Aza’s hand-sanitizer ingestion

Aza Holmes’s hand-sanitizer ingestion is a recurring, dangerous response to contamination fears that she cannot resolve through ordinary cleaning. The episodes move from a swallow in a bathroom while she is visiting Davis to repeated gulps at home and, finally, a medical emergency in the hospital. Across them, sanitizer promises an impossible certainty: that Aza can make herself clean, or quiet the thought that she is not in control of her own mind. Instead, the act exposes the peril of treating an intrusive fear as a problem that can be solved by bodily purification.

Background: Fear, Medication, and Control

Aza’s ingestion takes place against a long-running struggle with obsessive thoughts and anxiety. In a session with Dr. Karen Singh, she describes feeling contaminated from the inside, imagining herself not as a separate human being but as a teeming mass of bacteria. Dr. Singh proposes trying exposure response therapy again: Aza would touch a dirty surface with her callused finger and then refrain from cleaning it or covering it with a Band-Aid. The exercise had helped for a time, but Aza remembers being frightened by it and cannot bear to repeat it. Her refusal is not a resolution of the fear; it leaves her still searching for relief while dreading the treatment meant to help her tolerate uncertainty.

Medication is another point of conflict. Aza admits she takes Lexapro inconsistently because the prospect of a pill changing her makes her question who gets to determine what her self is. She wants relief from what she experiences as a demon, yet taking medication seems to threaten the identity she is trying to protect. Later, at Davis’s house, she has not brought her Ativan and again acknowledges that she is not taking Lexapro every day. Dr. Singh stresses that medication requires consistency, while Aza remains troubled by the thought that becoming herself might depend on ingesting something that changes her. The tension between wanting the symptoms gone and fearing intervention in the self forms part of the background to the sanitizer episodes.

First Ingestions: Seeking a Clean Certainty

At Davis’s house, Aza’s thoughts turn to the bacteria that might pass between them. She considers the possibility that some are harmful and imagines bacteria already present in Davis’s microbiota. The thought gathers force rather than settling into a manageable worry. Aza leaves the basement, goes to the bathroom, and watches herself in the mirror, trying to find a way to silence her inner monologue. She then takes hand sanitizer from her jacket, puts a glob in her mouth, swishes it despite its burning sensation, and swallows. The action is brief, but its logic is revealing: in the grip of a fear about invisible contamination, she turns to a substance associated with cleanliness, even though it is not safe to drink.

A later episode begins with a Band-Aid on Aza’s finger. At night, after checking whether her mother has gone to sleep, she examines the old dressing and sees a little pink blood. She tries to reason that the finger is not infected, but the possibility keeps returning as a question she cannot settle. She washes her hands and replaces the Band-Aid, then takes aloe-scented hand sanitizer from the medicine cabinet and drinks it. Her thoughts swing between warnings that the alcohol could make her sick and commands promising that one more swallow will make her clean. She takes several gulps, feels dizzy, and develops stomach pain. Even the thought of the healthy bacteria that sanitizer might destroy and the danger of C. diff becomes another turn in the same spiral: information that might warn her away from drinking is pulled into the fear driving her to drink.

Hospital Crisis

The most severe episode occurs while Aza is hospitalized after the car accident, with a lacerated liver and an IV pole beside her bed. Her mother is near her, but Aza feels her sense of self slipping and cannot bring herself to ask for help in a way that interrupts the compulsion. Her internal struggle circles around the wall-mounted sanitizer: she recognizes the danger and the irrationality of drinking it, yet the possibility of infection feels intolerable. She pulls herself upright despite the pain, takes hold of the IV pole, and shuffles to the dispenser. She rubs sanitizer foam over her hands, dispenses more, and puts it into her mouth.

When her mother wakes and tells her to stop, Aza drinks again. She takes a third dose as her mother gets up, then gags and vomits. The pain in her ribs becomes blinding, and her mother catches her by the arm. Yellow bile covers Aza’s hospital gown. Her mother calls for help, reporting that Aza may have drunk sanitizer. The act has brought neither certainty nor control: it has produced a public emergency in the very place where Aza is already being treated for serious injuries.

Consequences and Meaning

At first, hospital staff assume Aza drank the sanitizer because she was desperate for alcohol. Dr. Singh’s arrival clarifies a different context. She confronts Aza about not taking medication as prescribed and about the danger of drinking a product containing alcohol and other chemicals while hospitalized with a liver injury. Aza says she felt the medicine was making her worse, but Dr. Singh refuses to treat the ingestion as evidence that stopping it was helping. She also recognizes the accident as a serious trauma and recommends a different medication that Aza can tolerate and take consistently. When Aza says none of the medications work, Dr. Singh revises the claim rather than accepting it as final: none have worked yet.

The treatment conversation eventually offers a distinction that the compulsive crisis collapses: thought is not action. Aza is frightened that thinking repeatedly about C. diff means she is in danger, and she wants certainty; Dr. Singh does not present sanitizer as a way to obtain it. The episodes therefore matter not as a single lapse followed by a clean recovery, but as a repeated pattern whose consequences grow more severe. They show the difference between an intrusive thought and a chosen action becoming difficult for Aza to hold onto precisely when she most needs that distinction. They also leave the struggle unresolved: the hospital response is to reconsider medication and account for trauma, not to claim that one intervention has ended the cycle.