valerie braylovskiy / essay

Social Determinants of Health

I. Food Insecurity

The summer my body unravels, my dreams tell me to never waste food. When I eat, my insides revolt. The internet calls it endo belly. I want to document it, the way pregnant women take weekly pictures of their wombs expanding to accommodate a fetus. At dinner with a friend, I wear high-waisted jeans, unzipping them under the table. I order noodles, douse them in peanut sauce. She asks why I am wearing pants in July. Our food comes before I can conjure a response, something other than wanting to hide my body. I pick apart the flora and fauna of the plate—curly white bean sprouts, carrot discs, fuzzy broccoli. I try to save them before my belly notices.

II. Financial Resource Strain

I come from scavengers, stone fruit lovers who peel apricots with closed eyes. When my mother was young, any fruit costing three rubles per kilogram was considered exotic. She used to eat bananas just once a year. She would line up in the woods with the other children, waiting her turn and hiding extra fruit in her trousers. Later she meets my father, his feet adorned with fur loafers stolen from the factory where his mother sewed. They immigrate, find jobs, create a sick daughter and a healthy daughter. The sick one is taught to be grateful: for America, copays, superbills, a company producing an uninsured series of black and white models of her skeleton.

III. Housing Stability

At the peak of my illness, an alternative doctor from the Midwest tells me I need to move. He calls me a victim of invisible mold contamination, claims the spores are hurting my belly. He looks for easter eggs in my blood work that regular doctors are too busy to notice, says my cells are self-destructing. I scoff while sifting through a thrift store’s sale rack. There is nowhere else to go. My family home has been the container for my illness. My bed carries me from yesterday to today to tomorrow. When the walls are finally tested, they are diagnosed with Stachybotrys chartarum. I notice the black fuzz, the tricks it played. It’s been hiding, in my sheets, behind the shower curtain, deep inside my pelvis. 

IV. Stress

I leave my psychiatrist on read. It will cost money to answer my questions about side effects— cotton dry mouth, brittle nails, forgetting mundane things like trash day and how long daffodils can survive. I find her online bio and cannot locate the one sentence where doctors promise they aren’t robots because they enjoy hiking, traveling, and gardening. When I sleep fourteen hours on a higher dose, I text her, disclosing that I am unable to participate in living. She tells me to not worry, asks if I have ever considered my illness to be psychosomatic. In Greek, psyche is the mind. Somato is the body of the organism, me.

V. Transportation Needs

I don’t know what to do if you love-tap a car and can’t remember where you came from. My mother tells me to drive home because cyber trucks are impenetrable. I can’t remember why I came to this coffee shop. You aren’t supposed to drink anything stimulating on your first week of antipsychotics. My car starts to resent me, envying my father’s electric one that drives me to appointments and follow-ups. He accelerates on the way back from an inconclusive ultrasound, passing a car with two faces—father and daughter. The girl wears my face and a knit cap.  

VI. Intimate Partner Violence

My boy drives six hours to fix my old bike. I ride it once that winter, before falling off and suffering a bloody knee. I let him dip my skin into rubbing alcohol and adhesive Neosporin. I have never been at once cared for and wanted. Last summer, when taunted by death, I did too much wanting. A male stranger joked that I could start smoking cigarettes, since I was going to die soon. In his living room, the boy tries to assert himself over me. I suddenly wish we were children living with his mother and father and rescue collie. They would stop him, tell him this girl cannot be touched.

VII. Physical Activity

I deem myself treatable, take a yoga class. On inhale, my pelvis grows tall. I am a mountain on fire, 2% contained. The teacher instructs us to reach toward our toes. No one ever stays in one place for too long, so I find myself abandoning cat and cow for a fetal enclosure, rocking myself like a fussy baby. When she says to exhale, find our bodies and love them, I hold mine tight.

VIII. Social Connections

Eventually, I visit the bookstore, apologizing to my coworkers and the neighborhood dogs for abandoning them without notice. There’s a new tea shop down the block. I order oolong and encounter a stranger who asks if she can sketch my portrait. She tends to draw lonely people in public spaces. I oblige, happy to be noticed, and continue reading. She paints me in soft shades of black and white, my back curved and adorned in an ivory cardigan, my hands cradling a book’s spine.

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Valerie Braylovskiy is a poet and writer from the Bay Area, now based in Salt Lake City, where she works as a magazine journalist. Her work has appeared in Santa Clara Review, Sky Island Journal, the Academy of American Poets, and ONE ART. Her second chapbook, Bellyache, is forthcoming next year from Lit Fox Books.