When Staying Composed Harms Your Health

Saying “I’m fine” when you’re anything but can have serious consequences

Illustration: Thoka Maer

“So how are you feeling?” the doctor, who I was seeing for the second time in two weeks, asked as she prepped the shot that would hopefully bolster my diminishing vitamin levels. “I’m fine; how are you?” I asked, replying with the immediate, automated bounce of an email out-of-office reply.

“I’m good,” she said, one eyebrow raised. “But it feels like you’re deflecting a bit here. Because this isn’t fine.” “This” meant the medical records that told her the chronic illness I’d been white-knuckling it through for the past five or so years was worsening. The severe vitamin deficiencies caused by the mystery condition were depleting my energy, melting my ability to climb stairs or firmly grip a coffee mug. They were also oozing into my memory, causing my normally rapid-fire thoughts to trail off into nowhere as I struggled to remember what I’d been talking about moments before.

It was the most recent of many times I’d said “I’m fine” when I wasn’t — because I didn’t know how to say otherwise.

Being “fine” is related to the virtues of composure and poise, or the “collectedness,” which I imagine is what people feel when they seamlessly put change in their wallet at the checkout without getting anxious that they’re holding up the next person in line. It’s a minuscule example of the composure I interpreted as moving through the world with the strength to be unrattled, unaffected, a definition that seemed to exist within me instead of something I learned. If anything, I watched as friends cried openly, or bemoaned the test they’d failed at school or a screwup they’d made, and wondered why I felt I didn’t have permission to push through the wall of poise and break down a little, too.

Composure is aspirational, and our society tends to cultivate it in women in particular. I learned this at an early age, when a ballet teacher struck me. I knew the routine: No matter the insult, no matter the mistake, no matter how badly you wanted to stuff your shoes and water bottle in a bag and flee, if you wanted her to want to work with you, you didn’t flinch. Being unaffected said something about you, that you were strong and steady, that you were capable. Upon…