“This is why one writes a memoir. This is why one tells strangers. We carry the invisible, and perhaps the telling can honour it, make it real and seen.”—Gayathri Prabhu, If I Had to Tell It Again
Sarah Roth // What is the medical memoir, and what can scholars in the medical humanities learn from attending to the shapes that it takes? What does it mean to give voice to an experience of illness in literary form, and what modes of attention are asked of a reader as she engages with what is written? Amala Poli, literary scholar and Writer-in-Residence at Synapsis, paves the way forward for exploring these questions. In Writing the Self in Illness: Reading the Experiential through the Medical Memoir, published by Manipal University Press in September 2019, Poli presents a careful study of reading and writing about illness in the contemporary world. She makes a case for recognizing the medical memoir as a powerful literary genre—one that reconfigures the scholarly possibilities for understanding medicine, care, and politics as bound up in one another. She encourages scholars and literary publics alike to animate new ways of reading the medical memoir and give it a home in evolving medical humanities curricula.
Poli brings together a constellation of texts from the past four decades, each reckoning with illness from a situated perspective. Inspired by Susan Sontag’s call in Against Interpretation and Other Essays, Poli reads these memoirs “from within,” responding to the particularities of each author’s sensory and affective world made into words. In doing so, she allows each author to guide her in understanding the aesthetic and political gravity of their work. “There exists a need to read the medical memoir on its own terms,” Poli writes, “with empathy for the intervention it makes… and for the brave task it embodies in critiquing the systemic, personal, and social violence of our times.” In the first three chapters, Poli focuses on memoirs written by individuals and families navigating cancer treatment, HIV/AIDS, and mental illness, respectively, and concludes with a chapter on physician-patient memoirs, which reflect on both giving and receiving medical care.
Central to many of these memoirs is the way in which illness affects relations, and not merely the bodies and minds of individual writers. In chapter three, Poli discusses Linda Gray Sexton’s Searching for Mercy Street, a book in which the author embarks on a personal journey as she considers her mother’s suicide at the age of forty-five, and as she approaches forty-five herself. Poli reads into the author’s attempts to make sense of depression and loss as enmeshed in relationship with her mother, the poet Anne Sexton. For Linda Gray Sexton, finding the words to express her time with her mother is complex, for it was not a relationship, nor an illness witnessed and experienced, that could be described in neat narrative strokes. In particular, Linda notes that it was a relationship touched by abuse, one in which violence and care were intertwined. As Sexton learned from her mother how to write, she also absorbed a kind of love that was touched by violence: a “kind of love that can be deeply damaging.” Literary writing was, between them, a way to both reckon with and dive into intense feeling. As with other authors who figure in Writing the Self in Illness, illness and relations form a complex weave that cannot be unraveled for telling in simple terms.
Alongside close readings of each medical memoir, Poli traces the routes of the books as they have circulated from the late 20th century to the present day. For many authors, the decision to write of illness—and attendant pain, bodily transformation, and loss—meant breaking silences, even within their intimate social worlds. For Audre Lorde, it was a political necessity. The work of interrogating taboos was an undercurrent as she wrote The Cancer Journals; she sought to build toward a world in which women need not suffer in silence. Linda Gray Sexton wrote Searching for Mercy Street in an attempt to “tell it true” and to explore how her mother’s illness reverberated into everyday familial life. In the case of Sexton’s memoir, reception of the book was affected by resistance among family members to accept “truths they would rather silence” about mental illness. As she shares these books with the reader, Poli acknowledges the bravery, and often risk, that is involved in choosing to tell a story that others would rather suppress.
Writing the Self in Illness also considers deeply the question of knowledge and joins important and historic feminist conversations about the body as a site of knowing. Poli writes that the authority of memoir is that it can claim the kind of knowledge that comes from the body, and from the bodying forth of experience into language. Memoir can also challenge the truth value of scientific knowledge—for instance, the obtuse fact of the prognostic statistic. Borrowing the metaphor of a mobius strip from the biologist and gender studies scholar Anne Fausto-Sterling, Poli suggests that we examine “how the particular individual body modifies and transforms the discourse of illness in question”:
“The Mobius strip is the simultaneity of three movements—the assimilation of scientific medical discourses into individual bodies, which in turn resist and engage with such discourses through the act of writing the memoir, which has the potential of transforming the medical discourse itself, over time.”Anne Fausto-Sterling, Sexing the Body: Gender Politics and the Construction of Sexuality
In other words, medical discourse acts upon the body; the body resists these discourses; the body writes, acting upon the world from which medical discourse emerges. Poli carries the question of knowledge across each chapter of the book, interrogating at many scales the work that is done in the craft and circulation of the memoir.
In the fourth and final chapter of Writing the Self in Illness, Poli considers the question of medical knowledge in relation to physicians who become patients, and patients who become physicians, writing between and across ways of knowing. In Paul Kalanithi’s When Breath Becomes Air, for instance, a young physician is diagnosed with advanced cancer and decides to write a memoir between his two roles. “As a doctor, you have a sense of what it’s like to be sick,” Kalanithi writes. “But until you’ve gone through it yourself, you don’t really know. It’s like falling in love or having a kid.” Poli reads across such memoirs to ask how moving between roles shifts and shapes the texture of experiential knowledge. For Kalanithi, the diagnosis leads him to reflect on what it means to be a patient. In his case, it brings a sense of uncertainty into his medical knowledge, and a “growing awareness of time ebbing away from him.” Kalanithi discovers himself as a writer as he interrogates the matter of death, and we journey alongside him as he navigates the dynamism of life in the face of an end.
In the appendix of Writing the Self in Illness, Poli has included brief summaries of each of the memoirs discussed or referenced. As we read along, she encourages us to engage with these texts as she does: with care.
Fausto-Sterling, Anne. Sexing the Body: Gender Politics and the Construction of Sexuality. New York, NY: Basic Books, 2000.
Kalanithi, Paul. When Breath Becomes Air. New York, NY: Random House, 2016.
Poli, Amala. Writing the Self in Illness: Reading the Experiential Through the Medical Memoir. Madhav Nagar, Manipal, India: Manipal University Press, 2019.
Prabhu, Gayathri. If I Had to Tell It Again. Uttar Pradesh, India: HarperCollins, 2017.
Sexton, Linda Gray. Searching for Mercy Street: My Journey Back to My Mother, Anne Sexton. Berkeley, CA: Counterpoint Press, 1994.