Despite his effort to do so, Charcot never discovered any physical origin or organic cause for hysteria. I began to wonder which illnesses might have been considered to be hysteria during his reign at the Salpêtrière—certainly, if he had witnessed my fainting spells or convulsions, he might have diagnosed me a hysteric. Eventually, hysteria became an illness associated with the mind. It’s often said that Charcot “invented” hysteria, meaning he coined the name for the collection of symptoms (including emotional excess, sexual desire, seizures, anxiety, and eating disorders) that occurred in a large number of women. The modern equivalents of the symptoms he observed at the Salpêtrière are thought to be functional illness, somatization disorder, or conversion disorders—Freud was the first to use the third term in 1893: “If, for the sake of brevity, we adopt the term ‘conversion’ to designate the transformation of psychical excitation into chronic somatic symptoms which distinguishes hysteria”—all of which lack clear clinical diagnostic criteria and are ascribed to women, like me, who have not yet been told what is wrong with them.

It’s surprising—given the insistence of multiple neurologists that my fainting spells were the result of unrealized depression or anxiety—that I was never diagnosed with a conversion disorder. Today, conversion disorders are thought to be psychiatric, even when a neurological symptom like numbness, paralysis, blindness, seizures, deafness, or losing the ability to speak is present. These symptoms are thought to present after a trauma or psychological trigger, and the conversion disorder diagnosis is made after other possibilities are ruled out. It is curious that Charcot insisted on investigating hysteria as biological given his early use of the term traumatic hysteria to describe the psychopathological impact of train accidents on passengers. In 1898, a law was established, based on Charcot’s science of grand ébranlement psychique, in order to compensate traumatized industrial workers who were the victims of accidents. French psychologist Pierre Janet agreed with Charcot that the onset of hysteria could begin with a shock, but he asserted that the ideation of a shock was enough for hysteria to take hold—for instance, in order for one’s limb to become paralyzed, one need not be in an actual accident, but merely imagine an accident.

The contemporary conversion disorder isn’t conceptually far from what Freud posited hysteria to be: somatic symptoms resulting from a psychic conflict. However, the Diagnostic and Statistical Manual of Mental Disorders preferences individual pathology, while Freud believed that hysteric symptoms emerged as unconscious protest against restrictive and patriarchal social conditions. It was Charcot’s insistence upon examining hysteria in a purely biological framework that perpetuated a harmful paradigm; he asserted that women were somehow biologically prone to hysteria. As Jacqueline Rose puts it, “The problem with Charcot’s work is that while he was constructing the symptomatology of the disease (turning it into a respected object of the medical institution), he was reinforcing it as a special category of behaviour, visible to the eye, and the result of a degenerate hereditary disposition.” Freud intervened in order to challenge Charcot’s visual evidence of hysteria and to deny hysteria as a distinct clinical entity. Hysteria’s medicalization (the process by which something gets framed as principally a medical problem) focused on individual biological bodies under Charcot, on social conditions and trauma under Freud, and on individualized pathology devoid of consideration for systemic or infrastructural conditions by the most recent DSM.

Western medical discourse has never relinquished the insistence that an illness that can be observed in a scan or measured by a test is real and that one that cannot is likely unreal. In 2006, the New York Times ran an article titled “Is Hysteria Real? Brain Images Say Yes”—the troubling implication of the headline being that neurological or psychological disorders without observable brain qualities can be safely assumed to be “unreal.” Of course, Salpêtrière hysteria patients’ brains were not scanned; the article refers to conversion disorder patients in Western hospitals and equates the observation that the “emotional” structures of the brain could be moderating sensory and motor neural circuits with the disease’s reality. Novelist Siri Hustvedt (sister of Asti) writes that the brain scans “demonstrate that there are neuroanatomical correlates to a hysterical paralysis or blindness—an organic change—but how that happens can’t be discovered from an fMRI; nor do these images tell doctors how to treat their conversion patients.”

