Literally dripping upon, it often starts this way. You notice the sudden fact of bleeding a beat too late and stain a towel, a favorite shirt. And even when you do manage to reach a tissue in time, which, you must admit, is more often than not, the force that sends you lunging desperately for some scrap of absorbent, disposable paper is the fear of the shame of public embarrassment. The fear of dripping upon something, anything, inappropriate, and sullying the sanitary, of appearing weak or deranged or self-indulgent with bloody egg on your actual face.
This is what tips your head back as time-biding half-measure even though you’ve heard plenty of times and for years that, in fact, they really don’t recommend tipping the head back anymore. It can block the airway, cause asphyxia. This seems unlikely, even absurd—how could anything truly bad result from some pissant nosebleed? (As one encyclopedia entry notes: “They may be alarming but are very rarely ominous.”) And yet, according to a short, unceremonious post on sciencefocus.com titled “Can You Die from a Nosebleed?”: “A 47-year-old man from Gravesend, Kent died this way in 2011.”
Even still, the Pathophysiology section of the Wikipedia entry for “Nosebleed” tells me that, most commonly, nosebleeds are anterior, minor. Caused by a rupture in the tight daisy chain of blood vessels in the septum known as Kiesselbach’s plexus. (Plexus –noun 1. a network, as of nerves or blood vessels. 2. any complex structure containing an intricate network of parts). Not much cause for alarm, fatal edge cases notwithstanding. Easily stopped with a little time and tactical pressure.
This rupture, technically a hemorrhage even if that word in this context sounds imprecisely grave, can of course be caused by trauma. The trauma of, say, surreptitious nose picking, or a fist to the face. But it can also be spontaneous, seemingly out of nowhere, all effect with no readily discernible cause. I’m more interested in this phenomenon, what it occasions and affords.
For one, the fact of a distinction seems ripe for being lost on mildly alarmed onlookers. And what do we assume about the person who can’t keep their blood cooped up in their body, in its circuits of veins and vessels, where it belongs? That they are weak or effete? That they were obviously asking for it with a too curious finger? That they lack a certain fortitude and can’t be trusted around the good furniture? The bleeder feels exposed in this ambiguity, relishing neither the dutiful concern nor the potential for scorn, and does not, after years of this unpredictable spectacle, want the thing to drag on. They rush to get it over with already. All anyone sees is blood blooming in a wad of tissue, maybe smeared across the lips or chin (consequently dying the dominant hand, which is carefully tucked at their side), as the bleeder charges toward the nearest sink while apologizing for the interruption, this rupture in the normal functioning of time and body and space.
I’ve been getting nosebleeds all my life. Chronically, without notice. Sure, occasionally they follow the extraction of a particularly vexing booger, or blowing my nose a touch too hard. But more often than not these bleeds really do come seemingly out of nowhere: the nowhere of the dry air that dominates certain summer and winter months as it meets my delicate nasal constitution. Once, most alarmingly, it happened while craned over a library book: I let one red drop (more than enough) fall on The Oxford Book of American Short Stories, edited by Joyce Carol Oates, in the Baldwin Public Library of Birmingham, Michigan; I don’t remember the exact page, but it might have been somewhere in the table of contents, not interrupting the flow of any narrative in particular besides my own.
I was there after work, still dressed in sweaty, unlovely clothes, something black or khaki, welcome in that stuffy, leather-backed place in that swanky, new-money community only because of my job in town—then all at once a streak of red where I’d been reading. Horrified, I threw my head back as I tried to wipe it away, though this only made the stain worse, deeper, enlarged. I finally shut the book and replaced it on the shelf in one swift, quiet motion, and did my best to act natural (head tilted back just far enough to prevent further dripping, but not so far as to arouse suspicion) as I fled the scene, quick-stepping past the checkout desk on my way to the bathroom.
