SEASON OF SICKNESS

POROCHISTA KHAKPOUR

There was a time before all this, that much I know.

In December 2017, I went back home to Los Angeles to spend the holidays with my family. At that point I was the healthiest I’d been in a while; I ran a lot and did yoga daily. Prior to that, though, I had spent several years dealing with intense chronic illnesses—all stemming from my untreated late-stage Lyme disease. But I was sure, after years of intense conventional and experimental therapies, that I was past it. So I flew from New York to Los Angeles, as I often liked to do in the winters, to enjoy a few sunny weeks with my family.

Within the first week in L.A., I got sick. It took me a second to realize there was something off with the sky, a heavy haze, a bad smell. It was past October’s peak wildfire season, so I didn’t think of fires until I started seeing footage of what was happening just a few miles away from me. Passengers were driving on the 405 amidst what looked like a David Lynch montage: walls of ash and blaze all around the highway, pouring in from the Getty area. Little did I know that 2017 was going to be the worst wildfire season in California history up to that point. With a total of 9,133 fires burning and 1,381,405 acres of land affected, this year would become historic.¹

As a child, I used to fear the Santa Ana winds. I remembered that old fear during that holiday season, when they were especially intense. Santa Anas have always been wildfire fuel, but this particular year, other weather conditions intensified their impact. According to the National Oceanic and Atmospheric Administration, 2017 was the third-warmest year on record for the United States, and it was the second-hottest in California.² Climate change was on everyone’s lips, as it did not take a rocket scientist to understand how it contributed to the fires: the hotter the temperatures, the drier the vegetation, and the drier the vegetation, the more likely it is to burn. Add some Santa Anas to the mix and you had the proverbial fan for the flames.

Los Angeles was burning, Ventura was burning, and for some weeks it truly felt like we lived in hell. I would walk outside just to return back inside—the air was too hard to breathe. Soon, I started to have trouble breathing indoors. At first I was slow to understand that this could be a Lyme relapse, but it finally dawned on me: Lyme needed a trigger—in this case, poor air quality—and it thrived in poorly oxygenated bodies. Since book tour season would be upon me again in spring, I took action: my Christmas gift to myself was an Inogen G3 portable oxygen concentrator. It cost more than any used car I had ever bought, but it seemed important. At that point in my life, I had been in many ER rooms with Lyme relapses and knew oxygen was one of the only things that helped me. On and off for that entire season, I was connected by canula to my calmly purring device.

I bought a backpack for the device and my parents eyed it warily. Neither of them had ever heard of Lyme before I got diagnosed—my family were Iranian immigrants and Iran was not a Lyme hotspot. Neither, at that point, was California. My father thought my Lyme doctors were quacks, and my mother worried it was depression and anxiety that were really plaguing me, like they had plagued her at my age. After years of seeing me walk with a cane, the portable oxygen seemed too much for them.

“I will be fine,” I kept saying. “I think the bad air just set a few things off. I am sure I am getting better!”

But I was not. Not yet. I did not get better until 2020.

On its website, the World Health Organization offers this warning: “Humans have known that climatic conditions affect epidemic diseases from long before the role of infectious agents was discovered, late in the nineteenth century. Roman aristocrats retreated to hill resorts each summer to avoid malaria. South Asians learnt early that, in high summer, strongly curried foods were less likely to cause diarrhea.”

The WHO also warns of other climate-related effects. For example, global temperature increases of two to three degrees Celsius would increase the number of people at risk of malaria. The WHO also tells us that reforestation is linked to an increase in cases of Lyme, which has much in common with malaria. Wherever there are increases in tick populations, Lyme flourishes. But, of course, malaria itself was not gone even with so many medications and vaccines. An ABC News article from September 2019 claims that “malaria, a mosquito-borne illness, killed 438,000 in 2015 alone, according to the World Health Organization, and the insects carry Zika and West Nile viruses among others.”

