Representations of Illness in Literature and Film [1 ed.] 9781443820905, 9781443820837

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Representations of Illness in Literature and Film

Representations of Illness in Literature and Film

By

Bennett Kravitz

Representations of Illness in Literature and Film, by Bennett Kravitz This book first published 2010 Cambridge Scholars Publishing 12 Back Chapman Street, Newcastle upon Tyne, NE6 2XX, UK British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Copyright © 2010 by Bennett Kravitz All rights for this book reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the copyright owner. ISBN (10): 1-4438-2083-0, ISBN (13): 978-1-4438-2083-7

To my grandson Yonatan: welcome to the family, with love from us all

TABLE OF CONTENTS

Introduction ................................................................................................. 1 Chapter One................................................................................................. 7 The Dis-ease of Culture in Jonathan Lethem’s Motherless Brooklyn and Jonathan Rosen’s Eve’s Apple Chapter Two .............................................................................................. 21 Re-membering the Body in Fight Club and Memento Chapter Three ............................................................................................ 39 Asperger’s Syndrome as Metaphor in the curious incident of the dog in the night-time Chapter Four.............................................................................................. 57 Living with AIDS in Pearl Cleage's what looks like crazy on an ordinary day: ‘Wherever you go, there you are’ Chapter Five .............................................................................................. 75 Erectile Dysfunction: The “In” Disease Chapter Six ................................................................................................ 83 Chronic Pain in David Lodge’s Therapy and Alison Lurie’s Truth and Consequences Chapter Seven.......................................................................................... 103 Taking Care of Alzheimer’s in Jonathan Franzen’s “My Father’s Brain,” and John Bayley’s Iris Conclusion............................................................................................... 121 Works Cited............................................................................................. 125 Notes........................................................................................................ 129

INTRODUCTION

The idea of incorporating disease or illness in literature has been with us from the beginning of fiction writing. Take, for example, the concept of madness: there have always been narrative strands of madness, dating from the works of Homer, Cervantes and Shakespeare. Representations of illness have captured the imaginations of countless readers. Why, then, is it important to explore modern works that repeat these patterns of the past? One good reason to do so is because of the currently sympathetic, empathetic and realistic viewpoint vis-à-vis illness projected today. For example, few of us currently believe that some diseases might be the result of diabolic possession. In addition, many of the diseases under discussion in this work either did not exist in previous times or presented themselves very differently. Anorexia and bulimia, topics of the first chapter, could not have existed in their present form in pre-modern times because society was not sufficiently industrially developed for people, especially women, to starve or gorge themselves in reaction to the lives they lived. Although there has been some speculation that saintly women who fasted might indeed be the precursors to anorexics, a conscious decision to alter body image could not have been made. It seems fair to say that Teresa of Avila would not have looked in a mirror and decided that, for aesthetic reasons, she would just have to lose a few pounds. Only a postmodern, postindustrial world could have produced a character like Ruth, in Eve’s Apple, a novel we will discuss in the first chapter, who is acting out her familial and personal difficulties through her obsession with caloric intake. And only our society could consider the machinations of the couple, her partner Joseph’s investigations, and Ruth’s destructive inclinations, reallife problematic behavior. The cultural representation of anorexia and bulimia is no less a cry for help for the calorically challenged in society than the pleas of the protagonists for their own personal resolutions. These particular disorders, then, anorexia and bulimia, owe their existence to specific economic and cultural conditions of the western world. In examining Eve's Apple, we will learn about the particular aspects of eating disorders that are posited on specific conditions of the world we live in. We might also develop a better understanding of the motives that drive people to view their bodies in a distorted manner.

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In the second part of chapter I, Jonathan Lethem offers us a sympathetic view of Tourette’s syndrome. Often a debilitating social disease, Tourette’s does not prevent Lionel Essrog (the latter word is that of is a fruit used in Jewish ritual for the holiday of Succoth that must be without blemish) from fulfilling a highly social role, that of an investigating detective, to impose his will upon the world and discover whodunit: that is to say, who killed his boss and mentor Frank Minna. Lionel’s Tourette’s syndrome is an obvious impediment to the investigation, not least because he is likely to release his Tourettic mantra of “eat me” and other choice linguistic morsels at the most inappropriate of times. Nevertheless, Lionel manipulates his disorder, most often culturally activated, as he claims to live in a city with a Tourettic beat, to solve the conundrum he has sworn to unravel. That someone is able to go beyond or at least circumvent his own cultural and organic limitations is a refreshing and original viewpoint for the notion of disorders. Not only is there room in the world for a Touretter, but his or her malady can also on occasion be turned into a strength, especially when Lionel confesses to the homicide detective’s determined prodding that Tourette is the guy behind the scenes manipulating the investigation and no doubt the key to the case. Lethem helps us to acknowledge that people with disorders and syndromes are not beyond the social pale. To the contrary, Lionel's ability to solve a murder mystery reinforces the idea that he is a constructive member of his community and that no one should be excluded from society because of his or her "condition." In chapter II, schizophrenia and loss of short-term memory come into play in the films Fight Club and Memento respectively, not particularly as completely realistic syndromes, but more as symbols in capitalist morality plays. Put simply, the bottom line for both films is that capitalism can make one sick in an unpleasant variety of ways, even, and perhaps especially, at the workplace. One need not bother to search the wards of mental hospitals to meet the schizophrenics that have opted out of reality to embrace a psychotic world because of their job, or because of the world around them. Nevertheless, should one search for an example, it is not beyond the pale to find such a “real-life” person. Indeed, it is a fairly common complaint to hear one grouse about one's boss or one's job, most often because of the work's stressful nature. These movies and their protagonists carry these neurotic complaints to a higher level. The point is, then, that certain aspects of capitalist society can indeed make people engage life in full-blown, anxiety, ennui, or estrangement. And it has become legitimate to engage cultural artifacts – the movies under investigation here, for example – to formulate such a discussion, even if



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we know that that these capitalist films will eventually do nothing more than reinforce the spirit of capitalism. The idea, however, that cultural production must engage in a dialogue with the illness of capitalist life is encouraging and certainly cathartic. In Fight Club, the unnamed protagonist (who might be Jack) is paralyzed by his work for the automobile industry. He must choose dollars and cents over his moral sense every time he calculates whether or not an automotive recall is the economically viable decision to make. As long as people are dying in accidents from a defective part or system at economically sustainable rates, a recall is out of the question, no matter how many lives are lost to automotive defect. This untenable situation eventually leads Jack into a dual personality, one in which his alter ego, Tyler Durden, can plot the painful downfall of capitalist society, while his ever increasing group of followers beat each other senseless in order to feel alive. The film, then, revolves around a cultural use of a medical condition. The audience will no doubt enjoy fantasizing about the downfall of the "man" or the system, even if the feel-good ending leaves the post industrial mode of production in its dominant position. In other words, some systems are just too large and powerful to destroy, even if we employ mental illness to escape their boundaries. Apropos reactions to the post-industrial world, Leonard Shelby, the protagonist of the film Memento, has an interesting condition of his own, a kind of postmodern Alzheimer’s (a disease itself that is always already postmodern), which prevents him from retaining any new memories. His work as an insurance claims adjuster has saved his company much money, but his immoral judgments have brought death and destruction to innocent lives. Partly in reaction to his guilt over his capitalist machinations, Leonard's life is reduced to a Sisyphean quest to track down and kill John G., the man who may have murdered Leonard’s wife. Unfortunately, there are many John G’s in the world to keep Leonard occupied. Having denied the just insurance claim of someone who is memory impaired, Leonard, primarily because of his own memory problem, is responsible for the death of many innocent people, as he desperately attempts to escape from the burden of his cultural disease. Once again, we learn through a cautionary tale about the evil that men do because of their place in the economic hierarchy. Yet there can be no solution for Leonard other than the endless repetition of destruction. There is no tragedy here, because the protagonist was never free to behave differently. And he must pay the price of his dubious place in the world, by drifting aimlessly and murderously through life without the ability to recall events of the recent past.



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Chapter III examines the curious incident of the dog in the night-time, a novel which marks the official emergence of Asperger’s syndrome in literature, something that has become legitimate and recognized in medical circles within the last two decades (unfortunately, Asperger’s as subcategory of autism may soon be revoked by the AMA). Formerly grouped together with autism, Asperger’s is now understood as an independent disorder, one that affects one’s social behavior rather than one’s intellectual abilities. Also under discussion is the life and work of Temple Grandin, an autistic professor with an Aspergerian bent who manages to use her disorder to further her career and her profession. Grandin claims that autistic people and animals think alike. That is, they visualize in pictures rather than in words, which is the very characteristic that allows her to sense the anxiety of animals in slaughterhouses. She has fashioned a career troubleshooting the problems of slaughterhouses to make sure they operate humanely even if she seems incapable of expressing emotion about the kind of work she does. In curious incident, Chris, the young boy afflicted with Asperger’s, also is able to utilize his disorder to ameliorate his life and the lives of his parents. He manages to solve the mystery of his neighbor’s dog’s murder and also succeeds in reconnecting to his mother, whom he has been told had passed away. While the boy is clearly hindered by the effects of Asperger’s, he also is able to employ his disorder to make his way in the world. Much like in Motherless Brooklyn, the disorder becomes the star of the novel, and Chris is able to influence the world around him because of and despite his affliction. The novel reveals a great cultural acceptance for the impaired, which conflicts with earlier times when most people suffering from illness were isolated at best, and ostracized at worst. The cultural acceptance of the other, especially the afflicted other, makes for a more just world in which the impaired can use their handicap to make a life among the so-called “normal” people of society. In Chapter IV, the presentation of AIDS in Pearl Cleage’s novel, what looks like crazy on an ordinary day, portrays the cultural aspects that have made the disease one that threatens the very existence of the African American community. The cultural factors that lead to the spread of AIDS in minority communities, specifically here in an imaginary all-black town (Idlewild) in Michigan, are also those that have a devastating effect on African American women, currently the most susceptible group to new HIV infections. Yet the novel offers feminist and didactic perspectives and is not an attempt merely to create sympathy for victims who first and foremost fall prey to their own ignorance. Ava Johnson, the middle-class protagonist who is infected with AIDS, on more than one occasion notes



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that she should have behaved differently and taken responsibility for her sexual actions because she knew better. And she will allow no mystery as to how she got infected: that is, by having unprotected sex with men. The novel is a didactic attempt to educate a young generation of black youth that might suffer devastating rates of infection if they do not learn to adapt their behavior to AIDS. Simultaneously, while fighting the ignorance that leads to STDs, most often resulting from the didactic strategies of abstinence and denial, the novel also attempts to rebuild the shattered family life that is in part responsible for the ignorance of the youth. Chapter V examines the explosion of sexual enhancement products and how they have helped turn erectile dysfunction into an “in” cultural disease, especially for many people who need not rely on such medication. Nevertheless, it is hard to resist the charms of the little blue pill and its spin offs, especially since sexual enhancement products have spread tales of sexual execution on par with the greatest of urban myths. Far from straightforward medication for sexual dysfunction, the drugs of sexual enhancement are tightly bound to cultural needs and conventions, if not patriarchy itself. In addition, the very notion of medication, in all its cultural ramifications, gives rise to thoughts about what it means today to be human while relying on pharmaceuticals. The reader will be tacitly asked to consider the consequences of taking sexually enhancing drugs. Chapter VI explores the manifestations of a relatively new disease, chronic pain, in two works of fiction, Therapy by David Lodge and Truth and Consequences by Alison Lurie. In the former, Lodge offers a humorous account of a ubiquitous pain in the knee, inexplicable in conventional medical terms, which leads the protagonist, Tubby Passmore to understand that he suffers from the IDK syndrome, better known as “I Don’t Know.” Although he undergoes therapy to understand the root cause of his psychic and physical pains, he eventually understands that the two categories are mutually inclusive, if not inseparable. He undergoes a comedic journey of initiation into self-knowledge so that he can understand the cultural and psychological causes of his pain and dissatisfaction. Alison Lurie, in contrast, alerts us to the horrors of chronic pain that seem to become a permanent fixture in the marriage of Alan and Jane. The former suffers from debilitating back pain and allows it to destroy his love for Jane and eventually to ruin their marriage. In both novels, chronic pain is portrayed as a postmodern illness, as for the first time in human affairs the pain becomes the illness itself, rather than a mere symptom of impairment. We will trace the development of that former symptom, chronic pain, into an independent condition or disorder.



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The final chapter explores the cultural effects of perhaps the most debilitating disease to confront the elderly of the 21st century: dementia and its subcategory Alzheimer’s. Jonathan Franzen, in his essay titled “My Father’s Brain,” and John Bayley, in his memoir of his wife Iris Murdoch, titled Iris, explore their relations with loved ones through the prism of memory and the inability to remember. The cultural entanglements for both the caregivers and receivers are almost larger than life. Franzen deals with many cultural topics that closely relate to his father’s illness, chief among them the very notion of memory itself. He also takes a look at the difficulty of naming and dating the exact moment that forgetfulness ends and Alzheimer’s begins: as a result of his father's condition, he decides to tell his father’s story in his place. He also tells his own story and explores, among other topics, the ground rules of his parents’ relationship, and the problematic connection he shared with them, as well the difficulties his parents encountered in their marriage. Alzheimer’s is portrayed as a postmodern illness, with important cultural implications, most often because we come to understand that the disease attacks the personality – and destroys it – well before it leaves its toll on the body. Bayley’s memoir is especially poignant because of the intellectual stature of his wife, Iris Murdoch, who eventually comes to take her greatest joy from watching television cartoon characters. Bayley on occasion hopes against hope that the “real” Iris Murdoch, she who wrote 27 novels and other nonfiction works on philosophy, might actually be buried beneath the plaques and tangles of her Alzheimer’s brain. Bayley also delves into the world of the caretaker, the endless frustrations brought about in a marriage that once brought them close by being apart. The upheaval of that world, with the couple drawn into a choking closeness, makes the caretaker almost as much of a victim as the Alzheimer’s sufferer. These illnesses and works of art, then, begin our initial exploration of the many manifestations of the relationship between culture and disease.



CHAPTER ONE THE DIS-EASE OF CULTURE IN JONATHAN LETHEM’S MOTHERLESS BROOKLYN AND JONATHAN ROSEN’S EVE’S APPLE

Should the postmodern view of the world legitimate the ideas of cultural disease, cultural dis-ease, the dis-ease of culture and the disease of culture? Or is that going too far? I think not. There seems to be an almost symbiotic, cultural link between disease and dis-ease and that link was most probably well established long before the postmodern era.1 The diseases humankind experiences vary with the changes in culture, but the link is always there. Therefore, in this chapter I will argue that we cannot fully understand certain diseases unless we approach them holistically and allow for a cultural as well as physical or chemical explication. 2That is to say, I will argue that Tourette’s syndrome and anorexia may have either cultural roots or cultural catalysts, if not both. Furthermore, in the case of the former, it is possible to utilize the oddities of the syndrome to further one’s cause in the world. If this is so, it is no longer possible to grasp and perhaps treat these diseases without considering their cultural connections. Nor is it possible to appreciate fully the scope and ramifications of what we call culture. This is perhaps one reason, then, that disease and dis-ease have attracted the notice of popular culture, both in literature and in film. Specifically, in this chapter we will examine the following cases: in the novel Motherless Brooklyn, the hero/detective must not only unravel the conundrum of whodunit, but must also battle the wild ticking and involuntary outbursts of his Tourette's Syndrome “self” while searching for the murderer of his friend, mentor, and boss. In Eve’s Apple, we will track the machinations of yet another would-be detective, as he follows his anorexic, possibly still bulimic, girlfriend to discover if, when, and how much she eats and then subsequently how and if she gets rid of the calories. In both cases the cultural origins and catalysts of the diseases are present by their absence. That is, we can imagine and even describe their cultural origins even if it is not possible to prove this thesis scientifically.

