Sick: A Memoir By Porochista Khakpour
New York, NY; Harper Perennial, 2018, 272 pages, $15.99, paperback
Reviewed by Julia Berner-Tobin

The best memoirs about trauma are never just about the injury itself. Ghostbelly (2014) is about stifling Western attitudes toward birth, death, and mourning told through Elizabeth Heineman’s struggle to grieve her stillborn son. When Breath Becomes Air (2016) ponders mortality and time explored through the story of Paul Kalanithi’s diagnosis of stage IV lung cancer. Jana Leo's Rape New York (2011) is about racialized city planning, architectural theory, and the criminal justice system anchored in the story of Leo’s own rape.

But Porochista Khakpour ’s new book, Sick, is about Porochista being sick. It details the mysterious and severe physical pain she endured after years of wrong calls before finally receiving a correct diagnosis of late-stage Lyme disease. It’s about her body—where it went, who it slept with, what it felt when it came in contact with ecstasy, benzos, a cigarette; about her eyesight that comes and goes and creates “hyperglycemia-diabetes-cancer-AIDSgodknowswhatIhave” stars in her vision when she stands. How her spine goes into shocks when it’s at rest. Excerpts from emails to friends provide revealing details: “I have increased salivation and gum bleeding, weird heart rate and blood pressure and dizziness and disorientation ... if candida was detected in the blood, then is this sepsis?”

It’s feverish and frantic. Each chapter is just long enough to establish who she was dating, where she was living, and what she was taking. There’s New York, LA, Santa Fe, Germany, Chicago, Jacob, Alexander, Ryan, Jerry, Cameron, Xanax, Paxil, Celexa, Ambien, Neurotonin.

But each place, person, or drug fails to make her better. She has always been sick. She writes, “I don’t remember a time when I wasn’t in some sort of physical pain or mental pain, but usually both.” Khakpour was born in Tehran during the Islamic Revolution, the Iran-Iraq War following just a few years later. To escape the turmoil, her parents moved their family to the US when she was five. They lived close to a suburb of LA nicknamed “Tehrangeles,” but she never felt at home in California and found her own escape in a small liberal arts college in upstate New York. There, like so many New York liberal arts freshmen, she immediately started smoking cigarettes, dressing all in black, and using drugs.

“The best parts of Sick are about drugs. She’s honest about her desire to alter her physical state using means she can control.”

The best parts of Sick are about drugs. She’s honest about her desire to alter her physical state using means she can control. Here her writing is sharp and personal, switching to second person so there’s more space to enter into these moments. “Drugs make holes so they can fill them for you later,” she writes. Then, later “If you know a part of you is always dying, taking charge of that dying has a feeling of empowerment. My body goes against me often, so what if I put it through that myself?” Her descriptions of getting ahead of some of the inevitable pain—emotional or physical—is relatable.

The emotional pain caused from being sick is tied in with emotional pain caused by her many boyfriends, the characters who serve as witnesses to her body’s ups and downs. I’m a fan of romantic novels, so I was surprised at myself for wanting less of these lovers, with whom we rarely get beyond the surface-level. They bleed into each other, distinct more for the time they came into Khakpour ’s life than their own discernible characteristics. Though she does reflect on how her identity as a sick person defines these relationships and raises the stakes—“I liked that there was danger involved with me, that I was someone people could lose”—she could’ve delved deeper into the role of the caretaker: how those people can make and fill holes in a sick body just like drugs, and how caretakers can define themselves by the job of keeping their loved one from falling apart. Khakpour provokes many interesting questions like this throughout Sick, but they’re often asides, given a back seat to the details and facts of what happened, when.

I loved this book before I started it. I loved that the whole thing is dedicated to the story of her body. The premise is so brave, and I felt in awe of her fearlessness at the start. All these things happen to her physically, but there’s still a thinking person, a writer, attached to this body that is falling apart. So tell us, writer, what that’s like. I opened the book wanting—I knew my (often falling apart) body had never been given someone else’s story to find itself in; I wanted this to be it.

