Latest news with #tension
The Guardian
11 hours ago
- General
- The Guardian
I found myself Googling: can brain cancer cause hiccups? How I fell into a hypochondriac rabbit hole
Throughout my adolescence and into my mid-20s, I spent a lot of time trying to understand my body. I was unwell, that much was certain. The question of exactly what was wrong with me was one to which I applied myself studiously. I had theories, of course. Looking back, these tended to change quite frequently, and yet the fear was always the same: in short, that I was dying, that I had some dreadful and no doubt painful disease that, for all my worrying, I had carelessly allowed to reach the point at which it had become incurable. This started at university, when I developed a headache that didn't go away. The pain wasn't severe, but it was constant – accompanied by a strange feeling of belatedness that told me it had already been going on for some time. How long, exactly, I couldn't say – weeks, definitely. Maybe it had been years. After about a month, I visited the doctor. She had an earnest, warbling, confident way of speaking, which, in spite of her evident commitment to the tenets of mainstream medicine, gave her the air of an alternative healer. She explained that what I was experiencing were tension headaches, a common ailment among students, and during exam season practically universal. I said that I didn't feel very tense. The doctor asked whether the pain felt like a tightness across both sides of the head. A kind of squeezing? Like an elastic band being pulled tight? Like a fist clenching around your skull? I said that it did not feel like these things. Yes, she said, nodding meaningfully. Every person experiences tension differently. The doctor asked me what medication I'd been using to manage the pain. I was thrown by this question; the thought had not occurred to me. This was, in many ways, quite surprising, since I consider my tolerance of pain to be less developed than the average. In the case of this headache, however, my attitude was edging closer to that of Franz Kafka. A century earlier, the writer told his fiancee, Felice Bauer, that he never took aspirin because doing so, he said, created 'a sense of artificiality' far worse than any 'natural affliction'. As Kafka explained to Bauer, if you had a headache, you had to undergo the experience of pain and treat it as a sign, before examining your entire life, right down to its most minute detail, 'so as to understand where the origins of your headaches are hidden'. The idea of taking painkillers struck me as irresponsible, even reckless, like disconnecting the fire alarm because it has interrupted your sleep. Like Kafka, I wanted to understand the headache. I wanted to know what it meant. The doctor told me to come back in a few weeks if things hadn't got better, sooner if they got worse. I left the practice holding a bottle of aspirin, which I promptly deposited in the bin. In the months that followed, I began using Google to research what was wrong with me. The thinking here was not unreasonable: I wanted to know what was causing the headache, so it made sense to go searching for information. The problem was that these online searches often produce a sense of disproportion: the list of 10 things that cause headaches might fail to mention that certain items account for the vast majority of cases, while others vanishingly few. And for those of us looking for trouble, our eyes tend to pass over the more prosaic – and plausible – explanations (eyestrain, dehydration or indeed tension). Only the worst will satisfy us. As the critic and Nobel laureate Elias Canetti once wrote, hypochondria is a form of angst that 'seeks names and finds them'. Predictably, I arrived at the conclusion that I had a brain tumour – an interpretation for which my Googling provided abundant evidence. As I trawled through lists of symptoms, more and more aspects of experience came to fall under my conscious scrutiny. Soon I was noticing lots of other little anomalies. I became forgetful; words kept escaping me. At the same time, I seemed to be walking around in a continual state of deja vu. I developed a twitch in my left eye. One pupil became slightly larger than the other, and coffee started tasting weird and metallic. I developed a mild but persistent case of the hiccups; just one, two, maybe three solitary little hiccups each day. 