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This chapter clearly owes a debt to Susan Sontag’s groundbreaking essays, Illness as Metaphor and AIDS and its Metaphors. Sontag argues that TB, cancer and AIDS have clear cultural components and attributes and must be examined and/or interpreted in light of their societal ramifications. While TB was once a culturally “desirable” disease, cancer and AIDS strike the “impure,” with the body reflecting an unhealthy state of mind. In contrast to the cases of cancer and AIDS, having TB, she notes, “was imagined to be an aphrodisiac, and to confer extraordinary powers of seduction.” Yet “cancer, as well as AIDS, is considered to be de-sexualizing” [13]. TB was, indeed, a “sexy” disease, while cancer and AIDS are illnesses that have clear stages leading to “unattractive” death. Henry David Thoreau conceived of his own TB as follows: “‘Death and disease are often beautiful, like…the hectic glow of consumption’” [quoted in Sontag 20]. Disease for the romantics was “merely” “love transformed.” People who loved too much got TB; people who were disappointed with life, like Freud and an abundance of literary characters, got cancer! [23] To this day, we still credit the patient to a certain extent with the responsibility for his/her illness. Those who are better fighters and have more reason to live are those we expect to recover, while those who given will probably not. Yet I believe that Sontag is overly negative when she claims that “psychological theories of illness are a powerful means of placing the blame on the ill. Patients who are instructed that they have, unwittingly, caused their disease are also being made to feel that they have deserved it” [57]. Perhaps it would be more appropriate to suggest that those who engage their disease with a positive mindset, living life to the fullest as if every day were their last, are more likely to overcome their diseases. Clearly, beginning in the 19th century, TB was a highly attractive malady because of its cultural/artistic potential. It was more than a disease; thus its physical characteristics could be used to put together a “consumptive appearance,” whether one suffered from the disease or not. This appearance or affectation could signify sexuality, or, paradoxically purity, but suggested that one had managed to reach the sublime, even if to do so were deadly. Cancer, in contrast, was something that destroyed the body and has, even today, yet to be aestheticized. “Romantic” agony was a lot more appealing than mere agony. Perhaps today’s non-romantic modern version of TB is AIDS, an illness that is often supposed to strike those who “deserve” it. Culture and society have long been described in terms of metaphors of illness. Shakespeare had his infections of the body politic, and his demented King Lear, while Nietzsche claimed that his infirm civilization



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under the authority of Christianity attempted to throttle and destroy culture [Will to Power, 85-87]. But in the postmodern world we can take the relationship between culture and disease to a more complex level. That is, culture acts as either the creator or catalyst of certain diseases. Perhaps the least obvious example of those diseases and disorders we will discuss is the cultural connection to Tourette's syndrome. But before we do so, let us review the disease as it is described and defined in the medical literature. Tourette’s syndrome is a neurological disorder named after the French neurologist Georges Gilles de la Tourette, who, in 1885, described nine patients with childhood-onset tics, accompanied by uncontrollable noises and utterances [Jankovic 1184]. Tics, the clinical hallmark of Tourette’s syndrome, are sudden, brief, intermittent, involuntary or semi voluntary movements (motor tics) or sounds (phonic or vocal tics). They typically consist of simple or coordinated, repetitive or sequential movements, gestures and utterances that mimic fragments of normal behavior. Examples of complex motor tics include headshaking, trunk bending or gyrating, brushing hair, touching, throwing, hitting, jumping, kicking, making rude gestures, grabbing one’s genitalia, and making other lewd or obscene gestures (copropraxia) and imitating others’ gestures (echopraxia). Burping, vomiting, and retching have also been described as part of the clinical picture of Tourette’s syndrome. Some complex, repetitive movements and sounds may be considered a compulsion when they are preceded by or associated with a feeling of anxiety or fear that if they are not promptly or properly executed, “something bad will happen.” [1184-1185] Before the1960s the disease was considered a bizarre psychological disorder, yet when the positive effects of neuroleptic drugs on the disease were recognized, Tourette’s earned the distinction of becoming a relatively common, biological and genetic disorder. The more medical and educational personnel are trained to spot Tourette’s syndrome the more cases appear in the literature, so that this phenomenon can also be called cultural. Aside from biological, neurological and genetic factors, there is also limited discussion of the ways in which environmental factors affect Tourette’s symptomatology in children. For example, factors associated with an increase in Tourette symptoms include events causing anxiety, emotional trauma, and social gatherings [Munoz et al 306]. This suggests, then, that the more uncertain the world we live in is, our own postmodern world, for example, the more we can expect to encounter cases of Tourette’ s. As clinical neurologist and author Oliver Sacks points out, a



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Tourette’s syndrome association came into being in 1974, with a membership of 50, yet seven years later, it had a few thousand. The membership grew, apparently, because suffers began to recognize themselves, and family members were able to associate the symptoms of Tourette's with their loved ones [The Man Who Mistook His Wife for a Hat 94-95]. Sacks provides a rich cultural context for this, and other, .infirmities. Thus Sacks explains the “disappearance” of Tourette’s syndrome in the first half of the 20th century as a result of the split between neurology and psychology. “By the turn of the century, a split had occurred, into a soulless neurology and a bodiless psychology, and with this any understanding of Tourette’s disappeared” [Sacks 93]. Sacks believes that the disease was too “strange” for modern medicine. Strange diseases [Tourette’s and encephalitis lethargica], he argues, “could not be accommodated by the conventional frameworks of medicine, and therefore they were forgotten and mysteriously ‘disappeared’” [Sacks 93]. But because Sacks had become involved with post-encephalitic patients who exhibited Tourettic symptoms, he began to notice “ticcers” in the streets, potentially suffering from Tourette’s syndrome. Sacks’ most “cultural” Tourette's patient was known as “Ray.” He exemplified the ways in which art and play become part of and temporarily overcome Tourette's. That is, “when the galvanised [British spelling] Touretter sings, plays, or acts he in turn is completely liberated from his Tourette’s. Here the ‘I’ vanquishes and reigns over the ‘it’” [96]. Ray’s way of dealing with and surviving his near incapacitating tics was to play the drums. He was, (like many Touretters) remarkably musical, and could scarcely have survived – emotionally or economically – had he not been a weekend jazz drummer of real virtuosity, famous for his sudden and wild extemporizations, which would arise from a tic or a compulsive hitting of a drum and would instantly be made the nucleus of a wild and wonderful improvisation, so that the ‘sudden intruder’ [Tourette's] would be turned to brilliant advantage [97]. Drumming is what helped Ray survive being fired from dozens of jobs, though he had managed to make it through college and was married. His marriage, however, was often threatened by his involuntary cries of “shit” and “fuck” at inappropriate – most often sexual – moments. Yet what is most interesting about Ray is not how he dealt with his malady, but how he described it as part of his life. Although Sacks suggested medication that would mitigate his syndrome, Ray was hesitant about losing his tics, fearing that he would also lose his identity.



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“‘Suppose you could take away the tics,’ he said. ‘What would be left? I consist of tics – there is nothing else’” [98]. He related to himself in the third person, calling himself “Witty ticcy Ray.” He could not imagine life without Tourette’s both because he was a drummer who was convinced [apparently rightly so] that his drumming reached occasional heights of greatness because of the speedy movements Tourette's allowed him and because he so identified his very existence with the disease. Ray had employed and exploited his malady all his life and the thought of living without it was initially unacceptable. He and Sacks eventually worked out a compromise, whereby Ray took his medication during the week so his “square” self [Ray’s term] could hold down a job and satisfy societal expectations. But on the weekends he reunites with Tourette’s in order to be the great jazz drummer that he is. He also believes that his disease affords him an insight into life that “straight” people never have. He knows what it is to live life in the fast lane, after living in the dull lane for five days a week. Ray’s experience, it seems, is strong confirmation of the cultural connotations of a neurological/chemical imbalance in the brain. Just as Sacks has shown the cultural connection to Tourette’s, so too has Jonathan Lethem’s novel, Motherless Brooklyn. Lionel Essrog, American orphan, must embark upon his quintessential American quest to reinvent himself with a twist. He is a would-be or wannabe detective that suffers from Tourette’s syndrome. Indeed, from the first sentence of the novel, “context is everything,” the text prepares the reader for the possibility that there are cultural connotations and origins to Lionel’s malady. From the opening narrative we realize that the disease also manifests itself as a performing art in addition to its physical symptoms: Context is everything. Dress me up and see. I’m a carnival barker, an auctioneer, a downtown performance artist, a speaker in tongues, a senator drunk on filibuster. I’ve got Tourette’s. My mouth won’t quit, though mostly I whisper or subvocalize like I’m reading aloud, my Adam’s apple bobbing, jaw muscle beating like a miniature heart under my cheek, the noise suppressed silently, mere ghosts of themselves, husks empty of breath and tone. (If I were a Dick Tracy villain, I’d have to be Mumbles.) In this diminished form the words rush out of the cornucopia of my brain to course over the surface of the world, tickling reality like fingers on piano keys. Caressing, nudging. They’re an invisible army on a peacekeeping mission, a peaceable horde. They mean no harm. They placate, interpret, massage. Everywhere they’re smoothing down imperfections, putting hairs in place, putting ducks in a row, replacing divots. Counting and polishing the silver. Patting old ladies gently on the behind, eliciting a giggle. Only – here’s the rub – when they find too much



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perfection, when the surface is already buffed smooth, the ducks already orderly, the old ladies complacent, then my little army rebels, breaks into the stores. Reality needs a prick here and there, the carpet needs a flaw. My words begin plucking at threads nervously, seeking purchase, a weak point, a vulnerable ear. That’s when it comes, the urge to shout in the church, the nursery, the crowded movie house. It’s an itch at first. Inconsequential. But that itch is soon a torrent behind a straining damn. Noah’s flood. That itch is my whole life. Here it comes now. Cover your ears. Build an ark. ‘Eat me,’ I scream. [1-2]

In essence, this rather long quotation is the key to understanding the dynamics of the entire novel and the plight of Lionel as Touretter. In this rich and spellbinding description of Tourette Syndrome, the narrator presents both cultural and physical metaphors and similes, yet he begins with the former, as if to suggest the cultural connotation of Lionel’s suffering. Thus the narrator describes accommodating and conventional cultural roles in order to create a societal context for his own social transgressions. He plays a variety of roles, “performance artist, carnival barker, auctioneer, speaker in tongues, and senator drunk on filibuster.” All of these social functions rely on language to reach fruition, though most of them function in the realm of linguistic distortion. Ultimately, since Lionel sees himself as a potential Mumbles, his attempts to make sense of a chaotic world lead to chaos rather than understanding, a reasonable approximation of the postmodern world. Despite the physical manifestation of the disease, “Adam’s Apple bobbing, jaw muscle beating,” the mission of Lionel’s Tourette’s, as he sees it, is to send out an army of words into the world and make sense of it, by “smoothing down the imperfections.” Indeed, it is not the latter that triggers his “irrational” verbal response, but rather a seemingly perfect world that has no visible flaws and thus becomes incomprehensible. When Lionel’s ability to categorize the world [apropos of the imagery of the flood and Noah’s Ark] breaks down, he loses his ability to placate his verbal excesses. As a last resort, he must scream “eat me” or something similarly outrageous to an unwieldy world in order to engage it. The text makes numerous cultural references to the disease, even implicating geography in the malady’s formation. Therefore, it is appropriate to describe New York, the setting of the novel and Lionel’s whole world, as a tourettic city [113], thus suggesting a symbiotic relationship between the city’s dis-ease and Lionel’s symptoms. Indeed, Lionel has never known peace, as one character suggests, because he has never left the city. Therefore, Lionel sums up his city life as follows:



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My life story to this point: The teacher looked at me like I was crazy. The social-services worker looked at me like I was crazy. The boy looked at me like I was crazy and then hit me. The girl looked at me like I was crazy. The woman looked at me like I was crazy. The black homicide detective looked at me like I was crazy. [107]

This summary of Lionel’s experience suggests the cultural bind in which he finds himself. While being crazy is a cultural determination, as Michel Foucault suggests, Lionel’s affliction is not easily recognizable to the layman and is immediately labeled “crazy.” Yet these experiences have also contributed to and enhanced Lionel’s tourettic behavior, since each time he has been branded a “freak,” a much repeated description of Lionel, he behaves more and more freak-like. In effect, Lionel becomes a selffulfilling prophecy as his symptoms emanate from specific cultural and social contexts. The narrative emphasizes the self and other game that Lionel plays with his disease. Sometimes they are one, while at other times Tourette’s syndrome is a separate entity that acts as Lionel’s adversary. When the homicide detective questions Lionel, the latter is forced to explain that his outbursts are the result of Tourette’s. In fact, he declares that Tourette is the “shitman.” Assuming that Lionel is speaking some kind of esoteric street talk, the detective demands to be taken immediately to see Tourette, as if he/it were the key to the case. When Lionel insists that “there is no Tourette,” the detective promises to interrogate Tourette without giving out Lionel’s name. Lionel is quite pleased to let Tourette be the suspect so that he can “get off the hook” [110]. Once again, the disease exists only if people are familiar enough with the symptoms to identify it accurately. Or perhaps it shows the obverse of that--not knowing=no disease. Yet another connection that the novel creates between culture and the disease is Lionel’s aside on the music of Prince, his favorite artist. I don’t know if the Artist Formerly Known as Prince is Tourettic or obsessive-compulsive in his human life, but I know for certain he is deeply so in the life of his work. Music had never made much of an impression on me until the day in 1986 when sitting in the passenger seat of Minna’s Cadillac, I first heard the single “Kiss” squirting its manic way out of the car radio. To that point in my life I might have once or twice heard music that toyed with feelings of claustrophobic discomfort and expulsive release, and which in so doing passingly charmed my Tourette’s, gulled it with a sense of recognition, like Art Carney or Daffy Duck – but here was



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a song that lived entirely in that territory, guitar and voice twitching and throbbing within obsessively delineated bounds, alternately silent and plosive. It so pulsed with Tourettic energies that I could surrender to its tormented, squeaky beat and let my syndrome live outside my brain for once, live in the air instead. [127-128]

Thus for Lionel life, disease and art become intertwined and allow him once again to distance himself from Tourette’s, giving it life outside of himself, allowing him the opportunity to observe culturally rather than act out his malady. Music, a cultural product, is just as capable of any human being of acting “tourettically.” The attempt to fuse culture and disease, I would argue, stems from Lionel and humankind’s desire to utilize human affliction constructively, to make one’s existence easier, or perhaps more meaningful, in the world. And that is exactly what Lionel accomplishes by becoming a detective. He uses Tourette’s as an ally – the black homicide detective was not so far off the mark – to solve the murder of the person closest to him, his boss, Frank Minna. Minna was the first person to “diagnose” Lionel successfully, so that it is both ironic and fitting that Lionel employs Tourette’s to find Minna’s killer. Lionel, as rational detective, fulfills an important cultural function in the world, giving us all hope that, despite our maladies and deficiencies, we have a chance of making sense of human existence by solving a difficult conundrum of life and death by employing our wit and reason. We all might have the chance to become a postmodern Oedipus, so to speak. Lionel, as Touretter, becomes a successful human being, someone who exploits his own handicap and refashions it into a “cultural” strength. *