An article in the New Scientist also draws links between climate change and illness by showing how planetary warming is “making new areas into suitable homes for disease-carrying species” like in the example of Ebola. “For example, if the trees that fruit bats—believed to be a reservoir for the Ebola virus—rely on can grow in a new area, the bats can follow.” Given that research on Lyme is still far behind where it should be, scientists and doctors have often followed models posed by these other infectious diseases that come from an overpopulation of hosts. After all, the ticks with Lyme cannot fly or jump—without hosts they cannot travel. Lyme-disease-carrying ticks were always “deer ticks” (also known as “blacklegged ticks”) but we now know deer are not the only carriers: mice, squirrels, birds, and many other animals carry these Lyme-diseased ticks.³ Just as climate change has affected vector-borne diseases like yellow fever, Dengue fever, malaria, and more, climate change has also dramatically altered the distribution of Lyme-disease vectors.⁴

It feels futile, almost embarrassing, to argue against the reality of climate change and its consequences. I grew up in Los Angeles, so I know smog, earthquakes, and wildfires well. But the nearly unprecedented wildfires in that late fall and early winter of 2017 were something I had never seen before. Everyone I knew said the same. We knew it was coming—we’d been warned for ages about global warming—but I guess we just did not know how soon.

And even as I watched a machine count my breaths as I inhaled through a tube, I realized just how little I had understood how global warming could affect me personally.

In December 2017, when I left my Harlem apartment for that extended holiday in California, I had no idea it would be two and a half years until I found a home again. Within days of returning to New York, I felt toxic. I started having trouble breathing, then trouble swallowing. I felt horribly dehydrated no matter how much water I consumed. I had body aches and headaches, and I experienced excruciating neuropathy. Construction was being done on the apartment above mine, something that had not happened before in my time there. The building’s management had been trying to push old Black families out, even though they were protected with rent control. The management succeeded with the family above me. And since this was the first time that unit had ever been touched, the construction workers had no idea what they were doing.

For weeks parts of my ceiling crumbled, sending clouds of toxic particulates into my apartment. I knew they contained tiny flecks of lead paint, and likely asbestos, too, but something I hadn’t noticed yet was the presence of black mold—an environmental hazard that had likely been there for some time and was exacerbated by the construction. Eventually spots began to gather in my bathroom. By the middle of spring, I could barely breathe without cycles of panic attacks in my own apartment; I was on oxygen the whole time. I kept asking my landlord and super for help, but they kept denying I needed it.

My medical bills were in the high thousands, and exposure to the lead, asbestos, and mold was the proven factor behind my health collapse. My emails went from polite to desperate, with the possibility of death in between every line. We are very lucky i did not die in there, which could have easily happened, I wrote one day; I continue to fight for my life, I wrote on another; one email draft just had the subject header, please help me.

And so I began sleeping at the homes of various people in the city, from friends to absolute strangers I reached out to online. Not many people had a spare bed in New York City. I knew I could not stay there, so I eventually went back to California. But even though it was a comfort to see my family, the air out west was still making me sick, and by then I had become intensely allergic to mold. The unprecedented rains in California that spring—climate change leaving its mark again—had created mold problems in buildings that just weren’t designed for moisture.

I decided to do what I had done years ago and return to Santa Fe, where I had a doctor I trusted from my previous time there in 2012, and a world of Lyme treatment. There were nutrient IVs to build my immune system, conventional pharmaceuticals like antifungals to address mycotoxin illness, plus a whole world of alternative resources, from my beloved apitherapy to ozone therapy. They were all extremely experimental and left of the mainstream in America, though my doctor reminded me that in Europe these were considered far more conventional among the general public. In Santa Fe, I had previously experienced such a miraculous comeback after several years of mysterious maladies that I believed recovery awaited me there once again.

But, of course, bad luck struck again: the city had also experienced a shocking break in its drought and was plagued with mold as a result. The adobe soaked up the moisture and mold was everywhere in the high desert. I moved from home to home, inn to inn, stranger to stranger. It was beyond draining, because I would hit dead ends everywhere—an Airbnb I first stayed at proved to have extra-strong VOC paints, which were impossible for me as I had become chemically sensitive; an inn just outside town was freezing cold and unbearably austere to the point where I could not fall asleep there; a friend’s house would give me migraines so bad that they finally had it inspected and discovered mold; another friend’s place made me feel very sick for reasons we could never figure out. Occasionally, deeply disturbed eccentrics would discover me from a Facebook post and take me in and within days I’d find out that they were dangerous racists. Nothing was right. Through this process, my body failed more and more: irregular heartbeat, shocking weight loss, air hunger, tremors, dizziness, dangerously low blood pressure, allergies to everything. I felt like my health had relapsed back to where it was before I ever got treated for Lyme.

