The Recovering: Intoxication and Its Aftermath

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Letter from the Pestilence

One particularly brutal winter, more than half a decade ago now, I used to find myself fantasizing about stripping down to my underwear and t-shirt and calmly walking out into the massive field of snow that blanketed the flat lot across from my apartment complex so that I could quietly freeze to death. These day dreams came on casually, and it was only after a few times of realizing that I had been online looking up “What does it feel like to die from the cold?” that I might be in trouble. For several weeks following an arctic blast, my small Pennsylvania town was covered in snow and ice, which the tax averse city fathers did little to clear. Though I obviously wasn’t ensconced inside my apartment for the entirety of that time period, able to mostly slide down the hill to my job, and more frequently to the bar where I could get black-out drunk and somehow amazingly get back home, the isolation somehow felt both metaphorical and literal. During that time I mostly kept company with box wine, liquor, beer, and a Netflix subscription, and despite my Google searches I thankfully never saw fit to try my experiment during those blackouts. Weather wasn’t the cause of my depression obviously; my father was dying of a terminal illness at the time, I had yet to figure out that I should stop drinking, and there is some betrayal in my brain chemistry. But the chill permanence of the starkly beautiful and isolated landscape was certainly an affirmation of the pathetic fallacy, every bit as trite as if I’d made it up for a book. I eventually came out of the depression—as one does.

If you’ve ever been depressed, then you know that sometimes it feels like you’ve been wearing dark sunglasses on a bright day; the strange film that seems to cover everything and muck up the synapses in your brain. There might be drama to some people’s depression, and while there was certainly anxiety and the dull hiss of fear punctuated by moments of panic in mine, for much of it there was a surprisingly low volume. It occupied you all the time, but there was something almost relaxed about it, like the way the moment before you freeze to death is supposed to feel like a gentle letting go of one sense after the other. One of the signs of depression is that you lose interest in things that you love. In a clinical sense, that was true for me; I abandoned a lot of the intellectualization of literature that was my passion (and my paying job as a graduate student), but in a far deeper way it wasn’t accurate at all. Maybe I didn’t want to write interpretations of poetry, teach the novels that I kept on teaching, or talk about drama in graduate seminars, but words were stripped to their most elemental and jagged for me, boiled down and rendered into a broth that I kept on drinking. This isn’t going to be where I set up a false dichotomy between thinking and feeling, between interpretation and experience, nor is it a rejection of the critical discussion of literature. I truly derive pleasure from those things, and it was a blessing when my desire to engage them returned.But when everything was stripped away from my desire, when I could scarcely feel love, least of all for myself, the words were still there. At the core of the humanities, it turns out, remains the human. Sometimes reading felt like running in place in a swimming pool; sometimes I was so distracted by my malady that the connection between sense and syntax was all but severed. I was lucky enough that I could still do it though—and with a dim awareness that it was because I had no choice if I was going to come out on the other side. During this period, either ironically or appropriately, I read Andrew Solomon’s stunning personal etiology The Noonday Demon: An Atlas of Depression. Much like Leslie Jamison in The Recovering: Intoxication and Its Aftermath, Solomon gives an account of our shared affliction in terms of history and medicine, and offers his own dark nights of the soul. Solomon writes “To give up the essential conflict between what we feel like doing and what we do, to end the dark moods that reflect that conflict and its difficulties—this is to give up what it is to be human, of what is good in human beings.” The Noonday Demon’s great power is that it doesn’t reduce depression to character building, nor does it simply explain it away, but it does give some scaffolding of meaning to the experience of meaninglessness. Solomon’s prose is exemplary, his empathy is complete, and though I don’t personally know him, reading The Noonday Demon was just enough a connection—as weak as my transponders were—that a bit of static electricity was able to power me through when I got better.I only bring this up because currently we’re all in the pest house. What a strange thing, this social isolation, the self-quarantining? Suddenly societal survival depends on all of us anointing ourselves as depressives, staying sequestered in our homes as whatever hell burns through the immune systems of our fellow humans. When I was depressed, I drew hope from the fact that other people weren’t depressed; it felt like if my world was unravelling there was at least a world. The surrealism of our current moment is that none of us have that same luxury anymore. Ironically there’s something democratic in our common situation, the way in which we’re all feeling the same fear, the same uncertainty, the same panic, worry, anger, and anxiety. A solidarity, finally. If there’s anything different between our current situation and personal depression—the sense of doom, the preoccupation with a malignant force, and the inability to fully immerse yourself in that which gives joy make this feel like a type of cultural depression—it’s that there’s also a weird joviality out there. The often funny social media gallows humor (I’m partial to a picture of the advertising mascot Mr. Clean with the caption “He left us when we needed him most.”) and the odd confessions with strangers, like the Trader Joe’s checkout guy who told me he’d miss karaoke most of all.

The depressed, ironically, might have an immunological consciousness more prepared for the quarantine that is now necessary. No longer kept in my apartment by diminished serotonin levels and several feet of snow, now it is the coronavirus that keeps me home. “Depression at its worst is the most horrifying loneliness,” Solomon writes, “and from it I learned the value of intimacy.” Our school has been those feelings of nothing that have trained us in the art of that most human of things, our need for connection, precisely at the moment when its necessary to sever those ties. “You cannot draw a depressed person out of their misery,” Solomon correctly notes, but “You can, sometimes, manage to join someone in the place where he resides.” We live in an ugly era—mean, intemperate, cruel, cynical, narcissistic. Everyone says that of their age, but doesn’t it feel a bit more true of our own? Now, as if the Earth has a breaking fever, it seems as if the very planet itself is shaking us off. We’re all in that dark place now; some of us will get sick, as well. Many of us will. We will all require a kindness in that.

