To print this page, select "Print" from the File menu of your browser salon.com > Books June 24, 1998 URL: http://www.salon.com/books/feature/1998/06/24/feature My syndrome, myself A recent crop of memoirs chronicles our obsession with illness, from Tourette's syndrome to anorexia to obsessive-compulsive disorder. - - - - - - - - - - - - By Laura Miller "I should like to die of consumption," Lord Byron once, insensitively, told a tubercular friend. "Because the ladies would all say, 'Look at that poor Byron, how interesting he looks in dying.'" Among all diseases, TB was the Romantics' darling; Keats died of it, and its preferred victim was imagined to be (in the words of Susan Sontag) "a hectic, restless creature of passionate extremes, someone too sensitive to bear the horrors of the vulgar, everyday world" -- a poet, an artist, that is. Someone "interesting." Antibiotics made short work of this particular manifestation of artistic temperament, but illness -- the right one, at least -- is a more popular way than ever of making oneself interesting. The contemporary equivalent of the feverish, ethereal, consumptive Romantic poet, swooning on his deathbed, quill in hand, puffy shirt falling from one shoulder, is Elizabeth Wurtzel's glum-but-glamorous, waiflike visage on the cover of 1994's "Prozac Nation: Young and Depressed in America." Extravagant, soulful (and pretty) suffering has proven a reliable way to sell lots of books since back in Byron's day, but in the 19th century, the truly fashionable diseases were few. Today, it helps if you're photogenic, like Wurtzel, but almost any old affliction can provide the occasion for a searching work of autobiography and/or cultural history, from asthma (Louise Desalvo's "Breathless") to stuttering (Marty Jezer's "Stuttering, a Life Bound Up in Words"). It used to be that the story of your life was a matter of what you did, where you went, who you knew. Now, it's what your diagnosis is. In her decidedly nonautobiographical essay "Illness as Metaphor" (1978), Susan Sontag claimed that "insanity is the current vehicle of our secular myth of self-transcendence." That was more true in the '70s, during the heyday of the idea that schizophrenia, like LSD, offered a mind-expanding journey into the unconscious. (And it was easier to believe that when the streets weren't full of deinstitutionalized travelers who never returned from their Magical Mystery Tours.) Today, it's near-madness that fascinates us, probably because most of us have visited that territory once or twice, however briefly; we can identify. To be stricken with depression, or manic-depression, or anorexia, or the urge to self-mutilate, or obsessive-compulsive disorder, or any of a host of other odd psychophysiological calamities, is to be handed the ideal subject matter for a modern memoir: an extreme version of a common complaint. Nevertheless, subject matter is only half the battle -- there's still the problem of execution. This hurdle turns out to be too high for Lowell Handler, author of "Twitch and Shout: A Touretter's Tale." After being written about by Oliver Sacks (the Chaucer of neurological dysfunction) and serving as the narrator for a 1995 documentary about Tourette's syndrome, Handler, a photojournalist, decided to commit his life story to paper. (Perhaps he was also encouraged by his brother Evan's successful autobiographical one-man show about battling leukemia, "Time on Fire.") Although Tourette's -- which is characterized by exaggerated tics, involuntary jerking movements, grunting sounds and sometimes by profane verbal outbursts -- is a strange, dramatic condition, Handler's account of having it is inert. "Twitch and Shout" meanders woodenly through the predictable stages of the syndrome memoir -- the first surfacings of Handler's illness during his childhood, the confused teenage years spent trying in vain to fit in, going to the wrong doctors, finally finding the right doctor, researching the condition, evaluating the treatments, joining a support group, bridling at the stigma attached to the illness and, ultimately, arriving at Lessons Learned as a result of it all. While a book about a little-understood condition like Tourette's syndrome serves the laudable purpose of increasing understanding and tolerance, in this case that's all it does. No amount of virtuous intent can make it a pleasure to read a sentence as wooden as the following: "Oliver is a scientist and a writer, and I am a photographer, but I also had an agenda of exploration and discovery and sought answers to my basic human questions about this disorder such as why must I engage