Story by Rachael Mitchell

In between minor disputes over what TV show to watch or who borrowed whose shirt without asking, my twin sister Amelia and I have expressed a sisterly love that is difficult to expound. We did not always get along, or have the same group of friends—especially senior year of high school when I ran for student body president and her stoner friends dubbed me “Bitchell Mitchell”—but we’ve always been closer than any siblings I know.

Amelia’s butt-length purple hair brings out the glow in the olive skin I’m eternally jealous of; her warm brown eyes gleam curiously from behind skinny rectangular frames. Tie-dyed scarves and body-hugging leotards drape Amelia’s dancer’s body, and then there’s me, Rachael, stout with my dad’s fair freckled skin, outfit lacking neon adornments and flair—we stand in stark contrast, united by shared experience. Our relationship has transcended the typical “twin thing” because of numerous bumps in Amelia’s medical history and one very prominent chemical imbalance.

From the day the two of us made our entry into the world, six weeks too early and twenty minutes apart, it was apparent that Amelia was not like other babies. More than the usual jaundice and nutrition problems associated with preemies, Amelia’s stomach was too fragile to hold down food. Everything we owned was stained with vibrant splotches of mashed peas and
 blueberries. Ceaseless ear infections blighted her infancy. There was the hernia when she was two. In elementary school, it was hypoglycemia that posed
 a challenge, causing low-blood sugar attacks characterized by incessant whining. By middle school, she’d contracted every illness from chicken pox to pneumonia and endured extensive testing to diagnose why she wasn’t growing.

Accompanying her list of medical woes was a number of unusual behaviors. As a baby, she had a strange affliction toward fans and flip-top trash cans—anything that moved in a circular motion sent her into distress. When she was two, her morning activity included collecting every bar of “I-shope” (soap) in the house and carrying it in a cloth bag for the remainder of the day. At four, it was her fixation with “pitty dess” (pretty dress) that drove my parents crazy; the only time my mom could change it for washing was after she was already asleep. I don’t remember a time when my parents weren’t worried about something Amelia-related. The stress was constant and it took a toll on all of us.

By third grade, Amelia’s hands were so cracked and dry they bled. She refused to sit down in class, and as peaceful as she was, neurotic frenzies were common. Teachers and friends translated her bizarre behaviors as “quirks,” but anyone who had the chance to witness mealtime at our house knew otherwise. It was rare that she’d eat what was on her plate, especially if she had not seen it prepared, 
but even more rare that she’d actually sit down. As she grew, her obsessions grew. We took her to see several psychotherapists, all who came to the same conclusion: Amelia had a severe case of obsessive-compulsive disorder that was only going to get worse.

For the next several years, doctors experimented with a host of psychoactive drugs to null all of the
 shit you would expect to plague a life where the world is a war-zone and the perpetrators are germs and crooked picture frames.

She stayed on these drugs for twelve years, passively accepting the mind-numbing effects that robbed her of her personality in turn for feeling a little less stressed. The diagnosis put a name on her affliction, but it did little to tell us how we could help her.

When I heard, “No but I really feeeel them, they are REALLY crawling on me,”
 it was as if whatever squirming bacteria she was talking about existed in my world too. But it didn’t, so I played along, allowing her to drench me in sanitizer and learning what’s okay to touch in a public restroom—absolutely nothing. I questioned my own sanity for enabling her delusions and often, I felt like I was going crazy too.

The veil of drugs she was under made these battles especially tough. Zombies are no good at arguments. I was desperate to protect my sister, and to navigate our experiences together as it seemed we should, but as we grew, the rift between us did too. It annoyed me that my parents spent so much time making absurd accommodations. At the same time, I had a certain understanding that Amelia was suffering more than the rest of us. Even worse, the same sister who once allowed me to prepare blind taste tests of gnarly concoctions, who’d laugh with me until we sounded like old men—the sister who loved me—would no longer hug me. I could no longer braid the silken lengths of her hair or crawl 
into bed with her when I’d have a nightmare like I used to. I was dirty. We all were.

