A week after the poet Anne Boyer turned 41, she was diagnosed with triple-negative breast cancer, necessitating aggressive chemotherapy and a double mastectomy. When the novelist Jenn Ashworth was in her 30s, she suffered an uncontrollable haemorrhage in the wake of a caesarean. The epidural had worn off and, unbeknown to her doctors, she was conscious during the surgery that followed, though unable to speak or move, an experience that triggered a long bout of post-traumatic psychosis, in which she believed that as a child she had killed a baby.
These are narrative events, calamitous episodes in ongoing lives, but they are also events that disrupt narrative, especially for people whose job it is to create it. Both of these extraordinary books are memoirs against memoir, personal accounts that refuse the personal, attempting instead to discover a language and formal structure for what Boyer beautifully calls “pain’s leaky democracies, the shared vistas of the terribly felt”.
They are also indictments of a kind of medicine that, though it saved both women’s lives, came at an extravagant cost (Boyer again: “My life was a luxury good, but I was corroded, I was mutilated.”) Treatment requires being poisoned and cut apart. Even submitting to diagnosis means being objectified and abstracted, taken out of one’s own private body and turned into a collection of symptoms that might not yet or ever be legible to the patient. Compliance is rewarded; dissent unwelcome, particularly from women. It’s years before a doctor thinks to explain to Ashworth that the fact she feels as if her skin might split open and her entrails fall out at her feet – a sensation so pervasive that she can’t wear a seat belt and has to wrap her waist in surgical bandages – is not a delusion but a consequence of surgical adhesions. In ordinary language, her organs are sticking together.
Boyer is especially interested in the business end of all this, the awesome industry of unwellness. Who is doing the labour and who profits from it? When Ashworth knocks over a £20,000 machine in her feverish, unconscious flailing, she is scolded by a nurse and racked with guilt, but no one presents her with a bill. Boyer, on the other hand, is American. Her treatment occurs in what she names “the cancer pavilion”, a place organised not around care but the harvesting of profit from pain. A single session of chemotherapy exceeds her annual salary as a professor. Despite health insurance, she has to get out of bed immediately after coming round from a double mastectomy and leave the hospital, groggy and reeling from anaesthesia and shock. Ten days later, she must return to work, giving a three hour lecture on a poem by Walt Whitman with two surgical drainage bags taped to the open wound on her chest. (It goes without saying that The Undying should be required reading for anyone contemplating the further privatisation of the NHS.)
The vantage point of the sickbed is often thought of as narcissistic, but the revelations here are predominantly concerned with communality. While disaster is ubiquitous, some people remain more vulnerable and precarious than others. As Ashworth puts it: “The world does contain facts, and one of them is that some bodies grant some forms of immunity to some types of disaster.” Racked by her own aggressive, life-threatening treatment, Boyer imagines those less sheltered: the incarcerated woman undergoing chemotherapy, the uninsured sick person in a homeless encampment.
Any one person’s illness likewise occurs within a matrix of cause and effect. There is an ecological cost to ingesting drugs that began as chemical weapons, as well as a personal one: lost eyelashes and dead nerves alongside poisoned rivers from factory runoff and contaminated urine. The cause of cancer isn’t just individual, a case of bad genes or choices, but environmental, a consequence of toxic air and water, the contaminated nutrients of late capitalism, dubbed by Boyer the carcinogenosphere. Even the pink ribbon is suspect, the lucrative symbol of the breast cancer organisation Komen, which runs “a robust public relations campaign against the criticism directed at it by … activists” and in 2014 partnered with the Baker-Hughes corporation to make, of all things, a thousand pink fracking-drill bits.
“I hate to accept, but do,” Boyer writes, “that cancer’s near criminal singularity means any work about it always resembles testimony. It will be judged by its veracity or its utility or its depth of feeling but rarely by its form.” But the driving interest for both writers here – and the overwhelming pleasure of both their books – is in their formal construction, the innovation and ambition they’ve brought to bear on telling these complicated and entangled stories. Ashworth in particular is almost frantic to find a kind of container that isn’t chronological but captures instead the fluctuating, flickering, needle-jumping, train-derailing nature of the traumatic. She experiments with broken and braided narratives, modes for conveying the present tense of distress, the way it ruptures time. “The ‘impossible history’ or unnarratable aspect of trauma,” she explains, “isn’t the traumatising event – not always – but it’s the ‘now’ of aftermath. ‘Not then was their evil hour,’ writes Siegfried Sassoon, ‘but now.’”Boyer refuses to pose as “the angel of epiphany” and Ashworth is likewise scathing about too easily redemptive endings. Isn’t the story of damage, and certainly psychosis, more truly one of apophany: random data that seems abruptly charged with meaning? Both writers are academics, and sharp cultural critics. Ashworth writes about Dracula and Murder on the Orient Express, Charlotte Perkins Gilman and King Lear. Boyer watches cancer vloggers and reads John Donne’s sickbed treatise Devotions upon Emergent Occasions, as well as the novelist Fanny Burney’s account of the mastectomy she had in 1811 while fully conscious, an experience that took years to recover from.
Neither writer is convinced by Virginia Woolf’s claim that there are no words for the shiver and the headache. As Boyer says: “The claim that there is no great literature about being ill is a claim made in almost all great literature about being ill.” Creating it might mean converting your own experience into a fable, as Boyer does, or going in search of your past like a detective. During her recovery, Ashworth obsessively watched serial killer documentaries on her laptop in bed, spending sleepless nights trying to discover in them the missing fact of her own moment of wounding. She writes about a childhood conducted under the twin auspices of the Book of Mormon and a violent father. Sorting through photographs at her mother’s house, she is devastated by the disjuncture between memory and actuality. Writing isn’t so much a way of sealing these gaps as making them legible, part of the story.
How do you get back what was taken, the whole body, the healthy, uncut self? The answer is that you can’t. The compensation is to discover what Boyer calls the “gorgeous framework of mortality”, the common ground of vulnerability. It’s a good place from which to live and a very good place from which to write. I’ll be surprised if I read any better memoirs-that-aren’t for a long while.
• Olivia Laing’s novel Crudo is published by Picador. The Undying is published by Allen Lane (£16.99). Notes Made While Falling is published by Goldsmiths (£20). To order go to guardianbookshop.com or call 020-3176 3837. Free UK p&p over £15, online orders only. Phone orders min p&p of £1.99.