'Can hiccups be caused by brain cancer?' I asked Google. Yes, it answered – if it is advanced. Sometime later I started to smell things that didn't seem to have any external source. Burning, usually. Other times an astringent, chemical smell. One morning I woke up and my nostrils were filled with the indescribable scent of the villa in Spain where as a child I spent my long, dull, lovely summers. My eyesight, which had always been perfect, began to flare at the edges, as though there were always something flickering just outside my field of vision. I would turn suddenly, trying to catch it, at which point it would cease, recommencing as soon as I turned back around. I started keeping a list of all these things as they arose, on a loose sheet of paper headed 'symptoms'. Reading back over that list, it seemed to resemble the descriptions of illnesses that I browsed online. The doctor, however, took a different view – and the greater my fear that I was seriously unwell, the more she became convinced that my headache was being caused by 'tension'. In her recent book The Invisible Kingdom, Meghan O'Rourke writes about suffering from an undiagnosed autoimmune illness, an experience she describes as 'living at the edge of medical knowledge'. She writes: 'What really terrified me was the conviction that … I would never have partners in my search for answers – and treatments. How could I get better if no one thought I was sick?' O'Rourke is pointing out that diagnosis starts with a conversation between a patient and their doctor. There are important questions here about privilege: about who is and isn't deemed to be a reliable narrator of their own experience. Studies have shown that women are less likely to be believed by their doctors than men, and black women are less likely to be believed than white women. But, for everyone, conversations with the doctor are constrained by the need to appear credible – and if you are hoping to get a referral for medical testing, this might mean being careful to avoid seeming too anxious. In a desire to economise on my trips to the doctor, I would sometimes seek alternative paths to diagnosis. On several occasions, I visited the optician, because I knew they would use an ophthalmoscope to examine my optic nerve, which, I had learned online, might be inflamed due to the increased pressure inside my skull if I did have a tumour. (In the end, this did result in a diagnosis – one that, come to think of it, was rather apt: myopia.) On the occasions when I did visit the doctor, I was always very careful to limit what I said, not wishing to appear like one of those 'knowledgable' patients, a hypochondriac, who turns up requesting a second opinion on a diagnosis that they themselves have made. 'The position of hypochondria is still suspended in darkness,' declared Sigmund Freud in 1909. His colleagues wanted to make a publication celebrating the achievements of their new science, but Freud was cool, arguing they would have to be honest about what he called 'the limits of our knowledge'. For millennia, hypochondria has confounded patients and doctors alike. It first appears in the writings of the ancient Greek physician Hippocrates, and then in those of the Roman physician Galen. According to these accounts, hypochondria was a subspecies of melancholy, which was caused by an excess of one of the four humours, black bile. This meant it was a physical disease, seated in the abdomen, though it could cause an array of mental symptoms such as fear and sorrow. This view remained more or less unchallenged for many centuries. Then, in the 18th century – with the waning authority of humoral medicine – hypochondria was redescribed as a nervous illness with a set of symptoms that spanned mind and body. It was often considered to be a peculiarly male disease: a counterpart to the hysteria that was said to affect women. Having long been considered a 'scholar's disease', it became a fashionable ailment among an urban literati, with eminent sufferers including Samuel Johnson and James Boswell. During this period, several books such as Samuel-Auguste Tissot's An Essay on Diseases Incidental to Literary and Sedentary Persons (1768) warned of the consequences of reckless and excessive reading. This trend accelerated in the 19th century with the emergence of a genre of popular medical manuals. A Victorian physician was expressing the view of his profession when he decried the spread of 'pernicious books of 'popular medicine'', adding that there is 'no doubt that the reading of this kind of literature has often resulted in an attack of hypochondriasis'. As more and more people were reading about health and sickness, hypochondria settled into its current meaning: a fear of illness that is also a form of illness. Sign up to Inside Saturday The only way to get a look behind the scenes of the Saturday magazine. Sign up to get the inside story from our top writers as well as all the must-read articles and columns, delivered to your inbox every weekend. after newsletter promotion By the time I came to worry about my health, attention had been turned towards the internet, with some doctors speaking about the rise of a worrying new scourge: 'cyberchondria'. And for anyone who fears they may be