I found many points of connection. At thirteen, after months of feeling strange and horrible I, like Khakpour and many other women, was given a misdiagnosis of anorexia when there was much more wrong with me. Next, again like Khakpour and many other women, the diagnosis was psychological issues. Then finally, correctly, I was given a diagnosis of Crohn’s disease at fifteen. After the diagnosis there were years of medication, trying different combinations of steroids and immunosuppressants that gave me their own range of difficult-to-deal-with and at times nearly impossible symptoms. Like Khakpour, I felt my personality change with drugs, steroids giving me anxiety and strong mood swings, emotions I was confused by. But the drugs allowed me to go to school and graduate on time with grades that were good enough. Now, like Khakpour, after what I hope is the worst of it, I pretend my body isn’t sick at all, taking medicine only sporadically, drinking, smoking, and eating what I want. And this behavior does make me sick, but sometimes the indulgence is worth the sickness.

I know it’s an unfair thing to bring to a memoir, my desire to unlock or loosen the disassociation I feel with my own sickness, to read a book in the hope it will make me take better care of myself after some enlightenment brought about by connecting to someone else’s story. But it only feels so unfair to me because she was so sick, because she wasn’t taken seriously or listened to, I feel I have to. I don’t want to critique her because women are critiqued for their pain too much.

I worry that it’s also unfair to ask for a narrative arc from a body that’s defined by holes and stops and starts and wrongness. Khakpour addresses it herself in the epilogue, she explains that Sick “didn’t believe in my bows, my full circles, my petty arcs, my character development.” But what was there was not enough to hold onto or dive into or find myself in.

I left Sick on the table when I was out with a guy friend and he said, “God, we need to get you something else to read, not this depressing stuff.” I felt immediately defensive. “Everyone loves reading about depressing stuff,” thinking of A Little Life; Sing, Unburied, Sing; H Is for Hawk—all enormously bleak and critically acclaimed. “What do you mean?” And he looked down at the cover with the pills and her face with an oxygen tube in her nose, and said, “not this kind of depressing.” He meant physical pain and disability aren’t the kind of stories people want to hear. But I did.

This book reads like she worked through real personal trauma in its writing. I felt her catharsis at its finish, and that is the payoff. And it’s not unsubstantial after seeing her go through what she did in these pages. A section of self-analysis spoke to the feel and intention of the memoir itself. “I wrote ... as a person who could not be helped, who knew this, who could live with just being heard, a sign of being alive somehow, perhaps.” Her individual suffering is now out there in the world, and that changes it, and I’d argue (from the way the writing speeds up at the end) releases it. So reading this was never about me and my sickness, it was about me as a witness to what happened to Khakpour and her body. Sick was her catharsis. Her individual suffering is now out in the world. I can feel that release, and the satisfaction of unburdening some of her pain.

In the spring 2014 issue of VQR, Leslie Jamison wrote a much-discussed essay called “Grand Unified Theory of Female Pain.” In it, she argues that a “cry for attention is positioned as a crime, as if attention were inherently a selfish thing to want. But isn’t wanting attention one of the most fundamental traits of being human—and isn’t granting it one of the most important gifts we can ever give?” And that is what Sick is. It’s an account of pain for the gift of an audience. She didn’t have a listening audience throughout her illness—instead, she faced consistent deafness from the medical community, and often her friends and family—so she found her listeners by writing this memoir.

Women aren’t supposed to write about their pain unless it’s sexy. Pain because of a lover is sexy, madness-pain can be intoxicating—but pain because of an illness is unwelcome, perceived as imagined, irritating, gross. Khakpour wrote about it anyway. And in a publishing landscape that says no to many stories about this other, unsexy kind of pain, the existence of Sick is a really big deal.

Julia Berner-Tobin is the managing editor of Grove Atlantic.

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