“You’re an environmental refugee,” my doctor said, not realizing, of course, that my early years were devoted to being an actual refugee from war and revolution in Iran. “But unfortunately this state is overwhelmed with so many of you these days.”

“Where can I go?” I kept asking him.

And more than once I saw him look at me with tears in his eyes. “I don’t know.”

My doctor was a compassionate man—equal parts conventionally trained MD and alternatively minded naturopath. He knew his patients far more deeply than most doctors did. And of course, he had saved my life in 2012. But I had to face that he had nothing for me now. He said I had CIRS (chronic inflammatory response syndrome), that mold illness was my main problem, and that it had retriggered my Lyme disease. Unless I could find a mold-free space to live in, none of his remedies could help me. His office and IV room were filled with others with environmental illness who could not find a “safe space” even in Santa Fe. It was clear that this was our future, that more and more, as our climate evolved, our collective health would suffer.

I briefly stayed with my old sensei in Santa Fe, a bee venom therapist who administered the apitherapy through the Japanese Hoshin method, but even her space made me feel allergic. Hives, trouble breathing, unbearable itching, throat swelling, sinus infections—I was miserable every moment I was awake, and when it was time to sleep, I was too uncomfortable to check out of consciousness. But my sensei understood. Climate change had affected her as well. She was distraught by the state of her hives, the bees unable to handle the dramatic shifts in temperature. Bee venom had once been a huge help for me, but now we both eyed the honeybees with pity. They could barely help themselves.

“What have we done?” she used to say, staring at the heavens for answers that never came.

It took years for me to get better.

Eventually I decided to go back to New York City. I stayed in a friend of a friend’s apartment and hired a mold coach—a job I’d just learned about—to scout out an apartment for me. My mold coach had been homeless too and was very careful around certain neighborhoods in New York, constantly smelling “mold plumes” and “toxins” with different breezes, she claimed. Eventually I found a place in a suburban part of Queens—an old 1960 skyscraper that was built ruggedly and very clean, with doormen and elevators, and I set up my new life.

It wasn’t as hard as you’d imagine for me to start over: by this point, I had lost all my possessions. Nearly half a year after vacating Harlem, the roof had finally collapsed on my old apartment before a friend of mine could salvage my books and clothes, the whole of the apartment overtaken by brown and black murk. I had also thrown out the few possessions I collected in L.A. and Santa Fe, as even those had been exposed to mold. I slowly bought a few things here and there, washed them in borax, and even bought a cheap portable infrared sauna online, which doctors claimed helped with detox from mold illness. I put two air purifiers in place; one cost $1,400. I went to get weekly “immunity” and “detox” IVs at a Lyme clinic, plus phosphatidylcholine IVs as part of a mold detox regimen. I took strong antifungals and settled into a routine. Very slowly I got better.

And I had to: I had lost a hundred grand, after losing what seemed like a hundred years to Lyme. I had to get well if only to work again, because I could not afford this illness. This whole time, I had no real income other than a crowdfund friends had set up. Thankfully, it had raised $60,000—mostly from fans of my writing from around the world, and many anonymous donors who likely had experienced this sort of misfortune themselves, as their unsigned notes seemed to indicate.

I used to look outside my window and think, When will I be well enough to join the world again? I never considered I would one day be sitting inside, looking out and wondering when the world would be well enough to be rejoined.

By February 2020, all my chronic aches and pains and problems were gone. I could function at full capacity again. I went on a trip to Europe in early March and managed without a cane. I felt like my old self again. I was well.

But when I returned home, the world was not.

Upon landing at JFK, I was shepherded to a special line, and this was a first: I had my temperature taken. I was prepared with several face masks and hand sanitizer, but I did not realize how precious those items would be in the weeks to come, or how hard it would be to get basic dry goods and toilet paper. The world turned upside down in a matter of weeks as COVID-19 spread not unlike the wildfires of my old home in Los Angeles.

The heart of New York’s pandemic—of America’s pandemic—was just a few blocks from my apartment in Queens. We had the highest number of cases in the country. News reports showed footage of a hospital in nearby Elmhurst, where bodies were being piled up in refrigerated trucks parked just outside the hospital’s doors.

