Please Read This Leaflet Carefully By Karen Havelin
New York, NY: Dottir Press, 2019, 280 pp., $16.95, paperback
Reviewed by Kira von Eichel

We live in a noisy time. The noise of culture, politics, identity—and that particularly noisy place where they all intersect. It’s the era of voices once silenced being heard—shouted from rooftops, celebrated and liberated. Women, people of color, LGBTQ, and survivors of violence, sexual or otherwise, are for the first time speaking and writing about their experiences. Inherent to narratives of suppressed voices is pain. The pain is at the hands of an oppressor or a predator, either individual or a system or group, and clearly villainous. The best of these narratives can carry us, their readers, into, through and, finally, to triumph over that pain. Our hearts ache and soar alongside of a hero/heroine’s journey, as we align ourselves with them and revel in their successes. It feels good.

Karen Havelin’s debut novel Read This Leaflet Carefully is a different beast altogether, but no less potent. It is quiet and its transcendence comes not from the triumph over the villain, but from something else, something that challenges us to bravery in the face of no clear end. We are dropped into the life of a woman in her early thirties, Laura Fjellstad, who has long suffered from allergies to almost everything and, since her late teens, chronic pain from extreme endometriosis (a condition wherein the lining of the uterus spills out and creates a web of painful scar tissue throughout the pelvic cavity and sometimes beyond, resulting in everything from gastrointestinal issues to pain throughout the body to infertility). In this story, the villain is a lifetime of illness and pain—invisible to the outside world, as the body attacks itself from the inside. There is no visible handicap or assailant, save for moments when pain becomes unbearable and results in collapse. Internally, though, it is crashing noises and blinding white hot flashes. Externally, it’s a life of “grin and bear it” and being rewarded for not taking up space, not being a victim. The great accomplishment of this book is how it navigates what is created by the friction between the two.

The character of Laura is perfectly rendered in Havelin’s steady, unflinching prose as a real human being, simmering with rage at not being seen or heard or wanted as she is. Chronic pain is not unlike mental health in that it can elicit judgment and fatigue, even from the most loving and well intentioned among us. Society rewards the noble sufferer. The afflicted is dependent on everyone: doctors, family, friends, even strangers on a subway train. Havelin deftly navigates the murky waters of what the true voice of chronic physical pain is, and moreover, what simply being human and loving is. There’s a thrilling ferocity to this character. She simply is. She is brave, she is afraid, she is petty, she is resentful, and she is noble. About her divorce, Laura says,

The failure of our marriage hinged on him giving in to the temptation of secretly believing my illness was my fault. That there was some abstract, heroic, grand gesture to be performed, but I refused to do it.

That is at the crux of this story. Who is allowed to call herself brave, who is a victim and how should she behave to be deserving of love, pity, and empathy?

The novel moves back in time through Laura’s life, and through Laura’s body, from 2016, when she is a single mother of a toddler in New York City, all the way to 1995, at which point she is an underweight but strong fourteen-year-old figure skater in Bergen, Norway, beset by deadly allergies and illness since infancy. The narrative device is particularly effective—and poignant—because the reader becomes omniscient; we know what happens, what young Laura has ahead of her, as we move back in time. We know what each decision will result in, and we ache or rejoice all the more for it. The book is interspersed with passages from a book about figure skating and as we travel back in time with Laura we learn that she was once a competitive skater. That her brain had such control and symmetry with her body, that she could train and then will a form of perfection on the ice. Her body was once hers, it once obeyed her. We first meet Laura as a New Yorker, a European runaway from the shackles of being the family member who is sick and must be cared for, and the attendant guilt. In America, she is not simply the patient. She is the graduate, the mother, the writer; she has movement, hope, love, marriage (then divorce) to a man possessed with what she calls “rude health.” Laura embraces New York because New York is not afraid of hurting her. It’s refreshing. In New York there’s a freedom to the rough anonymity and the shoddy healthcare.

It turns out that the rest of the world is more like me than it’s like Norway. I’m more at home around people whose lives seem as hopeless and disrupted as mine does. My long list of allergies, which made me a freak growing up in the 1980s and ’90s, barely raises an eyebrow in New York City.

