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It is a beautiful Sunday evening in May—clear, still, warm—and I am throwing up my own shit. That this is biologically possible, let alone how it feels and how the nurses will respond to it (a faintly perceptible ripple of disgust, spreading evenly over a surface of practiced nonchalance), is one of a number of things I have learned since rushing into the hospital a few days earlier. Since then, things have gotten worse. My stomach is hard and swollen; I no longer move without pain; sleep in its familiar, restful form has long been out of the question. At one point my heart beats so fast that all I can do is lie back and silently repeat “my heart is beating, my heart is beating, my heart is beating,” the action of the words mechanized in time with the beats, dancing to their rhythm. The pain that brought me in is under control now, but the morphine shots are increasing in frequency just as the pleasure they initially brought me fades away. My condition is deteriorating. Before I am allowed to leave this place, I will have been sedated and anaesthetized, carved and skewered. Tubes, rubbing and grating, will have been passed in and out of every orifice and, unsatisfied with the old ones, the doctors will carve and prick new holes, running tubes into my arteries and veins, my neck and my spine.

When I am not hospitalized—and thankfully that is almost all of the time—I am nothing if not a thinking man. At home I read books, clutching my pencil, scribbling furiously in the margins; at work, I talk to students, and I tell them what I and others think and then they think about it. Sometimes I write my thinking down, and other thinking people think about it and write about it and then for a short time we think about it together. And yet there, in my hospital bed, drugged and pained, scared, I am not thinking. And now that it’s over, and my recovery is for the moment complete, I find myself back here again—back at my thinking and my writing. There is, however, a problem with writing about being ill. Confronting the sweaty labor of sickness from the sober state of reflection involves a translation between two distinct languages, languages which share no common roots, whose terms extend to none of the same objects. If I force myself to carry out this feeble conversion exercise, then it is because there is a market for it, at least one eager reader, who can never have access to the original: me myself, cured and thinking once more.

About the specifics of my sickness, it seems to me that three things must be said immediately: it won’t kill me; it could come back at any time; I have had it once before, or rather something very like it. The last time I spent this much time in the hospital, in an equivalent state of mind, I was still at school. I learned that time of my susceptibility, in my weakened state, to getting simple tunes stuck in my head—to what the Germans call “earworms.” Back then, the potent mixture of the television in my room and the resurgence—if they ever really went away—of plastic pop bands meant a couple of tunes went round and round in my head for weeks; and even now, when they occasionally repeat on a nearby radio, I feel instantly transported to the clean white bed, clutching the call button, the drip machine bleeping out of time with the twitching of my toes.

It can’t be completely accidental that this time around it wasn’t glimpses of poorly choreographed pop that replayed incessantly, but rather two fleeting phrases from a couple of books I’d read in the years between my hospital stays. Of course, there were obvious factors that blocked out the pop this time: I couldn’t watch TV and, chastened by my previous experience, I only listened to music I considered safe. But that the new phrases were verbal, not musical, should not obscure the fact that they appeared to me as almost contentless, mantra-like. These two phrases, insipid and by the end effectively meaningless to me, rolled around in my head so many times I felt as though my surgeon, had she opened my skull instead of my stomach, could have traced the groove they carved with her delicate finger. And a long time afterwards, when I had recovered my health and they their meaning, I noticed that they stand in complete contradiction.

There is a device, known to students of literature and students of creative writing, called “defamiliarization.” In the creative writing course, the exercise might go like this:

Take something that is familiar to you (an object, an occasion). Now imagine you are an alien who has just landed on Earth and make a report on it to your alien superiors back home.

In this case, the defamiliarization is brought about by the alien narrator, the stranger in the strange land. Standard defamiliarizing narrators include the naive child, the animal or the inanimate object—other contenders might be the very clever or stupid, the very large or small. Using both of those latter two, Swift’s Gulliver—first colossal, then tiny—proves an ideal vehicle for defamiliarized observation. Gulliver also shows us the connection between defamiliarization and satire: both can provide a kind of distance from that which we see too closely ever to understand—from the speeches of politicians to the objects on our bedside tables. Viktor Shklovsky, the Soviet literary critic who coined the phrase, associated it strongly with a description of seeing something familiar as if for the first time. He uses the example of a Tolstoy story in which the horse- narrator fails to comprehend how he can belong to a person, how, as the horse puts it, “there was some sort of connection between me and the stable.”

