The Sticking Point
A woman’s bureaucratic errand becomes a journey through memory and grief.
By Sarah Clark
It was a huge relief when I found out that I got into graduate school. Obviously, any time you’re accepted to a program you’re excited about, there’s a tremendous amount of excitement and validation involved. But for me, in my early thirties and between careers, so to speak, after a recent move across the country, the prospect of having something I really wanted to do in the fall of 2020 was a godsend. I celebrated. I cried a little. I sent in my tuition payment, housing forms, and official transcripts. I also had to submit a form documenting that I was up to date on all of my vaccinations.
Of course, when I was enrolling in graduate school in August of 2020, that form did feel a little, well, unnecessary. Counterproductive, even. Because I wasn’t going to be on campus with a bunch of other students, and in fact, I hadn’t seen much of anyone but my husband in months. After sheltering in place and avoiding other people and public places since March, the last thing I wanted to do in the middle of a global pandemic was go to a doctor’s office to have this vaccination form signed off on. Exposing myself to the novel coronavirus to prove I couldn’t pass any almost-extinct childhood diseases on to people I was never going to be in the same room with didn’t seem like such a slam-dunk victory for public health.
But okay, fine, I had to do it. And I am fully vaccinated. In fact, I’m actually more vaccinated than most people, because in addition to the full range of childhood immunizations and the tetanus shot I had to get a couple of years back after stabbing myself in the shin with a rake, I’ve also been immunized against malaria, yellow fever, and cholera. My body is practically a fortress against disease. And as an added bonus, I’m not the least afraid of needles.
I knew I had all of my vaccination records, too, because unlike many people my age, I have possession of all of my own official documents. I even have my report cards, from first grade all the way to high school. They had been in a box my father handed me once, saying, “I think this is your stuff,” along with an ethernet cable, a frisbee emblazoned with the logo from a dentist’s office, and a padded satin clothing hanger—none of which I had ever seen before. It also contained my brother’s old teddy bear, a gray plastic desk organizer, and my high school diploma, which I had better not lose because there will be no replacing it—the school that issued it is gone, the land sold and the buildings razed. I’m sure there’s a metaphor in there somewhere.
So I made an appointment at the local urgent care, and I filled in the dates for all my doses of the TDAP, the MMR, all the childhood standards. (They didn’t care about the malaria.) So far so good—until I got to the final entry.
Once you’re infected with this virus, it lives on in your body for the rest of your life—that’s why you can’t get chicken pox more than once. Once it’s inside you, it’s like your blood type—or your family. No one can see it, but it’s part of you.
Varicella (colloquially known as chicken pox) is a relatively new vaccine. According to the CDC, it was first developed in the 1970s, but it didn’t come into use in the United States until 1995. Since I was born in 1989, I was not vaccinated against the chicken pox. In fact, when I was a child the commonsense solution was to make sure your kids got chicken pox early to get it over with, so when my older brother came home from kindergarten covered in spots, we spent the afternoon playing make-believe in our shared bedroom in the attic of my parents’ restored farmhouse. I was soon red and itchy myself, but I survived with nothing worse than a few small scars on my hands from scratching the sores more than I should have. I’d like to say that’s something I’ve gotten better at since then.
Since I was never vaccinated for varicella, I could not provide proof of vaccination. Fortunately, there was another option: you could provide proof of having had varicella. In theory, your parents, or your childhood doctor, might have records of this. I considered my options. First, I knew there was no chance my father had such a record, because he had meticulously evicted anything and everything that might have belonged or pertained to me from his house already (remember the dentist frisbee?). I considered calling him and asking if he remembered who my childhood doctor was—I did not remember who I had seen when I was four or five, because we had lived in three countries on two continents since then (hence the immunizations against tropical diseases). The idea was as soon discarded as thought of. My father can no longer remember from week to week that I’ve been accepted to graduate school. My mother might have remembered, but we had scattered her ashes on the Blue Ridge Parkway the August before, and she had taken her memories with her.
Fortunately, the immunization form offered me one last shot: in the absence of records of either vaccination or infection, you could have your doctor do a titer, taking a small sample of blood and sending it to the lab to test for the requisite antibodies. Once you’re infected with this virus, it lives on in your body for the rest of your life—that’s why you can’t get chicken pox more than once. Once it’s inside you, it’s like your blood type—or your family. No one can see it, but it’s part of you.
I duly went to my appointment, presented all of my paperwork, and had my blood drawn. The doctor wouldn’t sign the form before the results of the titer came back, but he said I could leave it with him until the following week, when the lab would get back to us and the form would be ready. Done and done.
It was starting to feel like every part of this process had been designed to remind me that I had no family anymore, no home to go back to, no support system in this new place.
The following week, a little delayed since the lab was backed up with COVID tests, I got an email letting me know I could log in and see the results of my titer. It was negative.
I was utterly baffled. You see, I know I’ve had chicken pox. It isn’t just the vague memory or the scars on my hands. I know I’ve had chicken pox because I’ve also had shingles. Shingles is the other side effect of the varicella virus living in your system forever—usually it remains dormant and you get to keep your antibodies, but every once in a while it reactivates and starts to attack your nerves. No one knows exactly what triggers shingles, but outbreaks are common in people with lowered immune responses. Age is one factor that lowers immune responses. Grief is another. It is excruciatingly painful, and you can get it more than once.