Like Solomon was once something I was able to hold onto—however so slightly—that returned me to life, there must be an engagement with each other, with that which we’ve created, with that which exists to make connection, with that which joins us in the places where we reside. Creation can’t be a luxury, nor is it just entertainment, or a way of passing time. Recently, I saw a video of an empty street in Florence, where women and men are quarantined where Boccaccio was once sequestered from the plague, where Petrarch’s beloved Laura de Noves succumbed to it. From an open window, a strong baritone voice from an unseen man starts singing in an Italian I can’t understand, then a woman joins in somewhere down the alley, then another man, then another. Even the feral dogs in the street are barking joyfully by the end. All of them were isolated, but none were alone. Creation must be a kindness.

Image Credit: Needpix.com.

Questioning Her Own Questioning: On Leslie Jamison’s ‘Make It Scream, Make It Burn’

“The impulse to escape our lives is universal,” Leslie Jamison writes in her new essay collection, Make It Scream, Make It Burn, a book—both directly and indirectly—full of methods to escape the doldrums of daily existence: virtual-world games, travel, near-mythic sea creatures, fairy tales, past lives, the unreality of Las Vegas.
Jamison writes, “Inhabiting any life always involves reckoning with the urge to abandon it—through daydreaming; through storytelling; through the ecstasies of art and music, hard drugs, adultery, a smartphone screen. These forms of ‘leaving’ aren’t the opposite of authentic presence. They are simply one of its symptoms—the way love contains conflict, intimacy contains distance, and faith contains doubt.” These lines capture an attitude that runs through the collection, a particular perspective that adheres together the book’s wide array of subjects and styles: even though the manifestations of our interests and beliefs might look vastly different, the same underlying challenges and desires unite us.
Jamison is known best for The Empathy Exams, an essay collection from 2014 propelled to international attention by way of its opening piece, a memoir-driven, braided essay investigating the idea of empathy. In many ways, the book was an unlikely hit. Sharing little in common with humorous personal essay collections—which often reach wide audiences and hit bestseller lists—The Empathy Exams uses a wild mix of forms and styles. It was research-based and journalistic as often as it was personal and more reminiscent of the work of writers like Baldwin and Didion.
But the magic of The Empathy Exams is simple: Jamison is a stunning writer. She’s an emotionally raw and revealing memoirist; a journalist looking outward with a keen and nuanced eye; a literary critic finding clues to understanding the modern world from the literature of the recent past. In the book, she seems to be Jo Ann Beard, Janet Malcom, and Susan Sontag all wrapped into one. And in the years since its release, The Empathy Exams has become a touchstone; one of those books that other books are frequently compared to.
Last year she published The Recovering, a personal and literary history of alcoholism and recovery. But Make It Scream, Make It Burn is the true follow-up for which fans and interested admirers have been waiting. This level of anticipation rarely bodes well. There are so many ways that a follow-up can disappoint and, as great as it is, Make It Scream, Make It Burn will surely disappoint some.
While The Empathy Exams set its tone by beginning with its most personal essay, Make It Scream begins with one of its least personal: “52 Blue,” the story of a lonely whale, singing its own tune, and the humans who turn the whale into a metaphor. It’s perhaps one of the collection’s best essays, but initially it doesn’t seem like an ideal opener; it’s a slow burn, research-heavy, loaded with exposition. It’s only through the second essay—“We Tell Ourselves Stories in Order to Live Again,” a piece about past-life claims—that “52 Blue” is put into thematic context and the work it’s done as an opener suddenly becomes obvious.
“I’d grown deeply skeptical of skepticism itself,” Jamison writes in “We Tell Ourselves Stories in Order to Live Again.” “It seemed easier to poke holes in things—people, programs, systems of belief—than to construct them, stand behind them, or at least take them seriously. That ready-made dismissiveness banished too much mystery and wonder.”
It’s the ultimate essayist move: a writer questioning her own questioning; pushing against the act of pushing against. Though she never addresses where the boundaries of open-minded consideration lie, the essay’s bid for mystery and wonder feels exciting, almost ecstatic. It’s here that the book picks up speed and the collection’s larger themes come into focus: the limitations of doubt, how narrative and metaphor operate in our daily lives, and the universal need to believe in self-improvement. She writes, “Reincarnation struck me as an articulation of faith in the self as something that could transform and stay continuous at once—in sobriety, in love, in the body of a stranger.”
Jamison is an expert at restraint. She often holds her opinions back to let her readers come to their own conclusions, and she regularly keeps essays from becoming too personal to ensure the subject at hand isn’t overshadowed. But it’s when she lets the reins out—when she momentarily puts her journalist and literary-critic selves to the side—that her talent becomes more obvious.
In “Layover,” Jamison begins with a simple situation—“This is the story of a layover,” she writes. “Who tells that story? I’m telling it to you now.”—and lets it expand into the universal, like the perfectly impossible textbook definition of a personal essay and what it can do. What begins as a piece about an annoying, overnight layover develops into a piece about the blurry lines between selflessness and selfishness. “Does graciousness mean you want to help—or that you don’t, and do it anyway?” Jamison writes. “The definition of grace is that it’s not deserved. It does not require a good night’s sleep to give it, or a flawless record to receive it. It demands no particular backstory.”
Later in the book, “Rehearsals” opens with a line announcing a certain wildness to come: “Weddings are holiness and booze, sweat under the dress, sweet icing in the mouth.” As unhinged as the best wedding dance party, the essay flips from the second person to first person, bouncing around the country, chronicling the narrator’s experiences as a wedding guest. Beyond its sentence-level play, it manages to also be in conversation with the collection’s ideas about constructing narrative and casting doubt aside. “You feel the lift of wine in you, you feel the lift of wine in everyone, and you’re all in agreement—not to believe in love, but to want to. This, you can do.”
As skeptical as Jamison has become of skepticism, she’s still a skeptic in a certain essayistic sense: she’s always digging deeper, refusing to trust surface appearances, never letting a wedding be just a wedding. “Everyone talks about weddings as beginnings but the truth is they are also endings,” she writes. “They give a horizon to things that have been slowly dissolving for years: flirtations, friendships, shared innocence, shared rootlessness, shared loneliness.”
Despite these gems of forward motion, Make It Scream, Make It Burn doesn’t have the same energy of The Empathy Exams. In large part, it’s simply because the book is so neatly organized. While The Empathy Exams bounced between essay forms, giving it an excitement and unpredictability, this collection is broken up into three sections, with similar essays grouped together. The book is perhaps more coherent because of it, but it also creates spots where the pace slows to a crawl—especially in the middle section, where a series of three art and literary criticism essays bogs the book down, despite each essay working individually.
Still, Make It Scream is easily one of the best essay collections of the year, if not of the past decade. Jamison is a superstar of personal essay for a reason—not only is she a great prose stylist and meticulous researcher, she’s also infinitely curious. It’s this curiosity that makes everything she writes so infectious and makes this collection what it is: a wise and open assortment of essays that, throughout, feels like a gift.
Bonus Links from Our Archive:– Fellow Creatures: Leslie Jamison’s ‘The Empathy Exams’Notes from the Purgatory File: An Interview with Leslie JamisonA Year in Reading: Leslie JamisonBottoming Out: On Leslie Jamison’s ‘The Recovering’The Millions Interview: Leslie Jamison

