a still from the film Alien, in which a creature is bursting out of a character's chest, covered in blood. The character is visibly in pain and covering their eyes.

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Guts

In Alexandra Kleeman’s 2015 novel You Too Can Have a Body Like Mine, we are presented with the image of a man who, coughing up blood, is suspected of having cancer when an X-ray shows a spreading, rag-edged shadow on his chest. When they open him up, however, they instead find a six-inch fir tree embedded and growing inside his left lung. It is an image which informed a fleeting passage in my own novel, Our Wives Under The Sea (2022): a scene in which two characters read a newspaper report about a woman who eats improperly prepared seafood and unwittingly winds up with a dozen squid paralarvae incubating inside her cheek. In both cases, the image unfolds from the fact of the body as site, or even as habitat, and a markedly opaque entity in either instance. We are made to understand that the body, unchecked, will happily go about its business, playing host to things that ought not to be there. It is a feature of broader mistrust, this sense that our physical bodies cannot be relied upon if they will keep secrets from us. How, after all, is one supposed to have faith in something that claims to protect you if it chooses to withhold information of a potentially dangerous breach?

 

This is something I have often thought about: the fact of knowing and not knowing, the sense of the body as self and as something altogether different; as you but also as something liable to attack you, to harbour things that mean you harm. It is frightening, to be in one sense wholly inextricable from your body and yet not know what’s happening inside it. How do you square that – the fact of the physical dark inside you? The fact that anything could be going on in there? The monster in Alien (1979) is scary because it’s a foreign object, but it’s also scary because of how easily the body accommodates it, at least for a little while.

 

I’m obsessed with the concept of The Thing Inside The Body – the squirming something Noomi Rapace surgically removes from herself during the only good sequence in Prometheus (2012), the petrol-fuelled inventiveness of Titane (2021), in which a woman gestates a human-car hybrid, the unimpeachable perfection of Alien. It’s a trope that speaks directly to my personal taste-level, which is one of tangled squeamishness and voyeurism, a mess of wanting to look and knowing I shouldn’t that reflects the queasy core of every horror fan, but also touches on the much wider confusion of simply existing in a body. At the movies, you want to look at the terrible thing and you also want to stare at the seat in front of you until it’s over. So too do we want to know what’s going on inside us and we also want to ignore it, because the fact of all that preposterous squelching gore, and everything that could go wrong with it, is frankly more than any person should be casually expected to take in. Accepting the fact of oneself as a body and therefore a thing with insides, with guts, is accepting the fact of oneself as a thing that can degrade, mutate, unravel.

 

To watch a horror movie is to know that something bad is going to happen. To have a body is really the same thing. When you put it like that, it’s insane to spend any time thinking about your body. Insane and not a little morbid. Why is that something anyone would want to do? As Kleeman writes in You Too Can Have a Body Like Mine:

 

Inside a body there is no light. A massed witness pressing in on itself, shapes thrust against each other with no sense of where they are. They break in the crowding, come unmade. You put your hand to your stomach and press into the softness, trying to listen with your fingers for what’s gone wrong. Anything could be inside.

 

*

 

I have a scar about the length of my finger from tip to second knuckle, which I’m told is a good thing to have because chicks dig scars. It sits just between my hipbones and does not itch the way I was led to believe it would, which is about the only piece of good luck I had with it. It looks entirely normal now – sometimes red, sometimes purple – but in the days immediately following surgery, the skin directly surrounding the wound was so swollen it looked like I was wearing a bumbag filled with blood. A wound hematoma is not a particularly uncommon result of invasive surgery and essentially results from blood collecting in or near a recent surgical incision. It’s not something which is necessarily dangerous and the body can often be relied upon to absorb the excess blood over time, although the presence of clots in unusual parts of the body can raise the chance of infection and of blood leaking between skin sutures. In my case, the size of the hematoma which developed after my laparotomy led directly to my fainting off the toilet and vomiting three or four times the morning after first being released from hospital and subsequently being readmitted via ambulance later that day. But I’m getting ahead of myself.

