Everybody Hurts

The Empathy Exams: Essays BY Leslie Jamison. Graywolf Press. Paperback, 256 pages. $15.

If you like Joan Didion’s writing, her neurasthenic intelligence captivates; if not, its self-involvement—the tendency toward a princess-and-the-pea-like oversensitivity—can become intolerable. Leslie Jamison’s new collection of essays about bodies and their maladies provokes a similar set of responses. The title essay juxtaposes Jamison’s job as a performer who acts out symptoms for medical students with her very real experiences as a patient who undergoes an abortion and heart surgery in the same month; other pieces include a subtle and interesting report on one of ultrarunning’s most difficult races, and a wry examination of a group of patients who suffer from what they’ve termed “Morgellons,” a tormenting skin affliction that many doctors say doesn’t exist (the medical diagnosis is “delusions of parasitosis”). The essays all explore suffering, its representations in language, and the mixture of empathy and distaste that pain—especially female pain—elicits. Jamison’s most immediate literary role models are Caroline Knapp and Lucy Grealy, two great chroniclers of female damage, and when she is charged by a boyfriend with being a “wound dweller,” she accepts the label proudly: “Pain that gets performed is still pain,” the final essay concludes.

Jamison’s cerebral attachment to the process of considering her own pain verges, at times, on the ludicrous. She details surgery to repair a broken nose after being punched in the face during a street robbery in Nicaragua, and surgery to repair a jaw damaged by a twenty-foot fall off a vine in the Costa Rican cloud forest; she describes in detail her experience with cutting, disordered eating, alcohol abuse, and self-destructive relationships with men. Jamison knows what she risks here—not only self-indulgence, but the possibility that her empathy for others is “just a bout of hypothetical self-pity projected onto someone else.” Her approach is leavened by the attractively stringent clarity of her examination of pain and the feelings it provokes, both in those who experience it and those who watch them. At the gathering of Morgellons sufferers, Jamison falls into an “easy groove of identification” talking to one patient:

Her condition seems like a crystallization of what I’ve always felt about myself—a wrongness in my being that I could never pin or name, so I found things to pin it to: my body, my thighs, my face. This resonance is part of what compels me about Morgellons: it offers a shape for what I’ve often felt, a container or christening for a certain species of unease. Dis-ease. Though I also feel how every attempt to metaphorize the illness is also an act of violence—an argument against the bodily reality its patients insist upon.

Jamison’s range of reference includes Adam Smith’s interest in the way our bodies somatically anticipate the feeling of the blow we see another about to receive, and Edmund Burke’s invocation, in his theory of the sublime, of “negative pain,” the idea that we are delighted when we feel fear (watching the dismemberment of the heroine in a horror film, watching riots on the TV news) in a setting that is ultimately safe. There is no talking down to those who might not want to hear about philosophy (and for that matter no quarter is given to those who don’t want to hear about cutting): Jamison is determined to tell us what she sees and thinks without condescension or compromise, and as a consequence her act of witnessing is moving, stimulating, and disturbing in equal measure. The insistence on connecting personal experience to philosophical theory can feel strained at times: The essay “In Defense of Saccharin(e)” unsuccessfully attempts to link Jamison’s obsessive dependence on artificial sweeteners with a critique of sentimentality as unearned emotion, though even in that piece I was charmed by her quotation of the Flaubert passage in which Madame Bovary’s maid steals sugar and eats it in bed after saying her prayers. I am also skeptical about the notion that erstwhile addicts become ultrarunners because “they want to redeem the bodies they once punished, master the physical selves whose cravings they once served”: It is more intuitive to think of drugs and endurance sports as two closely comparable ways of giving the body something to distract it from the intolerable longueurs of human existence. And while this sort of writing itself can serve as a kind of self-punishment (other practitioners worth mentioning in the same breath might include Jenny Diski and Gideon Lewis-Kraus), it is intellectually exciting because of the writer’s intense intelligence, sometimes constrained, but ideally liberated by the persistence with which self and its pains dog all other inquiries.

Jamison is always interesting, often gripping. I don’t want to have dinner with her, but I do want to read whatever she writes next. The accounts grouped under the rubric of “pain tours”—in which she visits a silver mine in Bolivia, takes a “Gang Tour” in LA, and watches the reality TV show Intervention, each of whose episodes features anaddict being confronted by friends and mental-health professionals—are particularly effective at highlighting a broader set of cultural distortions around pain and its witnessing. Jamison is well aware of the possibility that the reader will charge her with glamorizing or idealizing forms of pain that can sometimes seem gratuitously self-inflicted. Who wants to be a victim? But the sharpness of her sentences gives that question more than merely rhetorical impact. Some of the most interesting writing today, both fiction and nonfiction, operates at the intersection of personal experience and intellectual endeavor (novels by Karl Ove Knausgaard and Teju Cole, Sarah Manguso’s memoir The Two Kinds of Decay), and Jamison ultimately does her readers a great boon by showing the extent to which a high-level intellectualism properly augments, rather than detracts from, the intensity of personal accounts of pain.

Jenny Davidson teaches in the Department of English and Comparative Literature at Columbia University. She is the author of six books; a seventh, Reading Style: A Life in Sentences will be published this summer by Columbia University Press.