Nightmares, Dreams, and God: The Millions Interviews Jeff Sharlet

Early in This Brilliant Darkness, the new book of essays and profiles by Jeff Sharlet, we see a photo and short profile of Mike, a 34-year-old night baker at Dunkin’ Donuts. This is his final shift. He’s going to paint the walls of a church, high up on a ladder: “You can’t be afraid up there.” A tear, tattooed by his right eye, is for his son—”who died when he was two months old.”

These moments fill Sharlet’s fascinating, heartfelt book. He has a knack as a writer, as a person, for capturing people in image and word. Sharlet has always been interested in the way the stories we tell shape and reveal the meanings in our lives—with good and bad results (see The Family; and the Netflix series version, for an example of the latter).

Sharlet teaches at Dartmouth College, where he is associate professor of English and creative writing. He is an editor at large for Virginia Quarterly Review, and his writing has appeared in Rolling Stone, Harper’s, GQ, Esquire, Mother Jones, The New Republic, Oxford American, and The New York Times Magazine. The Family, a celebrated Netflix series, was based on his book The Family: The Secret Fundamentalism at the Heart of American Power.

We spoke about belief, sharing stories, and bearing witness to this world.

The Millions: Early in the book, there’s a scene of you driving “over the Green Mountains, to Schenectady” to visit your father. It’s a frequent trip, and you almost always drove at night: “It seemed easier, the steep twisting road more likely to belong to me alone; the radio, when I could find a station, less clogged with news and yet more alive with voices. Night shift-voices.” Those voices, you write, believe “in God, or aliens, or blue-green algae.” You wanted to believe “in other people’s nightmares and dreams, projected onto the black night-glass of the car windows.” It’s beautiful writing, and it makes me wonder: now that the book is finished, do you believe in those nightmares and dreams? What do you believe the night does to them, to us, to you?

Jeff Sharlet: I believe in nightmares and dreams the way I believe in God—what matters most about stories, I think, is what people do with them, how they shape our lives. Whether they’re “real” or not matters, too—I’m a journalist, I love that creature we call “a fact”—but I’m moved by the great modernist poet Marianne Moore’s definition of poetry as “imaginary gardens with real toads in them.” The stories we tell with those “real toads,” the facts, are the imaginary gardens in which we live. Night is a fact, but my experience of it, then and now, is the imaginary garden for which I’ve attempted to write a geography. In the book, I write that darkness isn’t the absence of light, it’s the presence of ink, the stuff from which letters and words and stories are made. I’m not such an insomniac anymore—making this book maybe cured me of that—but I still see night in those terms.

TM: Late one night you stop to see Larry, owner of Treasure Center—“a grackle’s shop of shiny pop culture detritus, samurai swords, and Franklin Mint collectibles.” You say his store also has the best “religious kitsch” that you’ve seen in a while, but he doesn’t like that description. You buy plastic hands—”painted pink matte over veiny knuckles and long pointed fingers, as if they’d come from a horror model kit repurposed for prayer”—and when you think of them later, you write the “faith that put them in a glass case” was “as free of irony as I am of the divine.” Here—and elsewhere in your writing—you often come back to God and absence. Why the frequent return to these subjects? Why—if the perceived irony of Larry’s kitsch exists—are you still drawn to belief?