*

*

Joseph, the protagonist of Eve’s Apple, also uses an encounter with disease to refashion his existence. In this case, however, Ruth, his partner, suffers from anorexia, while Joseph does not realize that by trying to save Ruth, he is, in effect, trying to save himself. Yet I will argue that both characters suffer from their own maladies, with Ruth’s anorexia clearly affected by culture no less than by family history. Ruth’s affliction is the more obvious of the two, since the surface level of the text focuses on her problems with food. Just as Lionel describes New York as a tourettic city in order to establish a cultural context for his disease, Joseph makes a similar connection between anorexia/bulimia and New York. The latter is described as an “overweight” city, “with tons of concrete and iron and



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granite piling up greedily around me” [107]. The personified capital of Western culture, then, is a bulimic creature. A city on a permanent binge, so to speak. That anorexia and or bulimia is cultural/psychological is suggested even by the most conservative of medical sources, one that focuses on the physical aspects of the disease, the Diagnostic and Statistical Manual of Mental Disorders, commonly known as DSM IV [483-495]. 3 Anorexia Nervosa 1. Refusal to maintain body weight over a minimal normal weight for age and height, e.g. weight loss leading to maintenance of body weight 15 percent below that expected, or failure to make expected weight gain during a period of growth, leading to 15 per cent below that expected. 2. Intense fear of gaining weight or becoming fat, even though underweight. 3. Disturbance in body image, e.g. the way in which one’s body weight, size or shape is experienced. Feeling fat when emaciated or experiencing one body part as too fat, even when underweight. 4. In women, absence of at least three menstrual cycles, when otherwise expected to occur (primary or secondary amenorrhea). Bulimia Nervosa 1. Recurrent episodes of binge eating 2. A feeling of lack of control over eating during the eating binges. 3. The person regularly engages in either self-induced vomiting, use of laxatives or diuretics, strict dieting or fasting, or vigorous exercise in order to prevent weight gain. 4. A minimum of two binge eating episodes a week for at least three months. 5. Persistent over-concern with body shape and weight. What is cultural in the DSM is the perception of body image, which is determined to a great extent by fashion, marketing, and the media. Moreover, only in a culture of leisure with an abundance of food does one have the opportunity to refuse to eat or to binge. Caloric denial is not a statement of ego power in starving societies, nor is bingeing a realistic option. Thus anorexia and or bulimia occurs almost exclusively in Western countries and other nations that have a high standard of living [Garfinkel 112-119] making New York City an excellent locale for the setting of



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Eve’s Apple. Indeed, the novel recalls De Tocqueville’s Democracy in America, in which the author describes “‘the strange melancholy which often haunts the inhabitants of democratic countries in the midst of their abundance, and the disgust of life that sometimes seizes in the midst of calm and easy circumstances’” [ Rosen 276]. Clearly, Ruth, our anorexic heroine, presents both the “disgust of life” and the DSM symptoms of bulimia and anorexia. Indeed, Ruth displays just about all of the symptoms of both diseases. She is obsessed with her body, imagines she is fat in specific body parts, skips rope obsessively at night to burn calories, vomits, hides her shape with oversized clothing, indulges in binge eating, and ceases menses for a number of months despite her inaccurate claim that she is pregnant. As we understand from the novel, her inability to get along with her parents, combined with their affluence and the ways they use money to keep her emotionally at bay, triggers her resistance to caloric intake. In describing her mother’s late-in-life academic success, Ruth declares to her partner, Joseph, “‘She wanted to have her kids and eat them, too,’ she told me once, bitterly. ‘She wanted to escape, [her marriage] which is fine, except that I had already been born. How could I compete with Katharine Hepburn when I was only five?” Whether Ruth is referring to her mother’s academic work on film or Hepburn as icon of an empowered woman makes little difference. Ruth’s resistance to her mother’s so-called cannibalistic desire is to eat as little as possible. Yet Ruth does conform to the cultural demands of her mother’s academic specialty – film – by adopting movie-star modeling standards to evaluate the female body, specifically her own. Disturbed body image is a predominant feature of both anorexia and bulimia. These phenomena are clearly multidimensional, and have been attributed to cultural standards for beauty, learning within the family, disturbances in psychosexual development and deficits in self-esteem [Bruch 1-25]. Once again, Ruth meets the criteria for all these categories, and never allows her body to accept itself. So if this disease is clearly connected to cultural malaise, why explore the ways dis-ease and disease are linked at all? I would argue that what make the linkage in Eve’s Apple special are the unusual metaphors employed to describe the cultural and psychological dis-ease of both Ruth and Joseph. Indeed, they make for an uncanny cultural/psychological experience via illness, one in which disease becomes a lifestyle. In addition, that anorexia has become the focus of fiction suggests the disease’s intimate bonds to popular culture. Moreover, anorexia, because of its "popularity," is the subject of countless Internet sites.



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If in the 19th-century tradition consumption is linked to heightened sexuality, Joseph is able to link the latter in the 20th-century to anorexia. Put simply, Ruth’s condition ensnares Joseph in a near voyeuristic trap of eroticism: The first time I undressed her – we were still in college – the vision of her body, not merely given but gift-wrapped, nearly knocked me out. That her physical unease should express itself so erotically, should prove so gratifying, gave me a vague pinch of guilt, but a greater pinch of desire. [15]

This is the essence of Joseph’s relationship with Ruth. He takes erotic and psychic pleasure in her dis-ease and denial. He is sexually enflamed by those rare occasions she is willing to give of herself because she spends most of her life hungry, thwarting her desires, often treating Joseph’s potential sexual penetration “as a kind of taboo food.” He is psychically captivated by her malady because it allows him to relive the suicide of his sister and relieve himself of his irrational guilt surrounding her death. If he was unable to save Hilda, he unconsciously reasons, he will certainly save Ruth, even if it involves denying his own problems and voyeuristically invading Ruth’s privacy. He follows her around New York, examines the bathroom after she uses it for signs of vomiting, and interrogates her hoping to catch her in an anorexic or bulimic falsehood. In doing so, he almost destroys them both. But beyond their psychological drama, at the heart of the novel lie the cultural emanations of Ruth’s disease. Dr. Ranji, the physician who treats Ruth for anorexia, claims that the latter is a luxury for the Rich in America. He has seen too much starvation in the place of his birth to believe otherwise. In their cultural machinations, Joseph and Ruth sometimes reduce her illness to a linguistic oddity. When they play scrabble he observes the slight difference in spelling between “fast” and “feast,” as well as “diet” and “die.” Indeed, both characters are caught between the polarities of both word groups. As Ruth’s mother’s companion [and advisor to Joseph] Dr. Flek, the lapsed psychiatrist notes, ‘Not everything is a substitute for something else, despite what my former colleagues might believe. Why discount the material aspects of our lives? More wars have been fought over food than over love. Our civilization exists because we found a way to make food reliable. All we are, all we make, all we do, arose because we found a way to make food our servant instead of the other way around. Ten thousand years ago we stopped being hunter-gatherers and learned to domesticate plants and animals. We tamed



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the earth and made it grow food for us instead of foraging for what we needed. These early cities grew and with them art, culture, literature, history.’ [126-127]

Although a bit simplistic, Flek’s explanation is basically sound. There is no progressive civilization as we know it without an abundant supply of food. The latter is what allowed humanity to take control of its destiny. Paradoxically, in her world of abundance, Ruth takes control of her destiny by refusing to consume, or, alternatively, eating and then bulimically disgorging the world before it or postmodern culture eats her. Perhaps the most outrageous cultural connection to Ruth’s eating disorder is the new age cure that she and Joseph endure to put an end to her refusal to consume. In an Alan-Ginsberg-like “Supermarket in California” gone mad, they embark upon a wild journey into an all-night supermarket to flaunt the abundance of caloric possibility in America. Ruth’s new age cure is based on the premise that people who binge are anxious about the disappearance of food. They supposedly consume as much as possible to prepare for a rainy day, so to speak. Thus the solution is to buy everything one desires, without limits, so that no matter how much one eats there will always be something more to consume. Joseph and Ruth fill two heaping carts of groceries, but she breaks down before check out and takes off into the night, horrified by her caloric accumulation [188-194]. In this novel, then, shopping is not the panacea for cultural malaise or disease. Lacanian desire, the endless “I want” without an object, cannot be fulfilled in a supermarket, part of the very culture that brings out Ruth’s dis-ease. The journey to the all-night Food Emporium ends in failure, at least as far as eliminating bingeing from Ruth’s anorexic repertoire. How, then, do Ruth and Joseph emerge from the anorexic maze that has trapped them? As Flek explains Ruth’s relationship with Joseph to the latter, both of them have been playing a game of control, each with a separate agenda. Joseph has attempted to avoid the angst he feels over his sister’s suicide, while Ruth is trying to control the uncontrollable world in which she finds herself. ‘Please don’t ask me about my family,’ I [Joseph] said. His [Flek’s] gentle coaxing threatened to distract me from the purpose of my visit and I felt mounting anxiety. ‘Don’t you understand, it’s Ruth? She needs me.’ ‘You need her, Joseph. And I’m not sure it’s for the noblest of reasons. Ruth’s illness is about control – keeping chaos at bay, in her case through food. We all have different strategies for doing that, of course. I think yours is your obsession with her illness, but you can’t use Ruth to replay your childhood with your sister. Or to hide from it.’ [272]



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Although initially enraged by Flek’s analysis, Joseph comes to accept the truth of what he says just as Ruth admits that she is unable to control her denial of nutrition. Joseph is finally able to let go of the perverse side of his erotic desire, which focuses on what had become of Ruth’s body, in order to help her survive. Ironically they do get to save each other, not by trying to undermine and control the other, but by acknowledging their inability to cope. The future is open and positive, as Doctor Ranji notes that “‘Ruth is a strong person,’… ‘and eighty-eight pounds isn’t nearly so bad.’” In response to Joseph’s question “‘How can people allow it to get so bad,?’” Ranji remarks: “‘When society itself is ill, noticing illness in others isn’t easy’” [308]. So the doctor who apparently is about to treat Ruth’s eating disorders with multiple tools infers that her illness is a function of societal malaise. Her “disorder” has meant to put order back into the world, something that our postmodern anxiety makes extremely difficult if not impossible. What we have seen in both novels, then, is the way that culture and disease are not merely linked but how they create a loop in which one feeds off and nourishes the other. Culture helps to define disease because of the former’s dis-ease, yet disease also contributes to the making of culture. Indeed, both novels by their very existence and subject material testify to the powerful creative combination of culture and disease.



CHAPTER TWO RE-MEMBERING THE BODY IN FIGHT CLUB AND MEMENTO

In this chapter, we will explore the ways in which certain illnesses, specifically schizophrenia and loss of short-term memory, originate in cultural practices. Both of these illnesses are closer to verisimilitude than real life, yet they provide an imaginative and reasonable reaction to late capitalism. Thus, although it may not appear so at first viewing, the films Fight Club (1998) and Memento (2000) revolve around similar themes. Both films, exemplars of popular culture, struggle against late capitalism in order to establish individual identity in a de-centered world. Whether such a possibility to contract these diseases exists or is merely the fantasy of the creators of these movies matters little. What is important is that society, in its capitalistic guise, has the imagined potential to make people ill. Thus, in Fight Club, Jack works for the auto industry and must literally determine the value of human life, as he decides upon the economic justification for recalling defective automobiles. According to a rigid formula, Jack either recommends paying off the law suits of accident victims or recalling the problematic automobile model if the accidents and subsequent suits are too financially demanding. Simply put, Jack recommends the option that will cost his firm less money, including the “death” option, if the latter is more financially appealing. Consistent with late capitalism, human life is reduced to profit and loss. In Memento, prior to his memory loss, Leonard Shelby [Shall be?] worked for an insurance company, as a claims adjuster/investigator. His greatest coup, the case that earned him a promotion, involved Sammy Jankis, someone who seemed to have lost all capacity to form lasting memory since the time of his automobile accident. Shelby succeeds in denying Jankis’s wife’s claim, leading to her suicide [with Sammy’s unwitting assistance, as he continuously injected her with insulin, unable to recall his short-term actions when his wife repeatedly told him “it’s time for my shot”] and Sammy’s incarceration in an asylum. In both movies, capitalism literally makes each of the protagonists ill and limits their

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ability to function, though in very different ways. Each protagonist attempts to use his body to escape the control of society and reestablish his individual identity and will. Each protagonist suffers from a disease not conventionally thought to have cultural origins or triggers. Yet Jack’s schizophrenia or dual personality and Leonard Shelby’s inability to create new memories in some measure are both a result of their work and place in society. Finally, each protagonist will experiences difficulties that seem to be a direct result of the contradictions of the capitalist, postmodern societies that they seek to avoid. I will begin this exploration with Fight Club, perhaps the more “obvious” case of the connection between culture and disease and a film in which the body is clearly an arena where the battle for control over the individual is fought between society and the protagonist, Jack/Tyler Durden. In order to survive his postmodern nightmare, Jack, the “unnamed” narrator, creates an alternative personality, a schizophrenic alter ego he calls Tyler Durden. Durden is everything Jack is not: a bold, flamboyant, highly sexual, charismatic man who lives his life on the edge. In Michel de Certeau’s terms, Jack invents Tyler to “make do” in the world. Or as Tyler puts it to Jack: “You were looking for a way to change your life. You could not do this on your own. All the ways you wish you could be? That’s me. I look like you want to look, fuck like you want to fuck, I am smart, capable, and most importantly, I am free in all the ways you are not.” Freedom is indeed the issue. By creating Tyler and Fight Club, Jack hopes to “short-circuit institutional stage directions” [de Certeau quoting Foucault xiv] in order to “sap the strength” of institutional power. But before we examine Jack’s schizophrenic creation and evaluate his plan of action, it is necessary to understand the ways in which he finds his world intolerable. Aside from his being paid a salary to reduce human life to an entry on a balance sheet, Jack’s most obvious problem is his insomnia, as he moves through life like a zombie. His life is unreal to him, not only because of his work, but because he has nothing to live for other than the latest consumer toys of late capitalism. Reducing him to a metonymy, Tyler derisively labels Jack “IKEA boy,” a dupe of advertising and marketing who spends his constipated toilet time phone-ordering catalogue products that he will never use. Jack understands his bizarre existence as nothing more than “a copy of a copy of a copy,” a man with no identity, center, or authenticity, completely removed from any meaningful, constructive activity in the world. He appears doomed to live his life as if he were a commodity, to be used and then discarded, as he fills a minor niche in the great capitalist chain of being. Thus when Tyler blows up Jack’s condo, the latter



