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By Nancy Au •

In the title essay of The Empathy Exams, a 2014 collection by Leslie Jamison, the author writes about her time as a medical actor playing Stephanie Phillips, a fictional patient who experiences seizures as a result of her grief over her (fictional) brother’s death. The unique structure and form of the essay, mimicking the format of a medical case study—with subheadings such as patient name, case summary, medical history, and encounter dynamics—serve to differentiate between Jamison’s fictional patient/character and the author’s real-life experiences with abortion, heart surgery, and her brother’s Bell’s palsy diagnosis.

Jamison uses the fictional space of Stephanie Phillips to illuminate her personal reflections on empathy, trauma, and pain. She explores Stephanie’s inability to articulate her pain, and the hypervisibility of the fictional patient’s seizures, in order to elucidate and contrast with the struggles of individuals who experience invisible forms of pain, such as grief. Likewise, in order to write about the deaths of my parents, I write stories where fictional characters experience the loss of a loved one. In the title story for my 2019 collection, Spider Love Song and Other Stories, the circumstances surrounding the disappearance of the protagonist’s parents are fiction, which allowed me the necessary distance to delve into the difficult and nonlinear journey through my own loss and yearning.

As Jamison’s essay progresses, and as the author builds upon Stephanie’s fictional struggles coping with the death of her brother, I began to see more of Jamison. Although her use of the medical case study form was helpful in delineating between her fictional versus her nonfictional selves, there were times when the two identities felt so entwined that I had trouble distinguishing and remembering who was real and who was imagined. Jamison explores this blurring of boundaries when she writes into the private, physical, shadow-realm of her real-life brother’s Bell’s palsy:

“I tried to imagine what it was like to move through the world with an unfamiliar face. I thought about what it would be like to wake up in the morning, in the groggy space where you’ve managed to forget things, to forget your whole life, and then snapping to, realizing: yes, this is how things are. Checking the mirror: still there. I tried to imagine how you’d feel a little crushed, each time, coming out of dreams to another day of being awake with a face not quite your own.”

Jamison describes how her obsession differs from genuine empathy, which humbly acknowledges that the limits of imagination—how her imagining a life moving “through the world with an unfamiliar face”—is not the same as personal experience or true knowing; essentially, she allows that her empathy is a form of fiction. I thought about how Jamison’s background as a writer may have fueled her obsession to understand her brother’s struggles, and how this obsession fueled her writing and supercharged her writer’s imagination. I thought about how generative these types of obsessions and questions, blind spots, and the unknown can be for writers.

When Jamison imagines into Stephanie’s juddering, jolting, grief-filled body, she writes:

“You live in a world underneath the words you are saying in this clean white room, it’s okay I’m okay I feel sad I guess. You are blind in this other world. Your seizures are how you move through it—thrashing and fumbling—feeling for what its walls are made of…Your body wasn’t anything special until it rebelled…. I imagine you in every possible direction, and then I cover my tracks and imagine you all over again. Sometimes I can’t stand how much of you I don’t know.”

This passage describes so beautifully the way a fiction writer crafts stories about topics and subjects they are not an expert in, but, rather, they hold a wonder and curiosity and reverence for. Fiction is the constant negotiation of the unknown. Writers articulate and choreograph the thoughts of their characters, while asking themselves questions such as: When do I hold back? What do I hold back? When do I allow the unsaid to remain unsaid? When can the question become the answer? They will sleuth and be humbled by their unknowing; like Jamison, through Stephanie Phillips, they will thrash and fumble in the dark as they attempt to speak to the invisibilities and unsayables.

Within my own writing, I am particularly drawn to the rich, deep worlds of my grandparents’ generation (since I have not yet experienced life as an elder), and the fleeting worlds of the very young (since I cannot recall much of my life before the age of six), and to the lives of my parents before I was born (because they have passed away, and I cannot ask them what I need to know). I’ve written stories where pregnancy and parenthood are central concerns of the characters. I have never felt the desire to have children. But, I’m at an age where many of my friends and family members are pregnant or have young children, and because of this, I am deeply curious about their courage and desire to grow a living being inside their womb, to adopt, to care for a baby, to diaper and coddle, to manage a teenager, to embrace the uncertainty, the multitasking, the struggles and fears and joys. Writing about parenthood is a way for me to imagine into the unique and diverse worlds of mothers and fathers, grandmothers and grandfathers.

Before reading The Empathy Exams, I believed that writing about parenthood, and that my curiosity about parenthood, were forms of empathy and courage. I believed that in writing about this topic I would come to truly know and understand it. After all, I’ve had to stretch my boundaries and comfort-levels as a writer when, for example, I wrote my first graphic sex scene about a couple struggling with fertility. I’ve had to do extensive research and speak with many friends who are parents, navigating the sensitive and difficult memories that they so generously share with me. I would like to say that my writing—which is fueled by a curiosity about “another person’s state of mind”—has been working towards growing empathy, a genuine intentionality that Leslie Jamison commends. But I now understand that my curiosity about parenthood seems to subsist in the same realm as my reasons for reading stories that speak to truths I haven’t been able to find my own words for. I write about what and whom I do not personally know because these fertile topics enable me to know without knowing, to explore every possibility, to meld multiple people’s memories into one fictional one, to keep a distance of my own choosing.

As a writer with Bipolar II disorder, I am aware of many invisible ways that pain communicates itself. The distinctive shapes of my bipolar resemble a vibrant and uneven quilt, a life patterned with anxiety and deep valleys of depression. But, a life also filled with other invisibilities such as hope and happiness and love, made possible through effective therapy and medication, and the constant support of my partner, family, friends, and mentors. My writing and work as an educator give me such joy and agency, weaving into my quilt luminous days filled with dignity and self-respect. As a writer, I explore invisibilities in ways that I hope honors those who live with the same condition.

Jamison shares that she has “always craved a pain so visible—so irrefutable and physically inescapable—that everyone would have to notice.” She has achieved this through her powerful collection of essays; she granted the unsayables and invisibilities a “substance and choreography.” Jamison’s essays achieve what I wish so much for in my own writing: allowing fear and unknowing to “erupt slantwise,” for readers to share in the secret language of pain.

 

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NANCY AU’S essays and stories appear in many journals, including Redivider, Gulf Coast, Lunch Ticket, and Michigan Quarterly Review. She teaches creative writing (to biology majors!) at California State University Stanislaus, and in the fall will begin teaching at San Francisco State University. She is co-founder of The Escapery, a writing and art unschool. Her flash fiction is included in The Best Small Fictions 2018 anthology, and in Vestal Review as the winner of their 2018 VERA Flash Fiction Prize. Her flash also won Redivider‘s 2018 Blurred Genre Contest. Her debut full-length collection is Spider Love Song and Other Stories, (Acre Books / U of Chicago Press, September 2019).