JS: I think of something my writing students sometimes say, about a book or a story dealing with some reality very different from the way they understand their lives. “I can’t really relate to it,” they say. To which I respond: we read, we look, we try to perceive the world because whether or not we can relate to any given reality, it may well relate to us. That is, the story—broadly speaking here, belief—matters to my life whether or not I believe. I’d better try to understand it. But that’s just being pragmatic. I’ve always been drawn to belief as a nonfiction writer because to engage with it you have to reach beyond the stack of facts that comprise ordinary journalism. Who-what-where-when-why does not account for what Larry saw in those prayer hands, which matters as much or more than any kitsch I might perceive.

TM: In one photo, a man is on the ground, spread in front of a gated archway, smothered in birds. It’s an almost impossibly perfect shot: some birds are mid-flight, others scurry toward him, and one faces the camera. Early in the book, you write that phone cameras can capture a state of reality that the technological perfection of more advanced cameras cannot. Phone cameras, you describe, capture “sort of what it looked like, something like what I saw, something like what I felt.” Like so much of This Brilliant Darkness, this is really worth pondering. What is that space between reality and artifice? Is it art? The man smothered in birds—is that moment real?

JS: The pigeon man—he preferred not to use his name—a sort of St. Francis of Dublin, where I met him, is real, and that moment—that snapshot—is as real as any other moment that’s past. The snapshot is its memorial, its echo, its ghost. A friend calls these pictures+words “ghost poems,” and adds, “only, these ghosts show up in photographs.” That feels right to me. The space between reality and artifice—which is, of course, the only means we have to attempt to represent reality—is what we speak of when we speak of documentary art. I’m drawn to work that accounts for the approximation, the mediation of the one who looks and listens and tries to understand. I think there’s a transparency—a hopeful transparency—in recognizing that I can’t tell the pigeon man’s story, or anybody else’s story, any more than I can be a “voice for the voiceless,” an inadvertently arrogant bit of phrasing. These people’s stories, and voices, are their own. What I can share is my story about the moments between us, stories that are made up of bits and pieces of both of us. There’s an idea that empathy is something you extend to another. I don’t think that’s quite right—I think it’s something that happens, usually in brief moments—maybe only the duration of a snapshot, a conversation—between people. Maybe it’s a process of seeing and being seen, that vulnerability like a flickering current between you.

TM: Mary, a 62-year-old woman who lives in a motel, cracks open her door when you knock. “You want to interview me,” she says. “Why? I don’t have any power!” She finally invites you inside. Why did she let you in? Why did people—strangers—talk to you during the years you worked on this book?

JS: Because I asked? I don’t know. As a journalist, with an assignment and a notebook in hand, it’s easy for me to break the fourth wall of daily life. That’s my job. This book was different. I told people I was working on a book, but nobody cared one way or the other about that. I wasn’t on assignment. I found it awkward and embarrassing, sometimes, to approach people who I hoped to talk with often for reasons I myself didn’t yet understand. And those people opened the door, when they did, for as many reasons as there are people in the book. We speak of “taking a photograph,” and some writers thank “subjects” for allowing them to “take their time.” But those manners obscure a much more interesting and often more intimate exchange. I can’t “take” Mary’s photograph, unless I’m sneaking up on her, which I’d never do. For better or worse, we made those images together. Mary wasn’t much interested in them—she’d glance at them—but maybe that was because her contribution—her body, her self—was already so vast. Likewise, I can’t “take” her time. She’s not really my “subject,” I have no authority over her. She opened the door for her own reasons, and this is my story about the time we spent together. Maybe that seems limited, but I don’t think so—I keep coming back to this beautiful line from Leslie Jamison’s brilliant book The Recovering—“the saving alchemy of community.” Leslie’s writing about the recovery community, but I think that alchemy is possible—I think I felt it, anyway—in the smaller exchange of stories that make up this book. This is sentimental, I know, but here I embrace that—there’s a poem in the book my daughter said when she was very little. She’s sort of a quiet current throughout the book—there are ways in which it was written to her and her brother, though they may not read it for years (or ever!). She said: “The night I was born / you were born / we were born / we were born together.” That to me is what the book is about. I think it can be true far beyond the bounds of family.

TM: “Sensation is what’s possible when seeing won’t change anything, when you don’t know enough to bear witness, when all you have is the fact of your eyes, the fact of the camera: a record of things, seen and unseen.” What a fantastic line. Bear witness, seen and unseen, there’s the vocabulary of belief (almost liturgically so). Do you still take photos? What sensation remains now that the book—these stories, these images—is out in the world?

JS: I do still take photographs, though since the heart attack at the end of the book—mine, three years ago—not as many. I’m fully recovered, healthy, I move more than ever, but I do feel sometimes as if even just the fact of my eyes is enough, that the fact of the camera is sometimes more than I need. That line accompanies an image of a burning car, [which I believe] is the same as is on the cover. There’s a body in the car. I was second on the scene; shortly after a young cop arrived. There was absolutely nothing he could do—the car was an inferno. But the next day in the news the police said he had tried to rescue the burning person. That broke my heart a little. I thought that shamed the cop in a way that was terribly wrong, because the undercurrent of that false statement was that somehow he had failed because he had not incinerated himself to recover a body from which any soul was already smoke. I get where the impulse to tell that untrue story comes from, I think. We don’t like to admit the damage done, we’d rather believe it’s never too late than learn how to live with hurt and loss. Bearing witness is, I think, a big part of how we live with hurt and loss. Sometimes when we insist on greater powers than we possess, we obscure powers we actually have. You ask what sensation remains. I think witness remains. The book—originally I subtitled it “a memoir of other people’s lives”—is just a marker of what I saw. Like any book, really. A snapshot. As real as all the other moments that pass and still linger.

