I’ve long admired Anne K. Yoder’s writing, which I first encountered in a 2009 fiction workshop led by Lynne Tilman. Ten years in the making, Yoder’s debut is a stunner, which challenges readers to think deeply about the impact of pharmaceuticals on our mental, emotional, and physical health. A poetic dystopian text that blends multiple voices, The Enhancers has haunted me since I read it. I was so excited to catch up with Anne and discuss her work in greater detail for this interview.
Arielle Bernstein: The Enhancers is such a beautiful novel. I know that when we spoke more casually the other day you had mentioned this is a project that you’ve been working on for years, but when I was reading, I definitely saw echoes of recent events like the pandemic, so I was curious: how long have you been thinking about The Enhancers?
Anne K. Yoder: I’ve been working on the book for about 10 years, so it’s like time has caught up with the book. Thinking about illness and pharmaceuticals has been a large part of my life in terms of my work as a pharmacist and my experience working in many facets of the industry. Public health was really the reason I thought I would go to pharmacy school in the first place. Writing The Enhancers was an endeavor to bring pharmaceuticals and that world that I know into my creative work, and to think about what roles pharmaceuticals play in our world. It’s such a large part of our lives and our nation’s GDP. This really become apparent recently, like with the Covid vaccine. I am totally pro-vaccination, by the way, and I think the vaccine is incredible, but we’re also aware of how much money was thrown at drug companies to develop vaccines. And now the companies have ownership of the patents and choose not to share that information to make a larger profit. And then, of course, climate change is also on so many people’s mind. It’s terrifying, and there’s an awareness that we’re not altering how we live or the larger systems that can have an effect. I wanted to look a little into the future at the possibilities of what this all looks like, and also what it’s like being a young person coming of age with these different forces at play.
AB: How far did you feel like the gap was between our very real world and the world of The Enhancers, where everyone is so obsessed with optimization?
AKY: I don’t think it’s very far from our present day, and the distance has narrowed in the 10 years since I started writing, which is kind of terrifying. With the Trump presidency and the acceleration of the dystopian elements in our own society, I felt like that the novel itself is no longer more dystopian than our reality.
AB: I was curious to talk about centering the story on teenage girls and their experiences. Did you always imagine The Enhancers with a teen girl as the central protagonist? Because there are a lot of interesting characters here, some of them are adults, and I was curious about your choice to give us some extra interiority with Hannah’s world.
AKY: From the beginning, Hannah and her friends Azzie and Celia and their story in Lumena Hills were at the center of the novel. I wanted the reader to identify with Hannah, and I wanted to create an intelligent female teenage narrator. This is something I’ve been thinking about recently because I had so many people suggest that this could be a YA novel at various points in the process. But—and this isn’t anything against YA—I just thought, There are so many depictions of teenage boys in fiction, would the same book with a male protagonist get the same question? It was important to me to depict the friendship among the three girls. The multiple narratives are functioning to create a more complex encounter. When I picture the novel functioning as an entity, I look at the voices as different instruments in a score. When I consider how the voices function together, I think Hannah is telling her story from the future, performing all of the voices.
AB: It was interesting just how many different kinds of social pressure Hannah was facing throughout. There was this larger kind of social pressure, the pressure from school, from parents, and from peers. And then there’s also the way that kids are using them “off-label.”
AKY: Teenage girls encounter so much social pressure to perform femininity and to perform certain roles. The supplements in Lumena Hills are seen as a kind of cure-all, these pharmaceuticals are a way of smoothing over the rough spots of the dystopia. I think there are ways that we see this happening politically, with people who are afraid to question, or who refuse to question the foundations of their belief and why they support who they support. In Lumena Hills, there’s so much information circulating (and being ingested) and so much happening that it’s impossible to process all of it. So there are supplements to deal with that because there’s always something coming at you. I recently read an introduction that Aldus Huxley wrote for a reprint of Brave New World in 1946, where he was talking about pharmaceuticals and technology as tools that future governments will use for control. So you know, the Marxist quote that religion is the opiate of the masses—here the pharmaceutical is reinstated as the opiate of the masses. The supplements in Lumena Hills allow its citizens to function within a dysfunctional society.