 

What happened was that I had an ovarian cyst that was 35 cm long and contained 7.2 litres of fluid. For scale, a school ruler is approximately 30 cm in length. For scale, before Jamie Oliver ruined them, the big Coke bottles used to contain approximately 2 litres of fluid.

 

What happened was that nobody thought to send me for an ultrasound between the time I first started complaining of symptoms in February 2021 and the time my GP finally gave up in September 2021 and told me I might as well go for a scan. In between those two points, complaining of digestive issues, persistent but not severe bloating and pain whenever I, an habitual runner, tried to go for a run, I was treated to the following: a cervical smear, a stool test, an ovarian cancer blood test, a prescription for Omerprazole, a stomach exam, a visit with a physio to examine my gait and generalised advice to stay off gluten for a bit and see what happened. By the time I was finally sent for an ultrasound, the cyst was so big that the technician was unable to tell which ovary it was actually connected to. It had been there for so, so long.

 

I am not at all interested in relitigating what was going on with the NHS or with my GP in particular that led to this comedy of errors. The NHS is a service being systematically and perniciously stripped of resources in a deeply cynical attempt to convince the public that it would work better as a privatised system and I don’t believe that the blame for this lies with anyone but the obvious culprits. Even so, the fact remains that had my cyst been caught earlier, I would conceivably have been eligible for keyhole surgery, which is a far less invasive procedure than the one the size of my cyst ultimately necessitated, and I might still have my right fallopian tube, and a whole heap of things might not have happened.

 

It should, I suppose, be noted that given the size of the cyst as I’ve described it to you, I ought to have looked a lot weirder than I did by the time it was finally discovered. And whilst my body certainly wasn’t right towards the end of things, it still looked ordinary enough for me to just about accept it when my GP dismissed the way my torso and stomach presented as ‘highly developed core muscles’. Set this next to the fact that a full decade of disordered eating meant I had absolutely no way of telling whether what I was seeing was real, and you’ll hopefully understand how many things were stacked against a speedy diagnosis.

 

Having a body is all about accommodation. We make accommodation for the things it can and cannot do and the way in which it shifts and develops, we make allowance for the fact that we can no longer tolerate dairy or onions or stand for too long without getting a crick in the neck. Before my diagnosis, I was so used to the fact of myself as I understood it that it was strange to realise a lot of what I considered ‘me’ was simply made up. As it was, it turned out that I wasn’t gluten-intolerant, or lactose-intolerant or unable to run without getting a stitch. It turned out I wasn’t unusually given to pain and discomfort during ovulation. It turned out I didn’t look like that.

 

*

 

I’ve been a hypochondriac for so long that I barely remember what it was like to exist without the possibility of disaster, to settle down into a brief period of calm without wondering what’s going to trip the switch and have me once again convinced that I’m dying. I’ve often felt it works a bit like possession, reminding me in a funny way of the silly but also rather incisive ‘three stages of demonic activity’ laid out in The Conjuring 2 (2016): first infestation, then oppression, then possession. First something whispers in your ear that you might – you just might – have whatever kind of cancer, then the idea gets inside you, then it’s using your voice to speak.

 

Hypochondria is an easy skill to master because it relies on very little but logic, if a creeping and unpleasant logic. It’s easy to locate one symptom and put it together with another one, even if neither of them amounts to very much on their own. Easy to realise you’re tired, that your vision isn’t what it used to be, that your hands sometimes tingle, and rush headlong into what seems like the most obvious conclusion: MS, malignant brain tumour, etcetera etcetera. To do so, as a hypochondriac, simply feels like facing facts. You’re not running wildly ahead, ignoring any number of more likely and less troubling explanations, you’re simply doing the right sort of maths.

 

When you’re someone who compulsively worries about your health, there is little more simultaneously vindicating and unnerving than actually being right. Your diagnosis is a victory of sorts but it is also a funny sort of let down. Once they’ve told you there’s something seriously wrong, where does all that nervous energy, all that logical devotion to computing the worst possible scenario, actually go? Now add to this the fact of being a person who loves horror movies, who loves watching a terrible, gory thing unravel. It can be odd, in the event of a personal disaster – something bloody and unforgiving and happening to you, in you, right this second – to sit back and think to yourself but I’ve seen this play out before. 