The narrator who sees for the first time needn’t be alien or beast or child. He might be the fully-grown man, the leader, the pillar of his community, where that community just happens to be technologically backwards—stuck, to borrow Marx’s phrase, in the idiocy of rural life—and confronted with the new. Such (initially, at least) is the narrator of J. M. Coetzee’s Waiting for the Barbarians, who, in the book’s opening line, tells us:

I have never seen anything like it: two little discs of glass suspended in front of his eyes in loops of wire. Is he blind? I could understand it if he wanted to hide blind eyes. But he is not blind. The discs are dark, they look opaque from the outside, but he can see through them.

The story of this narrator, the magistrate of a small, imperial border town, in part pays testimony to the remark of the nineteenth-century Russian statesman, Pyotr Valuev, that there is “something erotic in everything that happens on the distant frontiers of the Empire.” The Magistrate will soon be taken prisoner by the man with the sunglasses, the man from the Third Bureau. And he will be tortured. In the course of his description of the torture, he utters the first of those phrases which played in my head in the hospital. Here is the full quotation, with the phrase in italics:

But my torturers were not interested in degrees of pain. They were interested only in demonstrating to me what it meant to live in a body, as a body, a body which can entertain notions of justice only as long as it is whole and well, which very soon forgets them when its head is gripped and a pipe is pushed down its gullet and pints of salt water are poured into it. … They came to my cell to show me the meaning of humanity, and in the space of an hour they showed me a great deal.

The phrase comes to me as I lie in my hospital bed, later on that same Sunday, and a nurse arrives with what they call an “NG tube”—it is to be inserted first into my nose, then pushed past my pharynx, through my esophagus, into my stomach. As the tube is forced down my nose and into my throat, I throw up—blood and bile, this time—and I emit a kind of stunned whimper. They offer me a drink—to calm me down, I suppose. In fact it is to ease the passing of the tube, which they push even harder as I innocently swallow. It fails; I throw up what little I have drunk. They are showing me the meaning of humanity.

In Coetzee’s expert hands, the brutality of the torture is just the opposite of what is proclaimed on the placards of campus protesters. Torture is not inhumane; it is a reminder of what it is to be human. Being a human is not rights and freedoms, courtesies and dignities; it is flesh, nerves and tubes—like the tube of shit that ought to push it down but sometimes pushes it up, or the tube that runs from your nose to your gut.

This is the challenge of Coetzee’s torture. You are wrong to think that torture is the inhuman exception. What is inhuman is justice; thinking about justice (or any concept) is the luxury of forgetting about your blood vessels and your bones. Perhaps it was for this reason that Nietzsche, no stranger himself to illness, posited an “active forgetfulness” in man—a constant energy in the healthy person required to block out what he called “the noise and battle with which our underworld of serviceable organs work with and against each other.”

I’m not suggesting I was tortured. I was merely aware of that reverberating phrase, to show me the meaning of humanity, as the doctors approached with their trays of needles, or even as I lay there through no fault of anyone’s, writhing and wriggling, without food, for days and days. But we shouldn’t forget that the dividing line between disease and torture is harder to draw than one might first think. The idea that torture is something done by humans whereas disease is natural is doubly wrong. Although some diseases are natural, spontaneous and incurable, many have social dimensions such as the cost of treatment, the means of infection, or the lack of basic information. The connection between the Catholic Church and the HIV virus is only the best known example.

What’s more, not everything about torture is deliberate and intentional. This, Coetzee’s Magistrate is on hand to remind us. Starved for days on end, he wants to think that the torturers are sitting in another room, planning what to do with him: “But it is not like that. They have no elaborated system of pain and deprivation to which they subject me.” He has not been fed, it turns out, simply because they have forgotten him. This forgetting, the very opposite of the intense, careful torture of the movies, is almost more degrading. Still less like the movies, the Magistrate’s torture is not instrumental. His torturers aren’t interested in getting anything from him—the secret codes, the forced confession. How he wishes they were! Not because he could tell them and make it stop, but because if the torture has no goal, then neither does the suffering. “It will be a famous victory,” he tells himself, “if you can last the night.” But it won’t be famous. The purposelessness robs the pain of its meaning. Every martyr needs a cause, a comforting narrative portraying him as the hero, suffering for something higher. It can’t be a matter of pure accident.