Charcot never found his hysteria lesion. Some of my lesions eventually amounted to a diagnosis. While collecting a culture to confirm, once again, that the occasional lesions I had gotten since long before becoming sexually active were not, in fact, a sexually transmitted infection, my gynecologist said she was glad I had come in; she had been thinking of me. She had another patient, a young girl with the same lesions I had first experienced before puberty. The patient, apparently much more adept at navigating online symptom trackers than I was, sought out a rheumatologist, who used the lesions to diagnose her with a rare, congenital autoimmune disease of the blood vessels that caused myriad symptoms throughout the body’s systems. Like me, this patient also experienced lesions in flares with other symptoms, had arthritis and fainting spells—due to swelling of the brain during episodes of blood vessel inflammation, she learned. Was it possible that I had the same illness?

Off I went to a rheumatologist. He said I was lucky to have the lesions, burning topical ulcers that were almost certainly indicative of Behçet’s disease. Lesions meant a diagnosis, and a diagnosis is a gift. Now, he said to me, we can know that all this suffering was not only in your head.

The bad news was that little could be done, diagnosis was simply a confirmation of symptoms, which we would do our best to manage: oral ulcers; eye inflammation (possibly leading to blindness); rashes; genital sores; rheumatoid arthritis; swelling in the arms and legs; blood clots; digestive system upset, including abdominal pain, diarrhea, and bleeding; and inflammation of the brain and nervous system, causing headache, fever, disorientation, poor balance, or stroke. He took X-rays and pored over the slides with a red pen like a math teacher. He circled the places where my body could be more successful: the hyperextended joints that made my lines ideal for ballet were actually ill-suited for supporting the skeleton while performing daily activities and only worsened my symptoms of seronegative rheumatoid arthritis. I might sometimes “feel crazy” thanks to my occasionally swollen brain. My digestive tract is cratered with blisters. This is why “flavors” might hurt.

You’re lucky, he said—repeating what people say when something terribly unlucky, something horrendous, has happened. Many people with diseases like yours never find out what is wrong with them.

He confirmed his diagnosis through a pathergy test: a small needle inserted into my forearm, where an irritated pustule would form a day later, indicating that my immune system was overreacting to a minor injury. I had observed my immune system overreacting to minor injuries my entire life—my bumps and bruises had always been resistant to healing, and I often formed lesions and rashes where they occurred—and had frequently described these observations to doctors. How could something so quaint be a diagnostic criterion?

On my way out, the rheumatologist offered me an antidepressant.

Looking at my medical records from those earlier years, it is difficult not to grow angry at the acutely deficient diagnostic process. Why, when I was growing up constantly sick and fevered, had my blood vitamin levels been checked but not the common inflammation markers associated with autoimmunity? Why had this also been the case in college, when I went to the hospital after fainting while sitting down? (A rare occurrence, I was told.) Why had it been that, the more I asked for what I knew I needed to survive (relief from pain, induced sleep in order to occasionally sleep through illness), the less it was offered to me? Why, when I relayed to a doctor that a massage therapist had told me I had Raynaud’s—a condition resulting in decreased blood flow to the hands and feet, which is frequently predictive of other connective tissue disorders—had he done nothing to investigate further? Why had my growing medical articulateness been seen as inherently suspect? (Do me a favor and stop reading about this, one doctor had said when I brought to him papers on autoimmunity without the common biomarkers, which frequently go undetected. It’s no use.) Why had I, an extremely active young person, been told that I could be as abled or disabled as I wanted, as if any of this had anything to do with what anyone wanted? Why had the gynecologist tasked with my annual exam—“Always the genital thing,” Charcot reportedly said of hysteria to Freud, even as he investigated it as a disease of the nervous system—been the only one who took seriously the task of investigating symptoms ravaging other parts of my body? Why had it been easier for countless doctors over the course of more than a decade to chalk up the symptoms in every bodily system in my body to hysteria, when there wasn’t even an agreement on what conversion disorders were, how they worked, or how they should be treated?