One nation, under the weather

Stung by a pan in the New York Times, an "illness memoirist" defends her art.

Published July 5, 2000 7:04PM (EDT)

I am self-centered. I am an exhibitionist. I pose whenever possible in public places. I have a billy club (Watch out!) and it would not be beyond me to flog you on your tender head, just to get my point across, my point across, my point across. Immature and whiny, constantly ill, a voluble bellyacher, not to mention derivative in all pursuits artistic, I still, at the ripe old age of 36, blame my mother for it all.

It is Thursday, June something, and this is what I wake to, the points above, written, alas, in a huge newspaper, the New York Times, a newspaper as wide as the world, with print as black as an old bruise. My new book -- the book I love best of all my books, my baby -- has been panned by a woman named Maslin, named Janet. She hates it. She hates me. Her dislike seems to seep from the spaces between the words, and my first response, after reading it twice -- "'Lying' flogs these important things to the point where they cease being important ... though she has already cataloged a full litany of complaints including depression, anorexia and self-mutilation, Ms. Slater now locates a whole new vein of illness to mine ..." -- after reading the review twice, no, three times, I do what any good illness memoirist would do. I reach for the shelf and take my meds.

I take, to be specific, two Valium, which I keep on hand for emergencies such as these. The drug is fast-acting and sweet, and soon I am calm enough to eat a corn muffin. I sit at my kitchen table and think. How could she say I'm so self-absorbed? Me? ME? Self-absorbed? I'm so nice that the mice I catch in sticky traps I later free in the woods, five miles from my home. I don't eat meat. I don't eat chicken. I personally palpate my dog's anal sacs because he's so afraid of the vet. Me? ME? Self absorbed? I love animals and people, and to top it off I'm a psychotherapist, goddamit, I'm in the helping profession; I don't whine, I listen to other people whine, me? ME? ME?

I call my husband at work. "I got a terrible review in the Times," I say.

"I'm sorry," he says.

"The reviewer basically accuses me of being narcissistic, solipsistic and writing too much about illness. That's not true," I say. "Don't you think?"

He doesn't say anything.

"Listen sweetie," I say, "Today is not the day I want your honest response. Lie to me."

"Honestly," he says, "you do write a lot about yourself, and yourself as ill, but I like your books."

"I don't believe you," I say.

"Really," he says.

"I'm going to call her," I say.

"Call who?" he says.

"The reviewer," I say, "Janet Maslin."

"I don't think that's a good idea," he says. "Why don't you calm down first?"

But I am calm. And it suddenly occurs to me, or the me-on-Valium, that this is exactly what I need to do. I need to call Ms. Maslin up on the phone and have a heart-to-heart.

Exactly what my heart will say to her heart is not clear to me, but the urge to hear her voice is. I feel, I suppose, a little like a jilted lover. A very powerful person has rejected me, and there is nothing like rejection to stir that little crimson clementine in our chests. I am stirred. I hang up with my husband. I imagine Ms. Maslin as very tall, with handsome hair and a freshly sharpened pencil tucked behind a compact ear. I imagine her briefcase, well-worn and Coach; her Manhattan apartment, where a cat curls on top of a sleek black stereo set. She is impeccable, powerful and beautiful, with a brain like a blade. I must redeem myself in her eyes. I must reason with her. I must persuade her to write another review, I must make her feel guilty. I call her.

I'm surprised by how easy it is to find her. All you have to do is call information and get the main number for the New York Times. Then you tell the gum-snapping operator on the other end of the phone that you'd like to speak with Janet Maslin. It's as though they've been waiting for my call. Not a second's hesitation, the operator ferrets me through.

I hear Janet's phone ring once, twice. I imagine her desk, with my book on it, the margins marked up. Click click. "You call is being answered by Audex," I hear, and then a pregnant pause, and then what I know is Ms. Maslin's voice saying, "Janet Maslin is busy right now." I am taken aback by Janet's voice. I am surprised by its sound, soft, tentative in its tone, a voice without the vim and vigor of her muscular writing style. She must be short. I am shocked to think that Janet Maslin might be short, and that she has such a human sound. Suddenly, her deeply critical review of me is much harder to dismiss. Maybe I am self-centered. And why do I write so ceaselessly about being ill? I replace the phone. There is sweat on the receiver where my hand has been. Damn hand. Ugly hand. Derivative hand. Ms. Maslin has it right. I am a part of, alas, the once-fashionable, now-fading brat pack of illness memoirists, and we can be a tiring bunch to read.