But my illness is accidental. Nobody chose it, caused it, controlled it. It “presents,” as the doctors say—it presents itself as a brute fact. The Stoics thought of man as tied to fate as a dog is tied to a cart: either you run with it or it drags you. Illness is the cart: you can scream and writhe, or act bravely and try to take it. Either way, you’re headed for the same place—in my case, trailing behind the cart, strapped to the surgical trolley. We say, of the deceased, that “after a long struggle, she lost the fight with her illness.” And we choose our words carefully. We dress up her helplessness in the armor of battle, dignifying it with choice. I have known the brave, dying of their illness; perhaps you have too. But they are not warriors, choosing between fight and surrender; they are not Leonidas—the great, single-minded Spartan hero, defending Western civilization against the tide of barbarism; they are the dog that is sometimes dragged, that sometimes runs, but that ends up, for no good reason, in the very same place. And there is a torture in that. Not the one that has ways of making you talk; rather, the one that’s forgotten about you, that doesn’t want anything from you, that won’t even notice when you’re gone.

Just like his opening lines, the Magistrate’s torture is a defamiliarization. Meeting the Colonel, he sees his own former role, as a minor imperial official minimally concerned with justice, as if for the first time: “I was the lie that Empire tells itself when times are easy, he the truth that Empire tells when harsh winds blow.” Starved and humiliated, he sees himself, and humanity, for the first time. He now understands what it is to be a human, even though he has always been one. Sunglasses are discs of glass in loops of wire; ownership is an obscure connection between a horse and a stable; humans are bodies—tubes, blood and bones. When my disease presents, it presents me with myself, anew.

One day, I am the subject of a class. A teaching doctor comes in, trailing students and subordinates. The students ask me questions, practicing their attentive scribbling and knowing clucks. They want to know how my flesh works. They want me quantified: How many days? How many pills? How many times? I am the object of scientific inquiry. I tell the doctor afterwards that I, too, have students, that I am a teacher at the university. I am met with stale incomprehension—as though I have told a young child that the bent old woman at the bus stop used to be famously beautiful.

For my part, the doctor is an enigma. Sometimes she is the Queen, or the Empress: more reasonable, to be sure, more worldly and sensitive than the teams of petty officials and courtiers who surround her—but only if one can gain an audience with her, for the sick and the aggrieved all clamor for her judgment and her kindly gaze. Surely, if I can only see her, she will recognize and understand me? But then sometimes she is the technician, the skilled laborer whom I have hired and yet for whom I am, by chance, the very machine I have hired her to work on; and just as every car is really the same to the mechanic, and every lock to the lock-picker, so our bodies are to the body-fixer, as she examines our motions and functions.

In the third volume of Proust’s great novel, Remembrance of Things Past, the narrator rushes his ailing grandmother to the doctor. But the doctor can give them only a few minutes. He must get his tailcoat mended, his buttonhole fixed; for he is dining that evening with the Minister of Commerce. In the end, a few minutes are all he needs: the grandmother has had a stroke; her condition is fatal. Politely but efficiently dismissed, and on his way out, the narrator hears the doctor as he rages behind the closed door:

The maid had forgotten to cut and hem the buttonhole for the decorations. This would take another ten minutes. The professor continued to storm while I stood on the landing gazing at my grandmother who was doomed. Each of us is indeed alone.

The doctor’s shift from his professional to his private concerns, from doom to hem, jars. How is it that he can wait ten minutes for a buttonhole and spare only a few minutes for a kind, selfless old lady in her hour of need? What could be so important about the Minister of Commerce? But then doctors, like writers and academics, must be commercial at times, too; and they must drink and dine. So what do we expect? Shall our doctors stay at home and mourn the loss of each patient, each organ, each limb? After all, we don’t want the physician to weep with us, to share a story about her father’s stroke or her daughter’s gambling addiction. She must go out; she must forget.