 

*

 

Many people have said this, but the scariest part of The Exorcist (1973) isn’t all the rotating heads and crab-walking but rather the run of scenes in which Regan is sent to the hospital for tests.

 

I thought about this the day I went back to the hospital. Having been released post-surgery the previous afternoon, I spent the evening on the sofa with the cat on my stomach. (A fact which my girlfriend and I later came to interpret as prophetic. Some people have claimed that the frequency at which cats purr can promote healing and Tiggy certainly seemed to be trying to accomplish something that night.) In the morning, I had first passed out and then thrown up all of my medication almost as soon as I took it, so we called my consultant and decided to get an Uber back in, a move which culminated in my asking the driver to pull over in order to throw up extravagantly onto the pavement for I don’t know how long. The Uber driver reacted to this turn of events by passing my girlfriend a stack of paper tissues and telling me this wouldn’t affect my Uber rating, so wherever he is I salute him now.

 

The hospital at which I had had my cyst removed was a private one, funded by work insurance, which turned out to be both lucky and unlucky. On the positive side, my consultant made the point to schedule us in the moment my girlfriend called her. I remember her saying ‘you look pretty rough’ when we got to her office and thinking well yes because I was wearing yoga pants and an orange jumper that no longer fit since I’d recently lost seven litres of bodily fluid and also I’d just thrown up out of an Uber and also I was in a lot of pain. She scheduled me for a blood test, followed by a CT scan. Having staggered up three flights of stairs to get to Radiology, I caused a minor commotion by loudly announcing I was going to throw up again and then proceeding to do just that. A lot of things about that day will stay with me, but for some reason the sheer abjection of realising I was going to have to change to have the CT scan was the first moment I really felt close to giving up. The body doesn’t remember pain – like the concept of extreme cold, it lets go of it in an oddly conscious way that makes it hard to recreate the feeling later. I cannot recall exactly how it was I felt, in physical terms, only that the thought of having to move my body in the manner required to remove my clothes and don a hospital gown felt next to impossible, and had my girlfriend not been there to help me I’m not sure what I would have done.

 

In The Exorcist, Regan has a number of increasingly invasive procedures to determine what’s going on with her. These include an arteriogram, in which contrast dye is injected into the blood vessels in order to gain a more distinct image of the circulatory system and organs via X-ray imaging. When they took me in for the CT scan, they told me they’d need to inject me with dye so they’d know what it was they were looking at. ‘It’s going to feel like you’ve wet yourself,’ said a nurse whose name I wish I remembered, so I could send her a card and thank her for being so kind. ‘Try not to be upset. It’ll just feel like warmth around your kidneys and your brain won’t know how to interpret it. It’s unpleasant but it’s nothing to worry about.’

 

They injected me with the dye and slotted me feet-first into a machine the size of a Ford Fiesta before retreating behind a protective screen. A strange thing about X-ray machines is the fact that you always have to be alone with them, like someone your friends set you up with, friends who then leave to observe from a discreet distance. I remember the machine and the flood of warmth around my kidneys and starting to cry because this wasn’t how the day was supposed to have gone. I remember thinking about Regan trapped in her many machines and Regan earlier in the movie, at the party her Hollywood mother has thrown. Regan wandering into the room in her nightgown and pissing all over the floor.

 

*

 

Navigating what is classed as ‘women’s healthcare’ as a lesbian is uncomfortable, which is not to say impossible. It’s not that they mind that you’re a dyke, exactly, it’s just that they never seem to have heard of the concept until you bring it up. I remember before I even had the cyst removed, my girlfriend happened to be looking for support resources on the NHS website and found an informational article on recovering from a laparotomy which contained the line ‘your partner may have his own worries about the effect of the surgery’, under the heading ‘Feelings’. She complained to the Mid Cheshire Hospitals Trust and in due course was called up by a Customer Care Officer who declared themselves both gay and shocked. The resource reads differently now.