suffering from this disorder, Dr Google promises to step in to help: '5 Ways to Tell If You Have Cyberchondria' (Psychology Today); '15 Signs You're a Cyberchondriac' (Yahoo). (One sign is 'you assume that the first result is the most plausible explanation'; another is 'you trust the internet more than your doctor'.) At the heart of hypochondria is the fact that it's impossible to really know what's going on inside your body. A person can 'feel well … but he can never know that he is healthy', Immanuel Kant wrote in 1798. Today, medical websites, with their lists of the seemingly innocuous 'warning signs' of serious illness, have grown into multimillion-dollar businesses by publicising this potential gap between reality and perception – between how well you might feel, and how sick you might be. More than a year after the headache started, I was referred to a neurologist. The referral was made reluctantly, with a mixture of sympathy and contempt. The neurologist sent me for an MRI. A few weeks later a letter arrived. In its entirety, it read: 'Dear Mr Rees, your brain is reported as normal.' Over time the other symptoms started to disappear. But that was not the end of things. Up late one night, I found myself looking into error rates within radiology. Across all areas, it's about 3-5%. This was not that bad, I thought. Then I Googled the number of annual radiology scans in the UK; that year it was about 40m. If 4% of those were wrong, this amounted to 1.6m incorrect scans – a number, I reasoned, that was certainly large enough to include me. In a study of those diagnosed with a lung carcinoma, the lesion could retrospectively be found in 90% of 'negative' scans. After a brief, ecstatic period of reprieve, my fears came back. At some point I forgot my headaches and directed my attention towards the lymph nodes in my neck, which I nervously fingered as though they were rosary beads. Once again, I was sure there was something seriously wrong with me – and, as I sought to get to the bottom of things, I found myself trapped in the same cycle of recovery and relapse. If hypochondria is a need to know, then no test is likely to offer a definitive cure. Ultimately, one has to learn to make peace with uncertainty. Perhaps this is what Freud meant when he said that hypochondria exposes the limits of our knowledge. Not simply a gap that could be filled with new information, but a more categorical deficiency: the failure of knowledge to ever bring about the states of health and happiness or even certainty we desire. I'm not really sure how I came to stop worrying so much about my health. After nearly a decade of anxiety, in my mid-20s I simply ceased to give it much thought. It is probably fair to say I've overcorrected. A couple of years ago, when I woke up in a state of extreme allergic response (shortness of breath, dizziness, eyes swollen shut), I took a hay fever tablet and tried go to work. Luckily, my partner convinced me to go to A&E, where I was immediately given a shot of steroids. The poet Anne Boyer has written about what she calls 'reverse hypochondria', and I suppose I have joined these ranks. I think writing about hypochondria helped. Reading about the fears of others – writers such as Kafka, Marcel Proust with his extreme sensitivity, and Alice James with her wavering and debilitating symptoms – was strangely comforting and helped to keep my own fears under control. Besides, researching and writing a book is a sort of apprenticeship in uncertainty: finishing it required me to give up my fantasies of fully understanding the topic. The NHS's standard treatment for health anxiety consists of cognitive behavioural therapy. Some people report being helped by CBT, but it's never really interested me. By the time I started psychoanalysis at the age of 30, my fears had been more or less put to rest. But I think it would have been helpful back at the height of my hypochondria. One thing I enjoy about conversations with my analyst is how they generally make me less certain about my version of events – the way they loosen me, in an undramatic and indefinitive way, from my attachment to my own narratives. And so I can't help but feel this would have been good then, back when I only had one story to tell: the story of my illness. Hypochondria by Will Rees is out now, published by Coach House Books at £12.99. To order a copy, go to Delivery charges may apply.
Yahoo
25-05-2025
- Yahoo
American travel to Canada remains limited as U.S. marks Memorial Day weekend
It's the Memorial Day long weekend in the U.S., which traditionally marks the start of the summer travel rush. But as Julia Foy reports, the past few months have seen fewer U.S. visitors heading north, due largely to the increased tension between our two countries and despite the "good value" of the low Canadian dollar.