Sometimes the doctor is more like the priest or the prophet than the empress or the technician. Shortly after the scene just described, Proust’s narrator finds himself “in the presence of a sort of miracle.” In the space of a few minutes, his grandmother can breathe more easily, more comfortably; her pitiful gasping and whining has been transformed into graceful song. She is at ease.

What changed her was, in part, a dose of morphine. And although they were never likely to get caught up in miracle-working, some philosophers have also been astonished by the effects of morphine—not so much with its gliding, opiate melodies, as with the experience it can produce in patients, who have been known to say things like: “I was in terrible pain. Just after getting the morphine, the pain was still there—but it didn’t bother me. Then the pain went away.”

For the patient, it is the disappearance of the pain (and perhaps the attendant wave of pleasure) which makes morphine an object of interest. For the philosopher, it is what happens shortly before that. What does it mean to feel the same pain, but for that pain not to bother you? Isn’t it part of the very concept of pain that it bothers you? I was therefore looking out for this phenomenon during my treatment, but it never came. Once recovered a little, I tell a visiting colleague how disappointed I am that there was no middle stage where my body felt pain and I didn’t. Something in my description is displeasing: he tells me I am being a dualist. And this, between philosophers, is an insult.

For dualism has a long and difficult tradition. We philosophers may chop off a head here or there, but the beating heart of this hydra is the view that a human comprises two parts: the body and, something completely different, the mind. It is a view that is conducive to Western religion: if it’s not bodily, the mind might survive the body, might even end up somewhere else, like heaven. It is a view that is not conducive to Western science (or to the philosophy which tries to emulate it): For if the mind is not physical, then just what is it? Something very mysterious which we cannot study, measure or quantify. And, of course, thinking is bodily: it is brains and nerves, it is energy. Talking to my colleague, I had not meant to be a dualist; but then, I was ill, and a little confused. In fact, the relation between sickness and dualism was the subject of the second of my “earworms,” which comes as Proust considers his grandmother’s sickness:

It is in sickness that we are compelled to recognize that we do not live alone but are chained to a being from a different realm, from whom we are worlds apart, who has no knowledge of us and by whom it is impossible to make ourselves understood: our body. Were we to meet a brigand on the road, we might perhaps make him sensible of his own personal interest if not of our plight. But to ask pity of our body is like discoursing in front of an octopus, for which our words can have no more meaning than the sound of the tides, and with which we should be appalled to find ourselves condemned to live.

Like Coetzee’s Magistrate, Proust’s narrator finds torment not only in suffering, but in the inability to communicate with it (or its source). Just as the Magistrate wants to imagine an intention and a purpose for his torture, so the narrator imagines meeting a brigand—an intelligent, human other, responsible for his suffering. In such a situation, human vs. human, we at least understand the conflict of wills, the incentives that bring about the pain. Our language and our reason could have an effect. It’s worth a go. In sickness, we feel this urge too—and our increased medical understanding makes it all the stronger. We know what our bodies are doing, and what they are doing wrong. We want to tell them to stop. The crippling pain has done its job. It has got me to the hospital; its cause will be taken care of in the course of the next few months. “Couldn’t you just give me a break?” I want to ask. “Please. Be reasonable.”

Like Coetzee’s Magistrate, Proust’s narrator feels the absurdity of pleading for mercy, but also of mental activity in general in relation to his suffering. That word—“discoursing”—suggests a kind of eloquent, reasoned, academic action. The kind of action over which one has control, from start to finish, premises to conclusion, exordium to peroration. When I first came to the hospital, the pain meant I couldn’t stand still or straight. Bent over, pacing, I muttered short, repeated phrases, quietly to myself. In the hospital waiting room, a woman turned to her friend: “I guess this is the kind of crazy person they get in here all the time.” The pain made a mockery of my intellect, just as writing about it now
makes a mockery of the pain.

So both writers picture a divide: the body and its (mis)functioning on one side, the mind and its ideals on the other. Yet, despite these similarities, the difference is clear: for Coetzee, sickness places the sufferer firmly on one side of the divide; for Proust, the other. For the Magistrate, the suffering confirms that mental activity (or at least the higher, sophisticated kind that deals with things like justice and political organization) is irrelevant; only the body is human and significant. For Proust’s narrator, the experience confirms that the human, he himself, is the discoursing mind—and that this mind is chained to a foreign body, the octopus.