One thing I was thinking about after writing the bulk of the novel, is that there’s a dichotomy was exploring—this sense of what is the scientific-technological approach to medicine and what is actually healing? Maybe it comes down to this idea of optimization and personal enhancement, that we’re prioritizing Western medicine and technology over so many other forms of healing. That healing requires the integration of so much human knowledge and experience that isn’t respected or that doesn’t function in the same way. How can this be better integrated?
AB: The ads for medications were a hilarious and sad portrait of a dystopia where human needs are flattened into robotic warnings about side effects.
AKY: I interned for a company that writes patient package inserts for pharmaceutical companies one summer during pharmacy school, back I when I thought I might be happy doing medical writing as a pharmacist. And as somebody who is very attuned to language, I’ve been very aware of the language of pharmaceuticals and how drug names are made to sound enticing—in the novel, for instance, there’s a drug called “AZPIRE.” You have people in corporate positions naming these drugs, probably with some type of focus group giving feedback about what sounds best. It was a lot of fun to write that part. But then when marketing to consumers, pharmaceutical companies have to include disclaimers. That always struck me. They’re like, Okay, here, take this great drug, it’s going to make you feel less socially anxious but also side effects might be death! I really wanted the pharmaceutical voice threaded through the novel. By having multiple voices, including the pharmaceutical voice, I hoped it would give more of a context, and maybe more texture to the world than a straightforward first-person narrative could provide.
AB: That connects to a question that I had about the character of Hannah, and whether you view her as an unreliable narrator. She is taking so many supplements and they do seem to be shaping her consciousness.
AKY: Is anyone reliable beyond their own narrative? I’m fascinated by the ways that two narrative accounts of the same event can be so divergent. It’s something that Hannah questions—Who would I be without taking [the drug] VALEDICTORIAN? Who were these people who existed before VALEDICTORIAN? Would they have been better off with it? Am I? Hannah has had these experiences with supplements, but I don’t think they’ve damaged her ability to think. I feel like we encounter this divergence in perspectives all of the time and it’s most apparent right now politically, with two separate narratives and it’s really difficult to empathize and just sit with it. I mean, for example, my parents and I have very different ideas about what’s happening politically, and we have very different narratives about what’s happened over the past five years.
AB: Hannah’s so fascinating because wants to understand herself but she also really wants to connect to other people, even though it’s hard to do that in the world of The Enhancers.
AKY: Connection is often brought about through drugs, but there is so much distance and loneliness too. Ads for drugs are obviously about selling emotions. There’s a fascinating book, Testo Junkie by Paul Preciado. He wrote this book before he transitioned, and he was using topical testosterone for his own personal experimentation—n off-label use indeed!—it also functioned as a subversion of the system, and he kept diary of his encounter with T during that time. In the book, Preciado coins the term pharmacopornographic, and talks about how, as a society, we don’t create any material things anymore. We create and sell feelings.
AB: I was thinking about how in today’s world, the ideal mental state seems to be less about cognitive optimization and more about good, relaxed vibes.
AKY: Oh god! A drug that enabled you to do everything and feel very chill and rested. Or to not need sleep and also not feel stressed. I’m sure someone would love to find that pharmaceutical. I have a friend who was just trained as a forest therapist, which I find fascinating. From what I know of the practice, she leads people through natural settings while prompting them to observe and just be present. The effects of this are remarkable—just being around trees and trying to focus on the sounds and textures. And you can actually do this anywhere. I’ve participated in a few walks with her at local urban parks, where cars are visible and audible, and it’s still so transformative. So thinking about optimization, it’s so easy to be fed—like people are in The Enhancers—this sense of optimizing oneself with a drug. But what if it’s you know, something you can’t sell, like the experience of being in nature?
AB: It seems like one of the things that you hope readers can gain from your book is thinking about what would be a more holistic relationship to pharmaceuticals.
AKY: I was writing with the sense of being very aware of protocols, you know, having worked in hospital pharmacy for a very long time. There are protocols to follow for meds when someone has a heart attack, or a stroke, and these protocols and medications make it possible for people to survive situations they wouldn’t without them. But at the same time, there is just a wall when it comes to the individual person within the larger system. The system is bigger than any of us.
