Porochista Khakpour’s Sick: A Memoir insists on sickness as an experience that collapses boundaries. To be sick is to slide between dualities that separate body and mind, health and illness, fact and fiction. Against the projections of doctors, family, and lovers, Khakpour sets down what it is to exist within the space of that encounter, struggling toward the truth of her experience.
Memoir is, among other things, an assertion of truth. The writer’s truth asserts the truth of personal experience, of life, over the truth of simple facts. Yet the experience of illness lends itself to fiction, to the surreal: it distorts your perception of reality, your trust in your own body. It fogs clarity and engenders doubt. And sick people, sick women, especially women of color, are doubted. Khakpour spends years in and out of hospitals, misdiagnosed, treated for varying ailments that are symptoms of Lyme rather than Lyme itself, routed to psychologists, prescribed drugs that lead her into addiction. Reading her life in the present, we already know the whodunit of this mystery, but as Khakpour lived it, she did not. She combs through her life for answers, clues, breadcrumbs: Is this when I got sick? Is this?
Like the bacteria at the root of Lyme disease, this memoir spirals through time, rather than moving in a straight line. It begins in the narrative present, then leaps back into the past, to the beginning of Khakpour’s life. From that beginning, fleeing Tehran as a child with her parents, she is on the move. Though the book is divided into sequences based on location—from Los Angeles, to New York, to Chicago, to Leipzig, to Santa Fe—it isn’t tethered to them. In between the places she’s lived, Khakpour sprinkles in “interludes” on appearances, on support, on love, etc. In these meditative sections time collapses, and we could be at any point in her life: back before the chapter we just finished, or years ahead. Suggesting an experience of time less linear than recursive, archipelagic, and textured, the memoir draws readers along the spiral of Khakpour’s experiences.
“I am a foreigner,” Khakpour writes, “but in ways that go much deeper than I thought, under the epidermis and into the blood cells. I have started to consider that I will never be at home, perhaps not even in death.” As Khakpour moves through her life—from college in New York, to graduate school in Maryland and Illinois, to Pennsylvania for work, to Santa Fe for help, and on, and on—with a sense of dislocation inherited from her parents, she always finds herself on the outside of the place she’s in. She is other, both in this country and in her body, as a woman of color in the United States, as a writer. To write about life, you place yourself, for a while, outside of it: you observe, you document, you set down.
Writing about her drug use, she tells us, “I always wanted that escape, and before I could even escape the body, I realized there were easier ways to escape the mind.” This propensity for drugs begins in college; her desire to escape begins much earlier, as a child. Her first memories, after all, are of flight; later, writing becomes an escape as well. “My childhood with ever-fighting parents had been an unhappy one,” she writes, “and I’d lock myself up to write on the weekends, not out of a joy for writing but out of a desperate need to escape.”
Yet as a memoirist, Khakpour is unflinching, not escapist: nakedly honest upon the page, neither hiding nor justifying her choices. In one of the book’s epigraphs, Virginia Woolf writes, “to look these things squarely in the face would need the courage of a lion tamer.” Khakpour gathers that courage, again and again, as she reaches into the most painful parts of her life, excavates them, and holds them up to the light.
Khakpour’s writing also shreds the flat stereotypes of illness. The sick are often shown as angelic in their illness; repentant, like somehow, they deserve it; transcendent, like their pain elevates them to a different plane; near-corpses stripped of contact with reality. Khakpour presents no angels, no penance, no transcendence. She insists on context, as each of her intersecting identities impacts what it means to be ill.
Money changes what it means to be sick in America. “What mainly separates me from healing,” she writes early on, “are financial considerations.” Many years later, after years of doubt, misdiagnoses, expensive medications and hospital stays, finally receiving an answer—Lyme—Khakpour crowdfunds her treatment in 2012. “It was the first time that it occurred to me,” she writes, “that wealthy people had such options, how with money you could actually take a stab at life, no matter how bad the odds.” At the writing of this review, she is again forced to crowdfund for the treatments that save her life.
Khakpour writes of doctors dismissing her, ignoring her; nurses laughing at her; of being shunted from uncaring specialist to uncaring specialist. These experiences can’t be untangled from her race and gender. Studies show that patients of color experience a lower quality of services than their white counterparts; that women’s experiences of pain are minimized and dismissed. “The experience of going for years undiagnosed and then misdiagnosed… can cause considerable trauma,” writes Khakpour, after pulling the reader through the living of that experience.
Reading this book plunges readers into the embodied, visceral truth of sickness. The ill body is not a home: it is pain, a trap. So often literature about the body—especially women’s bodies—is concerned with how a body looks. Appearance is treated as a window to interiority. Khakpour dispenses with that. She is less concerned with the body’s appearance than with being in the body. With what it feels like to be ill. To be an ill person. To be in that cyclical, suspicious, exhausted space.
Unlike autobiography, a memoir doesn’t owe its reader totality; it owes it a unifying theme. The kaleidoscopic range of Khakpour’s life with illness—how she has grappled with it, and how it has grappled with her—is this memoir’s offering.