So there. As a memoirist I am very good at making confessions. I concede Ms. Maslin her points. I now have three, count them three, books on the market in which psychiatric illness figures significantly. To make matters worse, I have a fourth on the way. This is an embarrassment.

Illness as an artistic or narrative device is cheap, easy to sensationalize, obvious in its plot. Illness is not subtle, and so the illness memoirist need not grapple with the problems of how to render those fleeting poignant moments of being, those Woolfian wisps that disappear in mid-formation, the quarks of emotion or perception, like how she touched her forefinger to her lip, or how the couple, rendered omnisciently, argued at the restaurant without ever saying a word. The illness memoirist need not struggle with all the possibilities of point of view -- first person, close third person, alternate voices -- because her tale is relentlessly singular. And how much easier it is to dramatize the syringe or the psychosis than it is to conjure up the haunting emptiness of Don DeLillo suburbia or the poverty of Jean Toomer's inner city.

Most disturbing of all, perhaps, is how the illness memoir can be reductive in its approach to the hugeness of human problems. At its worst, by framing everything as a syndrome, as diagnosis, the illness memoir underscores medicine's dangerous but alluring stranglehold on our understanding; existentialism, love, spirituality, even nihilism fade away as explanatory models, and we are left with only this: ourselves, myself, sick, staring at the singular wound, endlessly penning it bright, penning it black as an old bruise.

The day is bad. I speak to my agent. She says, "Well a review like this won't kill the book," which leads me to believe that, although the book will still be breathing, it will need some serious life support. My illness memoir has now become ill itself. It needs to be in the hospital, and I long to find a very special bed for it. My friend Lisa, who is very savvy about the publishing world, says, "I hate to say this, but other reviewers take their cues from the New York Times."

There is, of course, nothing I can do. Except think. And I am a reasonably good thinker, even on Valium. I think about all the problems with the illness memoir as a genre, its tendency toward artistic cheapness, its obsession with syndromes, its brass Oprah-ness. I think about whether or not I really am an illness memoirist or if I have just capitulated to the market forces that have shaped the image of work. After all, although my first book, "Welcome to My Country," was promoted as a book about me, it was actually a series of portraits of six schizophrenic men whom I treated as a psychologist. I think about the time I went on Roseanne, when my second book, "Prozac Diary," was published.

I tried to write a nuanced book about the complexities of the Prozac cure, but, ultimately, I wound up on Roseanne, my face caked with makeup, my hands gesturing wildly, hopefully (I saw a tape of it later), as I admitted, on air, to having this and that mental problem, and the audience clapped, and my number rose oh so briefly into the 80s. I will never forget Roseanne. She herself was nice, and plump and very feminist, and she seemed to feel secure enough in what she was doing.

But I will never forget myself on Roseanne, the six-minute segment when my writing sank to its lowest point as I allowed myself to be seen as simply sick and cured, sick and cured, trotting out on TV and showing off my war wounds -- for what? For fame? Of course not for fame. I am not so naive as to think a six-minute segment on a faltering talk show would bring fame. No. I did it simply to stay in print. I did it because, if you write about illness, there seems to be no other way of marketing it except to sensationalize it, or to let it be sensationalized by certain celebrity readers. You can't go on a talk show and discuss nuance. You have to bray, or say nothing and sell no books and lose your publishing house and your editor, who is very important to me, my editor is. In a way I even love her.

So I think about Roseanne, and whoring, on this bad day. And because even on a bad day I am a reasonably good thinker, I muse also on why the hell I keep writing these whorish books. Am I simply a whore? Is the illness memoir as a form just a crooked cheap shot by writers who can't conjure up a novel? This is what I think: Sometimes yes. But sometimes no.

As a psychologist, one of my favorite theorists to read is Irvin Yalom. He writes beautifully about existential psychotherapy and group psychotherapy, and he's one of the few in the field who has really been able to articulate what the healing principles of group therapy might be. Yalom claims that universality is a core healing component of the group therapy process. In other words, patients in group therapy learn that they are not the only ones who feel this way, that they are not aberrant, or perverse, and this in itself is deeply healing.