The panic people felt was new, but it also seemed familiar. Horror movies and dystopian novels have long painted a world ravaged by climate change disasters that looked a lot like this. And the connections between viral outbreaks and climate change were real. The Washington Post warned that climate change creates an opportune environment for the 320,000 viruses that infect mammals to thrive.⁵ In New York magazine, David Wallace-Wells warned, “If the disease and our utter inability to respond to it terrifies you about our future staring down climate change, it should, not just as a ‘fire drill’ for climate change generally but as a test run for all the diseases that will be unleashed in the decades ahead by warming.”⁶ Meanwhile at The Nation, Ana María Archila, George Goehl, and Maurice Mitchell penned a piece arguing that our current crisis with COVID-19 could be a cautionary tale for our inevitable future with climate change: “Perhaps the most important lesson of the coronavirus is that if we don’t prepare now, and start thinking about how to stop problems before it’s too late, we’re risking everything we care about: our homes, our jobs, and the health of our loved ones . . . Greater disease transmission, food shortages, energy blackouts, floods, homelessness, joblessness, species extinction—each will stagger us and then do so again.”

Day after day I read articles like this, as New York made it through a winter with almost no snowfall, and into a spring that produced the worst allergies I can ever remember. The Kwanzan cherry trees in my neighborhood were almost steroidal in their unchallenged beauty this season. A frosty hailstorm hit just as weather forecasters were predicting a hot summer ahead, and then, on a gloomy day in April, a first for me: a tornado warning in Manhattan. My dog looked perturbed by the turbulent sky—he no longer wanted to run in the dog park.

It has been many weeks, and as I write this, we are still in COVID-19 season. As it turns out, you can get used to anything, even lockdown.

I still think about how grateful I am to have found a safe home at last, to have healed. But now I wonder what will get me in the end. I was dying of America, declared a scrawl I found in a journal from 2018 when I was at my absolute worst, suicidal in Los Angeles, years away from living even an hour without pain.

During the spring in which I write this, everyone I know has been taking photos of lush flowers and fertile trees, radiant blue skies. My parents text me frequently to report that the air in Los Angeles is more breathable than it has ever been—thanks to the COVID-19 outbreak, L.A. is seemingly overnight no longer one of the most polluted cities in the world. Even New York smells crisper, cleaner. I look out my window that faces Queens Boulevard and see just one or two cars speeding down eight lanes. The sirens of ambulances are constant—this sound, almost a song, I am entirely used to now. It mingles with the songs of birds. A couple of people in face masks walk their dogs. Signs have gone up to indicate buildings coming down, and more businesses have closed. So much is happening, so much is not happening. Sometimes I can’t even remember what I miss anymore.

We know this pandemic will end and that it will take a long time, but probably the hardest thing we know is that this is just the first pandemic for us. There will be many to come and we will always be unprepared, or so we fear right now. Nature hates us, my friend jokes mock-bitterly, sending me a photo of her overgrown garden. But I think the truth is the opposite. All around us is potential and promise, from nature to science, waiting for us to take the cue to save ourselves. We wonder if our Earth’s recovery will happen in our lifetime, but I think we know the answer.

Notes

1.Thomas W. Porter, Wade Crowfoot, and Gavin Newsom, 2017 Wildfire Activity Statistics (Sacramento: California Department of Forestry and Fire Protection, April 2019), www.fire.ca.gov/media/10059/2017_redbook_final.pdf.

2.“2017 Was 3rd Warmest Year on Record for U.S.,” National Oceanic and Atmospheric Administration, January 8, 2018, www.noaa.gov/news/2017-was-3rd-warmest-year-on-record-for-us.

3.“Birds Identified as Hosts of Lyme Disease,” Entomology Today, March 10, 2015, entomologytoday.org/2015/03/10/birds-identified-as-hosts-of-lyme-disease.

4.“Climate Change and Vector-Borne Disease,” UCAR Center for Science Education, accessed February 27, 2021, scied.ucar.edu/longcontent/climate-change-and-vector-borne-disease.

5.Sarah Kaplan, “Climate Change Affects Everything—Even the Coronavirus,” The Washington Post, April 15, 2020, www.washingtonpost.com/climate-solutions/2020/04/15/climate-change-affects-everything-even-coronavirus.

6.David Wallace Wells, “The Coronavirus Is a Preview of Our Climate-Change Future,” Intelligencer, April 8, 2020, nymag.com/intelligencer/2020/04/the-coronavirus-is-a-preview-of-our-climate-change-future.html.