The Selfishness of My Self-Grief.

Grief is one of those strange words marked by the English language’s characteristic imprecision, a single word covering many discrete emotions.

In its most common usage, we grieve over the loss of a loved one after their death. A family member, or perhaps a pet. It is this grief that keeps funeral homes in business; as funeral directors patiently explain every day to new clients, the funeral and the wake are not for the benefit for the person in the coffin.

We also grieve over the loss of possessions, although there really should be a different, lesser word for that. I’m sure your favorite pair of jeans you just tore meant a lot to you, but c’mon.

There’s the more abstract griefs. When your team loses a heartbreaker in the playoffs. When the celebrity you don’t know personally dies or announces a grave diagnosis. When your country will be lost in less than a year.

Then there’s the grief over the loss of your future.

One of my first patients as a med student, long ago, was a 36 year old woman with end-stage ovarian cancer. Her medical chart read like a personal apocalyptic log in reverse; her own Book of Marzabul. She lay unresponsive that July in a darkened room, a TV on Wheel of Fortune giving the only illumination; the hospice was giving her among other things scopolamine, a drug that reduces secretions. This is because she was unable to swallow her own saliva and mucous, and they threatened to seep into her lungs; in fact, the resulting pneumonia from this is an extremely common way for terminal patients to pass.

I had flipped through the handwritten pages to April. It was noted then she was having difficulty making it down the stairs to reach her appointments and that she needed higher levels of pain medication. February: she felt fine. She expressed her hopes of at least enjoying one last Christmas with her family.

The enormous grief for her own future she must have felt, driving to the hospice for her first appointment that winter; that the oncologists considered the case so hopeless they had referred her to begin with. Her grief over the loss of growing old as her kids grew up, one Christmas at a time, joy, graduation, fights and reconciliations, life, seeing the world change, presidents coming and going, a retirement of happy memories: I only hope she allowed herself to cry, no, to keen; yes, to keen louder and harder over her stolen future than the most drunken aunt at an Irish wake.

It is not that grief that I personally deal with daily, knock on wood. I do not mean to compare my emotional pain to what the patient from above went through.

It is the grief I have over my lost past.

I talk more about how and why I have no past here, but suffice to say it is all over one single condition; one single diagnosis code from the ICD-10 that took almost everything from me that matters. You see, every conceivable medical condition is assigned its own code for billing purposes, sorted into general groupings by their first letter.

The one that left my life empty is F84.5.

F84.5 took away my childhood birthday parties. F84.5 took away my childhood friends. It took away my high school friends. It took away my day trips with friends, my circles of friends, my proms and homecomings. F84.5 took away my weddings with friends, my bachelor parties with buddies, my group chats and their older ICQ/AOL equivalents. F84.5 took away my in-jokes, my knowing looks, my fears traded in secret talks long after midnight, the secret crushes only sometimes shared, the jealousies, the quiet get-togethers and the absolute keg-soaked ragers.

F84.5 robbed me of sharing of earpods while wordlessly sitting next to each other, reading or on our devices. F84.5 stole my blurry group Polaroids outside the college bar, beaming, hats and scarves, street lights. F84.5 ran off with my calling everyone, one after the other, with either the worst or the greatest thing I had heard that week. F84.5 pickpocketed the obsessive sharing of lyrics together, analyzing every last word, trading guesses on what they meant to Thom or Kanye or Tweedy or Taylor.

F84.5 burglarized my entire life under 30. It left nothing but the floorboards.

F84.5 did not literally take my life; I again do not wish to diminish what my patient went through. It did not take away my (usually short-term) relationships. And it did not take away my career, although it came within an ace of doing so. I am forever extremely restricted in my livelihood due to the irreversible penalty of not being allowed to finish residency due to being afflicted with F84.5, an offense that my program director had taken personally; but I do not really grieve over that compared to the rest. And F84.5 did not take away my immediate family. But it took absolutely everything else.

That’s the funny thing about the F-series diagnosis codes. The psychiatric codes. They are the worst thieves and bandits in the whole book.

The C-codes are the violent armed robbers. That is what my patient above got. The E-codes — endocrine, including diabetes — usually are instead a slow leak, a tax, draining you over decades if not fully contained.

But there is something particular in the cruelty of the F-code thieves. Anxiety. Depression. Schizophrenia. Bipolar. Autism. They can rob you of your tribe, your band, your family, your clan.

To a social species like ours, that is arguably a fate worse than death.

If it weren’t for F84.5, I would have had a life. Not that I didn’t make plenty of mistakes, or wouldn’t have lost friends as I aged like everyone else does. But I would have memories. My teens and 20s would be more than a shoebox with a few dozen old unlabeled photos, jumbled randomly out of order.

I do not miss any particular person from my past; that is not what I mourn. Mine is a selfish mourning, and I mourn not having anyone else to mourn.

And what sucks the most is that there’s no do-over. It’s never coming back. I’ve aged way the fuck past, even if F84.5 mercifully disappeared tomorrow and I finally got to act like a normal person. I am never going to a wedding in the Hamptons with people equally as unmarried and childless. I am never getting an invite to a abruptly thrown-together midnight get-together. I am never getting the “Thinking about you” or “Wyd” text completely randomly.

I will never be laughing on the porch or on the beach with everyone else, talking in hushed and excited tones about our future plans.

Therefore, I am never getting the friend invite from a face I had almost forgotten, simply wanting to catch up.

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I can walk through the Village with my headphones on, and yes, that can temporarily salve the empty pain of what F84.5 left. I become just as anonymous, just as much an NPC as literally everyone else on 4th Street, which is comforting… that is, until I make it to near NYU and its people being all annoyingly “together” like they do, and the tears well up again.

I still pick up and hold my son sometimes, even though his mom points out he’ll be too big for that soon enough.

The island I live on now is miraculous. It is also on solo mode, a Destiny 2 run without an internet connection.

I do not want to turn back the clock or be young again; it would turn out exactly the same. All I’d want is to send this back in time to Kansas City, perhaps as a nod to our Mr. 87, but mostly as a letter to all the people I should and would have been close to; to classes together, endless nights together, adventures together; if it weren’t for F84.5.