The attacks came out of nowhere and brought life to a miserable standstill. And she had the scars to prove it.

The 62-year-old woman shifted in her seat. The flight to Honolulu was full, the mood a little giddy. The unbroken ocean and sky filled the window. She and her daughter were four hours into the trip from Los Angeles to the wedding of a close family friend; it was going to be a great week. Then, she caught herself scratching lightly at a place on her forearm, just below the crease of her elbow. She lifted her arm to look at the spot. Nothing there. Immediately she was filled with dread.

She reached over her head to touch the call button. She needed ice, lots of ice, and she needed it right away. The mild itch had already exploded into spasms of an intense sensation — it seemed wrong to call it an itch; surely there was a better word for it. The fierce intensity of the feeling shocked her. It was a feeling that insisted she scratch. Except scratching never helped. And she had the scars to prove it.

She had suffered episodes of itching like this a few times in the past couple of years, though never quite as bad as it was on this flight. Her doctor back home had no idea what caused the crazy itch or what more she might do about it. These attacks came out of nowhere but immediately brought life to a standstill as she tried to ease the unbearable sensation. A bout could last for hours and almost always ended with her arm a bloody mess. When her daughter first saw her mother raking her nails over the invisible injury and the distress she felt fighting this unwinnable battle, she had offered her a Valium. And it helped. The itch was still there but the intensity somehow lessened.

On the flight, the woman retrieved the pills she now carried with her all the time. The little bags of ice brought by the flight attendant melted slowly, numbing the hand that pressed them against her arm and easing the itch. She knew from experience that as soon as the ice was removed, the itch would roar back. The attendant brought an ice bucket. But within the hour, she needed more ice. More Valium. She was drenched with the condensation. Her clothes were dotted with blood. She didn’t care. She just had to get through it.

The Valium and ice had done their job by the time the plane landed. The two women went to their hotel. The older woman went up to her room, closed the curtains and tried to manage the fear and the pain. The itch was gone, but her arm ached from the self-inflicted injuries. Two days later, the itch was back, this time on the other arm. She didn’t make it to the wedding. The unpredictable need to scratch was too grotesque for her to risk having to do it in public. Instead, she went to doctors. She saw four dermatologists during the trip. None had any idea of what was wrong or what she could do about it.

She had long since tried the usual remedies: antihistamine creams and pills; steroid creams; hot-pepper lotions; oatmeal baths; acupuncture. All completely useless.

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