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mournfully declares to the investigating detective, “that apartment was my life.” That is precisely why – in the guise of Tyler Durden – Jack destroyed it. In Memento, the events are far more complex than in Fight Club, but the basis premise is the same. Both protagonists rely on their impediments to fashion a quest that has meaning. The major difference is that Jack and Tyler imagine that they seek social justice, while in Memento pursuit of justice is strictly personal. In Memento, the protagonist, Leonard Shelby, attempts to overcome his cultural malaise and culturally triggered disease to return to the rational world of “whodunit,” something that his postmodern culture no longer recognizes as relevant. This is so because Shelby becomes the ultimate postmodern, de-centered subject, one who lacks the ability to make new memories. As he puts it to others, “I have this condition,” never suspecting that what he has is a metaphor for a postmodern condition. Indeed, among many other things, this film is a thoughtful meditation on the meaning of memory and how the de-centered life takes control over anyone who cannot remember. In the protagonist’s case, his future takes place in the past, both because of the way the film is put together and because he has lost his ability to make sense of the present. Moreover, the film does its utmost to put the viewer in the same situation as is Leonard Shelby, so that even the plot and story line offer multiple possibilities rather than linear progression and clarity. Put simply, Leonard’s world is our world and as such has no master narrative. Jack’s world also has no master narrative, which is why he so desperately seeks to create one via Tyler Durden. Indeed Jack is so detached from the world and its meanings that he sees himself as a body without or detached from his organs. Thus he is able to read out loud to Tyler Durden from pamphlets supposedly written by various organs of someone named Joe; Joe’s prostate, for example, suggests that it can contract cancer and “kill Joe.” Body organs take on lives of their own, and Jack fully identifies with this bizarre state of affairs. Yet aside from its black humor, the scene exposes the dynamics of the postmodern conundrum from which Jack suffers. In Deleuze and Guattari’s terms, Capitalism and capital have a similar relationship to that which exists between “the body without organs” and “desire production” [Anti-Oedipus 10-11]. Capital is indeed the body without organs of the capitalist, or rather of the capitalist being. But as such, it is not only the fluid and petrified substance of money, for it will give to the sterility of money the form whereby money produces money. It produces surplus value, just as the body without organs reproduces itself, puts forth shoots, and branches out to the farthest



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corners of the universe….Capital thus becomes a very mystic being since all of labour’s social productive forces seem to issue from the womb of capital itself…The body without organs now falls back on (se rabat sur) desiring production, attracts it, and appropriates it for its own… The body without organs, the unproductive, the unconsumable, serves as a surface for the entire process of the production of desire. [10-11]

The above passage presents a number of issues that are critical to understanding the dynamics of Fight Club. First, it establishes a relationship between the “body without organs” and capitalism, as if the dynamics of the latter are responsible for the former, thereby cementing the relationship between culture and disease. Just as capital eventually becomes a “full body to constitute the recording or inscribing surface,” “the body without organs serves as a surface for the entire process of the production of desire.” The body is made whole again by desire, which is the same phenomenon that occurs with capital and social relations. Deleuze and Guattari develop this connection further to link the schizophrenic to capitalist practice so that, “the schizophrenic, the possessor of the most touchingly meager capital[,]… inscribes on his own body the litany of disjunctions” [12]. In this way, Deleuze and Guattari link schizophrenia, political economy, desire, and capital to a body without organs that seeks to make itself whole. Similarly, the plot of Fight Club revolves around Jack’s attempt to breach the gap between culture and disease, using his desire [alter ego] to subvert the political economy of the postmodern world and make himself and the world whole. In Memento, Leonard goes through a similar process with his own body, as he tries to make it whole again through the realization of his desire, to implement his tattooed body directives to locate and kill the man who murdered his wife. Moreover, in terms of the alienation of the two films, a man without a memory is almost like a man without a body. “Now, where are you?” says Leonard to himself as he utters the first words of the movie, but this is exactly the unanswerable question for one who has no capacity to make new memories or to recall the recent past. Moreover, this question actually signifies the film’s conclusion, as Leonard then asks a similar question: “Where was I?” There would be nothing original about beginning the film at the end, if the film were simply to fill in the gaps, from its ending, back to the beginning, to an orderly progression of events. But this is not the case. Alternating between black and white and color, Memento presents an erratic movement from past to more distant past and a return to the “present” past. On first viewing, one would naturally assume that the scheme is otherwise, from past to distant past and a return to the present. But that belief is rendered



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false with the film’s conclusion, which also turns out to be its beginning. The exact mechanics of the progression, however, are less important than the overall feelings of confusion and dis-ease that result from the time scheme, thus placing the audience in a position similar to that of the protagonist. The world does not make much sense when we lose the ability to apply our short-term memory to our experiences; in this case the audience is unable to turn the film into a unified, coherent narrative, which is a term devoid of meaning in the postmodern world. Yet the difficulties of the film do not end with the time scheme of the events, but rather include the very notion of plot. Plot has no clear order and takes on the guise of multiple plots; thus it is impossible to determine a master narrative in Memento. We return to the past as future together with Leonard, as he is condemned or condemns himself to live life as a bizarre postmodern Sisyphean quest. His agenda is seemingly simple, or at least feasible: find the man who killed his wife, the infamous John G., extract his revenge, and find some peace and order in the world as he overcomes his inability to remember. But he apparently repeats this chain of events over and over again. Or as Leonard would say in another context, “I have this condition,” not realizing that his illness is not only physical/mental, but culturally triggered as well. In Fight Club, Jack also searches for a way to achieve some personal peace and order in the world. To do so, Jack attempts to integrate the notion of culture and disease in his life even before he creates Tyler Durden. He begins to attend support groups for the terminally ill and finds a warm albeit temporary home in the arms and huge steroid induced breasts of Bob in a testicular cancer support group. Literal emasculation is appealing to Jack, as he sees himself already spiritually castrated by his pursuit of the American corporate dream. Finally, life makes sense to Jack, as he thrives on the attempts of others to live every day as if it were their last. Indeed, for some of the members, that is pretty much the case. So Jack uses products created by the dominant culture, support groups, and exploits them to his own advantage [de Certeau 31]. Disease is reduced to a cultural artifact that Jack exploits to escape his cultural dis-ease and malaise. He may not be able to avoid the cancerous nightmares that modern life has created, but popular culture, via support groups for various illnesses, allows people to come together intimately to face their fate and live meaningful lives. For Jack, the effect is miraculous. He is able to cry, express emotion and sleep like a baby. But his respite is short-lived once Marla Singer – soon to become Tyler Durden’s sex toy – has the audacity to join the testicular cancer group and challenge Jack’s emotional restoration. Paradoxically, she challenges his masculine hegemony by



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acknowledging his “balls.” Although willing to admit that they are both impostors at the testicular cancer support group, she claims to have greater privilege than Jack as he still has balls, implying that once she, too, had her own. 4 Since he no longer finds new-age support groups effective, Jack must employ a different strategy if he is ever to escape the insomniac nightmare of the “living dead.” To do so, he expands the connection between culture and disease by creating his alter ego, the “sublime object of [his] ideology” [Zizek]. As a creation of the mind, Tyler Durden perfectly matches Slavoj Zizek’s Althusserian explication of ideology. Thus Ideology is not a dreamlike illusion that we build to escape insupportable reality; in its basic dimension it is a fantasy-construction which serves as a support for our ‘reality’ itself: an ‘illusion’ which structures our effective, real social relations and thereby masks some insupportable, real, impossible kernel… a traumatic social division which cannot be fully symbolized. [Zizek 45]

To deal with this social division that “cannot be fully symbolized,” and to allow himself to function in the world, Jack creates a psychic and social division from which Tyler Durden can emerge. Using the raw energy of his alter ego, his body with organs, Jack can begin to change the world in ways that his “corporate,” yuppie self could never imagine. His plan begins modestly, establishing Fight Club so that men can reinvent their masculinity; but his final program is Project Mayhem, whose ultimate goal is nothing less than the destruction of the system of consumer credit and debt upon which the postmodern world thrives In Memento, Leonard’s quest is no less destructive than Jack’s, but before analyzing it, we should first determine the nature of his malady and whether it is reasonable to classify it as cultural dis-ease. Although the inability to form new memories is clearly a mental, physical or chemical illness, I believe the specific situation of Memento suggests that the disease has a cultural trigger. Just as Jack suffered from capitalist malaise on the job in Fight Club, Leonard is devastated by his experiences as an insurance claims adjuster. His activities in the late-capitalist world have had a ruinous effect on the lives of others and, eventually, on his own life as well. What has happened to Sammy Jankis – someone whose claim was unjustly denied because of the “good work” Shelby had done on his case – and then to Leonard himself – their inability to form new memories – is either ironic, coincidental, a manipulation of the plot or a fantastic projection of Leonard Shelby. And all of these possibilities suggest



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multiple plot lines. But whatever plot line we choose to follow, the late capitalist rationale is either the trigger or source of Leonard’s condition. Thus one way of understanding Memento is that in a remarkable coincidence, the universe plays a nasty trick on the protagonist and has Leonard suffer from Sammy’s “condition.” As a matter of chance, or ironic doubling, Leonard, too, loses his wife, ostensibly in a brutal murder that he is unable to prevent. Then, because of a traumatic reaction from a brutal blow to the head, as well as the guilt he feels for determining the material worth of human life as an insurance claims adjuster, Leonard loses his capacity to form new lasting memories. Nevertheless, he decides to overcome and at times rely on his illness to track down his wife’s killer. Just like Jack in Fight Club, Leonard assumes that he will undercut the traditional role of society and inscribe the new laws of his behavior on his body in the form of tattooed facts. Or as de Certeau would have it, The credibility of a discourse is what first makes believers act in accord with it. It produces practitioners. To make people believe is to make them act. But by a curious circularity, the ability to make people act – to write and to machine bodies – is precisely what makes people believe. Because the law is already applied with and on bodies, ‘incarcerated’ in physical practices, it can accredit itself and make people believe that it speaks in the name of the ‘real.’ It makes itself believable by saying: ‘This text has been dictated for you by Reality itself.’… The law requires an accumulation of corporeal capital in advance in order to make itself believed and practiced. [The Practice of Everyday Life 148]

Thus Leonard in the guise of “social traditionalist” believes he can trust his own handwriting and rely on his newfound facts merely because he has inscribed them on his body. But as the film shows over and over again, the tattooed fact has no special legitimacy and is, in fact, highly unreliable. This is the nature of the postmodern world and Leonard’s postmodern condition as well. The same lack of legitimacy also holds true for the written fact. Or as Natalie puts it to Leonard, after complaining that he lives his life according to notes on scraps of paper, “mix your laundry list with your grocery list and you end up eating your underwear for breakfast.” In this version of the film, Leonard finds the killer of his wife, the so-called John G., and justifiably [in his mind] executes him. Were this the story, the plot [aside from the problem of memory] would be more or less the standard fare of the “whodunit.” But the audience cannot assume that this version of events is more truthful than any other. Though uncomfortable for the audience, this lack of a master narrative is a paradoxically convenient state of affairs for Leonard, because he has lost



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the ability to create new memories. Indeed, he intends to rely on his disability to make do in the world. In Fight Club, Jack’s strategy is similar to Leonard’s, from the moment he first encounters/creates Tyler on an airplane. Jack uses his schizophrenic connection to Tyler as a vehicle for self-enlightenment, so that he can begin to “lose everything” in order to gain something meaningful in life. But the first thing he loses is the capacity to realize that he and Tyler are two sides of the same postmodern, de-centered individual. Psychologically, Tyler is the product and reification of Jack’s schizophrenia, which includes “distortions or exaggerations of inferential thinking (delusions), perception (hallucinations), language and communication (disorganized speech), and behavioral monitoring (grossly disorganized or catatonic behavior)” [Diagnostic and Statistical Manual of Mental Disorders -IV 275]. In general, the DSM tells us that anyone suffering from a number of the above symptoms is schizophrenic. Jack’s behavior is indicative of all of the above; moreover, bizarre illusions are considered especially characteristic of schizophrenia, as they involve an extreme misinterpretation of perceptions or experiences. Thus Tyler Durden certainly qualifies as a “bizarre illusion,” though even the mainstream DSM-IV points out that the “bizarreness” of a specific illusion may be difficult to judge, especially across different cultures…Delusions that express a loss of control over mind or body… are generally considered to be bizarre; these include a person’s belief that his or her thoughts have been taken away by some outside force…or that his or her body actions are being acted on or manipulated by some outside force (‘delusions of control’) [275].

So relying on the conservative standard of mental disorders, I would argue that Jack is suffering from something close to “real” schizophrenia; also that to a certain extent his malady is defined and even triggered by a specific mode of culture. In this case, our schizophrenic seems to be a creation of capitalist malaise. In Jean Baudrillard’s terms, late capitalism, in the guise of “the categorical imperative of communication,” is the basis for postmodern schizophrenia. We are now in a new form of schizophrenia. No more hysteria, no more projective paranoia, properly speaking, but this state of terror proper to the schizophrenic: too great a proximity of everything, the unclean promiscuity of everything which touches, invests and penetrates without resistance, with no halo of private protection, not even his own body, to protect him anymore.



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The schizo is bereft of every scene, open to everything in spite of himself, living in the greatest confusion. He is himself obscene, the obscene prey of the world’s obscenity. What characterizes him is less the loss of the real, the light years of estrangement from the real, the pathos of distance and radical separation, as is commonly said: but, very much to the contrary, the absolute proximity, the total instantaneity of things, the feeling of no defense, no retreat. It is the end of interiority and intimacy, the overexposure and transparence of the world which traverses him without obstacle. He can no longer produce the limits of his own being, can no longer play nor stage himself, can no longer produce himself as a mirror. He is now only a pure screen, a switching center for all the networks of influence. [“The Ecstasy of Communication” 153]

Thus Baudrillard, describing with uncanny accuracy the situation in which Jack finds himself, offers an eerie justification for the creation of the likes of Tyler Durden. Jack has lost his mirror image, so to speak; thus he feels compelled to create one. In Memento, Leonard’s inability to form new memories creates a schizophrenic lifestyle as well, because he is often unable to recognize his surroundings and relate to his own presence. Thus the film seems to argue that Leonard’s condition is our cultural condition as well, as if all postmodern subjects were somewhat schizophrenic, unable to remember anything new and create contemporarily vibrant traditions. This also explains why the plot could develop in a number of other directions. The unreliability of plot allows the audience to experience Leonard’s detached reality, which is life without new memories. One possible plot, which Leonard’s companion Teddy suggests, is that Sammy Jankis and his story are the creations of Leonard’s memory-less delusions. Just before Leonard executes him, Teddy, who might be the elusive John G. himself, possibly a police informant, or even a corrupt police detective, informs Leonard that the latter has made up this coherent narrative. There was no Sammy, Leonard is the only one suffering from his peculiar condition, and Leonard killed John G. long ago. He even implies that Leonard might be responsible for his wife’s death, who he claims suffered from diabetes, a notion that is bolstered when Leonard’s fantasizes about being in bed with his wife with an “I did it” tattoo inscribed on his chest. Teddy claims that he helps Leonard track down bad guys so that Leonard will acquire some peace in the world. Though not especially convincing, Teddy is neither more nor less reliable than any of the other characters in Memento. Thus the possibilities of plot are just as rich as Teddy’s potential roles, all of which contribute to the film’s alienated ambiance. If Teddy is a dirty cop, or a drug dealer himself, then he has had Leonard execute the competition, a drug dealer by the name of Jimmy G.,



