The last couple of weeks have been kind of rough. I started antibiotic treatment for one or more chronic tick-borne infections. (In my last post, when I called the diagnosis chronic Lyme disease, I spoke too soon. It’s probably another infection, Bartonella, and maybe persistent Lyme as well.)

As advertised, the antibiotics are producing something called a Herxheimer reaction. My body’s reacting not to the drug itself, but to the dying bacteria and the toxins they spill into my bloodstream. Typically, Herxheimer reactions intensify the underlying symptoms. In my case, that mainly means fatigue, muscle pain, sleeplessness—when the back pain keeps me awake—and headaches.

It’s all pretty yucky, but none of it is absolutely horrible. And it means the antibiotics and my immune system are doing their job, killing bugs. There’s no way around it; I just have to ride it out.

But that doesn’t mean I have to tough it out.

I’m really good at toughing things out. It comes naturally. I toughed out this chronic illness for more than three years, worrying that the doctors had missed something while trying to persuade myself that it was all psychological, as they suggested. But this morning, as I thought about the difference between riding it out and toughing it out, I recognized that hanging tough is the wrong choice for me here.

When I decide to be tough, I usually start by being tough on myself. And that’s exactly what I’m trying not to do.

“Wherever you go, there you are,” they say in AA and in mindfulness meditation. Wherever I go, in sickness and in health, there is my inner critic. That’s the voice that tries to motivate me through bullying, fear, and shame—the voice I have learned to identify as my yetzer hara, my evil inclination.

Being diagnosed with a genuine, albeit controversial, physical illness has not silenced the yetzer hara. It still has plenty to say about how much I should be able to accomplish while I feel sick—and, paradoxically, about how well I take care of myself.

Into one ear, the yetzer hara pours worry and criticism about my performance as self-caregiver. Are you eating right? What are you going to do about that back pain? You should be meditating or napping, not playing solitaire. In other words: You’re screwing it up.

In the other ear, the yetzer hara hisses: Don’t be lazy. Other people have it much worse. In other words: Toughen up. 

But I’m trying to be gentle with myself, not tough. I’m trying to take good care of myself, not just because I’m sick, but because I deserve it, and it’s the right thing to do. Or so I am striving to believe.

This is the voice of my yetzer tov, my good inclination. It tells me that every person has value, including me. That I wouldn’t call my loved ones lazy or selfish—nor would I think it—so why should I say it to myself. And because it’s a smart yetzer tov, it knows when to drop the persuasion and simply say: I love you. It’s okay.

Instead of calling on me to be tough, the yetzer tov tells me to be soft. Fighting the Herxheimer reactions makes them worse. Instead of tightening up against the chills and pains, it’s better to curl up with a heating pad and distract myself with a book—or even solitaire. In other words: ride it out, but don’t tough it out.

I often think about how I used to love jumping in the waves when I was a kid, and then bodysurfing when I got a little older. I don’t know whether I can recapture that joy, but I want to recapture the feeling of surrender. I didn’t love getting slammed onto the beach; I didn’t love catching a mouthful of salt water. But it was worth it: spit out the water, rinse the sand out of my bathing suit, and jump back into the surf. It wasn’t about being tough. It was about having so much fun that I didn’t mind.

No one will say Bartonella or Lyme disease is fun. But in this illness, as in the rest of my life, I want to learn to ride the waves: the ups and the downs, the happy surprises and the mouthfuls of sea water. I’m tough enough already.

What is the Mary Oliver Challenge? Glad you asked. You can read about it here.