Bonus Links from Our Archive:– The Jeff Sharlet Memorial Award for VeteransJeff Sharlet Revisits The Fellowship

The Ascent of the Sick-Girl Narrative

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I recently saw a playwright I had studied with at a cafe. Her mother had just been hospitalized and this led to a discussion of how women’s symptoms of heart attack often present differently than the “typical” signs we’ve been told to look for. Nausea and vomiting, pain radiating up the arm, shortness of breath, fatigue and sweats. Not crushing chest pain. Gender plays a role in how an illness presents and how medications work, and it can affect prescription dosages too. Women make up half the population but most medical research is biased toward men. My grandmother also suffered from a few heart attacks with atypical presentation. It was a challenge to persuade her to go to the doctor then, or ever. While her reasoning was never explicitly stated, it was clear that she would rather die than spend more time institutionalized, which was how she passed a number of her middle years, due to schizophrenia.

Women make up a disproportionate number of mental health cases, too. We are twice as likely to suffer from depression. Twice as likely to develop an anxiety disorder. At greater risk than men for developing bipolar disorder and seasonal affective disorder. As I have been thinking more about women and illness, I’ve been struck by the proliferation of memoirs about women’s illness published recently—and there’s more on the horizon, including Anne Boyer’s much-anticipated memoir, The Undying, recently excerpted in The New Yorker. There were enough that I started thinking of these memoirs within their own subcategory, what I came to call “sick-girl narratives,” a term that aligns with Tiqqun’s Preliminary Materials for a Theory of the Young-Girl. The only requirement for the Young-Girl is that “she” is a model citizen, i.e., consumer:
The Young-Girl is not always young; more and more frequently, she is not even female. She is the figure of total integration in a disintegrating social totality.”
The Young-Girl is ever consuming, is desirable; she is spectacle, a brand, a handle. In this way, the healthcare industry has made us all Young-Girls as our bodies have entered its labyrinthine system.

The healthcare industry is this country’s largest employer and accounts for nearly 20 percent of the GDP. It may not be apparent to readers of this site, but I have been working in healthcare for as long as I’ve been out of undergrad. My first degree was in pharmacy and for nearly 20 years I have been writing alongside working in hospitals, in long-term care, and now for a drug company. I’ve had a good glimpse of healthcare’s flawed systems as a provider as well as a patient.

I’m sure I don’t need to tell you that healthcare prices are rising and we receive fewer services in return—we’ve all felt the pinch. What does this mean in real-life terms, in our era of late capitalism? I am relatively healthy; my only real problem is a tendency toward depression that’s relatively under control. Even so, medical expenses are my largest monthly pay out, even taking into account the government credit. I am grateful for Obamacare, or rather, despite Obamacare being flawed and slowly being undone by many forces, I am grateful that I am able to afford the support I need. In 21st-century America, healthcare is a privilege few can afford, not the accessible and affordable service that it should be.

Our narratives have been shaped by the ways we experience illness, by the illnesses we live with, by the advertisements we see on TV that make us wonder if we are less happy than we should be, if our bowel problems could be eased, or perhaps our social malaise can be cured at the local ketamine clinics that now sponsor public radio. Illness is a lens through which we see ourselves. How could it not be? So much has been written on the experience of being ill, from Virginia Woolf and Susan Sontag to Robert Burton and William Styron. But that’s not the point. The point is that the industry has its grip on our wallets and our bodies, and thus our minds. This has played a role in making medical narratives a primary focus.

Our bodies and their state of upkeep preoccupy us, in part because we are built for this, but also because our healthcare systems rely on this and our recurring needs. When we’re ill we have little choice but to forge ahead and try to find our way through the convoluted and often disorganized system. Illness takes a toll not just physically but also financially. Nearly half of people diagnosed with cancer drain their total assets within two years. As Tiqqun states: “The initial form of Biopower is a process of submission to and by the body.” The point I’m getting at is that our preoccupation with medicine isn’t coincidental. It’s systemic, and this plays a role in the stories we’re drawn to and the stories we tell, such as these memoirs of illness and specifically those of the sick-girl.

Let’s consider this rather sudden appearance of memoirs written by literary women who’ve published at least one novel. Each of their current books is devoted to chronicling struggles with an affliction, whether it’s addiction or mental illness or late-stage Lyme disease. It’s possible that their inclinations toward writing fiction have made them more adept at depicting the emotional terrain of their own lives. In memoir, the empathy the novelist would bestow upon her characters is turned on its head. As Leslie Jamison writes in her essay, “Empathy Exams,” about her job as a medical actor role-playing sick patients for medical students learning how to diagnose, empathy is a focused and discrete attention paid to another’s experience that requires an effacement of self: “Empathy isn’t just remembering to say that must really be hard— it’s figuring out how to bring difficulty into the light so it can be seen at all. Empathy isn’t just listening, it’s asking the questions whose answers need to be listened to. Empathy requires inquiry as much as imagination. Empathy requires knowing you know nothing.”  In the sick-girl narrative, the attention is turned inward to chronicle the author’s experiences of recognizing, treating, and living with illness. The empathy evoked is of the reader, who is encouraged to find compassion for the author’s account.