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so that yet another potential suspect on Leonard’s quest has been eliminated. Another possibility has Natalie behind the machinations of the plot; she is certainly using Leonard to achieve her aims and has no qualms about it. She revels in her honesty, telling Leonard to his face that she will use and abuse him. From offering him a draft beer with a substantial spit base created before his eyes, to having him beat up Dodd, who is either a competitor in the drug business or someone who has threatened her life, Natalie cynically takes advantage of Leonard’s “condition.” The viewer can be sure, however, that the bruises she shows Leonard on her face are Leonard’s handiwork, as Natalie goads him into hitting her. In perhaps the most brutal scene of the film, Natalie lectures Leonard on the consequences of his “condition” and his approach to life. She hides the pens in her apartment so that Leonard will not have time to write anything down and thus preserve what she tells him. She informs him that she will get him to do her dirty work for her, even though she will lie to him consistently. And she calls him pathetic because he will not remember what she has just told him. Indeed, after baiting him to hit her by insulting the memory of Shelby’s wife, she leaves the apartment, waits outside for a few minutes, and rushes back into her home to show Leonard her new facial bruises, supposedly administered by Dodd. Leonard unwittingly agrees to help her and thus falls victim to his “condition,” unable to recall that he is responsible for hers. So Leonard, no less than Jack in Fight Club, is always busy playing the schizophrenic other. For Jack, however, Tyler Durden is a schizophrenic double-edged sword, and not merely because he begins to take over Jack’s existence during the latter’s so-called blackouts. Tyler does not realize that his course of resistance to the dominant culture itself becomes part of the institution. In other words, despite the desire of Jack/Tyler’s Fight Club organization to revolt and destroy the dominant postmodern mode of consumption, the Fight Club faithful, with their robotic and unquestioning behavior, simply become part of the late capitalist problem From the earliest stages of the film, the audience is subtly informed that capitalism overshadows not only the dominant culture, but also its modes of resistance. Even if John Fiske is correct in his assumption that “There can be no popular dominant culture, for popular culture is formed always in reaction to, and never as part of, the forces of domination,” this does not preclude the Foucaultian possibility of the dominant culture subsuming the revolutionary aspects of a mode of popular culture designed to resist institutional control. An early and poignant example of this phenomenon is the way Fight Club deconstructs the power of subliminal messages in film. Tyler,



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working as a projectionist in a movie theater, has introduced pornographic flashes into family movies to destabilize society and undercut American family values. Yet Fight Club does much the same to the idea of resisting the dominant culture, influencing its audience by inserting images of Tyler Durden/Brad Pitt to show that nothing escapes the long shadow of capitalism. Tyler will not succeed in destabilizing society, destroying family values or undermining the capitalist project. The inserted images remind us that Fight Club is a cultural artifact, a product of mainstream Hollywood, and will not significantly alter the society from which it comes. Everything is artificial in this portrayal of late capitalism, even the film itself. Another way that Fight Club proves itself to be part of the dominant culture is the choice of its most basic activity, that is, the organization of fight clubs throughout the country. Baudrillard argues that the body disappears in postmodern culture, “in orbit, living no longer as an actor or dramaturge but as a terminal of multiple networks” [“The Ecstasy of Communication” 148]. Indeed, “the real self [whatever that is5] appears as a large useless body” [148]. Thus at its most basic level, Jack/Tyler strives to bring the body [without organs?] back to life and find an appropriate substitute for his physical and spiritual constipation. Rather than rely on the ineffective “latte enema,” Jack’s usual panacea for his taxed bowels, Jack/Tyler seeks a spectacle to combat or neutralize the obscenity of life, “the obscene freedom of communication” in Baudrillard’s terms, and hopes that Fight Club will fit the bill. When Bob, formerly of the testicular cancer support group, drags his seemingly “useless body,” “ball-less existence, “and gigantic breasts to Fight Club and becomes an outstanding combatant and key player in Durden’s organization, it seems that Fight Club might just fulfill its goals. Leonard Shelby, too, is certain that he can overcome his disability and cultural disease. He believes his “system” is sufficient to overcome the pitfalls of those that rely on memory to “make do” in the world. He refuses to recognize that his role in the late capitalist system – along with a bump on his head – has taken away his most precious possession: his memory. As he confidently informs Teddy: ‘Memory’s not perfect. It’s not even that good. Ask the police, eyewitness testimony is unreliable. The cops don’t catch a killer by sitting around remembering stuff. They collect facts, make notes, draw conclusions. Facts, not memories; that’s how you investigate. I know, it’s what I used to do. Memory can change the shape of a room or the color of a car. It’s an interpretation, not a record. Memories can be changed or distorted and they’re irrelevant if you have the facts.‘



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Despite Leonard’s passionate declaration, the audience witnesses Leonard’s recurrent failure to make sense of the world precisely because he cannot rely on memory. His “facts” are as treacherous as his memory, if not more so. He claims to be able to “read” people, to examine their gestures and know when they are untruthful. But the audience knows better. For example, Leonard – because of his inability to remember – rents a number of rooms at the Discount Hotel; every time he enters the lobby the clerk gives him a new room and demands payment. He is manipulated by Natalie and Teddy and even finds a way to manipulate himself – when he decides to kill Teddy – as he struggles to put the pieces of his “whodunit” together. His “system” of controlling the “facts” cannot protect him from the ambiguity, deception, and predation of the world. When Teddy tells him that the “real” John G. has been dead for over a year, and that Leonard has removed pages from the murder investigation file so that he can continue his hunt, Leonard makes an informed decision to make Teddy his next victim. He is not about to let Teddy undermine Leonard’s Sisyphean quest. On a snapshot photo of Teddy that he carries with him, he writes that Teddy is John G., and commands himself first “not to trust him,” and then to “kill him.” Infuriated with Teddy for “using” him, Leonard, as he is writing down Teddy’s car license number, the elusive and conclusive “fact” number six supplied by none other than Natalie, tells himself that Teddy will be the next John G., guilty or not. “You’re a John G? Fine, then you can be my John G…Do I lie to myself to be happy? In your case, Teddy…yes, I will.” Thus for at least one brief moment Leonard knows that he is falsifying “evidence” and framing Teddy because he has challenged and ridiculed Leonard’s raison d’etre. So at that moment his system of fact gathering collapses. He has been unable to put the pieces of his puzzle together and even inscribing the “facts” of his case via tattoos on his body and on scraps of paper has done nothing to bring him closer to the “truth.” In his world he likes to imagine that only “facts count, not memories” and he is sure that he is better equipped to deal with the world than was Sammy. He asks his rhetorical question, “Does the world disappear when I close my eyes?” and answers with a resounding “of course not.” As he puts it, “I have to believe in the world outside my own mind. I have to believe that actions still have meaning, even if I can’t remember them. I have to believe that when my eyes are closed, the world’s still there.” This sounds much like an impassioned plea of all postmodern subjects. But his desire – and perhaps ours – to believe is just that. Because Leonard has no ability to create memory, the world does, indeed, disappear and he is “free” to create his own version of events over and over again. That freedom, .



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however, is a Sisyphean nightmare that allows him to attempt to kill the virtually endless supply of John Gs. in the world. This quest gives Leonard a feeling of being in control in the postmodern world that – without memory – has no order or logic. In Fight Club, in order to feel in control of their illogical and disorderly world and combat their cultural malaise, Jack and Tyler rely on well-founded mainstream American mythologies concerning the body and the individual that undercut the revolutionary potential of their project. What better way to test one’s rugged individualism, especially for a blue collar worker eager to administer a beating to a yuppie investment banker, than to mix it up in Fight Club and walk away after giving and receiving a colorful array of bruises. Both winner and loser emerge victorious. The physical courage necessary to compete in fight club is reminiscent of the working class physicality and effort expended in “real” labor and gives the participants the sense that they are behaving, perhaps even working, in a meaningful, masculine way. Beating one another and enjoying it, the competitors in Fight Club believe they experience a pristine reality, one in which the painful blows endured during their fights make for a “true” experience, one in which pain is the key to and perhaps even proof of existence. Thus in Fight Club the locus for the battle of the rebirth of the individual is the body itself, as Jack/Tyler recognizes that late capitalism, just like every other system of social organization, has taken control of the body [de Certeau 141]. Fight Club, as a type of modern Bakhtinian carnival, presents physicality as meaning. Yet both the club and the carnival serve the system in the guise of subverting it. Fight Club seeks to suspend [albeit temporarily] the class system so that the mail boy and the executive become equals when they fight. Fight Club seeks to inscribe figuratively and literally the laws of its society on the body, undercutting mainstream society’s traditional function. The body is clearly important as part of capitalist control, and it produces through labor rather than capital [Dyer 135]. Moreover, a clean aestheticized body is no threat to social control. Thus a seemingly effective way to resist social domination is to revitalize the body through the use of a blood sport. Perhaps that is why bare-knuckle boxing has always been outside the realm of the legitimate boxing associations sanctioned by the state. It may seem that the difference between the clandestine fighting of Fight Club and fighting in the ring is that only the latter has rules. Of course, this is not so, as we are told repeatedly throughout the film: “the first rule of Fight Club is you don’t talk about Fight Club.” The first rule opens the door to many others. Indeed, the eight rules of Fight Club – arguably a type of religion – take on



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the importance that the Ten Commandments have to Judeo-Christian thought. Therefore, Fight Club, just like its creator, is highly schizophrenic. That is, Popular culture is the culture of the subordinated and disempowered and thus always bears within it signs of power relations, traces of the forces of domination and subordination that are central to our social system and therefore to our social experience. Equally, it shows signs of resisting or evading these forces: popular culture contradicts itself. [Fiske 4-5]

Indeed, Fight Club is a method of resisting the domination of the ruling class at the very moment that it becomes a method of domination itself. Clearly Fight Club loses its avant-garde appeal – at least to Jack – as it develops into a network that begins to resemble the very system it seeks to destroy. For example, the growth of Fight Club is manifest in a succession of franchises, spreading throughout the United States, with no clear central authority. Jack implies that the franchises have a mind of their own, just as in late capitalism the goal of economic production is to further economic production. So the film implies that Fight Club and Burger King – along with many other well known franchises – have much in common. In Memento, Leonard, too, relies on the seemingly rational principles of his late capitalist, postmodern world and his own body to fashion a quest that has meaning. But just like in Fight Club, the violence and nonsense of the post-industrial world will ultimately subsume rather than aid Leonard’s quest. Leonard has attempted to escape the capitalist mode of production both to utilize and ignore his culturally triggered loss of memory in order to lead a rational, productive life. If he can accomplish this, then certainly, he reasons, Sammy Jankis could have done the same. If not, Leonard is responsible for playing the late capitalist “insurance” game and ruining Sammy’s life, family and his own life in the process. By using the well-established technique of social control, Leonard inscribes the law or the “facts” of the case upon his body. Like Jack before him, Leonard is convinced that he can meet the universe on his own terms and, by employing his investigative skills, overcome the society that has rendered him useless. But ultimately – like the soldiers of Fight Club – Leonard is unable to re-member his body and is reduced to robotic repetition. He executes anyone he can or desires to insert into his memoryless postmodern condition. As is the case with Leonard Shelby, masochistic anger and frustration also motivate Jack and Tyler. Thus Fight Club seeks as its conscious goal to avoid the so-called feminization of postmodern culture in order to



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reassert a type of male dominance. Tyler complains of an enraged generation of men, “raised by women” that should be eager to establish its masculinity. Jack himself readily concurs and admits: “My Dad…Don’t know where he is. Only knew him for six years. Then, he ran off to a new city and married another woman and had more kids. Every six years – new city, new family.” Unfortunately, however, the desire to reassert male authority leads to a totalitarian organization developed by Jack and Tyler that is just as dangerous to the individual spirit as is the society they so despise. As original as Jack’s alter ego seems to be, Tyler Durden always remains dependent on the machinations of late capitalism. Thus in his quest to purge society, he relies on his sale of homemade soap, his Freudian “yardstick of civilization,” 6 to fund himself and later his cause. Living off the fat of the land, literally, since the main ingredient of his soap is the brightly colored orange fat siphoned off of cellulite conscious upper-class women, Jack/Tyler sees neither an allusion to the holocaust nor irony in turning a product of human waste into an exclusive cosmetic. Thus capitalism, much as it served the nazis, utilizes the fat of the body to turn a profit. Despite the obvious satire on the western obsession with altering the body to conform to the social ideal of beauty, yet another cultural disease, Jack and Tyler continue to make money in the system they seek to destroy. Indeed, pissing in the soup at five-star hotels, as subversive as that might appear, does not free Tyler’s army of servants from the dominant social system. He and his minions believe that “God is dead” [or at least unavailable], hardly an original thought, and that men must take over. Referring to God, Tyler tells Jack: “We don’t need him… Fuck damnation. Fuck redemption. We are God’s unwanted children, with no special place and no special attention, and so be it.” So it is not surprising that Tyler’s plan culminates in Nietzschean excess. His “pissed off generation,” which has grown up in relative comfort and without a Great War, must find meaning in a life that has no meaning. But as Fight Club develops into a fascist project and reverts to an earlier mode of social dominance – mid-twentieth-century European totalitarianism – it is nothing like the revolutionary movement that Jack/Tyler had initially imagined. Project Mayhem, born of a desire to restore vitality to the American male, must ultimately fail because it offers no clear alternative to the dominant system. Of this Jack remains ignorant, although he does understand the dangerous violence of his project. He is abhorred by the monster he has unleashed, as he begins to comprehend that he and Tyler share the same body. Tyler, in contrast, is quite pleased to explore the



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limits of an ubermensch, or superior man. He is happy to abandon one American [corporate] dream in favor of another, older American dream. Thus he believes that Project Mayhem is what is necessary to regenerate America through violence, a fantasy as old as that of the first Puritan settlers. This is why Jack and Tyler must eventually part company, as Jack lacks the anarchistic desire of his alter ego. As for the plan itself – to blow up the buildings that house the great credit card companies – nothing could be more sophomoric. Does Jack/Tyler really expect to wipe out the debt of every consumer by destroying the home offices? Doesn’t Jack/Tyler realize that records are stored in more than one place, the capitalist rationale ironically echoing Jack’s description of his own life, insuring that there be: “a copy of a copy of a copy”? Despite the chilling effect of the blown up skyscraper on the audience viewing the film post- September 11, the film ends – in Hollywood terms – optimistically, with Jack and Marla Singer posed together very much as Charlie Chaplin and his heroines appeared at the end of a number of Chaplin’s films [City Lights, to name one]. With their backs to the audience, head to head, arm and arm watching the explosion, they remind us once again that everything that has occurred has been staged and reduced to the intertextuality of Hollywood film and history. In the last analysis, Jack, Marla, and perhaps even Tyler have pretty much achieved their goals and are free to continue to enjoy the fruits of the system they have come to despise. The only unrequited desire is that of Tyler, whose usefulness has come to an end. But he has managed to revitalize Jack – to return his balls, so to speak – and has given him a purpose in life without destroying the dominant modes of production or consumption. Corporate America will survive the bombings, the credit system remains intact and, as at the end of every romantic comedy, Jack and Marla can walk off into the sunset and fulfill their true love. Though capitalism made Jack ill, he managed to manipulate his disease and his body to overcome his dis-ease and cultural malaise until he no longer needed his schizophrenic creation and even seems to find true love. As he optimistically tells Marla: “you met me at a weird time in my life.” “All’s well that ends well,” then, is never a revolution, but always a return to the “natural” order of things. * * * Both Jack in Fight Club and Leonard in Memento have done their best to make sense of their late capitalist worlds with varying degrees of success. Both have suffered from yet employed culturally triggered diseases,



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schizophrenia and the inability to form new memories, to combat their capitalist malaise and dis-ease. Jack creates an alter ego to bring down post-industrial America but loses the struggle comically, as he settles for Chaplinesque “true love.” In contrast, Leonard’s experiences are rendered horrifying and memory-less, as he is condemned to repeat his murderous actions to make do in the world. Both protagonists have sought comfort in their disease, to shape a more appealing world, even if the reality they come from is responsible for creating the cultural conditions that inform their maladies. * * * In the following chapter, we will examine the ways in which a young boy uses his Asperger’s syndrome, an offshoot of autism, to prove his worth in the world to himself and his family.



