Writing and Illness
Still’s Disease is a kind of Winter. It settles on the bones and the joints with a wintry determination: pain and misery are the signatures. The pain makes you feel cold all the time. You sit by a fire or a radiator, no matter what the season, husbanding warmth. Warmth eases the joints the way a warm January day softens the budding branches. But there is no sap rising: knuckles and knees swell but it is a false Spring; the buds are galls, like the white hollow oak-fruit that the gall-wasp makes. You call for the doctor and the doctor comes with his bag in his hand and he looks at you with a kind of pity because he knows the truth. This is your disease and he can’t take it away from you.
(Unpublished Essay by the author)
I fell ill at twelve years of age with what became a lifelong illness and at the same time I began to write. Ever since then I have tried to untangle those two strands of my life without success. Would I have become a writer if I had not become ill? Did the illness somehow cause my writing? Is writing a therapeutic process for me? I realise that I have experimented with ways of expressing this intensely personal experience in a public context, by metaphor and analogy, for most of my writing life, bearing in mind what Susan Sontag said, that illness accrues metaphor to the point of cliché (‘Illness as Metaphor’).
So how does the experience of physical pain express itself in writing?
In my fiction I have avoided direct approaches (more about indirect approaches later) to what Sontag called ‘the kingdom of the ill’, and the same is largely true of my poetry. One exception is my poem ‘Q’ which appeared first in The SHOp and later in my collection Fahrenheit Says Nothing To Me (Dedalus, Dublin, 2004). I wrote ‘Q’ sporadically over many years, often in hospital under the influence of heavy medication or fever. It is three-hundred lines long so too long to quote in full, but for a flavour of the style, here is the opening section:
Q conspires with God
who appears in a green
gown and wears latex.
He leaves no forensics.
Scalpel, he says.
Q says: Say please.
Clamp, he says.
Say please. Chainsaw.
God is mechanics
and the triumph of engineering
and Q thinks
he is filling up with dead bits.
In the aftermath
he is ecstatic,
drifting between death and sleep
awash with pain.
It’s a good one, God says,
a beautiful piece.
Give me a spare rib, he jokes,
and I’ll give you a prosthesis.
The dreamlike (or nightmare) imagery and erratic structure enabled me to distance myself using humour, especially ironic humour and self-deprecation. The narrative, if that’s not too extreme a word, is formed by loosely connected passages paralleling the time between a surgical procedure and death. Along the way, the character Q falls in love with a nurse, discusses god with his surgeon, hallucinates flying and some kind of destruction of the hospital, meets ‘the good cripple’ (the kind of religious person who preaches acceptance of God’s will), argues with God, writes his will, and dies. It is not intended to be a coherent narrative but a portrait of a mind in torment.
Here lieth a crook
that was once straight as larch,
claws once piano,
too much neck,
relict of Q
However, I have never been able to write directly in prose about my condition, fearing the kind of sentimentality that often shows in ‘misery memoirs’. The epigraph to this essay represented one attempt at writing it—incomplete and unpublished.
I have come to the conclusion over the years that my illness most clearly expresses itself as a certain dark twist in my work—in stories that deal with isolated people, characters in physical or psychological pain or even dying, but also in the darkness of my five novels. Although all of the novels focus on political or social issues by accident rather than by design, it is not accidental that their mood and thematic burdens tend towards tragedy: for me, reality is essentially a kind of cruel entropy relieved only by love and solidarity. Alice Falling (Sceptre, London, 2000) attends to issues of power and abuse (Michel Foucault is never far away from my writing); Minding Children (Sceptre, London, 2001), which I always think of as a kind of Gothic realist novel, was about childcare and child murder; The Map Of Tenderness (Sceptre, London, 2002) considers end-of-life issues and euthanasia; This Is The Country (Sceptre, London, 2005) riffs on the Celtic Tiger and capitalism—the dominant trope is that capitalism is a drug; and Grace’s Day (Head of Zeus, London, 2018) is about the disintegration of a family around a childhood tragedy, but is also, among other things, a critique of the Green movement in its Irish incarnation.