I think my horror’s intensity owed something to how out of place, how outclassed, I felt in that library in particular. The city it served stank of money. There were stock brokers, high-end interior designers, and less explicably wealthy people everywhere, and I was there to serve them, too. One was meant to sense and appreciate it—the power, the privilege—from a hushed, respectful distance. Of my coworkers, I’m almost positive I was the only one who ever ventured inside, much less asked for a library card. And I already understood myself, every time I entered, as a barely tolerated contaminant. Then the bleeding nose. It’s no wonder I so hastily shelved my shame.
There does seem to be a classed element to the spontaneous nosebleed, though it’s not entirely clear to me which side of the divide bleeds more readily. The poem “Nose Bleeds,” by Alexandra Teague begins, “When I was the poor girl at the private school,” and continues:
…the girls with new penny loafers lay like swooning princesses
in the nurse’s office, their heads tilted back, nostrils trickling red
threads of refinement. They would return to class, collars stained,
Russian royalty like the hemophiliac Romanovs of whom I was
only a namesake, not an heir.
It has never occurred to me to think of the blood escaping my nostrils as “red threads of refinement.” A stained collar has never seemed particularly louche, though perhaps I only lack the aristocratic confidence to pull it off. No, nothing could have felt less refined, less sophisticated than this inevitable inky leakage. A teacher did ask me if I was a hemophiliac once, after I complained about my chronic condition in earshot. And did I regret, ever so slightly, that I couldn’t say yes?
Mostly the bleeds stop quickly, though there have been exceptions. Once, while waiting for my mother to pick me up from after school care, I seemed to drip for hours, though I couldn’t have. An unusually large amount of blood, too, which scared me for once (would I need a transfusion? I wondered to myself), requiring several changes of tissue before the gory slug of blood slid down the back of my throat and signaled the end, in my memory just as my mother finally arrived, harried and breathing heavy as always, running late from work. At least the wait had been eventful.
Another time, after picking up a friend to go to an open mic at which she’d worked up the courage to perform, we ended up sitting in the cold in my blue Smart Car while I dripped and dripped, and we missed the show. The persistence of the flow spooked me. I had all sorts of tricks to get a nosebleed to stop with urgency if I needed to (nasal spray, Vaseline, a scrap of Kleenex tightly rolled and shoved under the upper lip) but none of them were working. I was scared enough that I had her drive me to the emergency room, apologizing all the way there and for the several hours we sat in the waiting room. I remember feeling absurd, indulgent, ridiculous, even as the blood wouldn’t stop coming and a pinprick of fear distracted from the self-conscious guilt. Eventually a tired, bored-looking doctor saw me, stuck a long cotton swab tipped with something caustic up my nostril and made the bleeding stop; I had to suppress a sneeze.
Not long after this, and without warning, that friend stopped talking to me. I’ve never quite known why (was it something I said?), though apparently such an abrupt severance of ties wasn’t out of character for her, I learned later. Still, then and now, there’s a paranoid link in my mind, surely faulty, between our friendship’s catastrophic failure and that long, patience-trying night in the ER, as if it were an imposition too great, irrefutable evidence of my intolerable selfishness: All of that for a nosebleed.
My oldest friend, Meghan, has never quite gotten used to my nosebleeds. She’s still disgusted by the sight of my reconnoitering index finger pulling away, glazed red, however many times she’s seen it. Don’t touch it, she’s snapped more than once, stopping me mid-reach toward a nostril. I don’t think she’s ever had a nosebleed herself, not since the time she had her face smashed into a plate of something on the playground. But that’s entirely different, subsidiary to violence, a sideshow side-effect and a one-off. It doesn’t pervade a life with the risk of discoloring, disgusting interruption. Sure, she gets her period, but I guess that’s different. Utterly normal, personal, and private, tucked away from public view. Not that I’d know. I only have this irregular nostril-born blooming to compare to.
In preschool, then elementary school, the sudden rupture meant a guiltless trip to the office, a clean break in the day. This was “the nosebleed as interruption,” in the words of one internet commentator (Will Gottsegen, “The Year of the Nosebleed”), which affords a “reflective pause.” This seems just right. It has made, he points out, a “fittingly sudden” appearance on screen recently. Quietly bleeding into the culture.
