Poisonous blood, merciless prose


The illness endured and chronicled by Sarah Manguso is terrible, but what really makes her writing so compelling – and utterly idiosyncratic – is that she still comes across as such an unpleasant person, writes ARMINTA WALLACE

‘THIS IS the usual sort of book about illness,” Sarah Manguso writes in The Two Kinds Of Decay. “Someone gets sick, someone gets well.” Well, it’s her book – so she should know. But it doesn’t strike me as that sort of book at all.

The usual sort of books about illness tend to be a) tributes to people who didn’t make it, or b) the inspirational stories of people who did.

Their authors are either a) celebrities or b) gentle, well-meaning folks who, having turned their lives around as a result of their journey through suffering and out the other end, wish to help others to do the same.

These writers are rarely possessed of the kind of glittering literary ability and sardonic humour which Manguso possesses in spades.

And while she has undoubtedly turned her life around, and suffered to the enth degree squared, she still – and there’s no nice way of saying this, but it’s what makes her book such a compelling and utterly, utterly idiosyncratic read – comes across as a class-one bitch.

Don’t get me wrong. Her book has plenty of inspirational moments, and it’s not short on compassion – whether it’s for her fellow-patients, especially those in the psychiatric facility where she eventually found herself locked in, or for her parents, whose suffering was almost as great as her own.

The chapter entitled “Measuring” is a three-page essay which could give any professional philosopher a run for their money: and I wouldn’t mind betting that her description of how it feels to be paralysed will become a classic reference point, not just in medicine but in popular culture.

Sit to the right of someone on a sofa, she advises. Very close: thigh to thigh to thigh. Lift your right thigh and put it back down. Then lift your left thigh. Then lift the thigh after that. That’s what it feels like to be paralysed; “trying to lift someone else’s thigh with your own mind”.

For all these reasons and for many more, The Two Kinds Of Decayhas garnered a good deal of critical praise. But the predominant note of this praise has been of the “Ah, sure isn’t she great to do it at all, God love her” kind. Which is precisely the attitude which saw Manguso ban a certain doctor from her hospital room. Because he patronised her, and in a shaking voice. “He was forcing tears either forward or back,” Manguso the Merciless writes.

One thing’s for sure. Those doctors and nurses whose paths crossed Manguso’s during the nine years of her paralysing encounter with CIDP – aka Chronic Idiopathic Demyelinating Polyradiculoneuropathy, aka a rare and extreme form of an already very rare syndrome, aka a situation where her own blood was poisoning her – and who weren’t paying proper attention, are going to be sorry now.

There’s the nurse who “understood slow, simple English” and who persistently shook baby powder perilously close to the line in Manguso’s chest. There’s the Sikh doctor who “sweated onto me, and stunk up the entire room with his frustration”. And there’s the hapless college boyfriend, who liked to carry books around in his pockets: “. . . they stuck out just enough that you could see it was Kierkegaard”. Ouch.

On the phone from London, Manguso is nothing like this avenging Queen of the Night of the Long Knives. She’s patient and polite, softly-spoken and articulate. But she admits that The Two Kinds Of Decaydoesn’t pull its punches. “I tried to be as kind as I could,” she says. “But there are moments when I wasn’t able to behave as well as – maybe – I should have.” See that “maybe”? That’s my girl.

Manguso has much to be angry about. A bright young Jewish kid who should have sailed through college and into a top-end life, she went instead through everything from blood-drenched horror to steroid-induced mania. And every time she was told she was over the worst, things got worse. Not only that, but in many cases the treatment turned out to be almost as bad as the disease.

“There were actually several very traumatic moments that existed as vignettes that I ultimately cut from the book, because they were too distracting from the arc of the narrative,” she says. “I didn’t want it to turn into a book that contained two or three truly horrifying scenes to which the rest of the story was incidental.”

The Two Kinds of Decaymay be mean in places: it’s also lean, all the way through. It’s written in brisk chapters with titles such as “The Taste”, “The Wrong Symptom” and “The New Machine”.

The chapters themselves sometimes take the reader’s breath away – but the overall narrative arc is so well managed that there’s no trace of staccato or hiccups in the story. How did she arrive at such a perfect literary form to tell her very untidy story?

“The first part that I wrote is the section that is now somewhere towards the middle of the book entitled ‘The Signet’,” Manguso says. “I set out to write a medium-length essay about social class in America, so I started to write about the arts and letters society at my college. And in it I mentioned the catheter that I was wearing in my heart that year.

“So although most of the piece is about serving the soup among members of the upper class – among which I felt like a real imposter – I realised I would have to write some kind of companion piece in order to explain why I was wearing a catheter in my heart.” So she wrote another section, and another.

“It just kind of built from there. I decided each day that I would just try to remember one event or one experience that had something to do with that nine-year period of my life. It wasn’t until I had really quite a few of the sections written that I realised it could be a published book. At that time I identified myself as a poet, and I thought: ‘This is just a short break that I’m taking between my second book of poems and my third book of poems’. In fact, I never wrote my third book of poems.”

She’s now working on a book which will come out next year or the following year. Entitled The Guardians,it’s a prose elegy for a friend who died in 2008.

“He had a psychotic break very suddenly, and threw himself in front of a train. I realise it sounds like another book about horror and sudden trauma – and it is about the horror of his death – but most of the book is about the process of my outliving him and what that experience has been like.”

It will, no doubt, raise the bar for that other kind of book about illness – the posthumous tribute – and frankly, I can’t wait.

Manguso musings   

“Prednisone’s long-term side-effects include depression and mania, weakness and fatigue, blurred vision, abdominal pain, infections, painful hips and shoulders, porous bones, acne, insomnia, weight gain, stretch marks, facial swelling, and nervousness. There are others. Those are just the ones I have.”

“I remember meeting my Latin professor and knowing he thought I was dying and letting him tell me everything that would be on the exam.”

“In San Francisco I met a man who was missing a big chunk of his jaw. The conversation turned to a certain type of hospital visitor. Have you considered herbal remedies? this visitor asks. Both the man and I had entertained this visitor.”