I felt it crawling around for months. It was a prickling tickle coupled with the sound of scraping-a maddening ringing and itching, mostly in my right ear.
One night I was startled awake at 3 a.m. by a high-pitched piercing tone. I shot up and threw off the covers, thinking it was the fire alarm. As the sound faded, I realized the shrill ring was coming from my own head.
Throughout the day, there was a quieter tinnitus that came and went. Sometimes it faded into an oceanic rush that, at first, sounded like it was coming from far off before it grew deafeningly loud, all in under a minute.
After a couple of weeks, I realized that it felt as though there was a bug in my ear; something writhing around, scratching to get out. I tried Q-tips, flushing with water, and simply shoved my pinky in as far as it would go, but nothing helped.
At first, I didn’t tell my doctor or my fiancé, Joel. I feel weird things in my body almost constantly-my heart races out of nowhere, I sometimes wake drenched in sweat in the middle of the night, I get randomly dizzy. But I typically ignore them all. I’ve had an anxiety disorder since childhood, which throws my body into fight or flight too often for too long. So, although the ringing in my ears was nonstop, at first, I tried to ignore it, saving any need for reassurances from those close to me for more serious problems.
But then, weeks passed, and the ringing and tickling in my ear only intensified.
During that time, I saw my doctor for an unrelated reason: heavy bleeding and terrible cramps during my period. My doctor simply shrugged with a: “Sounds like being a woman,” before offering me a prescription for birth control-which is known to make anxiety disorders worse.
She stood to leave. We’d been through this before. Usually, when I demand blood tests for my discomforts, thinking they could be due to Lyme disease, tumors, or heart disease, I always receive back a clean bill of health. I slump in my paper gown.
“Then what’s wrong with me?” I’ll ask. “We know what’s wrong with you,” my doctor will answer. “You have an anxiety disorder.”
But this time, as my doctor was about to leave, I asked: “Would you mind? I feel like there’s something in my ear. Can you take a look?” I knew how I sounded. The highly anxious patient with anxiety disorder basically written in bright red letters all over her chart. The existence of a bug in the ear was a new low, even for me. Still, I wanted her to look-just in case.
My doctor looked in my ear with an otoscope. I could tell that before she even looked, she was expecting to find nothing. So she looked, and found nothing. She said, “Some dry ear wax, but nothing else.”
More often than not, my doctor is right. I am lucky to be very clinically healthy. And I know you’re thinking: Why shouldn’t a doctor assume someone with an anxiety disorder is experiencing just that: Anxiety?
But it’s complicated. Women, disorder or no disorder, are routinely told their symptoms are due to anxiety when they’re not. Although heart disease is the number one killer of U.S. women, according to the World Heart Federation, doctors often fail to recognize and treat it in women, and women are also more likely than men to die of a heart attack. According to one study, instead of painkillers post-surgery, women are prescribed valium. And a 2009 report found that women are often told we are suffering from depression, anxiety, or hormones when, in fact, the diagnosis should actually be autoimmune diseases.
This dynamic is like a modern incarnation of the hysteria diagnosis. Study after study shows that men reporting their symptoms are taken at face value, while female patients are perceived as overly emotional, prone to exaggeration, and therefore untrustworthy reporters of their own experience.
So, as a woman who also happens to have an anxiety disorder, it can be difficult to navigate a healthcare system that already routinely dismisses sick women as anxious. I’m constantly battling with the question: When do I sigh with relief that the doctor has found nothing, and when do I demand fourth and fifth opinions?
A few days after my doctor’s appointment, I was lying in bed with the left side of my head on Joel’s chest. As he stroked my hair, I felt blessedly, wonderfully relaxed. But I was also aware of the now-familiar prickling in my right ear, which was facing up to the ceiling. I resisted the urge to scratch, wondering, Am I imagining this? Is this just anxiety?
I felt a light tickling closer to my outer ear that caused me to sit up. Finally, I couldn’t help it. I jammed my pinky in my ear and my finger came out wet. I felt kind of euphoric relief that happens when water comes out of a stopped up swimmer’s ear after hours or even days.
Except now, there was something more dripping from my ear. I turned my head so that my right ear faced down. Warm liquid gushed out, and then something else. I gasped.
At first I thought it was blood-a dark shape falling from my head. From Joel’s shocked face, I could tell he did, too. He stared at me incredulously, silent, as we both looked down at the comforter. There, meandering calmly on my bedspread was an inch-long, brownish-grey silverfish with two roving antennae.
My reverie broke. “Get a jar!” I screamed at Joel, who sat there, stunned. “Go!” Still shocked silent with a gaping mouth, he finally flew up and ran to the kitchen. “Oh my god!” I couldn’t stop yelling. “I knew it! I knew it!”
Joel returned with the jar, and we captured the silverfish easily. It was active but not too fast, perhaps in shock at being in the bright, cold world after however many weeks it had spent inside my ear canal. I was panting and nauseated-disgusted, horrified, and infuriated. “I knew it! I f*cking knew it!” I kept saying.
The months of scratching, high pitches, and prickling inside my ear hadn’t been anxiety. It wasn’t my “active” imagination. It wasn’t somatization of nerves. All along, there had been a bug living in my head, tickling me from the inside. I’d known it, yet no one believed me. So after a while, I hadn’t even believed myself.