2.
In The Recovering, Leslie Jamison writes about her struggles with alcoholism while also attempting to disrupt our culture’s mythos of the alcoholic creative genius.  Jamison has stated that her intention was to elevate a multiplicity of addiction narratives while examining alcohol’s detrimental effects on some of the literary alcoholics who have been immortalized—from Raymond Carver to John Berryman to Jean Rhys to Denis Johnson (the list goes on). However, Jamison’s statement comes off as somewhat disingenuous when considered alongside the book’s contents. She isn’t employing Svetlana Alexievich’s methods of self-effacement by creating a tapestry of voices. Instead Jamison’s recovery narrative forms the backbone of the book, upon which these other compelling addiction narratives hinge. I mostly find Jamison’s account of her attraction to and subsequent struggles with alcohol solipsistic for the way that her story overwhelms the others. It’s not that she lacks empathy when retelling these stories. Rather, Jamison’s scrutiny and focus on her own struggles with alcohol dominate the book. Her intense first-person account overshadows the myriad other voices of addiction interspersed throughout the book’s 545 pages. (Mind you, I did first encounter the book on Audible, during a road trip where I listened to Jamison read her text for hours on end—there was no escaping her voice. It’s possible the book may have left a different impression had I first encountered it on the page.)

And yet, what memoir couldn’t be called solipsistic? It’s Jamison’s denial that The Recovering gives her narrative primacy that I find frustrating. Jamison aligns her plight with the struggles of the creative genius by placing them side-by-side. This is a longstanding trope of the “mood memoir,” writes Katie Rose Guest Pryal. The mood memoir is a subgenre in a long tradition of memoirs, including slave narratives and spiritual memoirs, told in order to give voice and authority to the oppressed. Daniel Paul Schreber is the author of perhaps the first contemporary mood memoir, Memoirs of My Nervous Illness—but, even so, his long trippy text is also part spiritual narrative. In his hallucinations, both God and demons spoke to him directly. In the preface, Schreber explains that his intent in writing the memoir is twofold. He wants to declare what has been revealed through his direct communication with God, and he intends to offer an explanation for his “oddities of behavior” and eccentric beliefs to the community he will rejoin when he leaves the asylum.

Guest Pryal writes that one of the four key features of the mood memoir is that it points to other well-known people who have lived with a similar affliction, in order to establish their authoritative stance and to imply this impairment can also be a gift. Jamison does this with a twist. While Jamison’s stated intent is to reveal the bleak toll alcoholism takes on even these wildly creative individuals—such as when Jean Rhys and her husband drank Champagne to calm their nerves as their baby lay dying at the hospital—I sense in this iconoclasm an underlying reverence for these myths. I mean, how awful and yet how wonderful that Rhys’s Good Morning Midnight exists. I think most young writers, myself included, have fallen prey to the myths of their literary heroes. It’s one thing to encounter an author on the page and another thing all together IRL.

In meeting Jamison on the page, I wish she had lingered longer with her moments of vulnerability. How tortured she was by the shame of her intense shyness and naiveté. How she questioned the contradiction of self-effacement despite her strong, driving ambitions. But she glossed over this for better plot points: We hear of her drinking excessively while pregnant, while wearing a heart monitor, drinking often and in ways that gave her access to communities with cachet, via parties at Yale, at the Iowa’s Writer’s Workshop.  Jamison desired to live largely, like Icarus flying near the sun, and she fell. And yet, how far? This isn’t the question to ask of an author attempting to subvert the notion that a story must be original or extraordinary to have value. One point that does come through is that it doesn’t matter how far one falls, whether one drinks herself into a coma or never misses a deadline. The daily struggle to become and remain sober is as real and perhaps even more so when admitting the ubiquity of this plotline.

3.
“Pacing, they told me at graduate school, is one of the beginning writer’s biggest challenges, because a beginning writer wants to tell all the wrong things, or everything at once,” writes Esmé Weijun Wang in her book of essays, The Collected Schizophrenias, that recounts Wang’s experience living with schizoaffective disorder and examines the scope of what living with schizophrenia means in its myriad varieties. The remark about pacing is made as she recounts preparing for an appointment with her psychiatrist, where they will decide whether she should receive electroshock therapy, used to treat severe depression and mania and a host of recalcitrant symptoms of mental disorders. Wang doesn’t discuss the treatment, its implications, the potential side effects of retrograde amnesia, or the treatment’s long history of use and efficacy despite its associated stigmas. As Wang prepares for her consult, she is deciding what to wear. Look too put together and her suffering will not taken seriously. Look too disheveled and she might be admitted to the psych ward.

I was befuddled by this emphasis on Wang’s preparation for the consultation rather than what transpired. The reader never learns the outcome, if she endured ECT, what her physician recommends. That couldn’t be her point, could it? Perhaps. This interruption gives way to more questions. Why does she stop here? Is Wang attempting to give a play-by-play account of her medical history? She certainly isn’t. Instead it seems she’s revealing how she must be hyperaware of her presentation of self and symptoms, as if she needs to enact an idealized version of her illness. Whose ideal? The doctors’? Or the industry’s? One that conforms just enough to the DSM? All of the above. It’s evident Wang adjusts her appearance so that her illness will be visible but just enough. Unlike Jamison’s role as a medical actor, Wang is enacting the symptoms of her own disease. Is this manipulative? Yes, and unfortunately it’s necessary. Wang has learned that this is a way she can navigate the system.

