This book is positioned as an essay collection, but it easily could’ve been called a memoir. Or one big essay in pieces. Or, as Meghan O’Rourke is quoted in the cover blurb, a “guide to the complexities of thinking about illness”.
The essays aren’t scholarly, though you’ll gain quite a bit of background knowledge, not just about her diagnoses, but mental health systems of diagnoses and treatment in general. They aren’t personal essays, in the “it happened to me” style, though there are plenty of personal details and even a little name-dropping. Wang doesn’t use schizophrenia as a metaphor, though she references the metaphors and plots of movies and books with ease.
And this book definitely, thankfully, doesn’t have the “overcoming adversity” inspirational feel of mainstream illness memoirs.
Wang’s choice to forgo the chronological telling of her story, or, her lack of committment to it, maybe (the first essay is about diagnosis and the latter ones move forward to 2018, but in between they move very fluidly through time), allows this book to be many things at once. It allows the reader to choose.
I was struck by how Wang writes about the concept of “insight” in the clinical, “patient shows lack of insight” sense (a quote from Wang’s medical records while hospitalized), but I found a lot of “insight” in the colloquial sense too. I’ve never read about mental illness this way, and while I can’t say I “understand” or “empathize” with her experience with, say, Cotard’s delusion, in which the sufferer believes they are dead, I appreciate her insights about about where illness ends and self begins (or vice versa).
When the self has been swallowed by illness, isn’t it cruel to insist on a self that is not illness? Is this why so many people insist on believing in a soul?
The essays only faltered for me towards the end, when that insight seemed to fade away with the onset of physical illness. This section, relating more recent events, coincides with Wang’s growing friendship (and shared chronic Lyme diagnosis) with Porochrista Khakpour. Khakpour’s memoir Sick was almost unreadable – not because it was poorly written, but because it was very affected, and completely lacking in insight, in any sense of the word. Early on in the first of these essays, Wang says that a chronic Lyme diagnosis is “a kind of belief system,” and that sentence contains more insight about chronic Lyme than Sick does in its entirety.
But soon, Wang is using Khakpour’s language, calling herself a “sick girl” (both women are roughly my age, the use of “girl” grates) and partaking in doctor shopping and unproven, expensive treatments like “multinutrient IV drips” and “ozonated saline”. I felt like I was reading about someone in thrall to and exploited by a quasi-medical, quasi-new-age treatment system, the kind of thing that made me extremely uncomfortable about Sick. By the last essay, Wang is dabbling in (and paying for) instruction in “the sacred arts” and visiting shrines. It felt exploitative and gross to read.
These later essays didn’t ruin the experience, though. Maybe a memoir about the schizophrenias, about psychosis and delusion, experiences that Wang calls a “hodgepodge”, shouldn’t and can’t be told in one tone, or in a way that the reader will always like. I’m still thinking about these essays and almost fully reread them to write this review, happily.