Times
18-05-2025
- Entertainment
- Times
The glorious tension of Sarah Moss's novels
Sarah Moss is a master of the ticking clock. Her novels thrum with tension, building towards a dramatic climax. In Ghost Wall (2018) a teenage girl is dragged along by her father to a historical re-enactment camp to live like Iron Age Britons. But that doesn't include the sacrificial rituals, right? Then came Summerwater in 2020, set in a perpetually rainy Scottish cabin park where families and lovers attempt to make it through their respective holidays. The ending, when it comes, is explosive. The Fell (2021) had a woman escape the Covid lockdown for a hike gone terribly wrong. The premise of Moss's latest novel, Ripeness, is equally promising. In the 1960s 18-year-old Edith is sent away from the family home in England to
Al Jazeera
13-05-2025
- Politics
- Al Jazeera
‘No guardrails': How India-Pakistan combat obliterated old red lines
New Delhi, India – Guns have fallen silent for now along the tense India-Pakistan frontier, after a ceasefire that appears to have held for three nights. On May 7, India launched predawn attacks on what it called multiple 'terror sites' across Pakistan to avenge the April 22 killing of 26 men, almost all of them tourists, in Indian-administered Kashmir's resort town of Pahalgam. New Delhi accused Islamabad of backing the gunmen. Pakistan denied its involvement. India's aerial assault kick-started four days of heightened tension, as both neighbours fired missiles and drones at each other's military installations in a rapidly escalating cycle that brought them to the brink of full-scale war. Both sides have claimed to have decisively damaged, even destroyed, the other's key strategic facilities, even though early evidence suggests more limited damage to military bases in both India and Pakistan. Yet even as India and Pakistan arrived at a ceasefire that United States President Donald Trump insists his administration brokered, experts say something has indeed been decimated, potentially beyond repair: Old red lines that had defined the tense relationship between the South Asian neighbours. 'India and Pakistan have entered a phase of 'armed coexistence' with little room for diplomacy and a narrow margin for error, despite having a live and sensitive border,' Praveen Donthi, senior analyst at the International Crisis Group in New Delhi, told Al Jazeera. 'This situation does not bode well for either country or the region, because even accidental triggers could escalate into a war-like situation with no guardrails in place.' The seeds of the India-Pakistan conflict were sown when their independence from British rule in 1947 was accompanied by a partition of the Indian subcontinent to create Pakistan. Since then, the two neighbours have fought four wars, three of them over Kashmir, a region they both control partially along with China, which governs two thin slices in the north. India claims all of Kashmir, while Pakistan claims all parts other than the ones governed by China, its ally. After their 1971 war that led to the creation of Bangladesh, India and Pakistan signed what is known as the Simla Agreement, which said 'the two countries are resolved to settle their differences by peaceful means through bilateral negotiations.' While Pakistan has often cited United Nations resolutions to argue for international involvement in the resolution of the Kashmir dispute, India has cited the Simla Agreement for more than half a century to insist that any negotiations between the countries be strictly bilateral. To be sure, the US has since intervened to calm tensions between India and Pakistan: In 1999, for instance, President Bill Clinton pressured Pakistani Prime Minister Nawaz Sharif to withdraw troops from the icy heights of Indian-controlled Kargil, where they had entered. However, Washington publicly played coy about its role, allowing India to insist that the US had only helped with crisis management, not any dispute resolution mediation. That changed on Saturday, when US President Donald Trump upstaged New Delhi and Islamabad to announce a 'full and immediate' India-Pakistan ceasefire hours before the governments of Indian Prime Minister Narendra Modi or his Pakistani counterpart Shehbaz Sharif confirmed the development. The next day, Trump went further. 'I will work with you, both to see if, after a 'thousand years,' a solution can be arrived at concerning Kashmir,' he posted on his Truth Social platform. And on Monday, merely 30 minutes before Modi was scheduled for his first address since India launched attacks in Pakistan, Trump told reporters at the White House that his administration had leveraged trade to reach a ceasefire. 'Let's stop [the fighting]. If you stop it, we'll do a trade. If you don't stop it, we're not going to do any trade,' Trump said. 