You Know You Want This

by Kristen Roupenian

  She says, “Itchy. Otherwise uneventful.”

  “Did you get a chance to . . .”

  They’ve been dancing around this subject for what feels like forever. Laura, who struggled to find work when they first came to California, is now furiously dissatisfied with her job as an assistant to a despotic local gallery owner—but she also (or so it seems to David) cannot resist the gallery’s swirl of drama and complaint. She hates it when David hints she might be happier elsewhere, and accuses him of nagging whenever he suggests she look for other work.

  True to form, she does not even allow him to finish his sentence. She snatches her arm away from him, spattering an arc of pink lotion across the couch.

  “You really can’t stop picking on me, can you?” she says. “You just can’t leave me alone.”

  * * *

  Three days. Three more bites. Laura grows even more irritable, sensitive to even the slightest provocation. When the third bite appears on her face, popping from the hard curve of her cheekbone, she scratches at it so much that her eye swells shut.

  “You should see a doctor,” David tells her over breakfast on Friday morning, unable to look directly at her. Her swollen eye makes it seem like she’s winking at him.

  “Can’t,” she says. “Deductible.”

  “Laur. Come on.”

  “There’s a free clinic on Langford Street. I’ve got an appointment on Monday. So.”

  A free clinic, when the last time they went out to dinner, they spent two hundred dollars on the wine alone. The force of Laura’s self-punishment can be a visceral shock to witness; it’s like watching her willfully slam her fingers in a door. But he refuses to rise to her provocation and counters instead: “If I can get the afternoon off, want me to come with?”

  She offers him a brilliant smile. “David. That’s so sweet of you. Sure.”

  * * *

  Only after spending a full forty-eight hours at home with Laura over the weekend does David realize how completely she has given herself over to the war against her skin. The number of bites has tripled overnight; her entire day is built around her attempts to soothe the relentless itching and trying not to scratch. A soak in a baking soda bath in the morning is followed by a basil and aloe rub. She obsessively trims her fingernails, washes and rewashes the sheets, carefully applies bandages that she immediately removes. The rest of her time is spent on internet searches, the frantic rephrasing of keywords: skin lump bite itch; itchy bite skin help; bites arms stomach face, along with the close analysis of a succession of awful, cringe-inducing images and the deep excavation of message boards filled with fellow sufferers: thousands of endless, plaintive, fruitless threads.

  David crawls through the apartment on his hands and knees, looking for culprits—flies or larvae, fleas or mites—but he comes up empty-handed. Ten minutes of his own internet research offers up so many possibilities that he concludes such searches are worse than useless; itching is a symptom so common that it stymies diagnosis. “I really think you should consult someone more qualified than WebMD,” he tells her.

  Laura digs her fingernail under the welt on her arm, which is now a glistening, cratered circle, ringed with yellow like a cigarette burn. “Do me a favor,” she says as she scratches. “Stop trying to help, okay? You’re only making things worse.”

  On Sunday night, he wakes to an empty space in the bed beside him. He walks out to the living room and finds her on the couch, surrounded by crumpled tissues, each one stained with a little red blossom of blood. “I can’t sleep,” she whimpers. “It’s like something is crawling in there, under my skin.”

  David has never seen her so undone. He presses his lips to the part in her hair, tucks a blanket around her shoulders, and makes her a pot of tea, and they stay awake together until the sun rises, and then he helps her wash and dress.

  * * *

  The clinic waiting room is crowded with sick people, and the air itself feels oily, laden with disease. They wait more than an hour past the scheduled time of Laura’s appointment, and when the nurse finally calls her name, Laura lifts her chin and insists on going in alone.

  She emerges less than fifteen minutes later, carrying a thin sheet of yellow paper, a disbelieving look on her face. “She recommended non-prescription antihistamines,” she says, not even slowing down as she passes him on the way to the exit. “She told me not to scratch.”

  “She didn’t have any idea what might be causing it?”

  “She didn’t have any fucking clue.”

