Good non-fiction writers should introduce you to ideas. They should get you thinking about the world and encourage you to seek these ideas further, to think, probe, read, question. In The Empathy Exams, Jamison introduces ideas and influential thinkers in a subtle but powerful way. She does this through first person narrative non-fiction, making concepts feel personal, whether they are familiar to the reader or not. She introduces the reader to broader works such as the writing of Susan Sontag and Joan Didion, but also to fiction writers, essayists and musicians. She motivates the reader to think further about politics, race and class in America. But most powerfully, she motivates us to question ourselves. This book was recommended to me by Rebecca Harkins-Cross after she saw my list of favourite non-fiction reads from 2014. This book is a gift and I will forever owe a debt of gratitude to Becky for bringing it to my attention.
The Empathy Exams is a series of essays, each exploring topics which open us up to questioning our empathy with the subject. In the first essay of which the collection is titled, Jamison herself is the subject: a medical actor assessing training doctors on their ability not only to diagnose but just as importantly to empathise with the patient, whilst weaving her own experience as a patient into the narrative. This incredibly powerful essay, which I first read in The Believer (which you can read here), begins the collection as it sets to continue: bringing both Jamison and the reader into the page and the environment in which it takes place, alongside the subjects in question. It sets to make us uncomfortable but only to the point of being uncomfortable with ourselves, to challenge our own reactions and ability to empathise. As Jamison writes in ‘Lost Boys’, “Empathy is easier when it comes to concrete particulars”, but this book explores the harder instances to understand - false confessions, psychosomatic illness, questions of morality and purpose - and as such gets right to the heart of the topic of empathy, and how it makes and shapes us as individuals. As she rights in ‘Devil’s Bait’:
This isn’t an essay about whether or not Morgellons disease is real. That’s probably obvious by now. It’s an essay about what kinds of reality are considered prerequisites for compassion. It’s about this strange sympathetic limbo: Is it wrong to call it empathy when you trust the fact of suffering, but not the source?
This book is heavily tied to place: the United States in it’s vulnerabilities and successes. Jamison is not shy to question her homeland and the spread of what she calls “the pageantry of American panic”. This is perhaps best explored when she sees America with an outside eye: firstly in her essay ‘La Frontera’ where she crosses the border to Mexico and meets Marco, a teacher with a life very similar to Jamison’s own until he is awoken by a grenade explosion; and secondly in ‘Indigenous to the Hood’ where she views the city in which she grew up, Los Angeles, as a place of crime and fear, rather than the shelter of home:
“Being a spectator of calamities taking place in another country,” writes Susan Sontag, “is a quintessential modern experience.” Part of what feels strange about this tour is that you’re assuming the posture of a tourist — How many people have died here? How do the boys come of age? — but you are only eighteen miles from where you grew up.
It is with great skill that throughout the collection, Jamison stops herself from alienating the reader by becoming too sincere, overwrought or humourless. She maintains an ability to laugh at herself, such as In Defence of Saccharin(e) - “Melodrama is something to binge on: like cupcakes in the closet” - as well as an ability to laugh at the human condition:
Bad movies and bad writing and easy clichés still manage to make us feel things toward each other. Part of me is disgusted by this. Part of me celebrates it.
But what Jamison manages to do perhaps best of all, and what made me clutch my chest as I read this collection, is articulate pain. In Devil’s Bait:
“Everyone who is born holds dual citizenship,” Susan Sontage writes, “in the kingdom of the well and in the kingdom of the sick.” Most people live in the former until they are forced to take up residence in the latter. Right now Kendra is living in both. She’s not entirely subsumed by sickness yet. She tells me she’s meeting a friend for sushi downtown tonight. She can still understand herself outside the context of this disease: someone who does ordinary things, looks forward to the events of an ordinary life.
I read this collection during a week of vulnerability. I began as I boarded a train to northern Victoria for a family wedding. Something about weddings, even of dear friends and people close to me, makes me feel overwhelmed and nervous. This is not because I have an issue with marriage: I plan on getting married myself one day, despite my reservations as a child of divorce, an ensuing messy custody battle and my anger at the limited marriage laws of Australia. But perhaps because of this or in spite of it, as we prepare to leave for the ceremony, each time I feel nervous. As I listen to the bride and groom speak of their families and of the family they plan for themselves in the future, as we sit and witness the emotion that is so publicly on display, I am hit every time by the enormity of the occasion, in its joy and its faults. My partner’s sister married her long term boyfriend, a man already accepted into their family in the beautiful, humbling way that they have also accepted me, and I was overwhelmed by empathy for them: by the work they had put in to making this day so special - choosing a stunning venue, hand making decorations, looking beautiful on the day - and in bringing two unlikely families together to form a union, for better or for worse, till death do them part.
But this was also against the backdrop of the week ahead. The day after the wedding my partner and I flew to Adelaide for an appointment with my specialist, a chance to see family, before I had surgery later that week. As I have written my health is an ongoing challenge, and recently my body has sought to put me in my place. It’s time to take things slowly for awhile, look after myself, think of the future. In order to do this, I had to prepare my body by having surgery. Like anyone who suffers from endometriosis or polycystic ovarian syndrome, regular surgeries are a reality, so it was not concerning or nerve-wracking. What I was nervous about was meeting with my specialist. Owning up to how I have treated my body in the four years since I last saw her. Hoping with everything I had that I wouldn’t require more invasive surgery than what had been scheduled (thankfully I didn’t). Planning ahead for the next few years, preparing myself and my partner for having children, of making a family of our own when we’re ready, of taking the place of the couples who’s weddings we have attended and who’s babies we have squealed with delight upon their arrival into the world.
