Review by New York Times Review
IN her second year of college, the poet Sarah Manguso developed a blood disease so uncommon it doesn't even have a real name. The autoimmune condition, a rarer form of the already rare Guillain-Barré syndrome, is known as chronic idiopathic demyelinating polyradiculoneuropathy, and it took more than four years to run its course. For several of them, Manguso had to undergo periodic treatments in which her plasma was completely removed and replaced. The treatments worked, but sometimes only for a few days. Later, she moved to steroid treatments, which restored a degree of physical well-being but created complicated side effects. In her sharp, affecting new memoir, "The Two Kinds of Decay," Manguso writes from the far side of a long period of remission. "For seven years I tried not to remember much because there was too much to remember," she writes. From an original welter of experience, she has carefully culled details that remain vivid. Filtered through memory, events during her illness seem like "heavenly bodies" that "fly until they change into new forms, simpler forms, with ever fewer qualities and increasingly beautiful names." Manguso is acutely interested in these processes of renaming and remembering, the way time changes what we say about the past. Her book is not only about illness but also about the ways we use language to describe it and cope with it. The author of two books of poetry, Manguso brings the virtues of that form to the task of writing memoir. Her book is divided mostly into one- and two-page chapters titled like poems. She mixes high and low language, the crass and the scientific, with a lyric poet's sure-handedness. The chapters themselves - among them "The Hematologist," "The Forgetful Nurse," "Corroboration" - resemble her own poetry, broken into aphoristic, discrete sections on the page. This disjointedness gives the prose a rhythm that mirrors the confusion and fragmentation of illness. It also clears space for one of the book's most remarkable aspects: its dark humor. What makes this account both bearable and moving is Manguso's keen sense of the absurdities that accompany severe illness. Often these come from its odd proximity to ordinary life. In the hospital, one of her nurses turns out to be a former cheerleader from her own high school. Manguso remembers how the woman and her squad "cartwheeled in their red and white and black regulation skintight uniforms in rows across the gym, then danced like strippers to bass-pumping music." Now this woman is a caregiver, helping with some of the less pleasant aspects of Manguso's illness. There is something surreal about Manguso's protracted alienation from her own body. In the chapter "The Wrong Symptom," she describes how, after having her nervous responses tested by "a metal tool resembling a pizza cutter," she reports a numb area on her stomach "coincidentally, about the size of a slice of pizza." Because there is no diagnostic explanation for her symptom, her doctors conclude she is reporting the wrong symptom. In fact, what she is feeling is not numbness but indigestion. Later, at a rehabilitation facility, a nurse takes her temperature. "She reported my body temperature as 82 degrees Fahrenheit," Manguso writes. "I suggested that that was not possible since I was still living." Elsewhere, she considers the metaphorical dimensions of her condition. "All autoimmune diseases invoke the metaphor of suicide," she writes. "The body destroys itself from the inside." Manguso was already a writer when she became ill, and her obsession with words, their capacities and limitations, permeates her book. The world of hospitals and doctors has its own language, which she translates for the uninitiated reader. Her plasma replacement treatment is called "apheresis," which she notes is "from the Greek aphairein, to take away." She is amused that hematologist-oncologists abbreviate their titles to "'hem-ones' (pronounced almost like hemonks)" But her interest is more than literary curiosity. When she has a line implanted directly into her chest so her plasma can be replaced more easily, she parses her reaction: "I had read Freud in school. He distinguishes fear, a state of worrying anticipation, ... from fright, the momentary response of our mind to a danger that has caught us by surprise but is already over." For hours, she writes, "I lay there, weeping in fright. Not fear. Fright." Manguso's desire for precision is urgent, even if it cannot always be fulfilled. "I need to describe that feeling," she says of the deep cold induced by apheresis. "Make a reader stop reading for a moment and think, Now J understand how cold it felt. But I'm just going to say it felt like liquid, 30 degrees colder than my body, being infused slowly but directly into my heart, for four hours." As much as anything, this book is a search for adequate descriptions of things heretofore unnamed and unknown. Manguso concludes her account with questions - and an exhortation to the reader to pay attention. Through her own attentiveness, Manguso has produced a remarkable, cleareyed account that turns horror into something humane and beautiful. Manguso has a keen sense of the absurdities that accompany severe illness. Emily Mitchell's novel, "The Last Summer of the World," was a finalist for the New York Public Library's Young Lions fiction award.