CHAPTER THREE ASPERGER’S SYNDROME AS METAPHOR IN THE CURIOUS INCIDENT OF THE DOG IN THE NIGHT-TIME

Inspector Gregory: “Is there any other point to which you would wish to draw my attention?” Holmes: 'To the curious incident of the dog in the night-time.” “The dog did nothing in the night-time.” “That was the curious incident,” remarked Sherlock Holmes. —“The Adventure of the Silver Blaze,” by Arthur Conan Doyle)

What's hot and what's not is a familiar state of affairs for popular culture, yet recently the same can be said for various diseases, disorders, and syndromes that seem to be portrayed as "sexy" in literature, the movies, and popular culture. What Fight Club has done for schizophrenia, Motherless Brooklyn for Tourette's syndrome, Eve's Apple for anorexia and bulimia, Monk, for obsessive-compulsive disorder, and The Corrections for Alzheimer's, Mark Haddon's curious incident of the dog in the nighttime has now done for Asperger's syndrome, a lesser known and milder variant of autism that affects one's social rather than physical or mental skills. In light of this newly developed fame, it is now in to ask the following question: what do Beethoven, Mozart, Hans Christian Andersen, Michelangelo, Wittgenstein, Einstein and Immanuel Kant have in common? (Iggulden 1 ). And along the same lines one could ask the same question about literary characters as well. That is, popular culture has referred to an unusual connection among Meville's Bartleby, Sherlock Holmes, Pippi Longstocking, and a number of characters from Pride and Prejudice (Morrice 1).7 I would add a few real-life and literary characters of my own, such as Charles De Gaulle, Ehud Barak, Isaac Newton, Professor Temple Grandin (the expert on cow slaughtering and probably the only officially diagnosed tenured autistic professor in the world), Chance Gardner (Peter Sellers' character in the film Being There),

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Raymond (Rain man) Babbitt, and the inimitable Cosmo Kramer. The common thread among these literary and real-life characters is that they have all been "diagnosed" by our culture as Asperger's suffers. Indeed, Asperger's might be the hottest disease on the market. In fact, it is doing so well that it can even be applied to United States foreign policy. That is the basic premise of Niall Ferguson's Telegraph article "America has got Asperger's syndrome." Ferguson, writing about the state of affairs in America before the last presidential election and focusing on the Iraqi imbroglio, claims that America, to his chagrin, may have Attention Deficit Disorder. But upon greater reflection, Ferguson decides to go with Asperger's syndrome: According to Robin Dunbar, professor of evolutionary psychology at the University of Liverpool, Asperger's sufferers 'cannot deal effectively with the social world in which we are all, perforce, obliged to live. They do not understand how or why people tick, and invariably offend or alienate friends or acquaintances with their uninhibited and direct ways of interacting. (Ferguson 2) This may be a cute stretch of the imagination in a desperate and perhaps impossible attempt to explain George Bush and current American foreign policy, but it does show that Asperger's is very much part of the American and British minds. It also suggests that we have come to understand our state of affairs as autistic, a metaphor for the lack of communication among states and individuals in the late capitalist reality of the postmodern world. If we now return to our list of cultural and literary heroes, we see that Asperger's has long been part of the human condition, though it is only recently that the syndrome has become a type of grand narrative, a way to explain how certain "odd" characters behave. In his novel, Mark Haddon does much to elucidate the syndrome, not content merely to create a character suffering from the disorder, but actually to have the hero become the author and narrator of his own book. Before we begin our discussion of the curious incident of the dog in the night-time, and Asperger’s syndrome as an offshoot of autism, I would like to note how one prominent autistic person, most likely an Asperger’s sufferer as well, has done much to illuminate the cultural potential of her affliction. Moreover, her real-life experiences will shed light on the escapades of our fictional hero in Haddon’s novel. Thus, Temple Grandin has successfully argued the case for the cultural applications of autism as a vehicle for making one’s place in the world. The very characteristics that



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have labeled her problematic throughout her life comprise the tools she uses to explicate the behavior of animals. Her belief is that animals and autistic people have much in common and are very different from nonautistic people. Grandin uses her commonality with animals to decode their behavior and to make the slaughter of cows, pigs, and chickens as humane a process as is possible, albeit without showing much emotion herself. Our interest, however, is to note the ways that she turns a clear existential disadvantage, autism/Asperger’s, into a culturally advantageous skill. Indeed, her academic acclaim, university position, and livelihood are all predicated on her understanding of animals, an almost instinctive talent she clearly attributes to her autistic sensibilities. As she puts it, “Autism made school and social life hard, but it made animals easy” (Animals in Translation 1). Not only was Grandin able to learn about animals from observing them and comparing them to herself, but she was also able to learn from their situation. When she saw how calm cattle behave when they are placed in a squeeze chute to receive their injections, she believed such a device would have the same effect on her. Already as a teenager, she built her own squeeze chute, made up of an air compressor and plywood. The sensory effect relieved her anxiety, and she still uses her squeeze machine to relieve herself of stress. Her relationship with horses and her ingenious device got her through the nightmare of her childhood and teenage years. These experiences gradually allowed her to understand that autistic people can think the way animals think. Of course, we also think the way people think – we aren’t that different from normal humans. Autism is a kind of way station on the road from animals to humans, which puts autistic people like me in a perfect position to translate ‘animal talk’ into English. I can tell people why their animals are doing the things they do. (7)

To clarify and perhaps quantify her success, Grandin also notes that “Half the cattle in the United States and Canada are handled in humane slaughter systems I’ve designed” (7). She believes her brain works differently from that of other people and that she chose a profession that is not impeded by her condition but one that rather allows her to make her ailment work for her. Grandin's handicap is almost paraded as a means to success. For Temple Grandin the great advantage that autism has granted her is the ability to be a visual thinker. She takes this concept beyond the realm of drawing well or designing systems in her head. Grandin believes that she actually “think[s] in pictures. During my thinking process I have no words in my head at all, just pictures” (17). And if she cannot imagine



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something in pictures, she cannot deal with it effectively. Such is her explanation for her inability to comprehend macroeconomics and algebra. On the plus side, however, she was able to predict (along with many others, I might add) the crash of the dot com market since she couldn’t “picture” the products they made (17). She creates images of her systems in her mind and imagines the potential flaws and advantages in advance. Grandin also uses her experience to understand how an animal might feel on its way to slaughter. On one occasion when cows were unwilling to enter the chutes she took black and white pictures (as cows see) to understand the problem. She quickly realized the shadows were making them fearful. She does much more than empathize with animals; she can visualize their plight. In fact, she makes herself see what they are seeing (19). Stress, or lack of it, is key to an animal’s health, growth and productivity. Grandin imagines what disturbs animals and eliminates the cause of their anxiety. She offers many examples of cows that were unwilling to cooperate because of their fears of color, shadows, light and dark, all of which she was able to visualize. Rather than aim low in life because of her handicap, Grandin has done everything she can to excel professionally by relying on what we might call her “autistic talents.” Grandin explains that most people have poor visual recognition. Once we understand this, we begin to comprehend why autistic people or people with Asperger’s get anxious and even frantic because of an overload of sensory perception. “Animals and autistic people don’t have to be paying attention to something in order to see it. Things like jiggly chains pop out at us; they grab our attention whether we want them to or not” (51). Apparently, the noises autistic people hear and some of the images they notice barely register with ordinary individuals. For example, Grandin recalls the experiment called “Gorillas in our Midst,” which has a woman dressed as a gorilla enter the video tape of a basketball game. “Fifty percent of all people who watch this video don’t see the gorilla!” Even a prompt brings no memory because they simply haven’t seen the image (24). “Autistic people and animals are seeing a whole register of the visual world [ordinary people] can’t or don’t (24). But rather than lament the differences between autistic and normal people she celebrates them. Grandin counts as an advantage the fact that visual thinkers are sensitive to detail, while verbal people are not (26). Perhaps that is why Sherlock Holmes was a detective and not a lawyer. Another important difference that Grandin notes between autistic and nonautistic people is that “Animals and autistic people don’t see their ideas of things; they see the actual things themselves. We see the details that make up the world, while normal people blur all those details together



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into their general concept of the world” (30). This might be the most interesting claim that Grandin makes. If she is correct, then autistic people have solved the age old philosophical conundrum of how to reach the thing itself without the filter of language. She claims they don’t see a representation or approximation of the world but that they see things as they are: in literary/linguistic terms, the signifier matches the signified exactly. We have no scientific method to measure this claim, but it is significant to note that if autistic people have solved the conundrum of language and representation, it has done little to make them feel more at home in the world, unless, of course the autistic individual can employ his/her autistic traits to carve out a place in society, as Temple Grandin has done in real life and our protagonist has done in Haddon’s novel. Grandin implies that autism can be understood as a type of gift. Although this view is controversial, others have made similar arguments. For example, Harvey Molloy and Latika Vasil suggest that Asperger’s has been socially constructed as a disorder, rather than a “normal” variant of personality (“The Social Construction of Asperger Syndrome: the Pathologising of a Difference” 659-61). They prefer to view Asperger’s as a “neurological difference” rather than accept it as impairment (662). Sara O’Neil also presents autism as far more potent than a mere disorder. She notes that there are autistics well known for their abilities. “Daniel Tammet, who has Asperger’s syndrome is renowned for his incredible skill with numbers and languages. Two of his most interesting accomplishments include memorizing (Pi symbol) to 22,514 decimal places and learning to speak Icelandic in one week” (O’Neil quoting from Tammet 2008). In this chapter, we will examine the ways that the narrator in curious incident utilizes his handicap, Asperger's syndrome, to find his way in the world. The reader is ordinarily well prepared to imagine the ways a disorder limits the possibilities of the sufferer, but it is important to note that in this case, the narrator does the unexpected and takes advantage of the abilities Asperger’s has granted him the ability to fulfill much of his potential, solve a mystery, and rebuild his fragmented family. Christopher John Francis Boone, a young teenager who suffers from Asperger's syndrome manages to "write" and narrate a novel that solves a whodunit. Initially, he sets out to discover who killed Wellington, his neighbor's dog. Dogs, as Christopher tells us, are, unlike people, easy to understand and predictable. Indeed, they have "four moods. Happy, sad, cross, and concentrating." They are also "faithful and do not tell lies because they cannot talk" (curious incident 4). This is, perhaps, why he is so attached to animals. And as Temple Grandin has explained, the autistic



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share with animals a natural understanding and affinity. But before we turn to a close reading of the novel, and investigate the ways that Christopher tries to turn his handicap into a cultural advantage, we should note how the scientific community defines the syndrome. The DSM-IV defines Asperger's as follows: The essential features of Asperger's Disorder are severe and sustained impairment in social interaction (Criterion A) and the development of restricted, repetitive patterns of behavior, interests, and activities (Criterion B). The disturbance must cause clinically significant impairment in social, occupational, or other important areas of functioning. (80).

The difference between Asperger's and autism is that in the former there are no significant delays in cognitive or linguistic development. A lack of social maturation seems to be at the center of the disorder. The diagnostic criteria also include impairment in the use and understanding of nonverbal expression such as body postures and facial expressions. Asperger's sufferers have difficulty in establishing peer relationships, and they exhibit a lack of emotional and social reciprocity. They have repetitive motor mannerisms and a preoccupation with restricted patterns of interest (DSMIV 81-82). Indeed, they seem to present behaviors similar to those of obsessive compulsives. What they do not have, although Christopher Boone does, is a problem with touching family members. But there Mark Haddon has most probably taken authorial license to make the plot more dramatic. In regard to most of the other symptoms, however, Christopher is a realistic portrayal of someone who suffers from Asperger's syndrome. Nevertheless, another thing that most Asperger’s sufferers would not be able to do is to write a novel. Yet our narrator tells us that he is going to write a murder mystery, even though he usually prefers to read math or science books. Moreover, because of his special condition, he informs us, this book will be limited in various ways. For example, it cannot contain any jokes, because he himself does not understand humor. Christopher recalls a certain joke that his father tells him that does nothing but create a type of "white noise" in his brain, because he is unable to deal with the multiple meanings of language. The joke, based on word play, is as follows: "His face was drawn but the curtains were real" (8). Although Christopher is logically able to explain the joke, he is incapable of enjoying it. "I know why this is meant to be funny. I asked. It is because drawn has three meanings, and they are (1) drawn with a pencil, (2) exhausted, and (3) pulled across a window, and meaning 1 refers to both the face and the curtains, meaning 2 refers only to the face, and meaning (3) refers only to the curtains" (8). Christopher is neither able to integrate



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these meanings simultaneously, or appreciate an unusual relationship between signifier and signified; thus for him the joke "is like three people trying to talk to you at the same time about three different things" (8). This is perhaps the most striking aspect of the novel. Through Christopher's first person perspective we learn much about how his syndrome affects his view of the world. But no less important is that we also began to grasp how our minds work to perceive the world around us. In Christopher's world every possibility must be exhausted before he can come to any type of conclusion. He does not allow himself to filter information, but takes in everything and tries to examine every single datum. Since Christopher is not a computer, though he does compare the human brain to one, his examination of every bit of information and possibility is an exhausting and frustrating process. The way he has to analyze something as mundane as a one- sentence joke based on word play is just one example among many of this agonizing procedure. To present his abilities, which also achieves the effect of illustrating his limited but unique perspective of the world around him, Christopher fills his narrative with many drawings and charts. He explains the meaning of prime numbers and explains why he likes them: "Prime numbers are what is left when you have taken all the patterns away. I think prime numbers are like life. They are very logical but you could never work out the rules, even if you spent all your time thinking about them" (12). As he has shown, Christopher can deal with mathematical uncertainty, but has great difficulty with the nebulous nature of life since there are few formulae to work from. And his own life is never as "logical" as he would like to believe. Although Asperger's sufferers have no significant clinical problem with the development of their verbal skills, the voice of the narrator is childlike and seems to be much younger than Christopher's fifteen years. This strategy, aside from representing what might happen if a child suffering from Asperger's actually did write a novel, uses the technique of defamiliarization to draw us into the narrative. While his seemingly simplistic thought processes might strike us as immature, his conclusions about people are surprisingly accurate. In that sense, his effort seems to be yet another authorial homage to Huck Finn and Holden Caulfield. Thus, Christopher is quite capable of understanding that the dog's owner, Mrs. Shears, is unreliable, but the way he arrives at his conclusion is unnervingly childlike: "I wondered whether Mrs. Shears had told the police that I had killed Wellington and whether, when the police found out that she had lied, she would go to prison. Because telling lies about people is called slander" (14) With simplistic language and basic logic, Christopher



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arrives at the reasonable conclusion that Mrs. Shears might have accused Christopher of killing her dog. Of course, what he does not grasp is that few people who tell lies go to prison; nevertheless, Christopher has easily convinced the reader that Mrs. Shears is unreliable. Another noteworthy aspect of the novel is that Christopher himself – like Huck and Holden before him – is an unreliable narrator who nevertheless reveals truth. That is, the more Christopher goes out of his way to tell us he does not understand people, the more we can admire the way he manipulates his disorder to comprehend people and the environment around him. As he informs us, I find people confusing. This is for two main reasons. The first main reason is that people do a lot of talking without using any words. Siobhan (pronounced shiVAWN) says that if you raise one eyebrow it can mean lots of different things. It can mean 'I want to do sex with you' and it can also mean 'I think that what you just said is very stupid. (14-15).

