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Finishing Porochista Khakpour’s Sick on Election Day 2018

My literary bestie gifted me Sick on last year, and it moved to a top position in my stacks and stacks of memoirs to read. I’ve been following this writer for some time and could hardly wait to dive in.

Election Day 2018 was a while ago, right? I’m only just sharing this post now because Khakpour’s book was so compelling and complicated that I read it again. I could go another round, too, but it’s been more than half a year since I did a memoir post, so here we go.

There’s something about an illness memoir. Memoir usually promises, for better or worse, redemption, so reading a memoir about illness, for which redemption would seem to be relief from illness, is further promising a cure, a balm, an antidote.

Khakpour says, I wish.

Reading this book, I kept wanting House to burst in and wisecrack his way to an obscure diagnosis with an easy fix, because the author’s suffering is so acute. The challenges of being female and Iranian in a post-9/11 white supremacist patriarchy that doesn’t give a shit about our access to high-quality, accessible, and/or affordable healthcare are as glaring as Khakpour’s Lyme diagnosis was elusive. She points out how Lyme progresses to late-stage more often in women because our symptoms are more routinely dismissed as psychosomatic. And when she, a recovering addict, finally decides a detox is in order—a detox from the dozens of pills that dozens of doctors put her on—she learns a month of rehab will cost $30,000.

Tell me the healthcare system is working, for women, for anyone.

A central point of agony for Khakpour is how she wracks her lethargic brain trying to recall when she might have contracted what doctors—few of them, but an emphatic few—believe is the singular original cause of her myriad ailments. The book explores more than a few possibilities, through exhaustive testing: “MS, ALS, PCOS, endometriosis, scleroderma, lupus, HPV, cervical cancer, ovarian cancer, hyperthyroid, hypothyroid, thyroid storm, dysautonomia, aneia, insulinemia, diabetes, Addison’s, Parkinson’s, Hashimoto’s, candida, dementia, ketoacidosis, West Nile, and yes, Lyme.”

Then there is trauma.

Then there is benzo addiction.

Then there is the car accident, multiple concussions.

Then there is her love life.

Which catastrophic setback is most to blame for Khakpour’s unwellness? And does it matter? Do any of our most formative life events fit neatly halved into one box for Cause and one for Effect?

Because this intensive study of memoir is a research of sorts for me, I identify with certain elements of each narrative I read, compartmentalizing them into possible future tropes an admired writer has given me permission, in a sense, to explore. Khakpour’s unabashed relationship-hopping, her admitted need—for admiration, for constant companionship, for a caretaker, or just for a ride to another damn doctor’s appointment—struck me deep in the part of my brain that recognizes but doesn’t want to admit to my own historic hops and needs. I also relate to the obsessive need to know why and how certain bad things have happened, even though it’s futile. I’ll never know either. And if I did, it wouldn’t change anything.

Further there is the havoc Lyme relapses wreak on the author’s creative energy and ability to think and process in order to write. Obviously, as a writer myself, these passages made me ache:

And my one solace, the computer that was for writing and communicating with friends and learning about the world, suddenly made me nauseated at best and put me in panic attacks at worst, as if its thinly vibrating frequency was suddenly amplified so that I could see its inner workings, its multitudinous networks busily announcing their duties, as if I could suddenly see the blood vessels underneath my skin.

“My full-time job became my health,” she writes, over and over, relapse after relapse.

Other reviewers have commented on the brilliance of grounding this memoir in the various places Khakpour seeks rest and treatment, and I echo their praise. Travel is the spine of the narrative. Back and forth between her parents’ LA and the New York of her youth and career, then to the Southwestern desert she finds so vibrantly soothing, across the ocean to Leipzig and back again, Khakpour is never at rest for long in any given city because she isn’t at rest in her own body.

What should the doctors treat first? Some insist that regular sleep is the most immediate goal, and prescribe pills. Others think the pills are destroying her and recommend detox. Then there are those who roll their eyes and want to commit her to the psych ward—the most maddening “diagnosis” of all. From one ER, one specialist, one friend-recommended healer or guru , one boyfriend, one city, to another, Khakpour exhausts herself trying to save herself. The reader, along with the author, comes to realize that we aren’t going to get more than a consolation prize.

In this memoir, redemption isn’t a marriage, a reckoning with inner demons, a book deal, or a even cure. It’s a diagnosis.

I grieved for Khakpour when I got to the book’s close, its honest depiction of relapse when the audience, let alone the author, so wants to hear that everything is fine now, the prescriptions are all sorted out and her days have returned to being full of writing and yoga and a good eight hours a night. Chronic illness doesn’t end, though. Not in real life, and not by the book’s close.

I grieved, but I also admired. What strength, to persist, but to craft that persistence as not redemption, but defiance of the redemptive uplift the memoir-reader expects.

I’ve read quite a few woman-authored memoirs by now, some I’ve posted about and some I haven’t. Among them are quite a few about surviving domestic violence, or childhood abuse, or sexual assault or rape. Among those, quite a few end with an uplift—the writer reclaiming her life, finding her voice, bolstered by a support system and a hard-won belief in her own abilities. I want that for all survivors, I do.

But the truth is that not all of us get there. The book doesn’t always end that way. There are real long-term effects to surviving something, be it trauma or illness or war or abuse or enormous loss. We are changed. Survival happens every day; it’s not a static point of arrival, a door to happily-ever-after, and certainly not a return to who we were before the thing we survived.

Sometimes, the endings of survival narratives, vital and moving as they are, leave me feeling unsettled, like I should be well on my way to a tidy closure, too. And if I’m not? If you aren’t? Is something wrong with us? And if so, who will tell us what it is? Who has a diagnosis, a treatment plan, a cure?

Sometimes the best ending is a reminder to keep going.


100 memoirs project