In Lady Bird, the titular coming-of-age heroine starts to bleed from the nose just as she’s lost her virginity. This has happened under false pretenses, and the commonness of the nosebleed accentuates the commonness of an awkward, disappointing first time. “I get nosebleeds.” I almost wish we all did at awkward moments. How much more easily the awkwardness might be diffused in the humanizing light of the body’s normal frailty. For Ladybird, the bleed could have necessitated a pause in the action, a rupture in this fragile, flawed intimacy. But the boy Ladybird has lost her virginity to has already finished, become satisfied without satisfying her. There’s already a rupture in the sentimental connection she imagines, and the nosebleed only redly underlines it. She throws her head back, pinches the bridge of her nose. He hands her a wad of tissue. She presses this to her face. He reaches up as if to hold it for her, and she swats his hand away.
The nosebleed as interruption makes another, altogether more tender appearance in Call Me by Your Name, which somehow appeared in the same year as Ladybird and also features Timothée Chalamet in an intimate moment punctuated (punctured?) by a nosebleed.
The main character, Elio, is at lunch with his parents, some friends of theirs, and Oliver, the object of his newly emerging erotic affections. The lunch is proceeding badly. It’s a tense affair. Just before it, Elio has made a pass at Oliver, and it didn’t go well. The friends of Elio’s parents’ are fuming about politics, accusing Oliver of not understanding Italy, and in Italian, a language he barely knows. Just as tensions reach a peak, Elio gets a nosebleed. “It’s nothing,” his mother says, “It happens all the time.” “You get used to absolutely everything,” someone responds.
As Elio hunts down some ice (a remedy I’ve never subscribed to), Oliver grows visibly concerned and excuses himself from the table. He finds Elio sitting in a corridor just off the kitchen, nursing his nose, and joins him on the floor. Both are wearing exquisitely short shorts, their legs on extravagant display. Oliver’s shirt is largely unbuttoned, his hairy chest looming. “That wasn’t my fault, right?” No. Maybe. Oliver looks down, lets out a resigned sigh. Where there had been distance, uncomfortably maintained, now the two are entangled in touch. Oliver runs his hand along Elio’s calf, pulls it across his lap, starts to crack his toes. “Trust me, it helps.” How? Elio reaches out and grabs Oliver’s shoulder, starts to knead his neck, gives his ear a little flick. Oliver slips Elio’s first foot between his legs, starts in on the other. “Fuck, you’ll kill me if you do that.” “I hope not,” Oliver says, and gives Elio’s foot a quick kiss.
Look what a well-timed nosebleed can do, what genuine intimacy it can afford.
I like the eroticism of this nosebleed scene very much, though I wouldn’t call it typical. Same goes for the intimate care Oliver shows Elio, at least at Elio’s age. In preschool, then elementary school, when in the office, some secretary or other had to take care of me. To pinch the bridge of my nose between a rubber-gloved thumb and forefinger. Hold up wadded tissue after wadded tissue. Dispose of these remnants of injury carefully and properly in the bin clearly marked with the interlocking crescents denoting biohazard waste, complete with a plastic bag tinted weak pink. But this cautious tending-to gave way not long after to a more-or-less compulsory self-sufficiency.
There’s a scene more similar to my youthful experience of routinized care in the school office in Terrence Davies’s The Long Day Closes, unique among filmic representations in my experience. The young, tender, film-obsessed, ineffably-yet-obviously queer protagonist turns up in the headmistress’s office, for reasons left unexplained, with a nosebleed. She, a nun, wipes his face with a damp cloth, and a large enamel bowl full of pale pink water rests in his lap. Cut to a moment later, and she’s working at her desk while the boy sits off to one side, clotting. Passing time. He’s just a beat away from returning to his day, the reflective pause almost passed. A minor incident immortalized.
This may in fact be the most autobiographical moment of the film, seeming to reveal as it does the roots of its elliptical, dreamy style. Who but a chronic bleeder could tolerate, much less enjoy, such gratuitous, contemplative rests?