His ability to explain body language to the reader implies, to a certain extent, that he understands body language himself. Moreover, his explanation, which presents two diametrically opposing meanings of the raised eyebrow, also suggests that he does understand humor, even though there is clearly authorial manipulation behind the narrator. Another reason that Christopher finds people confusing is that they speak in metaphors. Of course, though not exactly the same, we have already witnessed Christopher's ability to explain things in similes (8), by telling us when things are like or unlike other things. Here are his examples of metaphors: I laughed my socks off. He was the apple of her eye. They had a skeleton in the cupboard. We had a real pig of a day. The dog was stone dead. (15).

Christopher then goes on to define metaphor, as "carrying something from one place to another." Indeed, he proves his knowledge of metaphor by cleverly remarking that the word metaphor is itself a metaphor. Once again, he teases us into believing that he is more sophisticated through his innocence than we could possibly expect an Asperger's sufferer to be. But he immediately retreats from this position and returns to literalism, which seems to serve as a representation of autism in Christopher's writing.



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I think it (metaphor) should be called a lie because a pig is not like a day and people do not have skeletons in their cupboards. And when I try and make a picture of the phrase in my head it just confuses me because imagining an apple in someone's eye doesn't have anything to do with liking someone a lot and it makes you forget what the person is talking about.(15)

Once again, despite his literalism, Christopher is a lot more perceptive and amusing than he is able to understand or willing to admit. Nevertheless, he exclaims, "I want my name to mean me" (16). But his fluctuation between sophisticate and naïf adds up to an extraordinary tight narrative. For example, he is quick to point out the difference between metaphor and simile, though one might take exception to the way he assimilates that difference. In the narrative, after being arrested for hitting a policeman at the scene of the crime, Christopher describes the inspector who interviews him as having a hairy nose. "It looked as if there were two very small mice hiding in his nostrils" (17). That Christopher is aware that he has created a simile is evident by the footnote relating to his description. Moreover, he understands that the relatively sophisticated "as if" is a simile and realizes that the phrase is not metaphorical; this is a differentiation requiring highly developed linguistic abilities and is something that is not ordinarily true of those who are afflicted with Asperger's. As Christopher explains the phrase, “This is not a metaphor, it is a simile, which means that it really did look like there were two very small mice hiding in his nostrils, and if you make a picture in your head of a man with two very small mice hiding in his nostrils, you will know what the police inspector looked like. And a simile is not a lie, unless it is a bad simile” (17). Christopher’s description is similar to the modus operandi of Temple Grandin. If she can picture something in her mind she, like Christopher, is capable of understanding it. In contrast, however, to note that a "simile is not a lie, unless it is a bad simile" is to capture the complex nature of simile, something we find hard to expect from such a limited narrator like Christopher. Nevertheless, his explanation is also simplistic, because he insists on telling us that the policeman "really did look like there were two very small mice hiding in his nostrils." In effect, Christopher has created a simile to explain one; in turn, this sophisticated yet simplistic narrative style captivates the reader precisely because of the dichotomy between these stylistic perspectives. Why, then, does the text have so much to say about simile and metaphor? What role, if any do they play in the narrative itself? It seems that the way the narrator struggles with language is representative of the conflicts he faces because of his syndrome. That is to say, Christopher



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craves order and clarity because his system is overloaded with information. He would like a rose, to be a rose, to be a rose, yet he realizes that language is more complex and ambiguous than axiomatic certainty. Deep, down, I suspect, Christopher is a great admirer of simile, an approximation of things, even though, despite his denial, in the text he seems to prefer metaphor, a more exact formula for having one thing stand in the place of another. He is interested in ambiguity because he recognizes that it makes the world go round, yet he utilizes the tools of certainty that derive from his Asperger’s syndrome to make sense of and clarify his external environment. This is the dynamic that occurs whenever Christopher examines the outside world, or even his own internal motivations. Thus, when he discusses lying, the intertextual reference to Huck Finn and/or Holden Caulfield is striking: "'I do not tell lies. Mother used to say that this was because I was a good person. But it is not because I am a good person. It is because I can't tell lies" (19). Like Huck and Holden before him, Christopher distances himself from lying, but adds a twist. He does not make a moral choice about lying, but simply insists he is incapable of doing so and never does. He is close to acknowledging that he does have a choice, but he prefers to rely on his syndrome to insist that he cannot lie. This type of tension is apparent throughout the narrative, because he consistently applies this mode of thinking as a narrator as well. He tells the reader he does not like lying and, for that reason, disapproves of novels. Yet he chooses to write a novel himself, insisting that "everything I have written here is true" (20). By doing so, he aligns himself with a very old tradition of truthful liars, at one with the narrator of Don Quixote and many of the ancient historians, Thucydides to name but one, who also reassure their readers that their narratives are nothing but the truth. Truth and untruth are indeed central issues of the text, and one of the central problems that Christopher struggles with in his narrative is the telling of lies all around him. Nonetheless, as he eventually admits, he, too, is capable of defining and telling white lies (48). When Christopher's father asks him where he has been, he responds by saying that he has been out. Christopher then observes that This is called a white lie. A white lie is not a lie at all. It is where you tell the truth, but you do not tell all of the truth. This means that everything you say is a white lie because when someone says, for example, 'what do you want to do today?' you say, 'I want to do painting with Mrs. Peters,' but you don't say, 'I want to have my lunch and I want to go to the toilet and I want to go home after school, and I want to play with Toby and I want to have my supper and I want to play on my computer and I want to go to



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bed.' And I said a white lie because I knew that Father didn't want me to be a detective. (48)

A close reading of Christopher's definition of a white lie shows the sometimes tortuous, but always emotionless method that he uses to arrive at his own version of the truth. Christopher's definition of a white lie is incomplete in comparison to those of standard dictionary definitions. He does not relate to the idea of a white lie as an often trivial, diplomatic or well-intentioned untruth. Nor does he consider that a white lie is also an untruth told to spare someone's feelings or to be polite. The "white" in white lie projects the sense of the lie being harmless, but this, too, is not part of Christopher's understanding. Finally, because he has little comprehension of tact or politeness, he does not relate to a white lie as being unimportant, merely told to be tactful or considerate. As is often the case with Christopher's explanations, his definition is both simplistic and highly sophisticated, portraying the oddity of Asperger's syndrome itself. What is highly sophisticated about Christopher's definition of a white lie is that he has perhaps unwittingly posited the basic problem with historical fact: that is, what is fact and what is not? He has shown that all facts "lie" because they are never whole truths in themselves, but always already a selection of facts rather than an absolute presentation of truth. Thus his "historical" complaint is legitimate. He claims that we never tell the truth because we never tell the whole truth; this is the exact same situation with historiography, for which historical fact has always already been selected, but Christopher labels the difficulty inherent in presenting the truth as a white lie. And the example he gives of not informing his father about his detecting activities is not a white lie since it is not meant to spare his father's feelings, but to keep Christopher out of trouble. He has made a great effort to turn his mundane lie into a more palatable "white" lie. Despite his cold, scientific veneer, Christopher is a more devious or more complex character than first meets the eye. He is much less tolerant, however, of other people's lies. In fact, one lie he cannot accept is reminiscent of his father's remark “'to let sleeping dogs lie’" (67), but in order to tell his story and solve the two conundrums, that is exactly what he is unable to do. The plot revolves around two mysteries that are based on untruths. The killing of the dog Wellington and his own familial situation are two morally corrupt issues, since his father denies all knowledge of the "curious incident of the dog in the night-time," and maintains that Christopher's mother has been dead for two years at the time of his narrative. He insists that mother "ha[d] a problem…a problem with her heart" (22), which is only true to the extent that she was unable to open her heart to Christopher, choosing to abandon him because of his



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difficult behavior and to run away with their neighbor. Thus Christopher uses his investigating skills, which can be said to be a derivative of his Asperger's syndrome, to unravel these puzzles and find his way in the world. Moreover, Christopher makes us realize how complicated the notions of truth and lies are in our world. Once again, Christopher's presentation of his own limitations helps us realize our limitations as well. As an autistic literalist, Christopher devotes much of his narrative to the limitations of language. His own confusion and uncertainty in the linguistic world is merely an exaggeration of our own plight. We either take language for granted or misunderstand its usage, while Christopher, to a certain degree, is more aware of the gap between signifier and signified. For example, he complains that signs of the establishment have incomplete signifieds. Thus, KEEP OFF THE GRASS does not specify whether it is the grass around the sign or all the grass in the park (29). He could have added that the command comes from an indeterminate source. Who or what is the voice behind the upper case imperative? Christopher also notes the linguistic inadequacy of so-called special needs children, a group to which he is said to belong, because, he claims, everyone has special needs. However, he is determined to show that he does not belong in that category by being the first pupil in the special needs school to complete his A level in math, something that in his eyes will prove he is not stupid (44). Perhaps a more realistic goal for Christopher would be to show that despite his disorder he is capable of doing outstanding and unexpected things, like his O level exams or "writing" a novel. In other words, by being inconsistent and very often behaving like other people, Christopher shows us that like any other syndrome, Asperger’s is much more than the mere sum of its parts and may even be an essential part of what it means to be human. Perhaps what is labeled as syndrome is most often a matter of degree and context rather than substance. Despite the above, Christopher acknowledges that he is different and is even willing to present a list of his behavioral problems, something that defines him as an Asperger’s sufferer. A. Not talking to people for a long time B. Not eating or drinking anything for a long time C. Not liking being touched D. Screaming when I am angry or confused E. Not liking being in really small places with other people F. Smashing things when I am angry or confused G. Groaning



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H. Not liking yellow things or brown things I. Refusing to use my toothbrush if anyone else has touched it J. Not eating food if different sorts of food are touching each other K. Not noticing that people are angry with me L. Not smiling M. Saying things that other people think are rude N. Doing stupid things O. Hitting other people P. Hating France Q. Driving Mother's car R. Getting cross when someone has moved the furniture (46-47) Christopher clarifies this list with a number of footnotes to provide specific examples of his "behavioral” problems. No doubt, he is correct in his labeling, although we would do well to remember that context is everything. Many items on his list are true of most of the members of the Seinfeld and Everybody Loves Raymond casts. Thus problematic behavior can be considered the norm in the comedic context. Moreover, apropos comedic context, it is worth noting that one can be elected President of the United States and hate France without necessarily having a DSM-IV syndrome or disorder. Christopher's list, however, is incomplete, as he also has other obsessive compulsive problems such as counting cars. If he encounters 4 yellow cars in a row he will have a Black Day, for which he takes the privilege of being anti-social (53). A reversal of fortune, after sighting five red cars in a row, leads to a Super Good Day. These obsessions are not only reasonable symptoms in light of the DSM-IV presentation of Asperger's, and its connection to OCD, but they also oddly deflate Christopher's self-image as a "scientist." He relies on the "music of chance" to determine how his disorder will present, which is supposed to be scientific. He reveals his inconsistency here, yet in his defense I would note that Sigmund Freud, the ultimate self-perceived scientist, believed that Victor Tausk, a brilliant but disturbed disciple, developed the habit of reading Freud's mind and stealing his thoughts [Roazen 170-71]. Could Freud be yet another candidate for Asperger's syndrome? Like Freud, Christopher is engaged in a quest to make the unfamiliar familiar. Thus, most of his novel focuses on his tortuous process to make sense of human communication. For example, when he comes across a metaphor that makes no sense to him, he claims he does a search of his memories to deal with those metaphors. He must do so because of his



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emotional black hole. "See you later, alligator" has to be examined by him in terms of possibility. It must be real for him to accept it, even though earlier he convincingly explained how metaphor works. (78) The same is true of his concept of love. He is able to explain it rationally, but not emotionally: "loving someone is helping them when they get into trouble, and looking after them, and telling them the truth, and Father looks after me when I get into trouble, like coming to the police station, and he looks after me by cooking meals for me, and he always tells me the truth, which means that he loves me" (87). Christopher will have to revise his definition of love, since he comes to acknowledge his father's love for him even though he lies to Christopher about the death of his mother, and the murder of Wellington, the dog. To have a relationship with his father after such a fundamental betrayal is an enormous step forward for him. Aside from his father's lies, language and simplistic interpretation also affect the way Christopher relates to his father. Thus he has great difficulty with his father's use of a rhetorical question: his father asks him "how stupid are you?" because Christopher has refused to abandon his investigations. (81) Christopher implies that rhetorical questions themselves are foolish since the person who asks the question already knows the answer. Since Christopher is especially sensitive to the notion of being mistaken for "stupid," perhaps his objection to rhetorical questions has a psychological rather than a purely "logical" foundation. As always, Christopher will do whatever it takes to make sense of his environment with the abilities he possesses, and never really considers giving up his struggle to achieve his goals. When appropriate, he will even employ philosophy to make sense of the world. He accepts the premise of Occam's Razor, that "no more things should be presumed to exist than are absolutely necessary" (90). Christopher interprets this to mean "that a murder victim is usually killed by someone known to them and fairies are made out of paper and you can't talk to someone who is dead" (90). His interpretation may be a bit off, but everything is legitimate in his quest to find yet another tool to grasp his surroundings without having the benefit of possessing a developed emotional intelligence. Perhaps that is why he is such a great admirer of Sherlock Holmes, who, unlike most people, notices that "The world is full of obvious things which nobody by any chance ever observes" (73). And Holmes, like Christopher, "had, in a very remarkable degree, the power of detaching his mind at will (73). Aside from all his other problems, Christopher has to deal with volatile and unreliable parents, who often make it necessary for him "to detach his mind at will."



