Mattilda Bernstein Sycamore: The first time I read the book, maybe 20 or 30 pages in, I noticed a current going through my body, a kind of pulse, or an awareness of a pulse, and I think I would describe this as recognition—of searching for an answer to this pain, of methodically cataloguing the symptoms in the face of the indifference, incompetence, and inattentiveness of the people who are supposed to help us—and I say us, right, because I’m there with you in the pulse of the text so the sense of recognition is as much about the form as the content, the push and pull, and I want to start by asking about your method of intertwining the pain with the search, the quick movement of the text, and how this relates to breath.
Maggie Nelson: Interesting. I think I thought of it in a more workmanlike way—like, I had these different pieces of text, some about pain, some about doctors, some on dreams, some about other stuff, and I just started experimenting with their rhythm when put together. Meaning is something I try to hold at bay for a very long time. If and when it comes in, it’s quite late in the game. The quickness you note is likely an effect of radical editing, and an impatience with anything that might be deemed “filler.” Maybe the breath is the white space between entries. I’m not sure! It’s kind of Monday morning quarterbacking to try to explain.
MBS: So another part of your method is dreams. Starting with the third paragraph, we are in a dream, without any transition, and this is another part of the pulse, the back-and-forth and the in-between. What are dreams for you in this text?
MN: Hmm… maybe I’d rather not say, so that the reader can think of the dreams as she wishes. I guess I’d say that they are a realm about as real as the other realms here, and that I was careful not to over-interpret them, and not to change anything fundamental about them. They’re portals, or sinkholes. On a literal level, they are just occasions for making language.
MBS: There’s even BREATHE DENTISTRY in a dream. So the dreams merge with the not-dreams, they are sometimes a respite but more often an escalation. Some of the dreams are obviously dreams, and some of them are so real that you only realize at the end that they aren’t dreams, and I think the realness comes from anxiety, which is another thread in this book—the anxiety of pain, of Covid, of relationship stagnation, of abandonment, of everyday survival, of taking care of yourself, your son, the world. Anxiety is such an engine here, and I wonder how you curated it, if anxiety can be curated, or if it’s more about flow, and if there’s a difference between flow and release, if release is a goal. Or, to come at it from a different angle, how does it feel to use anxiety as an organizing tool for the writing when the feeling itself can be so destabilizing?
MN: This is a very good question. I never wanted to write a book with anxiety as the engine, but I came to accept while working on this book that anxiety was the theme, the drive, the problem, the mood—and, if I did my job right, maybe I could make it something interesting and energizing as much or more than repellent and disabling, as it can so often feel to its sufferer.
It took awhile in my life for me to understand that a lot of the different things I’m suffering are actually anxiety, that anxiety is the underlying thread and issue. One always learns about oneself in writing a book, and I certainly learned a lot here by using my own dreams and my repetitive concerns—probably like a lot of folks, Covid triggered old, primal concerns for me about my well-being and that of my loved ones—old concerns about HIV, and before that, fears that I would die young, like my father. So the book kind of hunts and tracks those fears down, trying to get to the source through the fog. Because when seen from a different point of view, anxiety is a signpost, a gift telling us where the deep cave is. I read something the other day about shamans that described them as “lightning conductors of common anxiety.” That moved me, gave me hope.
I am interested in what you say about release. I am not sure there is a lot of release in this book, though I do think the white space, the editing, and the sense of surprise in its leaps and jerks gifts me—and maybe the reader—something in that ballpark. A certain pleasure that acts, if not as a release, as a satisfying counterpoint to the unease.
MBS: In one dream a dentist offers a solution so simple that it feels like a moment of relief, until we realize it’s not real, or is it, so this brings me back to the blending of dreams and reality, and I think it points to the absurdity of both, is this part of your intention?
MN: That was not real—there was no big fat tire in my mouth, no outdoor track near the dentist’s office for me to walk around. I chose to put that dream at the start of my friend’s dying—I wanted it to feel like a sprinkle of magical thinking: like, maybe things can just evaporate, maybe it can all be a dream, maybe there is a simple form of release—but then we’re right back to the “real,” and it’s not so easy after all. And yet, maybe the dream also delivers some ease, some “not such a big deal”-ness, even in the middle of our living and dying.
MBS: I love the summations that seem to come out of nowhere, but of course they emerge from the destabilization of the text itself. So when you’re watching The Brady Bunch with your son, and you write, “To make it a comedy, no one communicates clearly.” And I think, yes, that’s exactly what comedy is, although would you say this is also true of tragedy?