In the final essay of The Empathy Exams, Grand unified theory of female pain, Jamison again quotes Susan Sontag:
“Sadness made one ‘interesting’. It was a mark of refinement, of sensibility, to be sad. That is, to be powerless.” This appeal mapped largely into illness: “Sadness and tuberculosis become synonymous,” she writes, and both were coveted. Sadness was interesting and sickness was its handmaiden, providing not only cause but also symptoms and metaphors: a racking cough, a wan pallor, an emaciated boy.
When you have an ongoing illness, it is inevitable that you will repeatedly feel nervous, overwhelmed and sad. In the week leading up to my appointment, and indeed the months from booking the flights until getting on the plane last week, and even in the months before that knowing that I needed to make the appointment in order to get on a plane for Europe in June, I felt nervous, overwhelmed and sad. But when it actually happened, when I sat in the chair across from my specialist and gave her my state of the union address, when I thought I would feel the most nervous, overwhelmed and sad, I was fine. For every problem I named she had a solution. For every problem I couldn’t articulate, she understood. For every concern I had, she had a strategy for moving forward. And then, as I came back from the hospital to the apartment where we were staying, and when we flew back to Melbourne a few days later, and when I got into my bed at home and didn’t get out again for a few days, there were people who empathised and cared. Some were obvious: my partner, my mother, my boss. But it was those I would not have expected: the friends I haven’t seen in months who appeared as if they already knew, like they had seen a signal in the sky. The flight attendants who saw me struggling to board and held out a hand, who then booked a wheelchair and people to help me as I disembarked. These are the people that Jamison celebrates and encourages us to trust, people who voice empathy for your situation/problem.
Last week I wrote about my love of eating snacks for dinner. This week, it’s been out of necessity. After a general anaesthetic and when you’re just feeling lousy, no one is going to get out of bed and prepare a meal from scratch. My partner has been extraordinary at picking up after me this last week (literally so - I cannot bend down and touch the floor. If I drop something, it stays there) and one of the ways we have coped is by eating very simply. Friday Night Mexican a few nights a week. Big plates of hummus and crudités. Simple food that is easy to prepare and digest. The week before I made this nut, oat and seed loaf and a big batch of granola - I have been very thankful to have these ready on demand. What I have looked for the most are big mugs of herbal tea. Ginger tea soothes nausea, aids digestion, boosts your immune system and is a natural anti-inflammatory that soothes swelling and pain. When I was really sick five years ago, drinking ginger tea and taking ginger tablets were the only thing that stopped a month-long stretch of chronic nausea. I hear it’s brilliant for morning sickness. Read more here and here if you’re interested. But when I was ready to get up and about, instead of relying on bags of tea I made my own brew by bringing to the boil three cups of water, the zest of a lemon, lots of chopped ginger, one star anise, three cloves and a cinnamon stick, then simmering for fifteen minutes before straining and serving with lemon juice and honey. Depending on how much ginger you use and how long you boil the mix for it can be incredibly spicy, so adjust to your own taste and add more water if you need to. But what you’ll get is a warming, nourishing drink that will feel like a little hug. I’d love to try it cold as well if it’s a warmer day. Either way, sit, be still, drink tea, rest, look after yourself, and listen to those around you. Empathise with their situation/problem. You never know when you’ll need it yourself.
I was incredibly heartened to see this piece by Rebecca Shaw on the Killings blog this week: An Inconvenient Truth: Social stigma and menstruation. For a long time when I would talk about my health issues, I would say ‘I have health issues’ and when probed further I’d say something like ‘female health issues’. I still find it difficult to talk to male colleagues about it. Well, here you go: I have endometriosis and polycystic ovarian syndrome. I see a world-leading gynaecologist to deal with the chronic pelvic pain I suffer from as a result of this and a bunch of other messed up reasons. If I menstruate, I bleed so heavily that I also bleed internally and suffer extraordinary cramping and pain that is so extreme I struggle to get out of bed. As a result, I am on drugs to make sure I don’t have them, period. When I hear other women talking about their periods, I can only empathise and offer ibuprofen, but I am also always grateful not to be in that position for awhile. When I’m ready to have children, I will need to come off of these drugs in order to become pregnant. That terrifies me. I am not putting this forward as a way of complaining or feeling sorry for myself. I am putting this forward because I know that someone else will read this and will feel better that I have said it. Maybe a male colleague of mine will read it and will understand a bit more about me or someone else in their life that is also affected. Endometriosis affects between five to ten percent of Australian women, and polycystic ovarian syndrome is present in between twelve and twenty percent of Australian women, with up to seventy percent of women remaining undiagnosed. If we don’t start talking about it - this inconvenient truth - we can’t begin to help women who are in pain. If we believe in looking after people we love and empathising with their situation/problem, we need to start talking about menstruation, no matter how uncomfortable it makes us feel.