Nobody warns you about the small things. What little there is to read prepares you for the big moments — the discovery, the first time you say the word out loud, the forms and the clinics and the conversations that change everything. Nobody mentions the hair bow.
It was a Tuesday evening in April. We were watching an old soap opera I used to love, the kind of thing that now felt like a documentary about a world I no longer wanted to belong to. And then a woman came on screen wearing a hair bow. Perfectly ordinary. The kind of thing that sits on a million heads on a million mornings and means nothing to anyone.
It hit me like a physical blow.
I’m going to name it plainly, because it took me too long to: that was dysphoria. Not grief, not sadness with a cause I could reason with — dysphoria, the exact thing the word actually means, arriving full force over something as small and ordinary as a hair bow. A searing awareness of something I had never had, couldn’t have, and wanted with a specificity that made no logical sense at all. On a television screen. From decades ago.
I excused myself. Bathroom. Cold water. The routine that was already becoming familiar.
Here is the thing nobody tells you about it: it doesn’t arrive when you’re ready. It has no respect for timing, or context, or the fact that you were completely fine five minutes ago, sitting on a bed watching old television with someone you love. It arrives in the gap between one frame and the next. A hair bow. A stranger on a screen. A single word in a clinical table on a Saturday evening.
You cannot reason it away. I tried, with the clinical precision I bring to everything. I understood the mechanism exactly — the gap between identity and presentation generating the signal. I’m a dermatologist. I know how it works. It made no difference whatsoever. Knowing why a fire burns doesn’t stop it burning.
I wrote in my diary that week: whose idea was it to put this in human consciousness? It’s awful, and you can’t reason it away.
Thirty-eight days in. Every one of them a yes. And every one of them, also, containing this. Because here is the part I most needed someone to tell me and nobody did: the joy and the dysphoria don’t take turns. They don’t arrive in sequence. They live in the same room, on the same day, sometimes in the same hour.
That’s what nobody tells you. So I’m telling you.