The Map Of Tenderness, most nearly approaches the ‘daily drama of the body’ (Virginia Woolf, ‘On Being Ill’). The plot centres on Joe, his girlfriend Suzie, his religious sister Mary and their father and mother—the latter is dying of Huntington’s chorea, an illness which has a genetic component and is passed down by the mother. Joe and Mary have a fifty/fifty chance of inheriting the invariably fatal disorder. But, for the purposes of this essay, it is important to note that, while writing the book, I was conscious of treating the mother’s illness and the family’s reactions as a metaphor for my own situation. Glancing back over my contemporaneous writing notes I find this entry:
Saturday, June 17, 2000
Problems with my left knee yesterday and had to have it injected. Consequently I woke early this morning and my head was full of thoughts about this book. As is often the case with steroid-induced thinking, not much came of it other than a general enthusiasm to start writing.
Tuesday, July 18, 2000
Inheritance. Joe inherits nothing except his disease.
Scylla and Charybdis: Charybdis is changed into a whirlpool because she stole oxen from Hercules. Scylla is changed into a many headed monster that swallows sailors: she was at first a nymph of rare beauty. Her mother was Lamia who went mad and devoured children.
None of my other novels approach the subject of illness directly, but I would argue that a cast of mind which sees the universe as a Manichean place full of pain is a direct consequence of, if not a response to, the sudden arrival in a child’s life of a crippling disease. What seems certain to me is that the experience of entering into ‘the night-side of life’ (Sontag again) at such a young age, of being a relatively helpless patient whose life was modulated by medical professionals and medication and who was dependent on parents very often for things like help sitting up in bed, had the effect, I believe, of making me aware of the physicality of the body in a way that normally resides in the unconscious for all of childhood. I think it accounts for such an early and determined drive to create worlds and plots and characters over whom I had at least partial control. That first period of enforced immobility (I was out of school for a year) at twelve years of age made me turn inwards and towards books; the imagination was my emancipation. Spending hours, days, weeks in bed, I began writing stories, poems and songs. It was the start of a lifelong habit (or indulgence) of writing on a tea-tray. Over the years I have acquired more elaborate tea-trays, including one with legs and a little drawer for pens. Coupled with the writing urge was an equal and correlative love of reading.
Curiously, I remember my first reading of Sylvia Plath. I can’t now remember how I found her work, but I suspect my best friend gave me a copy of Ariel, and he probably got it from his elder sister. Plath’s work spoke to me deeply—poems such as ‘Ariel’ with its startling opening line (‘Stasis in darkness’ (Plath, 36)) in which I imagined myself both the child and the suffering listener:
The child’s cry
- in the wall.
Am the arrow,
The dew that flies
Suicidal, at one with the drive
Into the red
Eye, the cauldron of morning.
I did not, at the time, know the source of the pain that was apparent in her poetry, but I found it spoke to something in my own life. I understood a poem like ‘Fever 103º’, for example, to be about the fevers that characterise Still’s Disease: ‘Your body/hurts me as the world hurts God…’ (Plath, 59). The slightly hallucinatory quality of much of her work attracted me too. It seemed to sit well with the strange states of steroid-medicated fever that I had to contend with, and that in due course would see their way into ‘Q’, as well as into the drug trip memories in This Is The Country.
Place is not important to me per se, but landscape and cityscape and how people interact with their environment are. I find it difficult to write about locations with which I am not intimately familiar. Thus, for example, it has taken me many years of visiting Italy, learning the language and spending long periods of time there to feel comfortable enough to be able to write about it. My first four novels are located in Ireland; it is not until Grace’s Day (2018) that I risked setting a book anywhere else. The first chapter ends with the sentence: ‘There were three islands and they were youth, childhood and age, and I searched for my father in every one.’ Those islands are in Ireland, England and Italy—in three places that I have known very well. It is my first novel to name the settings.