 

Anything to do with gynae is, I think, liable to land you in peculiar territory. Prior to surgery, I had to take the first pregnancy test of my life despite arguing several times that there was absolutely no point in my doing this. A miracle, the nurse joked, after it came back negative. It can be alienating, trying to operate within a system which repeatedly seems surprised to look up and find you standing there. (It’s a sensation which, of course, speaks to the larger issue of ‘women’s healthcare’ being a frankly troubled term. On the one hand, issues of abortion, pregnancy and reproductive health are important facets of women’s liberation. On the other hand, I’m not hugely interested in talking about what happened to me as being in any way synonymous with being a woman, given the blindingly obvious fact that women do not all have ovaries, that ovarian cysts are not something that only happen to women and that it’s reductive to the point of laughable to yammer on about the fact of femininity as it pertains specifically to the reproductive system. I mean, did we not just come from there? Did we not all just agree that it was bad?)

 

Over the course of the very bad day in which I was readmitted to hospital, no fewer than six members of both private and NHS medical staff looked between my girlfriend and myself and then asked if my girlfriend was my mother. My girlfriend is three years younger than me and astonishingly beautiful, but this is hardly the point. The fact that it didn’t occur to anyone simply to ask rather than shooting their shot will never cease to amaze me. At one point, receiving a hard no to the mother question, one brave soul tried to overcorrect with Oh, sister? then Oh, best friend?, and would, I imagine, still be taking similarly mad stabs in the dark if we hadn’t at some point managed to get a word in. Oh, roommate? Oh, member of parliament? Oh, priest?

 

After my CT scan revealed that I had a worsening hematoma and also that some undetermined damage may have been done to my bowel during surgery, it became clear that I would need to be readmitted. This was an impossibility at the private hospital, not because of any issue with insurance but because this was November 2021, mid-Omicron, and at that point this particular hospital required a clean PCR test three days prior to admittance, so I would need to be taken elsewhere.

 

The paramedics arrived, one of whom came over to introduce himself. His name was Matt, which is important, because he was important in the way certain people simply do turn out to be. He asked my girlfriend who she was and, when she replied through gritted teeth that she was very specifically not my mother, gave her an understanding look. It was, he said, not something that happened often to him and his boyfriend, but he knew what we were going through.

 

I’ve never wanted to kiss someone on the mouth more than I did at this precise point, which I guess means I’m straight after all.

 

In the ambulance, as we were bluelit to St Helier in Carshalton, he explained to us that his boyfriend had been in the musical The Lion King and told us repeatedly that it was all going to be alright. After a confusion at A&E where my girlfriend was told she couldn’t come in and then it transpired that she could, he went to look for her and brought her back. He held my arm at one point and told me with an intense sort of wisdom that I know it all seems shit right now but the thing is it’s just not? He disappeared somewhere around the time I was being administered morphine for the now semi-unbearable pain and we never saw him again, which is I suppose how these things go.

 

This isn’t really part of the essay in any meaningful way, I just thought I’d mention it.

 

*

 

I think about the movie Alien more than anyone really ought to. I think about the movie Aliens (1986) more, because it is better, but that isn’t really the point. There is something fascinating to me about the place Alien holds in cinema history, the way it speaks to an era of horror and science fiction that was interested in muddying the waters around what it meant to be human – from the man-as-machine fantasies of Blade Runner (1982), Tron (1982), Terminator (1984) and Robocop (1987) to the fleshier horrors of The Fly (1986). The late seventies and most of the eighties were replete with this trope, fixated on anxieties about the loss of bodily integrity in an increasingly automated age. It was the period which featured some of the most instantly recognisable David Cronenberg moments – parasites crawling out of mouths in Shivers (1975), the grotesque hallucinations of Videodrome (1983), the complete and total bodily collapse of The Fly. ‘Long live the new flesh,’ as Cronenberg would probably say.