We are in Laura’s body from the moment we first see her in the gynecologist’s office, legs in stirrups. The prose is not heavy handed, but simply suffused with the physicality of the experience, familiar to any woman who has endured the necessary prodding and awkward conversation over paper draped across the knees. Havelin writes, about the female body, “there are so many things that swell, ache, cramp and drop.” That body remains a mysterious inner landscape in this culture, understood by some, but only partially, especially when it comes to pain, allergies, intolerances, and sensitivities. Women occupy a strange no-woman’s-land of intolerance and ridicule on one end and pious judgment on the other. Things like the wellness website GOOP and its like have arisen, in large part, to address the murky hinterlands of pain that describe much of women’s experience. They explore alternative treatments to ill-researched and puzzling afflictions because women’s health concerns have long been ignored or easily dismissed as based in mental illness. Women have been trained, as Laura has, to “behave” with doctors and accept it when they’re told it’s nothing. At age 25, before Laura is finally diagnosed with endometriosis, her doctor treats her for depression and psychosomatic stomach issues.

In real life, endometriosis itself has only recently been identified and treated as a real condition. Lena Dunham has very publicly written of having a hysterectomy as a long-shot solution to the pain of her own endometriosis. On the other extreme, current, earnest, wellness fascism asks, have you done enough acupuncture and steamed your vagina as well as invested in extremely rare mushroom potion and organic biodynamic kale? Laura is conscientious in her care for herself, availing herself of the laundry list of alternative modalities alongside of the regular doctor ’s visits. Meditation, acupuncture, yoga, therapy, the list goes on. There is a sense, though, throughout the novel, that she is to blame no matter what.

As the story progresses (or retrogresses) we travel through the landscape of pain and love and where Laura falls on that spectrum. We meet lovers—men and women—family, friends, all of whom do their best in love and care and still casually humiliate Laura with asides and judgments. Perhaps most bittersweet and painful is the effect on love. Love will always be a hurdle for those who have to juggle need with being perceived as too needy. Either the lover or the loved will push away, disengage. Laura is left by lovers. But then, Laura also rejects the man who does stand by her side, who will take care of her. As we move back in time we find out that she saw herself as freeing him from that role of caretaker. Laura, like anyone, wants to be loved as she is, taken care of, but also to be free. The shame of illness and its effects are explored with generosity here: the, to put it bluntly, stupid, stupid, sad choices we make around shame. The stupid things people say. The stupid decisions to leave a loved one, to “free” him from caring, only to realize years later, that that may not have been the kind thing. There is a beautiful muscular physicality to the book, pulsing through cities and bodies and between characters. Some of the book’s best moments are when Havelin carries us into Laura, describing the sensations of walking, holding a child, having sex, being poked and prodded. There is something of a fever dream to it. It’s almost as if the plot is beside the point. It enhances the science fiction-like quality of pain, how it takes over the body, how it renders a woman helpless when she defiantly does not wish to be helpless, and how it is invisible. (Sigourney Weaver in Alien came to mind reading this book, in a good way.)

Havelin writes:

Perhaps I would have a better life if I could manufacture more meaning from it all. Through illness, you mostly just get screwed. You lose so much time, putting in full days of misery and there is really no end to how bad it can get. Time spent suffering didn’t teach me anything I wanted to learn. But perhaps as time passes, it’s possible to learn not to blame yourself. Life is hard enough. Take what is offered, because it might not always be around. You can’t be harder and harder, stronger and stronger, more and more disciplined until you compress into a diamond. People aren’t mineral or metal. They are soft flesh, where love and pain echo through the body. Sometimes you have to ease up, to let go. You never know what will be able to help you. Compassion and gentleness are also endless. There are limitless possibilities inside other people. They could possibly say something other than what you expected.

Although there is a very palpable lack of silver lining to the pain, there is still hope to be found in these pages. The story is bookended by Laura figure skating, first as a grown woman and then as a teenager with everything ahead of her. It is her strength, her sense of control over her body and how she finds beauty in her body. We know when we read the final part, set in 1995, what the young teenager will experience and we know it will be awful. But we also know that this character is triumphant in her way. That even with all the loss, she will love and be loved. She will find joy in being clung to and needed by her own child. It’s a story that not only gives voice to the invisible specter of constant physical pain, but it also challenges our notions of what constitutes happy endings and how meandering and messy the whole picture can be, with joy and pain interwoven. This book is ultimately not simply a view into chronic pain; it is also a close-up of how we love. How we see ourselves in the eyes and actions of those we love, and how we negotiate the freedom to take up the space we deserve. Of what could have been and how we wrestle with what is.

Kira von Eichel is a writer in Brooklyn.

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