Copyright (c) The New York Times Company [October 27, 2009]
Review by Booklist Review
Manguso caught a head cold in February 1995 during her junior year in college. She took lozenges and tea for weeks so that she could sing her solos in choral performances. The virus took greater hold, however, and days after spring break, her gait was affected, and her hands and feet felt increasingly numb. An ER trip ended in IC for apheresis, the removal of diseased blood plasma that was destroying peripheral nerve cells. The cleansing process' effects lasted only about two days, leading to more than 50 four-hour plasma replacements, the first 20 necessitating lying still with a 14-gauge needle in each arm while shaking with cold that comes from inside you. Apheresis doesn't prevent the body's development of new, rogue antibodies, hence was no permanent solution for her condition, a sister disease to MS that can resolve spontaneously or progress to death. The autoimmune malady prompts writerly metaphors, observations, and much more in Manguso's wrenching yet fascinating account of a nine-year struggle now seven years of remission behind her.--Scott, Whitney Copyright 2008 Booklist
From Booklist, Copyright (c) American Library Association. Used with permission.
Review by Publisher's Weekly Review
In 1995, when Rome Prize-winning poet and fiction writer Manguso (Siste Viator) was a junior at Harvard, she suffered the first attack of a rare autoimmune disease called CIDP, which would turn her body against itself. CIDP attacks the myelin coating of the peripheral nerves. The result is increasing numbness, followed by paralysis spreading from the extremities inward, until the sufferer can no longer control his or her breathing, and dies. In short, lyrical chapters--the book free-associates between memories, while sticking to a rough chronological order--Manguso recounts the harrowing indignities of her treatments, frequent relapses, descents into steroid-induced clinical depression, crucial college sexual experiences had and missed, and trips back and forth between schools, hospitals and her parents' Massachusetts home. What makes this lightning-quick book extraordinary is not just Manguso's deadpan delivery of often unthinkable details, nor her poet's struggle with the damaging metaphors of disease, but the compassion she acquires as she comes to understand her pain in relation to the pain of others: "suffering, however much and whatever type, shrinks or swells to fit the shape and size of a life." (June) (c) Copyright PWxyz, LLC. All rights reserved
(c) Copyright PWxyz, LLC. All rights reserved
Review by Library Journal Review
Poet and fiction writer Manguso's fourth publication (contributor, One Hundred and Forty-Five Stories in a Small Box) is her illness memoir. Thirteen years ago, in her early twenties, Manguso developed an unusual, life-threatening, and very debilitating viral infection that recurred over the course of the next several years, interrupting her relationships, her education, and her career. Her diagnosis was long unclear, and her treatment was sometimes incompetent and frequently painful and humiliating. Further, some of the medications she was prescribed caused serious physical and psychological symptoms; she eventually became an alcoholic and suicidal. Young adults are not "supposed" to get seriously ill, much less relapse repeatedly, so Manguso's story is a particularly compelling reminder of mortality and the isolation and loss imposed by an illness that doesn't follow the rules. But what makes it really stand out amid the glut of other illness memoirs is the author's literary talent. The writing is spare, with the story told in a series of one- to two-page vignettes and observations. That said, Manguso's final reflections reveal so little of her thoughts and feelings that the work seems incomplete. Young adults will strongly connect, but suitable for all public libraries.-Fran Mentch, Cleveland State Univ. Lib. (c) Copyright 2010. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
(c) Copyright Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
Review by Kirkus Book Review
Frank account of the autoimmune disorder that consumed the author in her 20s. The disease that plagued her in various ways for nine years had ravaging effects on Rome Prize winner Manguso (Hard to Admit and Harder to Escape, 2007, etc.), whose poetry and prose have never shied away from staring a subject in the face. In short chapters of slim paragraphs buffered by white spaces bearing as much emotive force as the poetic statements they insulate, she carefully unfurls the details of her eventual diagnosis of CIDP (chronic idiopathic demyelinating polyradiculoneuropathy), akin to Guillain-Barr syndrome. Manguso's condition first manifested in February 1995 as a head cold that wouldn't quit; by March it had escalated to numb feet and almost complete paralysis. She landed in the hospital and underwent her first apheresis, a four-hour procedure that took her blood's plasma (whose "devil antibodies" were stripping the myelin from her peripheral nerves and causing paralysis), removed it and replaced it with the plasma of others. The author endured more than 20 of these vampiric procedures before a central line was surgically implanted in her chest and a new neurologist recognized that curative treatment didn't involve apheresis but steroid and gamma globulin therapy. Manguso's abundant analytic and compositional gifts are evident throughout this harrowing memoir, from her expressions of hard-won appreciation for the relativity of suffering to a nuanced account of how serious illness can alter one's conception of time, robbing the afflicted of both compassion and accurate recall. "I waited seven years to forget just enough--so that when I tried to remember, I could do it thoroughly," she writes. "There are only a few things to remember now, and the lost things are absolutely, comfortingly gone." A powerful, direct examination of memory and suffering. Copyright ©Kirkus Reviews, used with permission.
Copyright (c) Kirkus Reviews, used with permission.