That Proust chooses the octopus can be no accident. At one time thought to be an alien survivor from a bygone age, its form and motion still remain incomprehensible to us. And yet it is undoubtedly sentient. We might be able to make it respond to us, but we shall never communicate, never understand one another. And so it is with mind and body. Staring at his dying grandmother, with the doctor raging in the background, the narrator may think that each of us is alone. But we are not quite alone: we are, each of us, alone with our octopus, condemned and chained to it, as if by way of punishment.

Or maybe the punishment is that we are each chained to each other. There is the ancient, religious idea that man is the unhappy combination of beast and god: if only we were divine, we would be liberated, immortal spirit; if only we were beast, we could be content in our instinctive ignorance. Ovid writes that the goddess Persephone gathered violets in a land where it was always spring. Snatched away by the amorous Pluto, Persephone loses hold of some flowers and weeps, realizing that for the first time something is gone for good. Centuries later, Rilke would write the same about animals: that, not knowing death and change, the spring blooms seem eternal for them. But here we are, we humans, the worst of both immortal and mortal realms: we’re going to die and we know we’ve got it coming. Maybe we should never have gotten smart enough to figure that one out. If only we could break the chain—as, in the soothing Christian fairy tale, we eventually do.

Proust is right to emphasize the horror of being condemned to live with the octopus. It’s not just the restriction of the chain or the dependence on the strange foreign being; nor is it, as Walter Benjamin once said, a matter of a soul banished to a body like a princess exiled to a foreign land. The octopus is tangible, live and responsive. Through the glass in the aquarium it may be a safe curiosity; but to stumble across its speed and its suckers, by accident in open water, to surprise it and be surprised, is terror. In sickness, Proust suggests, we are surprised by the body. We didn’t really understand that it was there; now that we do, it disgusts us. Lying on my back, I am concentrating on the ceiling as a nurse busies herself with the wound on my stomach. I feel something, very slight, and I hear her shriek. Instinctively, I look down. A part of my stomach has popped open; it gapes, filled with green liquid. I see deep into myself. It is disgusting.

We do not find our minds disgusting. True, we sometimes think disgusting or horrifying thoughts. But those thoughts are about something else. That there is something appalling about the body itself seems to be the reason the mind takes precedence in Proust’s dualism. In that respect what illness produces, for Proust, is not a defamiliarization. It’s not, that is, a description of ourselves from a new point of view. We are, for him, pretty much what we were—thinking things. What illness creates is a confrontation and a terrifying awakening: that this thinking thing is attached to something else—something alien, brutal and deaf to reason.

Sometime after my release from the hospital, those two little phrases slipped, one by one, from my consciousness and crept back to the comfort of their literary contexts, to the volumes on the shelves in my office. And it was there that, fully recovered, I was able to locate them, and then to distill them and set out their opposition. Proust’s narrator says that what matters is our minds and our ideals; Coetzee’s Magistrate says that it’s our bodies and functions. But they both agree on the division, and that this division is made apparent by sickness. Yet to the philosopher, once recovered, it’s the division that’s the problem. Coetzee cannot really convince us that the pain of torture is a lesson in humanity; that, as the Magistrate puts it, the torturer is priest-like—a “carer of souls.” We must have our ideals, whatever they are; and those ideals are born out of bodily needs as much as out of lofty, spiritual activity. And nothing in Proust’s remarks should make us treat our bodies as aliens. We know that minds are not mysterious, immaterial selves, assigned to lumps of physiology. We know what we are: intelligent apes, who have mastered the world and found it lacking.

But, as Proust and Coetzee both understand, unifying this divide, reconciling these differences, overcoming the dualism—that is the province of those who are, themselves, healthy, whole, united. It is the sick—a community of isolated, putrefying bodies and isolated, petrified minds—who touch the divide, when they touch the new lines carved into them. And, for this community, both those little literary phrases, for all their contradiction, feel truer than the science which aids them, the science for which, let it be known, they are truly grateful.

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