At 2 AM that night, I posted a picture of the silverfish in its jar on Facebook. I wanted to share my horror, maybe get a few thumbs up of support from friends. I woke up the next morning to hundreds of comments and reactions; people expressed outrage that a doctor could have missed a bug in my ear.
That got more responses than anything else I've posted. Apparently, having a bug trapped in your ear is many people’s worst fear, though it had somehow been one of the few things I’d never even thought to be anxious about.
I think it struck a chord on a deeper level-the universal fear we’ve all experienced when something is wrong, but no one else can find it. And amongst the female commenters, I noticed, there was a common fury we could all relate to as women who have been told It’s all in your head.
The insect crawled out of my ear on a Friday night. I called the triage line at my doctor’s office and was told it was unnecessary to go to the emergency room or Urgent Care, that I could wait until Monday for an appointment.
On Monday morning, I walked into the office of the doctor who’d deemed my ear empty with my jar in hand, bug inside. She did not apologize for missing it. She did not admit to dismissing me. On my chart, in fact, there was no mention that she’d ever looked in my ear or any note of the ear ringing I had complained about.
My doctor looked inside my ear with a light and said, “Yep, your ear is infected. There are scratches deep in the canal, as if something was trying to get out.” I didn’t have the energy to point out that I’d been right. I just wanted to see an expert, to ensure my hearing wouldn’t be damaged, and that the infection could be cured.
She prescribed me antibiotic ear-drops. I asked for an ENT referral, as I still felt an itchy, crawling sensation accompanying some residual ringing and buzzing. She said that wasn’t necessary and left the room-as usual-without saying goodbye.
I felt powerless. Throughout this process, so many people had told me: “Just get a new doctor!” But after trying eight doctors in the two years since moving to California from Boston, I felt I was choosing the best of the bad. With the state-issued health insurance I received from teaching at a state university, my choices were limited.
I filled the antibiotic prescription and dropped a cold liquid into my right ear for a week. It was soothing, but my ear was still ringing, and I felt the same inner tickling and itching from before.
The questions quickly began swarming: Was another bug in there? A deeper infection? Eggs? (Mercifully, I learned that bugs do not lay eggs in people’s ears.) After a week of continued symptoms, I returned to the doctor requesting to see an ENT. She looked in my ear again, said that it looked fine, and told me I didn’t need a specialist.
A few days later-my ear still ringing, itching, and now spasming in the ear canal-I called the office for a referral.
“You need to see your doctor to get a referral,” the receptionist told me.
“I’ve already seen her three times,” I said. “She won’t give me one. Can someone else in the practice please refer me?”
“Insurance won’t cover it without an appointment from your primary, hon.”
So I went in again, and again she said I didn’t need an ENT.
I looked her straight in the eye, and this time, I didn’t hide my fury or mistrust. “You missed a bug in my ear. I don’t want to be treated by you. I’m not leaving this office without a referral.” She left, and a nurse came to escort me out. I told her I wouldn’t leave without a referral. Fifteen minutes later, another nurse came in to tell me my doctor said she wouldn’t do it.
Finally, I demanded to see the practice manager. She made some calls, recorded my formal complaint against my doctor, and handed me what I'd been begging for.
A week later, I met with an ENT. He didn't see an infection-there was nothing in there, not even much wax. “Ears have tiny parts that take a long time to heal,” he said. “It could be many months before it feels normal again.” My friend who’d come with me was relieved. I wanted to be comforted by the good news. But I had already been told there was nothing wrong with my ear-and then, a bug fell out of it. I have it in a jar on my desk.
It’s been six months and I still experience periodic buzzing, ringing, and tickling. Thanks to many late night Google searches, I now know that silverfish and roaches can find their way into people's ears when they're sleeping at home or lying down outside. After my incident, Joel and I noticed several silverfish in our home-which means the insect likely crawled into my ear one night while I was sleeping.
We’ve since moved from California to Massachusetts, where I have a much better doctor now.
I’ve had half a year to reflect on the lessons I learned from this ordeal that I hope others might take note of.
Women (especially women who are of color, obese, or gender non-conforming) need to be ceaseless advocates for themselves. If doctors refuse to adequately examine something or refer them to a specialist, it’s time to request that they document that refusal in your chart-something I wish I’d done. Then, we are entitled to seek out second opinions and demand referrals, even if it makes you an unlikeable patient-or an unlikable woman, which many of us have been warned not to be. And any additional refusal gives you the right to file a complaint with a practice manager.
Having a bug that lived in the ear was a lot like my anxiety: An invader that came into my body without permission, causing vague symptoms that no one believed could have a physical cause.
But just because a doctor wasn’t able to find it, doesn’t mean it wasn’t there.
For those of us who are both women and patients with anxiety, going to the doctor is an even more difficult task. My disorder has caused me to grapple with the conundrum of how to differentiate between physical ailments and anxiety symptoms. I now constantly consider the question: When do we trust doctors when they say that our symptoms are benign, and when do we demand more testing?
As horrifying as the bug ordeal was, it taught me one incredibly important lesson: The first person I should trust, above all, is myself.
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