Putting the Experience of Hypothyroidism into Words

Excerpts from Lydia Davis’s New Yorker story “Thyroid Diary”

Thyroid Diary” is a short story written by author Lydia Davis, and published in The New Yorker in September, 2000.

The story traces the narrator’s experience overcoming an underactive thyroid, medically known as hypothyroidism.   In the excerpts below, one glimpses ― in real time ― the vexing degree to which hypothyroidism may affect a person’s body and mind.  Davis depicts this stressful journey with humanity, humor, and philosophical insightfulness.

Perhaps her words can be a helpful resource for those grappling with the disorder, or their loved ones, and anyone else, seeking to better understand it. 

On noticing her confusion and slow thinking: 

If I’m confused about all this, it may be because of my underactive thyroid.... 

Slow thinking, my doctor has told me, is one symptom of an underactive thyroid. But it’s hard to tell whether I’m thinking more slowly than I used to. 

The only way I can observe how I’m thinking is with my brain, and if my brain is slow, it won’t necessarily know that it’s slow, since it will be moving at a rate that is appropriate to it. 

On surprise about the thyroid gland’s importance and philosophical implications: 

I have never associated myself with such an unexpected part of the body as the thyroid, so it feels as though my body is suddenly strange to me, or I am strange to myself. 

On arguing with her endocrinologist about relying on hormone replacement therapy: 

“What if I were lost in a jungle without my thyroid medicine?” I asked [my doctor], and it is true that I always believe that someday I may be lost in a jungle, even though we do not call them “jungles” anymore, and we are losing them anyway, so that the word “jungle” is becoming just an idea.  

She said I would get along well enough without it until I could find my way out of the jungle. 

On slow thinking due to an underactive thyroid: 

...when I was talking to my husband on the telephone, I was confusing and contradictory, and so long-winded that he compared me to a legal brief he was reading. 

This document was fifty pages long and concerned a possible class action against an insurance company for misrepresentation. 

On optimism and patience with treatment: 

On the other hand, it occurs to me that maybe my brain is working well enough but simply more slowly than usual. Maybe my work will be good but it will take longer. 

Or maybe the dose of thyroid supplement I’m taking will be increased to the proper level soon enough so that by the time I reach the final draft of the translation I will be thinking sharply and quickly again. 

On the state of the world and the mystery of mental health: 

Another question I had recently was this: Is the rather pessimistic turn that my thoughts have taken these days due to the state of the world, which is bad and which gets worse more quickly than one can hope to save it, so that I become quite scared? 

Or is it due simply to the low level of my thyroid hormone, which would mean that maybe the world is not really in such a frightening state, and it seems that way only to me?

On the philosophical questions of identity:

What an insult to the mind...that the chemicals of the body and nothing else are causing my thoughts, which I take so seriously, to move in a certain direction.  What an insult to the amazing brain that such a simple thing as a level of chemicals should point it in a certain direction. 

On reconciling the body, brain, and mind (and then second-guessing it more):

I can think of it not as an insult but as part of another fascinating system. I can say, I would prefer to see it as part of one interesting system.  Then I think, ‘And, after all, it is this amazing brain that, in thinking this, is being so magnanimous to the dumb body.’ 

Though of course maybe it is the chemicals of the dumb body that are permitting the amazing brain to be magnanimous.


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