The world was a scary place for Amelia and day-to-day living was encumbered by hopeless attempts to avoid touching everything from money, unless it has been ironed, befitting it to go in the “clean” compartment of her wallet, to door knobs, to the hands of her friends. We lived for the rare days when her anxiety would subside, and she’d laugh so hard she’d fall to the ground, letting the germs overcome her. Those days always gave me hope. They were reminders that the demons in her head could be contained, that somewhere inside her she had the will to find happiness despite her struggle.

year of high school Amelia underwent surgery from a horror movie—doctors used Black
 & Decker drills and saws to take her right hip socket apart and reconstruct it using
 6-inch screws to cure a bad case of hip dysplasia made worse by ten years of competitive dancing. She had been dancing since the age of three, allowing music and energy to move through her, forcing out fears and fueling moments of inner peace. Her enthusiasm for dance was the other thing that gave me hope—somehow her disorder left her alone when she danced so she could pursue her passion unbridled. Then she was told she would probably never dance again.

After the surgery, it was easy for Amelia to stay home a lot, to waste her precious years in the confines of her room amid the stuff only her own sanitized hands touched. It was depressing to see this kind of imprisonment for the sake of ease, so I became the social one. My form of escape and atonement was visible in the vast amounts of time I spent at friends’ houses and participating in extracurricular activities. Amelia’s resentment and sadness showed in the ways
 she tried to numb herself—with countless hours of TV as a child, and then copious amounts of marijuana as a teen.

The guilt I had for being the “healthy” twin led me to overcompensate for the normalcy I felt Amelia lacked. I tried to be her protector, her advocate,
 and her voice. I didn’t realize I was robbing her of the chance to do those things on her own. With each step I took to be “the strong one,” she sunk deeper into an existence defined by our tiptoeing around her compulsions and catering to her various illnesses. I meandered in and out of understanding her world. Every day was a struggle to avoid “butt germs” and “contamination.” Our attempts to convince her that her fears were manifestations of a disorder simply alienated her more. What I should have been focused on was helping her feel strong enough to ignore them. But it was my anger that held me back. I naively believed that I would be better equipped to keep the anxiety under control if I were the one who had obsessive-compulsive disorder.

In 2008, Amelia decided she hated the way she felt. She was sick of letting harmful figments of her imagination beat her down. So she stopped taking medication. Sales of hand sanitizer skyrocketed globally, but that’s 
beside the point.

Despite warnings by her doctors, she started dancing again. To reclaim her brain, she developed a strategy that helped focus her compulsions into more positive energy. She used them to live better. She taught herself that it was more logical to be afraid of harmful chemicals like phthalates and parabens than germs the average person’s immune system can handle. Amelia switched to only organic beauty and cleansing products and started making her own natural sanitizer that moisturized her skin instead of making it bleed. These strategies empowered her and left her feeling less vulnerable to the demons in her head. Amelia’s relationships with people and the world around her began to improve.

The cycle began to change course.

It wasn’t until she stopped taking her medication that I finally realized how futile my struggle to help her really was. There was absolutely nothing I could do or say that would change the chemical composition in her brain. To Amelia, it was all too real. Somewhere along the way I shed my role as advocate and protector and I allowed her to wage her own war.

With every ounce of might in her five-foot frame she began to work through her fears without help. At twenty-two, when she touches a door knob—for even a second—she still feels millions of tiny creatures burrowing into her skin, but now it’s different. Along her journey she’s acquired tools that quell the voices in her head and keep the frenzies to a minimum. Recently, I came across two bags of laundry—one labeled “clean,” the other “totally clean.” Laughing, I asked, “what’s the difference?” The “clean” bag was actually reserved for “dirty days,” days where she practices ignoring the germs. Those days aren’t easy, but she takes pride in knowing she can do it. Now, I’m happy to assist with opening doors, pumping gas, and flushing toilets. And in exchange I get a hug at the end of the day. I’m thankful to hand sanitizer, toilet-seat protectors, and the fact that no one notices she always wears a jacket in case she needs something clean to sit on. Somehow these things help close the rift between clean and dirty, and between us. Amelia’s prescribed and self-medicating zombie-alter ego no longer exists, making room for more frequent fits of laughter and a renewed sense of herself, disorder aside.