She then directs the reader’s attention back to her preoccupations: her fear, her ability and inability to negotiate the system, a nurse who blames Wang for her delusions during another hospitalization—a result of her lacking faith in Jesus, the nurse claims. Which opens another can of worms, including how is our system even called healthcare? This nurse is assumed to be the “sane” care provider, while it’s obvious that she suffers from her own delusions.

Wang reveals again and again through her own encounters with the medical system that treatment for mental health operates on many tiers. Our individual experiences are modulated by the treatment we have access to and the healthcare systems we navigate. But so much about our experiences also comes down to personal interactions: the nurse who is attentive or stretched too thin. The dismissive doctor or the practitioner with a vested interest in isolating a difficult-to-pin-down diagnosis. Wang recognizes the importance of perception, and her role in what she signals to her providers. Her history as a fashion blogger helps her here. Again, I’m thinking of the Theory of the Young-Girl. The skills of manipulating her appearance, of the performance of everyday life (à la Erving Goffman) are inherent to her way of defining self. She’s very sophisticated in her presentation, in her appearance, and to be able to gauge how she will appear to someone else. She’s an expert navigator, generally able to recognize the difference between her perception and reality, and she’s largely able to see where these points converge. Dressing to impress or to seduce or to signal that she’s ill—it’s all about appearances.

Wang can pass as neuronormative in society and she’s aware of this, that this gives her autonomy and power and respect that’s not afforded to those who are less able, lower functioning, less intelligent. However, Yale wasn’t compassionate when Wang became incapacitated and was admitted to the psych ward. Wang’s expulsion, resulting from her psychiatric hospitalizations, and Yale’s later refusal to readmit her is shocking. It sends a striking message about how her mental illness stigmatized her, even after it was controlled.

Self-worth is an obsession that haunts Wang throughout the book. She often highlights her credentials as if she needs to prove herself to her audience. As if the reader needs a reminder that her capacities are far vaster than her diagnosis. As if she needs to remind herself of her self-worth. She says more than once that having gone to Yale is a signifier of her value. Similarly, she makes sure to remark during a speaking engagement that she went to a “prestigious university”: “That phrase, ‘prestigious university,’ was there to underscore my kempt hair, the silk dress, my makeup, the dignified shoes. It said, ‘What I am about to disclose to you comes with a disclaimer.’ I didn’t want my audience to forget that disclaimer when I began to talk about believing, for months at a time, that everyone I love is a robot.” Her emphasis on these external markers can be frustrating to someone who doesn’t buy into the institutional prestige machine, that credentials make for valuable people. And yet, I empathize with Wang’s need to demonstrate her value by reminding us of the intrinsic value of her personhood.

This focus on value is not coincidental. As Tiqqun writes, value is the standard measure of self, and that this image must be perpetuated and sold.  “The Young-Girl would thus be the being that no longer has any intimacy with herself except as value, and whose every activity, in every detail, is directed toward self-valorization. At each moment, she affirms herself as the sovereign subject of her own reification.” Wang’s personhood and intelligence has been devalued by her diagnosis—by the academy, by the healthcare system, by society—and so she reasserts her value again and again. But what about lower-functioning schizophrenics? What does this mean for those who don’t have a Yale admission? Wang speaks within this system of value, rather than questioning why she feels she must.

Without Wang’s delusions and hallucinations, which at times result in incapacitation, she would appear to be living a wildly successful version of a life. She is impeccable on paper—with a psychology degree from Stanford and an MFA from the University of Michigan. Her accolades include being anointed one of Granta’s Best Young American Novelists and winning a Whiting Award for her nonfiction. She married her college sweetheart who she met during her first tumultuous year at Yale. On the surface, she’s the epitome of achievement.  As Katie Rose Guest Pryal states, disability must be made invisible in the mood memoir. In this sense, it’s no surprise that Wang’s narrative has been embraced by People and the Today show. She demonstrates without fail how she’s an exceptional person. That Wang is exceptional is part of why it’s easy for the media, and the public at large to embrace her narrative, and her disability. Guest Pryal writes: “The rhetoric of these memoirs “tends to remove the stigma of disability from the author, leaving it in place for other individuals with the condition in question.”  So this is the trickle down theory of uplift.

4.
Wang knows mental illness is in her genetic make-up, with her mad great-aunt and her mother’s cousin who committed suicide and her mother, who at one point suggested that she and her daughter kill themselves together. Perhaps mental illness is also environmentally triggered, triggered through trauma. Wang encounters a neurologist who says that one day all mental illness will be linked to autoimmune disorders. Wang has flare-ups that appear with a fever, without a trigger, and she seeks answers, a cure. She wonders if late-stage Lyme disease could be a culprit—while also admitting that Lyme disease is a “belief system” of its own.  Late-stage Lyme is difficult to pin down, with many diffuse symptoms in people who often otherwise appear well. What they share is, “desperation based in suffering, and based on a system of conventional medicine that not only has no method of alleviating that suffering, but also accuses us of psychosomatic pathology.”