in actions I do not want to do." When your affliction is less exotic, you've really got to come up with a more appealing approach. Emily Colas, author of "Just Checking: Scenes from the Life of an Obsessive-Compulsive," opts for a style somewhere between stand-up comedy and performance art monologue, her story broken into evocative, sketchlike vignettes with titles like "If You Know Your Party's Extension, Press 1 ..." and "The Living Hell of Neatness." Colas' cool, droll tone makes a perfect counterpart to the escalating absurdity of her disorder, the "insanity lite" of a woman who freely partook of recreational drugs yet insisted that her husband sample every restaurant meal she was served so that he could screen it for poison and broken hypodermic needles. Her dread of contamination (particularly from blood) becomes so severe she can't walk down a sidewalk without triple-checking the soles of her shoes, refuses to let anyone into her house (they might be concealing a cut finger) and eventually decides she's contracted a disease just from watching a man bleed on television. One reason Colas' disorder makes for more intriguing material than Handler's is that its causes seem more mysterious. Once TB's onset could be traced to a mere microbe, the 19th century's fascination with the disease quickly faded. Tourette's has fairly straightforward neurological roots, and many would say the same of obsessive-compulsive disorder, which often can be controlled with medication. Nevertheless, Colas spends a lot of time in therapy and musing over childhood factors (a mother who needed to flick the light switch in multiples of four, a German nanny who "made the trains run on time") that might have contributed to her perpetual anxiety and need for ritualized structure. OCD still hovers in those interstices between the body and the mind, and the sane and the mad. When a New York Times Magazine beauty column about the current craze for disinfectant soaps casually mentions a young woman who waits for someone else to leave a public restroom so she can follow her out without touching the doorknob, Colas' disorder starts to look like everyday worry writ huge. That's another reason why the syndrome memoir is so compelling, even to the unafflicted. We all have our comforting little routines, our spates of hypochondria, our control issues, so we can well imagine what it's like to have the anxiety volume knob turned up to 11. Colas never loses her rational faculties; they just coexist with the intrusive neurotic thoughts that drive her to more and more fanatical feats of hygiene -- which is what makes "Just Checking" so funny. At an early age, Colas got taught the lesson of great comedy -- that the human condition consists of a perpetual tension between impulse and better judgment, with judgment losing out most of the time. Tourette's seems to have a family relationship with OCD (the tics of a Touretter have the same soothing effect as an obsessive-compulsive's rituals), and OCD bears a certain resemblance to anorexia, the subject of Marya Hornbacher's "Wasted: A Memoir of Anorexia and Bulimia." Hornbacher recalls a lot of counting and categorizing, a "system" applied to food that often echoes Colas' organization of the physical world into "safe" and "contaminated" objects. To an outsider, these memoirs begin to blur together, suggesting a continuum of neurosis, expressing itself differently through different characters. If Tourette's is its most down-to-earth manifestation, and obsessive-compulsives are its wry comedians, then anorexics are surely the high divas of "insanity lite." The model for Hornbacher's memoir is Wurtzel's "Prozac Nation." The two books are remarkably similar -- both amply quote suicidal poets Sylvia Plath and Anne Sexton; both offer minutely detailed dissections of their authors' unhappy childhoods; both contain frequent references to their authors' exceptional talents, ambitions and intellects; both resort to a surly, adolescent sarcasm that seems intended to disguise the underlying melodrama of the whole enterprise. This kind of book tends to arouse complex emotions in readers, who either completely identify with and admire the author or find her infuriating. "Had we a god, it might have been Dionysus," Hornbacher writes of the arts academy she attended with a passel of other scenery-chewing teenagers, and you're either with her all the way or you groan. Like Wurtzel, she's an incorrigible exhibitionist, and although she proclaims that this book is an attempt to "keep other people from going where I went," it often feels like an extended opportunity to dwell on