It’s a scene striking to me for its ordinariness, its undramatic dailiness, its mundanity, an unremarkable-yet-remarked-upon moment. More recent examples above notwithstanding, nosebleeds in movies and television more typically result from mid-sports violence, or else get used as nonsensical-yet-visually-dynamic shorthand for the extreme mental exertion of a psychic or telekinetic character (see: David Cronenberg’s Scanners; Stranger Things’ Eleven; near-infinite other examples from sci-fi movies and TV).
Given how frequently I get them, even, if less so, now, it’s somewhat surprising to me that I’ve only ever had one nosebleed during sex. All that heavy breathing. I remember that it happened, if not exactly how. An exclamation (Oh), the abrupt halt of whatever arrhythmic action was underway. And where exactly did the blood fall? A pause to get cleaned up, to stop the bleeding. More slapstick than tender, more Ladybird than Call Me by Your Name. This nosebleed didn’t set the scene for anything that wasn’t already allowed, but rather altered what had come before and what came after its rude, wet entrance. And how long did the bleeding take to stop, anyway? What did we talk about while I made a tissue saturated, sopping? And did we call it a night once I’d recovered, or pick up where we’d left off? I wish I could remember. I do remember that the guy, someone I’d been seeing casually but regularly, seemed surprisingly cool about it. Unfazed by the sudden incursion of the wrong kind of bodily fluid. Much more of an Oliver, come to think, than Ladybird’s doltish lover, played by Chalamet. Still, had he tried to help, I would have waved his hand away.
By the time I got to middle school, self-sufficiency and resilience were expected, by myself as much or more than anyone else. Time goes on, things and people change. Care gave way to self-care, institutional concern to emotional if (still) not physical resilience. There was, upon breaking out in blood, always or almost always an, “Are you okay?” from witnesses, more dutiful than anything, perhaps a hint of alarm, but I would brush it off and nonchalantly slink off to the bathroom, an improvised wad of something already stuffed up one nostril or the other to temporarily stanch the flow.
I do remember the guilt and anxiety, the sense of getting away with something, the first few times I threw those wads of bloodied paper away in the regular, everyday trash. This did not become natural right away. For a while, I would wrap each one, whether spotted or sopping with blood, in layer after layer of clean paper towel, clean tissue, clean toilet paper, whatever was handy, fastidiously hiding something shameful. I didn’t want to alarm the casual bathroom goer, to arouse suspicion. Because what was normal if not quite quotidian for me would surely prove, for others, alarming. Why so much blood?
Then, not so very long ago, while working on this essay, I opened that week’s issue of The New York Times Magazine. In it I found—the rush of coincidence, flowing—another poem about a nosebleed. This one was by Fady Joudah, a physician, and titled “The Scream.” Imagine the rupture of my surprise. In the poem, the speaker, a doctor, cares for a boy who has just screamed, “his fingers bearing the coagulating fluid of / his life.” Caught off guard, he goes over to the boy, “[cups] his face as in a prayer.” He is moved into a pose of reverential care. And as much as I want to appreciate the representation (a nosebleed in a poem! How fun!), I find the stark intensity of the event—the scream, the bearing—and the religious devotion it provokes coldly unfamiliar. I can’t inhabit that shock, that fear, that tenderness. It’s all too common to me. A key but easily overlooked part in the intricate network of my life. I get nosebleeds. You get used to absolutely everything.
Cameron Martin (he/they) is a fat and queer poet and essayist originally from Michigan. The last time they got a nosebleed, they were supposed to speak to the local PFLAG chapter and they couldn't make it stop, so they had a wad of toilet paper hanging from their nose the whole time. He has never been described as elegant, personally, and can often be spotted goofing off and/or irreverently bloviating on Twitter dot com @CMcLeodMartin. Their prose has previously appeared in Sonora Review, and their poetry is forthcoming from Palette Poetry. He currently sleeps and studies, i.e. "lives," in Moscow, Idaho.