I was 28 when I had shingles and having the worst year of my life. My mother-in-law had died suddenly in her sleep that summer at age 54, leaving us reeling from the shock. At the same time, my own mother was dying of leukemia at 69 while my father, her primary caregiver, acted increasingly unhinged (remember the ethernet cable?). A year and a half later, he was diagnosed with Alzheimer’s, giving us a neat box into which to fit his increasingly frequent lapses of memory (right next to the plastic desk organizer).
I lay on the couch for a month, unable to work or concentrate while agony traced a line along the nerve from the middle of my back around my side to my sternum. The pain eventually subsided, went away for a while, and then returned in the spot on my back where the rash had first broken out, though now with no visible symptoms. My doctor theorized that the severity of my outbreak had damaged the nerve there, possibly permanently—at any rate, it still hurts whenever I’m tired or stressed (or filled with the grief I still don’t know how to pacify or contain), and it probably will forever. It hurts right now, while I’m writing this.
Given all this, no one could explain why my titer came back negative. But the doctor couldn’t in good conscience sign my form, and I couldn’t get a shingles vaccine because they’re reserved for those over fifty—because young people aren’t at risk for shingles. I was left trying to find someone in the middle of a global pandemic who would give me a varicella shot. That’s supposed to be your primary care doctor, but I didn’t have one, because my husband and I moved right before the pandemic hit. We had put off annual check-ups (and most other activities) and stayed at home like we were supposed to. More than in any particular place, we felt as if we just lived in our apartment. Even when I finally found a pharmacy that said they had a varicella vaccine on hand when I called denied having ever carried such a thing when I showed up in person.
This was starting to feel like a conspiracy. Like every part of this process had been designed to remind me that I had no family anymore, no home to go back to, no support system in this new place. I felt uprooted and alone. Which was stupid, right? Because all that was really happening was that I was failing to check some nonsensical bureaucratic boxes. I wanted to cry—and not just a few small tears tastefully trickling down behind my mask. I was on the verge of a total breakdown in this bright, cheerful pharmacy lobby. I wanted to beg this pharmacist and the doctor at the urgent care and the registrar just to believe me that I know this virus is living inside me. I know where it came from. I know where I came from. I remember. But I couldn’t speak. I knew my voice would shake and the tears would start.
I am growing more used to knowing that the family I used to have is gone. It isn’t coming back.
In the end, I did get a shot that day. As I forced out a quavering thanks and turned to go, the pharmacist told me to wait. She made a few calls, found me a dose of the varicella vaccine at the nearby hospital’s walk-in clinic, and told me how to get there and where to park. It was exceedingly kind, and when I got out to my car, I did cry. Mostly out of gratitude, but also from lingering frustration. My victory, in the end, was to get a vaccination that I didn’t need, for a disease that I currently suffer from.
What I need are the things that being able to fill out that form without an unnecessary vaccine implies: a family, a community, and a home. As the second anniversary of my mother’s death recedes into the past and the third anniversary of my mother-in-law’s death approaches, I am growing more used to knowing that the family I used to have is gone. It isn’t coming back. The homes I lived in as a child are gone, a continent away or sold to some other family who have made them into a home of their own. Even if I could go back, I wouldn’t recognize them anymore. They are no longer mine. All that’s left of them is the memories, and those abide, even if I’m the only one who remembers them.
But at the same time, my husband and I are making a new home here. We moved from our apartment to a house, and we’re planning a garden for this spring and choosing fruit trees to plant. A dear friend has moved in right down the road, and we’ve started meeting our neighbors. We signed up to bring the coffee hour snacks at church. We’re putting down roots.
Six months after I finally got my varicella vaccine, I opened my computer to find a new message from the immunizations compliance office: could I please submit paperwork documenting my second dose of the shot? My heart sank. The feelings of loneliness and overwhelming grief triggered by my first experience with this struggle threatened to rise to the surface again. But I pushed them back, sighed, and decided not to fight it this time. I called the hospital clinic and scheduled an appointment to get my second dose the day after spring finals ended.
I was tired the day I went in for that appointment, and annoyed that I had to be there. I had a lot of plans for the summer, and I wanted nothing more than to get this over with without any fuss. The resident I was seeing was sympathetic when I explained why I was there. She asked me if I wanted to get the second shot, or if I’d rather try again with a titer, since I didn’t really need it. I considered that but opted for the shot. Whether I needed it or not, I didn’t want to have to come back for yet another appointment if the titer inexplicably came back negative once again. That was fine, she told me. The only thing was that since the varicella vaccine contains a live virus, I’d need to get a pregnancy test done first.
So that was the day I found out I was pregnant with my daughter—the day my family once again began to grow instead of shrinking. Instead of a vaccine I didn’t need, I came home with a prescription for prenatal vitamins that I did, and with the blossoming feeling that I was going to be spending the next weeks and years looking forward instead of back.
And a few weeks later, my titer came back positive too.
Sarah Clark lives in New Hampshire with her husband and daughter. She is a founding editor of Fare Forward and the current editor-in-chief, and she owns Scale House Print Shop, a letterpress printing studio. She is currently working towards her MAR at Yale Divinity School.