Day 3 of period number 351.

Sitting on the toilet, an intense wave of pain rises through me. This will definitely kill me, I think. Is this what 10/10 pain feels like? I can’t imagine it isn’t. I try to remember that I have survived this at least 350 times before. I always do.

My vision begins to tunnel, blackness spreading inward until parts of the room disappear. Ringing in my ears. I know it is time to lie down on the bathroom floor, legs elevated, waiting for consciousness to return fully. I press my cheek against the cold tile and wonder how this could possibly be a normal part of being female.

The thought returned every month: this cannot be normal.

Whenever I listened to it, I went looking for answers. Information came in fragments then. I searched the symptoms one by one.

Painful periods. Common.
Heavy bleeding. Common
Take ibuprofen. Three tablets every eight hours. Move on.

I am a pulmonary, critical care, and sleep physician. I was often the doctor patients came to when they felt dismissed.

“Shortness of breath.”
“I just don’t feel the same.”
“This isn’t normal for me.”

I knew how to recognize these stories in others. I did not yet know how to recognize them in myself.

In my family, women’s pain traveled through stories across generations: an aunt who hit her head against the wall to distract herself from menstrual pain; a grandmother who bled through sari after sari; a daughter who finally became a physician and insisted on a hysterectomy for her mother. Endurance was the inheritance.

Visibility carried its own consequences.

In eighth grade, I came home from school with a red stain blooming across the back of my white skirt. “Why didn’t you change in time?” my mother asked, her voice sharp with panic and embarrassment. I remember her shame more clearly than any explanation about menstruation. I traced my steps for the day. Who already knew?

The lesson was never spoken: pain must be contained before it becomes visible.

Medicine gave that lesson a second language.

As an immigrant woman in medicine, competence meant endurance. I arrived early, stayed late, took extra admissions, and learned not to complain. Asking for help felt riskier than pushing through.

Residency refined the pattern. Hunger, fatigue, pain – variables to override in service of function. Service before self.

In my own yearly clinic visits, I learned to edit myself. Painful periods. Heavy bleeding. Symptoms manageable.

This was technically true. It was also incomplete in a way that made it easier to ignore: the bathroom floors, the tunnel vision, the calculations about how far I could walk before I might faint. No one asked about the bathroom floors or the near-fainting, and I had learned not to offer them.

I translated my body into data: hemoglobin trends, iron studies, ultrasound reports. I counted pads in private and measured clots without ever describing what they felt like. The numbers accumulated for years before the diagnosis.

The turning point came when the pain stopped following any pattern. It was no longer cyclical or confined to my pelvis. It interrupted conversations, workdays, and sleep. For the first time, I complained about it out loud.

An ultrasound revealed an ovarian cyst. When it failed to resolve, my gynecologist friend recommended surgery. I trusted her completely. No one suggested a second opinion or referral to a center that specialized in complex endometriosis. So what was meant to be a straightforward cyst removal became something else entirely: adhesions, fibrosis, organs tethered together. Deep infiltrating endometriosis. Extensive. Consuming.

In the PACU, I drifted in and out of consciousness under fluorescent light. My gynecologist friend’s voice entered in fragments: extensive disease, frozen pelvis.

“I don’t know how you weren’t in more pain,”

The truth was I had been, for years.

What I did not yet understand was that I had been living inside a slow normalization of it.

I remember the way her words “frozen pelvis” landed without immediately meaning anything, as if they belonged to another body entirely. I kept waiting for my mind to catch up, to translate them into something familiar, something I could manage. Instead there was only a strange blankness, a refusal of comprehension that felt almost protective.

I nodded as if I understood more than I did. I smiled sheepishly and asked her to tell me later, when I was more awake. Instead, I asked about her family, their recent COVID infection, whether everyone was recovering.

That later never really came. Not because she never explained it, but because I was not yet ready to understand how much had already scarred inside me.

Through tears and conversations that followed, I remembered the other consolations she offered: at least you have one child. At least menopause is only a few years away. As if suffering became more acceptable when placed beside something worse. And then there was the reassurance I clung to myself: at least it isn’t cancer.

I found myself replaying old memories through a different lens. The bathroom floor. The near-fainting. The appointments. The explanations I had accepted because they were easier than uncertainty. Nothing about the past had changed, yet everything felt altered by what I now knew.

I went back to work within days. The diagnosis came with no cure and no clear ending. Patients still needed to be seen, and life resumed its familiar pace. The grief arrived later.

Nothing outside me looked different. I returned to clinic, read sleep studies, answered messages, signed charts. But the diagnosis followed me into ordinary moments—into showers, grocery stores, red lights, the quiet before sleep. Eventually, I began therapy.

My therapist suggested patient forums. Build community, she said. Don’t feel so alone. It was the same advice I had once given my own patients when their illnesses offered more uncertainty than answers.

I joined reluctantly- almost resentfully.

In those forums, I found women who had already built language where medicine had not.

In the art they shared, endometriosis became thorns wrapped around a uterus, snakes coiled through the pelvis, barbed wire threaded through the abdomen. They called it DIE – deep infiltrating endometriosis – and also, half-jokingly, “end of me.”

What struck me was not the imagery, but the caution. Women prefaced pain carefully, as if preparing not to be believed. They defended their symptoms as they described them.

I recognized the pattern immediately.

They were building metaphors where medicine had failed.

For the first time, I saw my own story reflected back to me.

The diagnosis had answered a question I had been asking for years. It did not tell me what to do with the answer. So, as I had always done, I returned to work.

That is where I met a patient I almost did not sit back down for.

She had been referred for excessive daytime sleepiness. She described falling asleep during conversations, at work. Carefully. As if anticipating disbelief before it arrived.

Three patients were waiting. I was already behind. My hand moved toward the door.

“I’m trying,” she said quietly. “I just can’t stay awake. I don’t know what’s wrong with me.”

Something in the sentence interrupted the reflex to categorize. Not dramatically. Mechanically. I sat back down.

Her chart contained years of fragments: tired, low energy, disrupted sleep, daytime sleepiness. Each note small enough to remain unassembled.

I began to assemble them.

Her testing had been inconclusive not because nothing was there, but because nothing had yet been allowed to cohere. Over time, with repeat sleep studies, she was diagnosed with narcolepsy – a condition that finally gave structure to what had been previously dismissed as fatigue or inconsistency.

A name arrived where there had only been accumulation.

What stayed with me was how easily I had almost erased her.

The mechanism was familiar. I had lived inside it myself: symptoms present but not yet permitted to become disease. Pain without permission to be legible. In her case, I had nearly repeated what I had once experienced from the other side – waiting for certainty before granting credibility.

Afterwards, I found myself writing – poems, essays, fiction, haikus. Not because creative writing could explain endometriosis, but because it allowed me to stop translating it. My medical record already contained the facts: lesions, surgeries, pathology reports. Medicine had already classified the body. But classification is not containment.

Writing held what could not be converted – fear, grief, anger, and the long years of mistaking familiarity for normality. It held the gap between what is known and what is believed.

And in that gap, I began to understand what I had almost lost–not the diagnosis, but the capacity to recognize what had not yet been named.

Toshita Kumar is a physician specializing in pulmonary, critical care, and sleep medicine in Connecticut. Her writing explores medicine, memory, grief, and immigrant identity, often examining the stories we tell ourselves about illness, belonging, and resilience. She sees writing as an extension of her work as a physician—a way to make sense of the moments that medicine alone cannot fully explain. Her work has appeared in Pulse Voices, Intima, Doximity, Poetry Habitat, Northeast Journal, and elsewhere. When she is not caring for patients, she is writing, reading, or painting watercolor landscapes.