 

There is so much, in all this, of what I described earlier in this essay as The Thing Inside The Body: the unwholesome or unwelcome something that has grown or otherwise found its way inside and set up shop where it ought not to be. It is a Thing which changes you, in as much as your body has to shift itself in order to contain it, but also in a larger sense – a sense whereby your humanity has to alter, to some degree, to accommodate the inhuman.

 

In the case of Alien, you can argue that the creature that burrows inside its victim’s chest is overtly sexual, overtly Freudian, overtly Marxist. People read it as pregnancy panic and rape fantasy, of course, as about anxiety around bodily integrity, bodies under the boot of the capitalist machine, a nightmare vision of reproductive science and so on. It can, in my opinion, be comfortably read as any one of these things. Good horror is like that.

 

During everything that happened to me, I thought about Alien a lot, both in terms of the violation inherent in a creature attaching itself to your insides and the emptiness of after. What are you, after all, when the thing that was inside you, part of you, has been forced out again? Funny, in a way, that the drama of what happened to me was less about the discovery than it was about the lack – the removal less dramatic than the swift collapse of after, my body clenching down around a sudden emptiness, trying to readjust to what it was without the thing that had given it shape.

 

As a person who watches movies, I believe that people often pick a surrogate, a character through whom to experience the plot. When I watch Aliens, I pick the marines, both because they’re cool but also because, for the most part, they don’t get Aliened – very few of them end up with something incubating inside their chest cavities, crawling up, staring out of their eyes. Strange to think that this might have been a form of self-preservation the whole time, a way of avoiding a certain sensation, the awareness of myself as something easily breached.

 

*

 

I was kept in gynae at St Helier for a week and it was mostly terrible but I also miss it now, in a curious way that I cannot entirely make sense of. The best way I can describe it is intense nostalgia for the sheer abnormality of that time, the fact of being thrown out of life into somewhere that made me long for the dailiness I took for granted, the sensation of sudden perfect clarity around what I loved and how piercing that clarity was.

 

My girlfriend was allowed to visit me for five hours a day, which wouldn’t have been permitted at the private hospital. She dressed up every time she came in, which was lovely and unnecessary, and made me feel dressed up by association. The flat was filled with flowers and cards wishing me a speedy recovery from the surgery I had not had a chance to recover from. The post, approaching Christmas, was a disaster and things just kept turning up. Our friends had essentially moved in with my girlfriend and were taking care of the cooking and keeping the cat entertained. At night they would sit up and talk in the living room so that she was able to get to sleep. My friend sent her a beautifully sensible grocery delivery. My other friend sent a club sandwich and pancakes. I’d never realised I had the capacity to love so many people so much.

 

I spontaneously got my period ten days early all over the bed and had to press a pad into a pair of mesh NHS knickers. I wasn’t able to use the toilet for four days and when I tried, I had to wipe blood off my catheter to stop it getting all over my gown.

 

I made friends with a couple of women on my ward and we shared magazines and talked about how good it was when you got a phlebotomist rather than a nurse to do your bloods.

 

My girlfriend took me to the shower room and washed me by holding the showerhead sideways while I sat on the fold-out seat. I was still covered in the orange dye that they slather all over you prior to surgery and we both commented that it was like I’d come back from the vet. 

 

I had to have several blood transfusions and was kept largely starving and unable to drink any water for two and a half days because no one was sure whether or not I would need more surgery to correct whatever was going on with my bowel. Surgeons and consultants would come and go in teams and ones and twos and would say ominous things about stoma bags and corrective surgery, only to never return. One consultant was reassuring in a manner that bordered on the patronising, which was unfortunately exactly what I needed, and I thought he was wonderful.

 

I paid for several days of full television access and considered watching The Turning (2020) before putting on Finding Dory (2016) instead.

 

My original consultant turned up on her NHS rounds at one point and gave me a fan from her office. St Helier’s is the kind of early twentieth-century building that reads like a Victorian seminary, complete with visible pipes painted the same colour as the walls, and was boiling hot morning, noon and night. Over the course of the week, nurses came in and told me about how it had been snowing when they left the house at 5 am, and I kept the fan trained on me all week.