'And all of a sudden they said, 'I think we're going to stop.' For a lot of reasons, but trade is a big one.' Such US mediation, were it to happen, would shatter India's longstanding red line against mediation by other countries, say experts. 'India has consistently sought to avoid third-party involvement in the Kashmir dispute even as it has occasionally welcomed third-party help in crisis management,' Christopher Clary, a former Pentagon official and a non-resident fellow at the Washington, DC-based Stimson Center, told Al Jazeera. When he spoke, Modi largely stuck to traditional positions he has taken after previous bouts of tension with Pakistan. He said 'terror and talks cannot happen together,' and 'water and blood cannot flow together,' a reference to the Indus Waters Treaty for sharing water between India and Pakistan, which New Delhi walked out of after the Pahalgam attack. Unlike Pakistan PM Sharif, who expressed gratitude to Trump for brokering a ceasefire, Modi claimed that India had 'only paused' its military action – noting the decision was taken bilaterally. He did not mention Trump or his administration. Regardless, 'the spectre of international intervention' in Kashmir has been resurrected, said Sumantra Bose, political scientist and the author of the 2021 book Kashmir at the Crossroads. He said India's furious barrage of missiles and drones at Pakistan in response to the Pahalgam killings 'catered to domestic jingoism but naturally roused global alarm'. India might, however, be helped in avoiding actual US intervention in Kashmir by the immediacy of the Trump administration's other foreign policy goals, like the conflicts in the Middle East and Ukraine, 'that will divert already overburdened [American] policymakers to other tasks', said Clary. According to Bose, India and Pakistan crossed not just red lines, 'but a Rubicon by attacking numerous high-population targets in cities and towns' last week. India, in its most expansive offensive against Pakistan outside full-blown wars, said it hit 'terrorist infrastructure' on May 7 as part of what it called Operation Sindoor. That was a reference to the vermillion that married Hindu women apply to their forehead, and an allusion to the manner in which the Pahalgam attack appears to have unfolded: Multiple witness accounts suggest the attackers segregated the men, then picked and hit non-Muslims. Modi claimed, in his Monday statement, that the Indian attacks had killed more than 100 'terrorists'. Pakistan has insisted that only 31 civilians – including two children – were killed in the May attacks. Yet both sides agree that the Indian missiles struck not just two cities – Muzaffarrabad and Kotli – in Pakistan-administered Kashmir, but also four cities in Pakistan's Punjab province, the county's economic heart and home to 60 percent of its population. The targets were Bahawalpur, Muridke, Shakar Garh and a village near Sialkot. This was the first time that India had struck Punjab since the 1971 war. As tensions spiked, India accused Pakistan of unleashing a swarm of drones towards it – a charge Islamabad denied. Then India launched a wave of drones that reached Pakistan's biggest population centres, including its two biggest cities, Karachi and Lahore. In the early hours of May 10, India and Pakistan fired missiles at each other's military bases across multiple provinces – far beyond disputed Kashmir – even hitting a few. Pakistan, which called its campaign Operation Bunyan Marsoos (a structure made of lead, in Arabic), targeted Indian air force bases and missile storage facilities in Drangyari, Udhampur, Uri and Nagrota (all in Indian-administered Kashmir), as well as in Pathankot, Beas and Adampur in Indian Punjab and Bhuj in Gujarat, Modi's home state. Indian armed forces said that while they shot down most incoming missiles and drones, four air force bases suffered 'limited damage'. 'We don't know what the quantum [of Indian losses] are, but clearly Pakistan has demonstrated capability to impose costs on India even as we try to impose costs on them,' Indian military historian and strategic analyst Srinath Raghavan told Al Jazeera. 'Regarding red lines, another thing Pakistan sought to demonstrate was that they could keep this [the fighting] going till they had hit Indian military installations in retaliation.' Meanwhile, India too targeted the Nur Khan airbase near Rawalpindi, Murid airbase in Chakwal and the Rafiqui airbase in Shorkot. 