  Briefly, they are joined in their shared indignation, but soon enough that temporary alliance falls apart. Another itchy spot has appeared on the top of Laura’s head, and she has scratched away a tiny bald patch the size of a quarter. The skin beneath it is thick and scaly, lined with dandruff. “Are you sure you don’t have any bites?” she asks him. “Even small ones? It doesn’t make any sense. We share everything. Why would they go after me and not you?”

  A thousand times over the past week, he felt a phantom itch start to crawl across his skin, but he always rubbed it with a flat finger instead of scratching, and it vanished back into the ghostly realm from which it came.

  “I don’t know,” he said. “I’m sorry, hon.”

  “Why would you be sorry?” she snaps. “How is this your fault?”

  “It’s just—I want you to know that we’re in this together.”

  “Oh, sure,” she says, blowing her nose into a bloodstained tissue. “I know.”

  * * *

  David goes to work as usual on Tuesday, losing hours to the same Google searches that he’d decided two days earlier were a waste of time. He returns home to find Laura examining her arm with a magnifying glass, using a Q-tip to dig deep into the little wound. She barely glances up at him, so intent is she on her hunt. “There’s something there. I can see it. It’s like this . . . little . . . white . . . smudge.”

  He stands over her, horrified. “What are you doing?”

  She pushes the Q-tip into the welt, and the blood foams up around it. She lifts the cotton tip in triumph. “There!” she cries. “You see?”

  On the very tip of the blood-soaked cotton puff, he thinks he can maybe make out a very tiny, pale, and glistening dot. Squinting, he tries to make out the shape: A bug? An egg? A bit of fuzz?

  Laura peers at the Q-tip. “Oh, my God. It’s still moving. You know what? I read about these. They’re called botflies. They lay eggs in you, if you have like a small cut or a burn I think, and then the eggs turn into larvae that burrow up under your skin. Or, actually, it could be these worms, that you can pick up from swimming in contaminated water . . . anyway, it’s some kind of parasite. That’s why you’re fine, why we couldn’t find anything. It wasn’t hiding in the apartment. It was hiding in me, all along.”

  “That’s disgusting.”

  “I know!” she says, but she doesn’t sound disgusted, she sounds relieved. David can understand why—at last, she’s found some kind of answer—but he cannot share in her relief, because even through the magnifying glass, he can see nothing but a little white dot.

  * * *

  Laura digs out four more of the mysterious specimens, saving them in a small Ziploc baggie that she keeps in the refrigerator beside the orange juice. Still adamant that she cannot afford a visit to the doctor, she returns from the grocery store carrying a smelly assortment of pseudomedicinal ingredients: coconut oil, garlic, apple cider vinegar. She measures out dosages of this home remedy in careful teaspoons, refusing to eat or drink anything else. Parasites feed on sugar, she tells David. This regimen is meant to starve them out.

  David believes in none of this, neither the diagnosis nor the cure—but at least her eyes are brighter, she’s a little more cheerful, and the rawest of the scratch marks have begun to fade. They even manage to have a handful of short, calm conversations about something other than her skin. Perhaps, he thinks, the episode will pass without him ever understanding it, a little eddy of unhappiness in an already di
fficult time.

  But then, he wakes up to the sound of scratching. He reaches over to bat her hand away from her face, and his fingers come back slippery and dripping. He turns on the light and recoils; in her sleep, Laura has torn open the scab beneath her eye, and the left side of her face is covered by a slick red mask of blood.

  * * *

  The fight that follows lasts hours; when the sun rises in the middle of it, David calls in sick to work. Laura screams for so long she loses her voice. David punches a wall.

  The fight begins, of all things, with a spreadsheet. David made it when they first moved to San Francisco. It’s titled David and Laura Live Together, and contains all their shared expenses: rent, and car, and food, and travel. They divide those costs each month, in proportion to their income. David, an engineer, makes more money than Laura, who’s still technically a temp. Therefore, Laura pays 18 percent of their shared expenses while he contributes the remaining 82 percent.

  As he mops the mess off her face, David says, “You need to go to the doctor.”