The best of the illness memoirs, especially those dealing with psychiatric illnesses such as depression, are offerings in this spirit. They were written, I believe, not for the purpose of a peacock display, but to offer solace, to forge connection in times of trouble. I, for one, expect that my readers will be troubled; I envision my readers as troubled, as depressed, as guilty, mourning, maybe, a medication that failed them. I write to say, you are not the only one.

I write with the full faith that the reader I envision is hungry for my tale. I know it, because, having suffered psychiatric illness myself, I am always hungry for tales from the trenches, stories in which I can see myself, stories that might help me map my way. We must consider the illness memoir not only as, or solely as, an Oprah bid, but also as this: a gift from me to you. A folk cure, a hand held out. I look into my heart and I see a whore there. But I also see something else. I can, if you are hurting, keep you company.

Perhaps, however, the purpose of literature is not social, or therapeutic. That may be, in which case, I suppose we should house these memoirs, my own included, on the self-help shelf. But that seems a little too easy. The illness memoir, after all, is not a prescription but a description, offered not to cure but to accompany.

Furthermore, shelving the whole lot of us in the self-help section would remove us from public discourse, and, if anything, the illness memoir as a social phenomenon is worthy of public discourse. Why are there so many? What might they mean, not only about their singular authors, but about the collective culture in which we all live? Remember this. No author authors alone. Every text is a joint construction of meaning. Every illness memoir came from the world that you and I co-created, and thus we all, together, Janet Maslin included, write and continue to write this long story of sickness? For what?

Let me begin by saying that in every age there has been a prevailing explanatory grid that the myriad writers of that time have used to frame or explain their lives. The 17th-century spiritual autobiography is a perfect example of this. So is the 1960s political memoir or the 1970s feminist memoir.

Beneath these grids, however, the same essential story prevails; the grid is merely the conduit through which the tale flows. From Augustine's "Confessions" to "The Autobiography of Malcolm X" to Nancy Mairs "Remembering the Bone House," the tale, if it is done well, is always the classic heroic journey, the Dantean descent into the hell of sin, or oppression, or sickness, the long night of the soul, the gradual redemption, partial or complete. This is the story we, as humans, tell ourselves over and over again, and an illness memoir, if it is done deeply, will put its own signature on this transcendent tale, and will be, thus, transcendent.

It is a mistake, therefore, to dismiss illness memoirs out of hand. The worst of them are showy and whiny. The best of them are tussling with the great human themes in an utterly contemporary context; here, modern diagnosis and the ever-present pill are just jazzed up versions of polytheistic gods teasing with mere mortals, the aching Achilles' heel, Sodom, Gomorrah, burning, cities and salt.

And yet. Are there not other ways of getting at these great themes than through the relentless use of disease? So the critic argues. So might Ms. Maslin say. I say no. Not for me. Not for now. This might be my great limitation as a writer, or this might mean I'm onto something the crazy optimists just can't see.

The fact is, or my fact is, disease is everywhere. How anyone could ever write about themselves or their fictional characters as not diseased is a bit beyond me. We live in a world and are creatures of a culture that is spinning out more and more medicines that correspond to more and more diseases at an alarming pace.

Even beyond that, though, I believe we exist in our God-given natures as diseased beings. We do not fall into illness. We fall from illness into temporary states of health. We are briefly blessed, but always, always those small cells are dividing and will become cancer, if they haven't already; our eyes are crossed, we cannot see. Nearsighted, farsighted, noses spurting bright blood, brains awack with crazy dreams, lassitude and little fears nibbling like mice at the fringes of our flesh, we are never well.

Science proves me right, the great laws of the universe, the inevitability of entropy. So there. The illness memoir is so many things, a kindly attempt to keep company; a product of our culture's love of pathology, or of our sometimes whorish selves; a story of human suffering and the attempts to make meaning within it, and finally, a reflection on this awful and absurd and somehow very funny truth, that we are rotting, rotting, even as we write. Salud.

By Lauren Slater

Lauren Slater is the author of "Welcome to My Country," "Prozac Diary" and, most recently, "Lying."

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