that burned like the fires of damnation and told to “keep it covered” at night to protect the Colonel. (When the Colonel last got ringworm, it cost $2,500 for multiple lyme dips, shavings, and numerous vet visits to get rid of it. It’s a persistent motherfucker.)
I went to the pharmacy, pulled up my sleeve, and told the pharmacist I had ringworm.
“I don’t know how I got it,” I said, annoyed.
The pharmacist pulled up the leg of her capri pants and said, “I got it working here! I was really stressed out because I was getting married and my mom had a stroke and boom.”
We both laughed and then I took my supplies home, hopeful things would soon return to normal.
Once I informed my friends of my condition, nobody would touch me. Friends and neighbors wouldn’t come into my apartment nor let me into theirs.
“We love you and your ringworm,” they’d chant from the other side of the door. I was beginning to feel very leper-like even though it was one fucking red ring. My sponsor told me I could still go to meetings but I didn’t want to take the chance of giving it to anybody…(except maybe a few specific people).
Two nights after following the urgent care doc’s protocol, the ringworm seemed to be getting worse. I saw a new circle sprouting up and there was a clear red rectangular demarcation from the band-aid. Kill me.
Panicked that I would soon be a walking petri dish of ringworm, I went to my primary care clinic as a walk-in patient. This clinic treats a lot of homeless people and has quite a few tents parked permanently outside with adjacent grocery carts packed with stuffed animals and recyclables and blankets. People are allowed to shower in the downstairs bathroom and it often gets crowded in the waiting area. But once I told the receptionist of my “condition,” I was quickly escorted to an empty room and quarantined.
Four long hours I sat in that room, my phone dying, sneaking out to smoke and feeling more and more depleted and well, just gross. A triage nurse came in briefly and told me that the urgent care doctor had made a huge error by telling me to cover the ringworm. It had created a tiny greenhouse, capturing the moisture and providing the perfect breeding ground for the ringworm to reproduce. Perfect.
Finally, I was taken to another area to see a doctor. As I waited, I looked at the white cabinets. Two were locked. Where were the syringes, I wondered.
Wait, what? An enormous urge to use had come over me. I wanted to get high, call my ex, die…. It’s just ringworm, I tried to tell myself. Calm down. Why the sudden impulse to use?
“You’re disgusting and poor and getting old and nobody loves you,” my head said.
Thankfully interrupting my horrible inner dialogue, the doctor, a big ruddy guy in his mid-30’s who looked like an ex-linebacker, came in and shook my hand. I cringed inside.
“I hear you have a rash,” he said.
“I have ringworm,” I corrected him, hanging my head in shame.
“Okay, let’s take a look.” He put on gloves initially but then took them off.
“You have one ringworm,” he said. “The rest of the redness and that other circle is contact dermatitis from the bandage. You’re allergic to something in that bandage.” He touched the irritated area with an ungloved hand.
“Oh.” I was near tears.
“I’m going to give you another cream and just wear long sleeves if your cat sleeps with you. Better yet, take him to the vet to get him checked out. This stuff is everywhere. It’s really a reaction to your own flora. Do you do yoga?”
“No.”
“It’s very common among wrestlers because of the mats and sweat and body contact.”
“No wrestling and unfortunately no body contact.”
“You could have gotten it anywhere. If your immune system is compromised from stress or HIV or chemotherapy…”
“Stress is my hobby these days,” I said. “Everything feels itchy, doc, like especially my head.”
“Do you want me to check your scalp?”
“Please.”
I took down my bun and into my dirty hair he plunged with bare hands. I felt ashamed but grateful that somebody was touching me.
“You’re good,” he said.
“Thank you for making me feel like a human being. Really…”
He smiled.
But as I drove to the pharmacy, I still felt depressed and still felt like using. Why?
The answer, as usual, came in a phone call from my friend, addictionologist and psychiatrist Dr. Howard Wetsman.
“I understand people being scared about the ringworm because of its name and reputation. But what you’re experiencing is being shunned and isolated. People are treating you like your presence can hurt them. Even medical people are treating you like a second-class citizen. Is this really about a skin fungus or is this reminding you of what it’s like to be a person with addiction?” he asked.
Whoa.
“When we’re isolated or feel ‘less than,’ the dopamine receptors in the reward center actually stop being available. You can’t feel your own dopamine as well as before. We need those receptors to keep up dopamine tone, and without that we’re back to feeling restless, irritable, and discontented. And that only goes to one place, right?”
“Yeah I really wanted to use and it freaked me out.”
“When you’re an addict and your dopamine tone is lowered, your brain goes ‘we gotta fix this fast.’ It doesn’t care if it’s an éclair or heroin or death…”
“That’s why I’ve been smoking…”
“Nicotine will give you dopamine for sure. But let’s talk bigger picture. When we go to treatment and we’re told to sit down and shut up, when we’re treated like stupid people who abused a substance that everyone else was smart enough to stay away from, when we’re told to wait three hours sitting on broken plastic chairs for someone who doesn’t give a shit, the deck is stacked against the treatment working. No healthcare system that systematically lowers people’s dopamine, much less one that treats addiction, will succeed,” he told me.
“It’s the same in the rooms,” he continued. “The reason the 12 steps work is because you don’t have to feel ‘better than’ to not be ‘less than.’ The two messages you should get from an AA meeting are that you are never alone again and you aren’t less than anyone. But when people don’t sponsor with love, when some old-timer wants to be the boss, when it’s all about some guy with more time being right instead of helping, you lose those messages. That’s not a problem with the message; that’s a problem with the messenger. Don’t let the messenger fuck up the message. You aren’t less than anyone!”
I sign every copy of My Fair Junkie with “fuck shame” and I don’t think I really knew why until just now.
For more on dopamine and feeling “less than,” check out Dr. Wetsman’s youtube talk.