  “I can’t afford one.”

  “Well, we can put it on the spreadsheet,” David says.

  Laura rolls her eyes.

  “What?”

  “Nothing, I just get so sick of this sometimes.”

  “I’m sorry, I was trying to help. Can you explain what I did wrong?”

  “Let me ask you something,” says Laura. “When I die, are you going to put eighty-two percent of my funeral expenses on your spreadsheet and send a bill for the rest to my heirs?”

  David says: “You’re literally covered in blood and still you’d rather attack me than ask for help!”

  And then Laura says, “You know what, David?” and off they go.

  “People who love each other take care of each other,” Laura shrieks as the fight rises to its peak. “They don’t keep track of every single dollar they spend on each other on a fucking spreadsheet. That’s not how it’s supposed to work!”

  “So what?” David shouts back. “You want me to pay for everything so you can keep on working at your shitty job, which you hate?”

  “Is that what our life looks like to you? No wonder you resent me so much, if that’s how you feel!”

  “I don’t feel any way! I just think it’s not too much to ask you to contribute something to—”

  “Oh sure. You don’t feel any way. That is very evenhanded of you, David, thanks.”

  “Of course I feel, I just—”

  “The problem with you,” Laura says, “is that you’re not invested in this relationship, not really. You’re always holding back, you—”

  “Oh. Come on. I’m invested—”

  “Yeah, you’re invested! You’ve invested exactly eighty-two percent. How could I forget? You pay, and keep track of every cent.”

  “I’m not supposed to keep track of my money?”

  She shakes her head furiously, as though it might help fling the words out of her mouth. “That’s not what it’s about. It’s about—about knowing how to love a person!”

  The words hang in the air, until David echoes her: “You’re telling me I don’t know how to love a person?”

  “No,” Laura says, setting her chin stubbornly, like a child. “You don’t.”

  That’s when it happens, the little moment of grace that can descend, all of a sudden, to signal the end of a fight. Her frown wobbles a little. She sees she’s being ridiculous. And he sees her see.

  “That’s funny,” he says, in a quieter voice. “Because I was definitely under the impression that I’d been loving you all this time.”

  “Well,” she says, sliding almost imperceptibly into performance. “You’ve been doing a bad job of it.”

  “Really?”

  “Mostly. Yeah.”

  “Even on your birthday?”

  “On my birthday, I guess you did okay.”

  “So what am I supposed to do? Tell me. I’m genuinely asking.”

  “You’re not supposed to do anything. You’re supposed to say: ‘Laura. I love you. It’s going to be okay.’ ”

  “Laura,” he says, taking her hands in his. “I love you. It’s going to be okay.”

  * * *

  As Laura naps fitfully on the couch, David makes an appointment with his PCP. He tells the secretary it’s an emergency, and she manages to fit them in that afternoon. When Laura wakes up, he tells her he’s made an appointment. Before she can object, he says, “Please, just let me do this, all right?”

  The doctor is an elderly man with smoky puffs of hair protruding from each ear, and when David wraps one arm around Laura and asks if he can accompany them to the exam room, the doctor does not object.

  Dr. Lansing clucks with concern over Laura’s torn-up cheek, and asks her to show him each of her welts in turn. She displays them one by one, and he asks gentle, prodding questions that she answers as best she can. When she finishes, she reaches into her purse for her little plastic baggie, and tells him her theory about the botflies, and about the evidence she’s found.

  Something strange happens then: the doctor’s face goes empty; it’s as if his curiosity has drained right out. He accepts the baggie, giving it only a cursory inspection, and then sets it on the table, crumpling it up.

  “Aside from the itching, how have you been feeling?” Dr. Lansing asks.

  Laura shrugs, and says, “All right.”

  David stays quiet in the face of this obvious untruth. Dr. Lansing pushes: “How have the past few months been for you, emotionally?”

  Laura shrugs again. “Fine, I guess.”

  “How have you been sleeping?”

  “I can’t really sleep, because I’m scratching all the time,” Laura says, at the same time that David says, “Laur! Come on!”