MN: Yes, for sure.
MBS: Pain is so complex in this book—it is the driving force, what propels the narrative, what brings you both into and out of your body. So it’s yours, but it also opens up a larger constellation of problems—personal, intimate, societal, structural. I wonder if you could talk about what this opening allows.
MN: Pain is famous for closing us down—it individuates, isolates, makes lonely, makes us feel forsaken—and also, weirdly, it’s famous for opening us up, via mechanisms such as empathy, fellow feeling, the desire to bear witness, alleviate, ameliorate, heal, memorialize, and so on. I gave myself permission while writing to be in the first aspect without trying to force the second—all the while knowing, or betting, that by sharing highly specific, indeed idiosyncratic—to say the least—experiences, I might leave an opening for collective experience, for connection. The world is seeping in all over this text—Covid, Twitter, the presence of others near and far, the January 6th riot, and so much more. I let it all be there, like decorative punctums, without trying to stitch it up. I guess I’m trying to say it’s a very ostentatiously interior text that knows the divide between the interior and exterior to be an illusion.
MBS: I have to say that some of these doctors, I just want to scream at their arrogance and incompetence, I mean why is this so familiar? To all of us who have to deal with these doctors. And, those testimonials of people who have been cured so easily by some random treatment—do you think these people really exist?
MN: It’s funny, you are not the first person to feel angry at these various doctors on my behalf, which I appreciate! But really I was trying to write a book in which I moved past blaming weird or idiotic doctors, with the goal of becoming more interested in what we, as patients—or, I should say, what I, as patient—bring into the room. The load of our suffering, our anxiety, our fear, our vulnerability, our history—all these forces we’re carrying, with the hope, sometimes unconscious, that some random doctor untrained in the pastoral arts will behold or hold them during a twelve-minute interchange mediated by a capitalist healthcare system that has no one’s human interest in mind. It’s a tragicomic mismatch, really. There are some doctors who have a talent or capacity for contending with that load—what we might call “good bedside manner,” and/or a felt understanding of the power dynamics at play, when one person is shivering in a paper gown, and the other, the white-coated, is the one “presumed to know”—but there are also jillions who don’t—and of course there are some who really do not, and even some who do mindless—or, in rare cases, intentional—harm.
As to your other question, I do think that there are treatments that work well for some people, but since no two people are alike, especially when it comes to complex or chronic conditions, there are not often “one size fits all” plans. Which, if we’re honest, is often what we want—“just tell me what to do, and I’ll do it.” This is partly why it can be so frustrating when we share our pain with others—you know, and people are like, “I know this great acupuncturist,” or “have you tried hormones?,” or “what about sleeping with a giant body pillow?,” or whatever. The thing is, underneath all that imperfect and often annoying sharing of experience or advice, we really are trying to help each other! It’s just that, in our effort to offer solutions—and, maybe, in our own discomfort with hearing someone else talk about their unsolved pain—we rush in with stories about ourselves. This is endemic to conversations about pain, but I think I’m also just describing a lot of normal, everyday conversations, in which we are not always very good at listening to and holding each other’s experience, for a variety of understandable reasons.
I say all this because I have a lot of experience on both sides of this dynamic—as I would bet we all do—so before one starts complaining about how other people aren’t doing it right, it behooves one to attend to one’s own side of the street, as they say. In some ways the book is about that—having unsatisfying or bewildering medical encounters is one thing, but my main interest was in burrowing into the self, and understanding the deeper issues at play. In other words—maybe this book is the correct place for my pathemata, rather than the doctor’s office.
MBS: Anger is another theme in the book. You write, “I have never felt as angry as I’ve felt over the past two years.” Talk about this anger.
MN: Holy crap, what to say. Until the last few years, anger has not been one of the salient emotions in my life. In fact, anger makes me extremely uncomfortable, both to feel and to be around; I’m much more at home in sadness, for example. So to have so many situations converging at once that were producing anger in me—the pandemic, the closure of schools, the sick, sadistic, and scary state of U.S. politics, a variety of domestic stressors—and, no doubt, some midlife changes—and then to have nowhere to go, physically, to be alone with my new angry feelings—it was hard. I didn’t want to model, especially as a parent, being someone who loses her cool in the face of stress—I didn’t want to become someone who yells, someone who smears her negativity around, and so on. And yet there I was each day, feeling flooded with unfamiliar feelings that I wasn’t always great at managing. It was humbling, to say the least.