All the other novels are set in fictional, usually unnamed places. Grace’s Day centres on two sisters—Grace and Jeannie and their family. It opens on Castle Island, off the coast of West Cork, a beautiful empty rock facing the majesty of the Atlantic (though I imagine it further offshore than it actually is). The house where Grace and Jeannie and their family live is, in reality, a ruin on the eastern shore. It looks onto a little pebble beach and the sound that separates it from Horse Island. This is Grace’s habitat. But the novel moves on to London and eventually a second island—The Isle Of Wight—where I spent many holidays as a teenager. I grew to love the chalky coast that fell into the sea after every storm, revealing fossils for the picking. I still have a fossilised sea-urchin that I found at my feet after a swim. Jeannie, the teenager who will grow up to be a geologist, is happiest here, collecting dinosaur bones and stones. The third and final island is Procida in the Bay of Naples, the most densely populated rural area in Europe. It’s the setting for the beautiful Massimo Troisi/Michael Bradford film Il Postino ('The Postman). I fell in love with the place many years ago and have struggled to write about it ever since. It is the setting for the denouement of the novel, the polar opposite of the first island surrounded by our cold North Atlantic. The conflict of the ending is, I hope, counterpointed by the luxurious and communal life of the Mediterranean.
Another constant across all my writing—in fiction and in poetry—is the presence of the sea, which is almost a character in its own right in the fiction. I grew up in a house on Cork Harbour, so close to the sea in my early childhood that spray from the waves of northwesterly gales would splash against the windows; a house that was exactly at sea-level and therefore subject to flooding in certain sea conditions. Swimming and messing about in neighbours’ boats took up much of my summer holidays. I have always felt uncomfortable in places at a remove from the sea, and when I visit a new city I always try to find a way to see it from the water—whether a river, a lake or a bay. I feel I have a better understanding and engagement with the city once I have seen it from the offing.
I have a habit of listening to music while I write—not always, but particularly when I feel the need for inspiration. In particular, I listen to Scottish and Irish folksong, including Border Ballads and sean-nós. I like the Border Ballads for their brutal lyricism, a quality I try to cultivate in my own writing. The sean-nós I admire for the beauty of their imagery and how the songs key into states of mind. Take for example the classic ‘Dónal Óg’. Like most sean-nós, it is a set of images rather than a narrative, typically (there are many versions) telling how Dónal promised that he would take the female narrator away over the sea, but then did not appear at the meeting point. Aside from that basic situation, the rest of song expresses the girl’s desolation—in other words, instead of a narrative, the song is concerned with a psychological state. The most famous verse is usually given as the last:
Ó bhain tú thoir agus bhain tú thiar díom,
Bhain tú an ghealach gheal is an ghrian díom,
Bhain tú an croí seo bhí i lár mo chléibhe díom
Is nach rí-mhór é m'fhaitíos gur bhain tú Dia díom.
Oh you took the east and you took the west from me,
You took the moon from me and you took the sun,
You took the heart from deep in my breast,
And great is my fear that you took God from me.
I read a good deal of history and philosophy, particularly political philosophy, as well as fiction both short and long. I believe writers should read outside their own genre, and preferably they should read outside of fiction and poetry. I tend to think of the ‘ideal reader’ as someone who has read everything I’ve read and experienced everything I’ve experienced (i.e. myself!), but otherwise I find it difficult to believe in an abstract concept of ‘the reader’. My wife, Liz, reads everything and if I have any concept of whom I’m writing for it must be her. Nor do I have any certainty as to how my writing begins. Grace’s Day, for example, began for me (appropriately at dawn) as that sentence about the three islands. I don’t know where it came from: the complete sentence was there in my head when I woke on a July morning in 2008, insistently demanding to be noticed, like a bird tapping at the window. I wrote it down and as I wrote I became convinced that the voice was a woman’s. I don’t know why. Objectively, there is nothing in the words that determines a gender. It was just a hunch, an instinct. Maybe whatever brought the sentence to my head during the hours of sleep was part of a bigger dream. It’s often like that for me, and that initial gift of a phrase gives me a voice in which to tell the story—a magical, and rare, moment in my working day.
Like most writers, I am at my keyboard early every morning; when a phrase like that presents itself, I try to be ready. Like most writers, I believe that anyone wishing to make a book—certainly a book of fiction—must be present to the imagination, must work daily whether the quality of the work is good or bad, and must be ready to seize the moment as it happens. I do not, however, carry a notebook and make constant notes as some writers do. Occasionally a whole phrase or a sentence will occur to me and I will make a note of it—often nowadays on my phone. But I do not spend my days searching for things to write down. Life itself is much too interesting.