 

I took a look at my scar when they changed my dressing and thought about the scene in Alien Resurrection (1997) where Ripley cradles the hybrid creature that recognises her as its mother, prior to shooting it out of the window to its certain death.

 

One day, they told me they’d be releasing me, only to turn around when I was all changed and packed to say that my bloods still showed inflammation and I might have to stay two more nights after all. When my girlfriend arrived for visiting hours, we lay on the bed listening to Taylor Swift for several hours and I sobbed that the cat would forget who I was. I don’t want to have to die feeling like this, I texted her later and a touch dramatically, which I do regret now.

 

When they finally let me go, it felt like a strange anti-climax, because none of the nurses I’d come to know or recognise were there. My girlfriend held my hand and led me out via the bewildering warren of underground tunnels that run beneath St Helier’s. We came out and I realised it was cold and it was Christmas and I hadn’t felt air on my face in what felt like a year.

 

*

 

I am good at yoga and pilates – I am strong and extremely competitive and enjoy being better at holding a pose than the people around me, despite the fact that I always assure my girlfriend no one is passing judgment in class. Without my cyst, my hip bones grind into the floor when I try to do the bow pose and I hate it, the peculiar bluntness of the motion, the uncomfortable sensation that isn’t pain but rather something akin to the horror of a dry towel dragged across skin. I hold onto my feet and pull my body backwards in a semicircle and ignore the fact that this felt better before.

 

It is hard to get used to your body as other than you thought it was. I look nothing like I used to and that is difficult knowledge to access in a neutral manner. It’s very possible that I had that cyst for upwards of two years without anyone noticing it. When I left the hospital, I was thinner than I have ever been in my life and attempting to respond to this in a manner beyond the qualitative is something I’m working very hard towards. Any day now, as they say.

 

I have periods now like I never knew periods could be – the way my body roars around them like something struggling up from deep earth is almost alarming. The pain is unrecognisable, the bleeding insane. I used to joke, at university, that my periods were akin to an old man coughing into a handkerchief – a couple of wet expectorations and over and done. I’m paying for that now, but I suppose it was a gross enough joke to deserve it.

 

Sometimes I think about possession, about the way a body feels when abandoned by an external force. Do the girls in those movies feel empty once the horror show is over? Does Regan feel hollowed out, somehow less herself than she was when playing host to a whole other being? Does she swim more cautiously, aware of the lightness which buoys her up? Does she bend her legs back, arch her chest up and reach for the arches of her feet?

 

I can run again now, and swim, and do pilates and yoga. I can drive my car and wear belts and go dancing without feeling sick. I can fuck, which I always did before, but I feel better at it now, more like myself when I do it. My body ate the remainder of the hematoma, the way it was supposed to. I continue to write about bodies – in my stories, in my novels, in this essay – and I wonder, sometimes, what might be going on inside me. It’s possible, I know, that something else could be going wrong even as I write this. The body is dark and unforthcoming and it holds itself closed until the moment you split it open to root through the mess of inside. We are afraid of the body, but we’re also in love with it. We hold it close and tell it we’ll take care of it, if only it could offer the same courtesy to us in return.


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ABOUT THE CONTRIBUTOR

Julia Armfield is the author of the short story collection SALT SLOW and the novel OUR WIVES UNDER THE SEA. Her work has been published in GRANTA, LIGHTHOUSE, ANALOG MAGAZINE, NEON MAGAZINE and BEST BRITISH SHORT STORIES 2019 and 2021. She was longlisted for the Deborah Rogers Prize 2018 and was the winner of The White Review Short Story Prize 2018. In 2019, she was shortlisted for the Sunday Times Young Writer of the Year award. SALT SLOW was longlisted for the Polari Prize 2020 and the Edge Hill Prize 2020 and was shortlisted for the London Magazine Prize for Debut Fiction 2020. She won a Pushcart Prize in 2020.  

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