Votives hanging outside the blue-tiled facade of a church in Olhao, Algarve Portugal (photographed by author)
Votives hanging outside a church in Olhao, Algarve Portugal (photographed by author)

Every sound we make is a bit of autobiography. It has a totally private interior yet its trajectory is public. A piece of inside projected to the outside.

Anne Carson, The Gender of Sound (Glass, Irony and God)

As a doctor who also teaches creative writing, I am aware that features of narrative such as temporality, causality, individual agency and closure, rarely apply to the bewildering and tumultuous experience of severe illness. In the health humanities, this failure of conventional narrative to adequately communicate illness and pain has long been observed. Even Arthur Frank, a pioneer of the illness narrative, allows in The Wounded Storyteller for a category of so-called ‘chaos’ narrative manifesting as an ‘absence of narrative order’ while Elaine Scarry in The Body In Pain laments the general inadequacy of language to convey pain’s distress. 

Recently, there has been a turn towards experimental technique and genre in an attempt to capture the lived experience of illness. The lyric essay has become prominent as a literary form of illness narrative. But what is the lyric essay? Mintz suggests it is ‘pain’s most suitable genre’ citing its ‘elusive, imagistic, ecstatic, associative and melodic’ qualities. A hybrid form, composed as a collage of personal essay, scientific fact, cultural references and poetic imagery, D’Agata and Tall in The Seneca Review (1997) describe it as follows:

The lyric essay partakes of the poem in its density and shapeliness, its distillation of ideas and musicality of language. It partakes of the essay in its weight, in its overt desire to engage with facts, melding its allegiance to the actual with its passion for imaginative form.

The narratologist Shlomith Rimmon-Kenan in her paper, The Story of “I”: Illness and Narrative Identity, documents how illness fragments her sense of self, suggesting only fragmented narratives ‘lay bare the ill subject’s vulnerability’. This fragmentation is another feature of the lyric essay alluded to by D’Agata and Tall, reflecting the experience of illness.

Given its genre mingling, the lyric essay often accretes by fragments, taking shape mosaically–its import visible only when one stands back and sees it whole. 

Rimmon-Kenan also finds illness at a ‘bodily, visceral level’ disrupts linear time, breaking the sense of past, present, and future necessary for selfhood. Lyric time, as Mintz says, operates by ‘more often circling and symbolising life events than narrating them in linear ways’ while Frank refers to the ‘chaos’ narrative as ‘the anti-narrative of time without sequence.’ 

The lyric essay, as with lyric poetry, frequently begins with an image or event in the present (the lyric ‘moment’) and unfolds in time and space, using imagery and repetition to produce its effects. The form also allows for gaps and elisions, which according to Mintz ‘remind us of the inarticulable qualities of pain, the silence it conveys.’ 

Lyric poetry emphasises the unique subjectivity of the poet or speaker (the lyric ‘I’) and this intimacy of voice connects the lyric essay with confessional and often marginalised forms of women’s writing such as the letter and diary. The Pain Scale by Eula Biss, A Grand, Unified Theory of Women’s Pain by Leslie Jamison and Sick Woman Theory by Johanna Hedva are lyric essays concerned with female subjectivity and embodied experiences of illness, while intensely literary in their engagement with language and form.  

            Eula Biss’s The Pain Scale wrestles with medicine’s inadequacy at judging pain in ten parts, its subheadings corresponding to the standard pain scale. Her clear, meditative voice interrogates the gap between pain as experienced by a patient and the numerals, words or images employed by health professionals, alongside discussion of scientific objectivity and interactions with her physician father.

‘We see these wounded women everywhere,’ begins Leslie Jamison in A Grand Unified Theory of Female Pain. Jamison uses Anne Carson’s The Glass Essay, a lyric essay detailing the psychic torment of a failed relationship, to discuss how literature aestheticizes women’s psychological and physical pain and her own history of anorexia and self-harm.

 Johanna Hedva’s essay Sick Woman Theory is a rallying cry to those living with chronic pain and illness. Writing at the onset of the Black Lives Matter movement, Hedva describes listening to the protests and considering the political position of those with so-called ‘invisible’ disabilities. If full citizenship is only for the productive, who does it exclude? Hedva’s intimate first-person voice is interspersed with medical facts and political references to give the essay its weight.

As illness narrative, the lyric essay is a hybrid genre which uses poetic artifice to express truths that resist telling directly. Born of the fragmentation of illness, its breaking-up of linear time allows the disruption of disability and pain to be explored, while its powerful imagery and experimental language engage the reader. Ranging in content from reportage to lyricism, poetry to social criticism, it illuminates lived experiences of illness and relates them to a wider political context. Reading these first-person, lyrical accounts, we move closer to a health humanities which as Hedva says, allows for, ‘radical kinship, an interdependent sociality, a politics of care.’


  • Biss, Eula, ‘The Pain Scale’, Seneca Review, https://www.snreview.org/biss.pdf
  • Carson, Anne, Glass, Irony and God, (New York: New Directions, 1995) 
  • D’Agata, John and Tall, Deborah, ‘Tall, Deborah, and John D’Agata. ‘New Terrain: The Lyric Essay’. Seneca Review 27. 2 (1997) pp. 7–8. 
  • Frank, Arthur W., The Wounded Storyteller: Body, Illness & Ethics, (Chicago: University of Chicago Press, 2013)
  • Hedva, Johanna, ‘Sick Woman Theory’. https://johannahedva.com
  • Jamison, Leslie, ‘A Grand Unified Theory of Female Pain’, Virginia Quarterly Review, https://www.vqronline.org/essays-articles/2014/04/grand-unified-theory-female-pain
  • Mintz, Susannah B., ‘On a Scale from 1 to 10: Life Writing and Lyrical Pain,’ Journal of Literary & Cultural Disability Studies, Liverpool University Press, 5.3 (2011) pp. 243-259
  • Rimmon-Kenan, Shlomith, ‘The Story of “I”: Illness and Narrative Identity.’ Narrative, 10.1 (2002) pp. 9-27 
  • Scarry Elaine, The Body In Pain, (Oxford: Oxford University Press, 1985)

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