This accusation of psychosomatic pathology is no stranger to the sick girl. Think of hysteria of the old days and the water cure. Women with illness are viewed as less reliable narrators. Women with pain are more likely than men to be prescribed sedatives; they experience pain longer in the ER before being given an analgesic. Women experience the majority of chronic pain and yet the majority of pain studies focus on men’s pain. To be taken seriously the sick girl must appear ill, and if ill then also weak, and if weak, then she is less likely to be taken seriously. It’s a loop that’s easy enough to enter but difficult to emerge from healed.

Late-stage Lyme sufferer Porochista Khakpour is a friend of Wang’s and they seek Lyme treatment together in Santa Fe, N.M. Khakpour is also an author of a sick girl narrative, the aptly titled Sick, which explores her confluence of afflictions: addiction, depression, and late stage Lyme. Khakpour is a self-confessed sick girl of many kinds. “People ask me for advice, and I tell them to look elsewhere…I am not the poster girl for wellness,” she writes. “I am a sick girl. I know sickness. I live with it. In some ways, I am keeping myself sick.”

It’s impossible to isolate Khakpour’s symptoms as related to her individual illnesses. Her depression, addiction, and neurological  deficits from late-stage Lyme intermingle. She’s lived in exile most of her life, a child of the Iranian Revolution, whose family sought political asylum in the U.S. She writes that she’s never felt at home in the world. This alienation plays its own role in the manifestation of her illness. Her community has failed her, and now the medical industry is failing her again. They will be her audience, however, as long as she can pay them. Tiqqun writes, “The Young-Girl mortified her flesh in order to take revenge on Biopower and the symbolic violence to which the spectacle subjects it. The distress she exhibits overwhelmingly reveals, in its former aspect of unshakeable positivity, sexual pleasure as the most metaphysical of physical pleasures.” Khakpour’s photo, face forward, wearing a nasal oxygen cannula, would not be on the cover of the book if there weren’t enacting a form of seduction while playing up her sick girl visage.

She had originally planned to write a book with more of a conventional narrative arc, one of recovery and triumph, where she heals herself. It’s wishful thinking as this isn’t the path her chronic illness takes. Instead, it persists and she continues to seek medical care, and her life is a revolving door of practitioners who want to help, who try to help, who are quacks, who are incompetent, who lack time, who lack compassion.

I admire how Khakpour allows the unforeseen progression of her illness to reshape and muddy the conventional arc she’d planned. She follows it down its rabbit hole. This narrative off-roading, if you will, “reminded [her] that illness will always be with you as long as life is with you. And tragedy will be with you too.”  Khakpour’s multiple diagnoses have presentations that aren’t necessarily discrete from each other, that bleed into each other. It’s complicated. The comorbidity of mood disorder and late-stage Lyme, which some write off as “psychosomatic” doesn’t help her come off as a reliable narrator within the healthcare system.  She deserves and needs a sensitive and knowledgeable practitioner to suss out the etiologies of her pain. She can afford this, at times. But also, her medical expenses exceed her resources and she must rely on a GoFundMe, to offset her debts—a system that relies on the generosity of others, their compassion and empathy and call to action. Her narrative extends validation to others who are suffering without acknowledgment, but her story also validates her own suffering. As Khakpour writes: “And the deal with so many chronic illness is that people won’t believe you. They will tell you that you look great, that it might be in your head only, that is likely stress, that everything will be okay. None of these things are the right things to say to someone whose entire existence is a fairly consistent torture of the body and mind.”

One of the sick girl’s biggest challenges is having practitioners take her pain seriously. If her presentation of symptoms is evasive, non-specific, she must act the role of the weak woman in need of help. Her sickness doesn’t conform to the physician’s diagnoses, there are no effective treatments for post-treatment Lyme disease, i.e. the symptoms of Lyme disease that persist after a course of antibioitcs. Even the Center for Disease Control and Prevention’s resources state a skepticism regarding symptoms that remain post-treatment. The sick girl is solipsistic because the system forces her to be preoccupied with her body, and she is preoccupied because she is suffering. She must follow her pain, listen to her intuition, in order to receive attention and care, to seek and find relief. And the general  disbelief from the system, when doctors don’t clearly see the results they’re looking for, turns on her itself. The sick girl questions her sanity. Khakpour makes too many ER visits to keep track of, seeks referrals and opinions, tries alternative therapies that cost up to $1000 a day. Think of all the energy her illness requires. Think of the monetary drain. Think of her adjunct’s salary and what she can afford. What she can’t afford. How she barely has the time or energy to teach. She’s not a model of health, but she deserves to be seen by doctors and followed by a team of healthcare providers. She deserves to have her pain taken seriously and a Lyme disease assay to be taken when it’s first suggested. This is not the story she lives out. This is not the system available in our country.

Without capital, without Biopower, without a man’s body, without a neuronormative mind there is less care available than there should be.  I wish we were closer to creating a network of support more focused on sustaining health than on the accrual of wealth, but wishing isn’t enough when it comes to one’s health. The repetition of chronic illness, of seeking help, of having to advocate to receive good care, is maddening. The industry thrives on it. And other industries also feed off it, including publishing, including the propagation of the sick girl and her narratives. So much is about what is made visible. One thing is sure: the suffering is real, and continues. As Wang stated, she doesn’t ever expect to be cured, and through our experiences we come to see ourselves anew: “I …do not consider it possible to ever be completely free of the schizophrenias. They have been with me for too long, I think, to be obliterated, unlike these more recent ailments, which feel like part of the wrong narrative, and make me wonder how many different types of sick girl I can be.”

Image credit: Unsplash/ Lacie Slezak.

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