every aspect of herself. Every illness memoir must arrive, ultimately, at the issue of the Cure. Finding one makes for a satisfying climax to the book, but it also erases the very thing that makes the life interesting enough to write about in the first place. Both Wurtzel and Hornbacher opt out of this Hobson's choice by announcing that, although the worst is over, they are topic of discussion during the publicity tour for "Wasted") describes her eating disorder as an "addiction," borrowing terminology and concepts that originated in Alcoholics Anonymous. An organization based on the idea that it's therapeutic to embrace your disease as chronic ("I'm X and I'm an alcoholic") and to publicly confess, in detail, your personal journey to the point of "hitting bottom," AA may well be the most significant force behind the proliferation of this kind of memoir. The movement has transformed illness from a metaphor into an identity. AA has also dragged many souls out of their own personal pits of self-destruction using the venerable, nonpharmacological practice of storytelling. For them, it recasts the basic maintenance of everyday life -- staying sober, holding down a job and showing up for regular meetings -- as an achievement worthy of Hercules. Likewise, in a world where unadulterated heroism is harder and harder to define, let alone accomplish, the syndrome memoir turns simple survival into a triumph. Read a bunch of them, though, and the effect can be enervating -- as if the best we can hope for is a world full of people just hanging on, getting by, grateful only that they haven't killed themselves ... yet. Easily intimidated readers might find such low expectations reassuring, but it's not a vision with a lot of pizazz. Of course, a gifted writer can make the most shopworn tale resonant and moving: William Styron's slim, harrowing "Darkness Visible: A Memoir of Madness" is a case in point. But when a writer pushes the genre in new directions, as Lauren Slater does with "Prozac Diary," even better. Slater's memoir, to be published in September, isn't the story of her illness, it's the story of her cure. Slater was one of the first patients prescribed Prozac, a drug she has taken for 10 years. Its effects were sudden, "the single most stunning experience of my life," and completely transformed Slater, who had suffered from a case of obsessive-compulsive disorder so severe that from age 5 she had been miserable, perpetually vexed and "knew nothing of pleasure." For Slater, becoming abruptly well was like falling down Alice's rabbit hole into normalcy. She barely recognized her life or herself. "Much has been said about the meanings we make of illness," Slater writes, "but what about the meanings we make out of cure? Cure is complex, disorienting, a re-visioning of the self, either subtle or stark. Cure is the new, strange planet, pressing in." She wanders her city in a delighted daze, eating ice cream bars, drinking cocktails, watching street performers, flirting with men. Ultimately, though, she has to face the implications of her cure: that her experience of the world, even her own identity, could be utterly changed by a mere pill. In their own way, illness memoirs fret away at a preoccupation that's on many people's minds today -- from evolutionary psychologists to criminologists to ambivalent advocates of psychopharmacology like Peter Kramer, author of "Listening to Prozac." How much of you is you, and is what feels like your own, unique self anything more than a cocktail of neurochemicals, subject to drastic change should someone (or something) mess with the recipe? Slater recalls a moment of crisis in her recovery when the Prozac began to fail her and she contemplated upping her dose, feeling enslaved to the drug and despair at suspecting that "when all is said and done, we are ultimately beast." She stalks off into the Kentucky countryside and faces down a devil duster (a tiny tornado), "sick of being sick ... sick of being so thoroughly and pathetically passive." Although she chooses choice: "So long as I could choose anything at all, I was more than my chemicals, more than my cure." And more than her illness. As long as she was sick and impaired, Slater never had to wonder what she would do with her life beyond getting well. Cure, for Slater, begs the question of what she will do with her life once she gets it back again. That's a question few illness memoirists ever get to, the hardest question of all. But it's also the most interesting. salon.com | June 24, 1998   - - - - - - - - - - - - About the writer Laura Miller is Salon's New York editorial director.