In that anecdote in the book, I was trying to get at how sometimes what looks like anger on the outside can really be a curdled desire to do things right, even to help or care—in this case, to get my son vaccinated, to protect him, to be a good mom. You know, it’s like when you hear a parent screaming at their kid in the parking lot and you think, wow, what an unhinged asshole. But when you’re the parent, you know that your scream came from the terror that your kid was about to get hit by a car. It erupted from you out of care, yet it came out sounding shaming and wild. How to get our love to come out as love and not get deformed on its way out is a perennial problem, in so many spheres. And, of course, sometimes you really do have to yell when a car is coming!
MBS: At one point, a therapist suggests that you write a letter to yourself in the voice of your dead father, and when I got to that letter I just felt a chill so immediately, and then I started sobbing. There’s this part earlier where you say that every artist wants the work to make their family understand, and this isn’t that, because your father is dead, you are the one writing, but still there is the way that it feels so soothing, sensing the artifice and the words together at once, so I wonder about the way that a sudden shift into the absurd can create a destabilization that actually feels like an embrace. So I’d love to hear you talk about destabilization, and the absurd, and whether words can embrace.
MN: I’m not sure I see my father’s letter—or the faux letter from my father—as something absurd, but it’s definitely a kind of embrace. I’m interested in the ways in which we know certain things, we all house a certain amount of deep wisdom—that we forget or lose sight of on the regular. My letter to myself in the voice of my father is full of a certain wisdom that I know but also don’t know, akin to the way the letter is authored by me and not solely authored by me, all at once. Maybe I need to read a letter like this every day, I don’t know.
MBS: Maybe we all do. Speaking of words, I want to ask about the editing process—the text is so spare and meticulous, it feels organic in form but so carefully crafted. What was your method for paring it down?
MN: I edited the fuck out of this book. That’s kind of all it was. Editing every little word in every little sentence. I had a lot of fun doing it—it’s my happy place, working on instinct, just making sure each bit sounds “right,” and moving things around until they find their right place. This book was really nice in that regard because it was short enough that I could read the whole thing through in a single working session, and keep every bit of it in mind. I just had to remember that if you edit too much, there is no book, so I had to be meticulous without being rash.
MBS: I know the feeling. And there are so many sudden moments of connection and disconnection in this text, sometimes alternating and sometimes both at once. There’s this beautiful moment onstage for a joint event with your friend “C,” when you are in so much pain that you look in the mirror beforehand to see if the pain is visible. And then, when you get onstage, “C,” who is disabled, whispers, “are you in pain?” And, “are you afraid?” And then she cradles your hand under the table. I found this to be such an intensely moving moment of camaraderie, a potential deepening of intimacy, a common understanding through the struggle but also of course the particularities of this relationship which you also describe in your book Bluets. You’ve called Pathemata a companion piece to Bluets, and I wonder if companionship itself is part of what makes it a companion piece.
MN: Yeah, I guess I say it’s a companion piece to Bluets precisely because of the companion—the “C” here who dies is a main character in Bluets, and Pathemata finishes her story, or, at least, the embodied part of her story. Also, Bluets has a lot to do with being alone—it’s about solitude, heartache, living in the afterglow of a lost lover, a lost companion—whereas here, I am living with many creatures, and feeling both flooded with love and companionship, and also sometimes very alone, the kind of aloneness you can feel when you are sometimes missing connections with your company, and you don’t know how to find each other.
Writing is, as you know, a strange beast, in that we often write alone—being alone is, for me, a necessary condition of finding out what I think and feel—but then in our aloneness we find ourselves writing about our relations. We evoke companions by writing about our dead and our living, our lost and our at-hand. So writing is rich with companionship while also being very solitary. At the same time, writing about our relations is not at all the same as living our relations—writing is a one-sided, monologic, some would say a self-focused activity, whereas living our relations is about dialogue, give and take, and so on.
All of which is to say—I do write about companionship, and I do think of my writing as a form of sociality, but I am also very aware that, for me, writing is a “me” activity—it’s about pleasing my ear, and making my own discoveries—and I would never want to fool myself into thinking otherwise. Like many people, I came to writing as a young person as a way of claiming space that I didn’t feel I had otherwise—it was the first place I could center my thoughts and feelings and feel they had value. In that way, writing is a way of keeping company with myself, and I’m okay with that.