  Laura and Dr. Lansing turn toward him, startled, and despite the warning glance that Laura gives him, David pushes on. “I mean, I’m not trying to—the itching has been bad, I know. But don’t you remember, honey, you were having trouble sleeping even before that, because of the stress at work, you said—and I mean, am I wrong in saying that, since the move, things have been pretty hard?”

  He keeps waiting for Laura to pick up the thread of the story from him, but when she doesn’t, he tells Dr. Lansing everything, recounting it with as much messy desperation as if it is his own story, and part of him feels as though it is. As he finishes, he sees Laura looking utterly betrayed.

  Only then does he realize the full impact of what he’s done: in trying to help, he’s exposed all her weaknesses without asking her permission; used her secrets to prove to an outsider that her pain is all in her head.

  The doctor says, “Laura, what I’d like to do, if you’ll allow me, is to write a prescription that might help treat the underlying cause of some of your distress. It sounds like you’ve been under a great deal of pressure these past few months, and I think you may be surprised, once your mood improves, how quickly the issues with your skin will follow suit.”

  Scrambling to make up for his error, David says: “But what about the actual itching? Do you have anything for that? Because if not, a referral to a dermatologist might be in order.” He turns to Laura: “Don’t you think?”

  But Laura looks exhausted, all the fight gone out of her. Her wounded face is dull and blank with pain. She says, “If you think mood medication will help, I’m willing to try it. I’ll try anything you say.”

  The doctor writes the prescription, and David, stunned, follows Laura out of the office. Guilt floods him. He says, “Honey. Wait right here?” and rushes back into the exam room, where Dr. Lansing is finishing up his notes.

  “David?”

  “I’m sorry—I just. Listen. I feel like I gave you the wrong impression. Laura isn’t crazy. She’s been stressed out lately, yeah, but she’s had good reasons—the job, the move. I maybe haven’t been the most supportive. And I think—I think if she says the itching is real, we should trust her. That’s all I’m saying. That’s all.”

&
nbsp; Dr. Lansing rubs his hand across his deeply wrinkled forehead. “I understand your concerns,” he says. “I do. But let me ask you something.” He picks Laura’s plastic baggie off the exam table, and passes it to David. “What do you think this is?”

  David stares down at the crumpled bag. “It’s the . . . stuff . . . she found. Where she was scratching.”

  “But what exactly do you think is in there?”

  “Eggs, I guess? Or larvae? It’s too small for me to see. But that’s why she came in for tests!”

  “Too small for you to see,” the doctor echoes. “But not for Laura. Laura thinks she sees something. You’re uncertain, but Laura thinks she knows.”

  David stays silent. He knows where the doctor is headed, and he doesn’t want to accompany him there. Dr. Lansing continues, “This isn’t just stress. But it isn’t a parasite, either. It’s a textbook example of what’s called a matchbox sign. From the days when patients would come in with empty matchboxes, offering them up as evidence of the bugs living under their skin. Now people use plastic bags, or Tupperware. Or take pictures on their phones. But the stuff inside’s the same. Bits of dead skin. Dirt and lint. All of it nearly too small to see, except by a person whose mind is turning on her body, tearing it up and scavenging it for proof of something that’s not there.”

  David crushes the bag in his fist. This sudden, sly reversal of meaning seems desperately unfair: that Laura should have spent so much effort trying to gather proof of what is happening to her, only to have that very effort taken as evidence that she is losing her mind.

  “Dr. Lansing,” David says. “If this were me. If I’d come to you complaining of an itch. Would you be so quick to dismiss it then?”

  The doctor’s mouth jabs downward in a frown. “Son, that’s what I’m trying to tell you. I’m not dismissing it. The bugs may be imaginary, but Laura’s suffering is real. Delusional parasitosis can be a symptom of depression, but it can also be an early sign of psychosis—and it’s very difficult to treat, precisely because patients so rarely want to accept the help that’s offered them. Right now, Laura is willing to get the treatment she needs. If you love her, don’t get in the way of that. Please.”