'India has shown that it is willing and capable of carrying out more strikes across the border, whether it's a terrorist or even military infrastructure in Pakistan,' Raghavan said. India's response went far beyond what happened in 2019, when Indian jets bombed what they described as a 'terrorist camp' in Balakot, in Pakistan's Khyber Pakhtunkhwa province, after a suicide bomber killed more than 40 Indian paramilitary soldiers. Now, the 2025 attacks will serve as the new baseline for India, experts said. 'India would respond [in the future] on a similar scale, perhaps even a little bit more. Given the way both Balakot and the current crisis have played out, that should be the expectation,' said Raghavan. It isn't just missiles and drones that the two sides fired at each other, though. Right after the Pahalgam attack, India suspended its participation in the Indus Waters Treaty, a 1960 agreement that had previously survived three wars – in 1965, 1971 and 1999 – unscathed. The treaty gives India access to the waters of the three eastern rivers of the Indus basin: The Ravi, Beas and Sutlej. Pakistan, in turn, gets the waters of the three western rivers: The Indus, Jhelum and Chenab. The river system is a vital lifeline for Pakistan, which relies on its waters. India, as the upper riparian state, has the ability – in theory at least – to restrict or stop the flow of the water into Pakistan. Islamabad described New Delhi's decision to walk away from its obligations under the Indus Waters Treaty as an 'act of war'. In an incendiary remark at the peak of the tensions, Pakistani former Foreign Minister Bilawal Bhutto said 'either the water will flow, or their blood will,' seemingly referring to Indians. Three days after the ceasefire was announced, India has still not recommitted itself to the pact. In his speech on Monday evening, Modi's statement that 'blood and water cannot flow together' signalled that New Delhi had not yet decided to return to the treaty. Even as India and Pakistan ratcheted up their measures – first diplomatically, then militarily – against each other, the rest of the world was spooked by the prospect of what could have turned into a full-blown war between nuclear-armed neighbours. Up until now, that reality of nuclear weapons has affected India's decisions in terms of how it treats its tensions with Pakistan, said Clary, the former Pentagon official. 'India's goal is to punish Pakistan without risking nuclear danger,' he said. But on Monday, Modi appeared to suggest that New Delhi was reassessing that approach. 'India will not tolerate any nuclear blackmail. India will strike precisely and decisively at the terrorist hideouts developing under the cover of nuclear blackmail,' he said. Modi's comments pointed to a 'fundamental shift that has occurred in relations between India and Pakistan', Donthi, the International Crisis Group analyst, said. 'Both sides are willing to take greater risks and explore the potential for escalation below the nuclear threshold. However, there is very little space there, effectively making the euphemism of the region being a nuclear flashpoint truer than ever.' Modi's comments on 'nuclear blackmail' weren't the only ones that marked a break from the past. When India launched attacks against Pakistan on May 7, it emphasised that it was only targeting 'terrorist' bases and not attacking Pakistani military installations. However, on Monday, Modi said that in future, 'India will not differentiate between the government sponsoring terrorism and the masterminds of terrorism.' That position raises the danger of war, said experts. 'The conflation of terrorists and their (alleged) backers – namely, the military and the government – portends serious risks,' Donthi said. 'It assumes that they are in lockstep. Such an assumption doesn't take into account facts such as the seemingly successful ceasefire.' India and Pakistan had signed a ceasefire along the Line of Control (LoC) in 2003 and had renewed it in 2021. Despite cross-border firing along the LoC, the ceasefire had largely held until last week. With the threshold for a military conflict lowered, 'the situation has become precarious,' Donthi said. 'A single militant attack is all it takes to plunge into war, leaving no room for diplomacy and raising no questions. Any power hostile to either or both sides can exploit this.'
The Sun
10-05-2025
- Entertainment
- The Sun
Win a copy of Cat Fight by Kit Conway in this week's Fabulous book competition
CORALIE, Emma and Twig are friends and neighbours, but tensions are never far from the surface. Then a panther is spotted on the road and cracks appear in their close community. 1 As the summer heats up and more big-cat sightings are reported, their friendships are pushed to breaking point. A wry and witty domestic thriller. 10 lucky Fabulous readers will win a copy of this new novel in this week's book competition. To win a copy, enter using the form below by 11:59pm on May 24, 2025. For full terms and conditions, click here.
