The first signs that something was very wrong were fevers that came without warning, a burning sensation that moved across my skin like something beneath it was lit, and headaches that invaded and stayed.
I called my mother from the doctor’s office parking lot, hands still shaking. Some instincts outlive their proof, but I needed the words out loud before they became fully mine.
“That’s a rich person’s disease,” she said after I told her my diagnosis.
My mother and I have always spoken two languages and understood each other in neither.
Before I could answer, she pivoted.
“Is it something you caught from being with someone?”
I pulled the phone from my ear and stared at it, as if maybe an app would open and offer me a different mother.
“Mom.” I put the phone back to my ear. “It’s not an STD, and I’m always safe.”
As a 42-year-old queer man living in San Francisco, I was offended, but as her son, I was not surprised.
“OK,” she said, in the tone she uses when she has decided not to believe something but is done arguing.
Her comment had been so absurd that I almost laughed. Then I realized she meant it. To her, illnesses that have long names and require specialists, follow-up appointments, and medications that sounded expensive belonged to people with the luxury to invent suffering. She believed hardworking people don’t have time for the body to attack itself — the immune system is too busy with real problems.
My mom had always believed this. When I was growing up, she translated everything into a bill. If the car made a strange noise, my mother asked how much the mechanic would charge. If a cousin got engaged, she wanted to know what the wedding would cost. If somebody got sick, she did not first ask if they were in pain, she asked if they had insurance.
Money, in my family, was not just a practical concern. It was a moral language. It told you who was careful, who was reckless, who deserved sympathy, and who had somehow brought trouble on themselves. What she refused to see was that my body didn’t care what class we belonged to. What she didn’t know — and what I would learn later while researching my condition — is that stress is a main trigger for the condition. The body does not distinguish between the anxiety of poverty or of receiving an unexpected phone call. It only knows the signal — and it responds.
Before a single visible symptom appeared, my body had already been sending messages I didn’t know how to read. There was fatigue, fevers, insomnia, and joints stiff in the morning and aching by the afternoon. At that time, I was an event producer hauling equipment. I was on my feet for 14-hour stretches, and I was overworked. At least that was the story I told myself. Then a single dry and scaly patch the size of a quarter appeared on my lower right back. A specialist ordered a biopsy and blood work. The numbers revealed I had low platelet levels and a vitamin D deficiency. The diagnosis was guttate psoriasis and early-onset psoriatic arthritis. My immune system, in what researchers call a failure of basic recognition, had declared war on my own skin and joints. It had identified my own tissue as the enemy, and it would not stand down.
The doctor prescribed topical creams. While I waited, the disease found my scalp, and spread until thick, inflamed plaques covered it entirely, like a tight helmet made of my own skin I couldn’t remove. As the scales dried, they pulled my hair out when they lifted. Bald spots appeared. Then the disease moved across my body and found other territories to colonize.
That was when my doctor said we needed to talk about biologics — a medication delivered via injection that is engineered to interrupt the immune response. It costs about $30,000 a year out of pocket. It would have been markedly cheaper with insurance, but I didn’t have any. I sat in her office doing the kind of math that makes your vision go white. She must have seen it on my face, because she was already pulling out paperwork for a sponsorship program that provided the medication at no cost to patients who couldn’t afford it. Thankfully, I was accepted.
The shots worked. My scalp grew healthy again. The bald spots filled in and my hairline was quietly restored. My arthritis receded too. I changed the way I ate and cut out what was feeding the inflammation.
I was overjoyed by my healing and wanted to share the good news with my mother, but I knew that if I told her I gave myself injections, she would think I was a drug addict. If I mentioned the price tag, she would say it proved her point.
The specialist asked whether anyone in my family had psoriasis, because it was genetic. I suddenly recalled that my mother’s father had recurring dry patches on his scalp, and how he’d scratch absently at them in front of the television, his heels split like old leather. He had carried it his entire life with no name. In my financially unstable Latino immigrant family, visible illness was treated as something to look away from, not out of cruelty, but because naming it made it real, and real things could be used against you. So, we turned away, and the diseases quietly moved through our bloodline in silence.
“Mom, Grandpa had it too,” I gently reminded her when I finally told her about my treatment. “There were those patches on his head and remember his feet?”
“My father was a healthy man,” she said, her voice rising. “He worked every day of his life. He didn’t have time for diseases.”
I’d been running into that wall my whole life. What I understand now is that her refusal wasn’t simple stubbornness. She went through three divorces and the death of my younger brother. Researchers who study intergenerational trauma call it a “conspiracy of silence” — the pattern by which painful experiences are not disclosed across generations, but instead passed down as an unnamed weight. Like so many parents who had endured similar hardships, she believes certain things shouldn’t be spoken about, which leaves younger generations to carry something they were never given language to identify.
My mother believed my autoimmune disorder and its treatment belonged in the same category: things invented by people with too much time and not enough real suffering. A disease created by your own immune system? That’s your body reflecting the softness of your life.
My mother believes in spirits, candles and saints. Her faith carried her through her hardships. Research consistently shows that high religious importance and lower health literacy are associated with greater mental health stigma among Spanish-speaking Latino adults. To need medication is to confess you cannot carry your own weight. You cannot fall apart, because falling apart is an extravagance. That supposed personal weakness doesn’t just sting socially, it actively deters people from seeking treatment, from finding out what is happening in their bodies, and from surviving things that are survivable.
My mother learned that silence was protection, and everything passes through that filter first. What comes out the other side is unrecognizable. She said she accepted me when I came out as gay at 22, but she never told anyone in her circle, unless there was something to gain financially, a sympathy to collect, or a story that made her look modern and brave. She never embraced my identity as fact — just her son — and never as “normal.” She’d monitor my walk, my hands, my clothes — a silent warden dressed as a caretaker, convinced that love meant surveillance.
She flinched every time I crossed my legs, so I started crossing them slower, harder, while looking her dead in the eye. I was the son she could never fix, because I was never broken. We’ve always been lost in translation — caught in between the world she left and the one I’m trying to live in — but there has still always been unshakable love connecting us to each other.
My mother and I have never seen the world the same way. We argue. We misunderstand each other. We fall into heavy silences. And yet, she remains the person I love most. I’ve stopped explaining this to people and stopped trying to change her. I’ve learned to manage our relationship the way I manage my autoimmune disorder — with consistency and the knowledge that there’s no cure, only maintenance. I can’t teach her to stop attacking what she was never willing to see. I can only reduce my triggers and stop waiting for a clarity that may never come.
I know my mother’s choices are informed by trauma. That isn’t why I stay. I stay because the bond between us is older than any disagreement. The body keeps its records — and so does my heart.
Emillio Mesa is an Orlando-based freelance writer and hospitality-special events producer, working on his memoir about being an immigrant and his mother’s five husbands.
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