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As if Asperger’s wasn't enough of a burden, Christopher's family is dysfunctional, not only because his parents are often incapable of dealing with his Asperger’s behavior, but because they, too, are prone to violent outbursts. As a result, they occasionally abuse him, and have been guilty of both physical and verbal abuse. His mother leaves home, and his father screams at and occasionally hits him. He also tries to destroy Christopher's book (83), the very project that will allow Christopher to prove he belongs in the world of the "normal." In light of these obstacles, one of the means that Christopher employs to survive at home is to become a "detective." He uses his scientific skills to put his life back in order, using Sherlock Holmes as a role model (88). Christopher practices his detecting skills by searching for his confiscated book and finds it in his father's room, which he is forbidden to enter (93). But even more important is that he also accidentally discovers numerous envelopes addressed to him in his father's secret shirt box. When he reads one of the letters he discovers that his mother is still alive, while the reader cannot help but note that she is dysgraphic (97). As someone with learning disabilities, she might have had more patience for and tolerance of her son's behavioral difficulties. The main point, however, is that after reading the letters, Christopher understands there are two mysteries that he must solve. Moreover, he has no choice but to come to the rational conclusion that his father is a liar, something that makes him sick and numb (112). Christopher's discovery leads to a confrontation with his father, who decides to make a clean break with the past and confess to killing Wellington. To defend his actions, he explains that he had had an affair with Mrs. Shears, the dog's owner and the abandoned wife of Roger Shears, who had run off with Christopher's mother. Unfortunately, we must come to the conclusion that Christopher is surrounded by violent, ignorant and treacherous people. In fact, among his other confessions, Christopher's father admits that his explosive anger is not so different from that of his son. Perhaps Christopher could have accepted one of his father's lies, but not two. In fact, the cold logic of Asperger’s leads him to believe that if his father could murder Wellington, he certainly could murder Christopher as well, so the boy decides to run away from home to save his own life (122). As he puts it, Christopher's proximity to and his fear of his father "were in inverse proportion to one another" (136). Therefore, in terms of mathematics, the medium through which Christopher feels most comfortable, he had to get away from home. Initially, he does not possess the confidence or mental fortitude to get very far though his plan is very clear: to get away from his father and live



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where he will be safe. Relying on his cold rationality, he tries to work out a diagram of possible choices of people to live with, but he eliminates everyone on his street. Demonstrating the multiple choice principle of distractor elimination, Christopher believes his only rational choice is to go live with his mother in London (131). Gathering his courage, Christopher spends his first night of freedom hiding in the backyard. He bides his time using math to take the romanticism out of the stars (125). Thus, he informs the reader that stars don't really form pictures; we simply connect the dots with our imaginations. The most formidable task in Christopher's young life is to overcome all the things that set him off in public and render him impotent in his quest to rejoin his mother. He must literally outsmart and exploit his Asperger's syndrome to make it to London without succumbing to the horrible pressures of modern life. Mundane logistics, noises, crowds, unknown places and people, all seemingly conspire to prevent Christopher from reaching his goal, but he demonstrates ingenuity, determination, intelligence and pure guts to reunite with his mother. Thus, he relies on Sherlock Holmes yet again, not only to master the railway schedule, but also to detach himself from the environment and not feel the pain in his head (132). He manages to keep his wits about him and take his father's bank card so that he will have the required funds for his escape (135). He meets the world on his own mathematical terms calculating in minutes every single part of his journey. He even employs breathing techniques to calm himself enough to complete his quest. Despite the brutality and suffering he undergoes, his syndrome, the very thing that would have him fail in his attempt to reach his mother, is also what allows him to eventually succeed. Getting on the train to London and then on a tube to his mother is the ultimate test for Christopher because he cannot bear to be in a crowd or with strangers. Aside from all his other difficulties, Christopher must bear the humiliation of wetting himself because he does not know that there are bathrooms on trains. Nevertheless, to overcome the obstacles he faces he employs his counting strategy, which calms him because it is a compulsive as well as mathematical activity (179). And once he realizes that computers control the schedules of trains he can eventually muster enough courage to board the underground (181). Finally, when he gets off the train he buys a street map to find his mom, since a shopkeeper won't give him free directions (187). Although he displays no emotion at their meeting, he is finally reunited with his supposedly dead mother. From here on, things go Christopher's way. His mother leaves her lover and returns home with Christopher,



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while his father temporarily moves out. He gets to take his A level math exam and show the world he is anything but stupid. Christopher then begins to talk with his father again and moves out with his mother to their own place (216). He even receives a puppy from his father to take the place of his dead pet rat Toby (219). Christopher gets an A on his math exam, lives in joint custody, and plans to take the advanced math A level exam. He is convinced he will manage to go to university, get an honors degree and become a scientist. His confidence seems to be well founded. As Christopher explains: "And I know I can do this because I went to London on my own, and because I solved the mystery of Who Killed Wellington? and I found my mother and I was brave and I wrote a book and that means I can do anything" (221) A broken family may have been the initial result of a problematic child, but the so-called problem child makes himself a winner and turns his dysfunctional family into a functioning, collaborate effort (213). The cultural ramifications of this feel good story are important. The complex dialectic among syndrome, sufferer, and society sheds light on the intricacies of the notions of disease, disorder, disability and syndrome. More and more often, the most unlikely of heroes gain admission to our world not because we pity them, but because they are able to employ successfully the very thing that makes them odd. Specifically, in terms of Asperger's we become aware that it is easy to recognize the difficulties of the labeled individual, but that we would do well to examine the similarities and deficiencies that so-called normal individuals exhibit. Put simply, we may indeed be in danger of becoming a world that suffers from Asperger's syndrome, if not all out autism, but the good news is that Christopher Boone has shown us that we can get along in the world while both engaging and employing our disabilities. One of the most difficult of all diseases to engage while living a meaningful life is HIV/AIDS, since the outcome of such a struggle is often premature death. Nonetheless, Pearl Cleage's novel, What looks like crazy on an ordinary day, not only insists that life to the fullest for the HIV afflicted is feasible if not obligatory, but that society has a didactic obligation to meet the denial and ignorance concerning the disease headon in order to prevent further infection, particularly in the African American community.



CHAPTER FOUR LIVING WITH AIDS IN PEARL CLEAGE’S WHAT LOOKS LIKE CRAZY ON AN ORDINARY DAY: ‘WHEREVER YOU GO, THERE YOU ARE’

Although the novel What looks like crazy on an ordinary day might be considered overly didactic, its saving grace, so to speak, is its vivid presentation of AIDS as a disease that is perpetuated by cultural behavior. That is, culture, in its broadest sense, is the sum total of norms, values, religious beliefs and artifacts that inform a people’s mode of thought and action. Thus even something like circumcision, originally a religious practice, is a cultural event that influences the prevalence of AIDS, as the New York Times reports that circumcision reduces the chances by 50% that a man engaged in heterosexual sex will contract the disease (McNeil Jr. 1). As David B. Morris claims, “From a postmodern point of view, AIDS is never simply about the science of a microbe. People infected with …HIV live within cultures that directly affect their health: cultures marked in the developed world, for example, by homophobia, government funding, gay rights activists, research grants, racism, pharmaceutical companies, addicts, and blood transfusions” (40). While the idea of cultural influence on disease – most often in this case unsafe sexual practices – might seem obvious to some of us, Pearl Cleage's important book points out the HIV-related ignorance of the poor and uneducated and the ways in which ideology, most often that which represents certain sectors of the fundamentalist religious community, contributes to the dissemination of the epidemic. Cleage offers a convincing portrait of the many ways in which the African American community falls prey to disinformation and, most important, does an excellent job of portraying AIDS as one major result of economic underachievement. In effect, the didactic approach posited by the authorial voice is pitted against another type of didacticism, that which stems from denial and recommends abstinence as a panacea for STDs. Throughout the novel, these didacticisms compete for the attention of black youth, yet the lessons to be learned are for everyone. The novel is also an early effort to

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recognize the phenomenon known as the "down low" and its connection to AIDS: that is, African American males who conduct homosexual relationships without their female partner's knowledge. In general, however, the novel relates to the myriad ways the ignorant, uninformed, misinformed and misled pay the price for their sexual behavior or the sexual conduct of their partners. The novel presents an HIV-infected protagonist, Ava Johnson, who loses her social and economic status through wanton sexual behavior. Rather than curse the fates for her “bad luck,” she takes responsibility for her actions, and returns to her (imaginary) all-black home town of Idlewild to help her sister Joyce combat the ignorance and indifference among the youth of the town that lead to disease, ennui and poverty. What is special about Cleage’s novel is that it seems to uphold but actually deconstructs representations of AIDS in women, which tend to glorify “the elevated abstraction of the mother/good woman as a way of tempering the degraded meanings associated with HIV” (Hogan IX). To a certain extent, this is what happens with Joyce, Ava’s do-gooder, social worker sister, in Cleage’s novel, yet that is deconstructed by Ava’s sexuality, which leads her to finding a life-long partner (however long that life may be) and a relatively happy ending. Nevertheless, the novel does seem to privilege the traditional roles of women and the conservative glorification of the nuclear family. In light of black history, and the fact that AIDS might well claim more African American lives than did slavery, it is hard to fault Cleage for her perspective. The very fact that a black female writer deals with AIDS in a nonconventional way and will not accept silence on the abject state of black women vis-à-vis STDs makes discussing this novel a must. In fact, as Kathy Hogan would have it, “initiating the theme of AIDS into black feminist literary traditions could save women’s lives. Progressive texts that speak out on women and HIV, even if these same texts subtly reproduce gendered ideologies, are still preferable to silence” (Hogan 129). I would endorse the first part of that sentiment and go much further, since the critical issue of the day is to challenge the black community’s relative silence on AIDS. What needs to be acknowledged immediately are the horrific statistics on the death of African Americans from AIDS. African Americans make up 12 percent of the US population, yet they represent 40 percent of all AIDS cases, more than half the female cases, and more than 60% of children with AIDS (Hogan 105). The protagonist of What looks like Crazy, Ava Johnson, may be educated and solidly entrenched in the middle class, but, before contracting her disease, she lived her sexual life in denial rather than in



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ignorance. Nevertheless, she is eventually able and willing to take responsibility for her irresponsible sexual behavior and come to terms with her illness. In contrast, the younger generation of Ava's home town is being intentionally misinformed about the disease and is offered solutions, most often abstinence, that will do nothing to stem the tide of the infection. Thus, this work transcends Ava's personal story, as AIDS is the "star" of the novel. Literature, a cultural product itself, is responsible for illuminating a particularly problematic issue that, far from losing its grip on American society, has returned with a vengeance to reach epidemic proportions. AIDS is a disease that continues to surprise us, precisely because of its ability to adapt to changing social and medical realities. Those who thought they could ignore prophylactic behavior because a medicinal cocktail would let them sexually carry on as usual are sadly mistaken. Moreover, large segments of the American public consistently underrate the severity of the problem. Because of the ways that AIDS functions, David B. Morris argues that it is the ultimate “postmodern” disease. AIDS is in many ways a mirror of postmodern uncertainties…Its once irreversible power to kill (now slowed by drugs) and its association with changing sexual behavior and gender roles give it a prime claim as the master illness of our time…Unknown before 1980, AIDS certainly has a chronological claim as postmodern. It has already killed over 80 million people worldwide and thirty million people are infected with HIV. Moreover, AIDS is the main cause of death in the United States among adults between the ages of twenty-four and forty-four, making it the most potent epidemic since the modernist outbreak of poliomyelitis. (Illness and Culture in the Postmodern Age 59) Judging by these statistics and others, I would argue that Americans think of AIDS, despite evidence to the contrary, as a disease that is meant to strike only African nations. Nevertheless, in the United States AIDS has already reached epidemic proportions. Moreover, surprising to most Americans, is that the US has inferior care for the afflicted in comparison to that of Africa and Asia (Hunter viii). Where the US really falls short, however, is in sex education. The idea of not using a condom in England, for example, is unthinkable, but that is because it is ingrained behavior that does not rely on the fantasy of abstinence (Hunter viii). The English public sphere and space consistently display advertisements for safe sex. This is not the case in the US. Reminiscent of Nancy Regan's program for the war on drugs, abstinence is a typical government policy in America. Just say no to sex and everything will work itself out. And perhaps more damaging is that most Americans



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believe AIDS is diminishing, despite evidence to the contrary. AIDS cases in the US are on the rise (Hunter 1). The opening of What looks like crazy, echoes the idea of blissful ignorance. The protagonist, Ava Johnson, fully aware of how her HIV infection came about, is watching airport TV and encounters "some editedfor-life TV stories" of people who have contracted the disease. The audience was eating it up, but it got on my last nerve. The thing is, half these bitches are lying. More than half. They get diagnosed and all of a sudden they're Mother Teresa. I can't be positive! It's Impossible! I'm practically a virgin! Bullshit. They got it just like I got it: fucking men. (What looks like crazy 3)

Her brutally honest approach to the suffering of others stems from Ava's unwillingness to buy into the cultural/psychological approach of ignorance. She refuses to be mystified as to how her illness came about and has no patience for anyone in denial. And, of course, she is essentially correct: there is no great mystery as to how these "practically virgin" women contracted AIDS: they had unprotected sexual intercourse. Thus Ava has very little use for Puritan strategies in relation to her disease. That is, she doesn't think public confession, which she had been witnessing on TV, is good for her soul. She has no intention of begging public forgiveness for her behavior, nor is she willing to accept the idea that the "punishment (AIDS) fits the crime (SEX)." I'm not buying into that shit. I don't think anything I did was bad enough for me to earn this as a payback, but it gets rough out here sometimes. If you're not a little kid, or a heterosexual movie star's doomed but devoted wife, or a hemophiliac who got it from a tainted transfusion, or a straight white woman who can prove she's a virgin with a dirty dentist, you're not eligible for any no-strings sympathy (4). The idea that certain victims deserve sympathy while others do not has farreaching cultural implications. Perhaps Ronald Regan would never have signed off on government funds for the research of AIDS if his good friend, Rock Hudson, had not come down with the disease. Most assuredly, AIDS research did not take off when the infirmity was considered by too many as God's curse on homosexuality. Unlike for any other major disease, social convictions and cultural judgments determine how people with HIV will be treated and how much of the available financial resources will be allocated to treatment, cure, and prevention. Perhaps that is why Ava finds that people want to know exactly how one got sick, or how many partners one had, so that they can satisfy



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morbid curiosity and decide whether a victim is worthy of sympathy. In terms of social judgment, it is not clear whether Ava should be sorry about getting sick or about having had a lot of sex. Nevertheless, practically speaking, she questions the importance of agonizing about repentance. Ava prefers and takes the existential and feminist high road; even women who enjoy sex deserve to live, and Ava believes there is a possibility to live with AIDS, which is what this book is all about. She is not about to waste her time soul searching about things she cannot change. Living is much more important than that. The antithesis of living in the novel – and in real life – is denial. As such, the novel is particularly adept in portraying the denial factor when Ava decides to behave responsibly and inform her former partners of her plight, even though it leads to an introspective critique: When I got the bad news, I sat down and wrote to all the men I'd had sex with in the last ten years. It's kind of depressing to make a list like that. Makes you remember how many times you had sex when you just should have said good night and gone home. Sometimes, at first, when I was really pissed off at the injustice of it all and some self-righteous anger seemed more appealing than another round of whining, I tried to figure out who gave it to me in the first place, but I knew that line of thinking was bullshit. The question wasn't who gave it to me. The question was what I was going to do about it. Still, when I think about all the men I slept with that I didn't even really care about, it drives me crazy to think I could be paying with my life for some damn sex that didn't even make the earth move. (7-8)

Perhaps the most extraordinary part of the above passage is that she refuses to focus on the specific person who infected her. She implies, rightly so, that playing the blame game will do nothing to improve her life and will distract her from the task at hand, which is to find a viable way to live with the disease. She also decides to do the right thing for society at large by informing all of her former partners. Though Ava behaves beyond reproach, despite her moral agonizing, this does not mean that her gesture will be well received by her former partners and society as a whole. In fact, it leads to her economic demise, as she receives a visit from the wife of one of the men to whom she had written about her infection. Unfortunately for Ava, the confrontation takes place in her beauty salon, where too many people witness Ava receiving her postmodern "scarlet letter." 'Are you Ava Johnson?'… 'Yes,'…'What can I do for you?'



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'You can tell me what you think you're doing sending my husband some shit like this through the mail. 'She reached into her purse, took out one of my letters, and waved it in my face, her voice suddenly rising to just short of a shriek. ..I tried to stay calm and ask her if she wanted to go into my office so we could talk. She didn't even let me finish. 'I don't want to go anywhere with you, you nasty heifer!'…'All right then,' I said. 'What do you want?' 'I want you to take it back,'… 'Take it back?'…. 'You heard me, bitch!'…'Take it back.' I held up my hand to let her know she had gone too far, and she drew back and slapped me across the mouth. Two of my operators grabbed her and pushed her out the door, but all the time she's hollering at the top of her lungs, 'This bitch got AIDS! This bitch got AIDS!' (9)

Although Ava sends out letters to all her customers explaining the difference between HIV and AIDS, she is unable to convince her clients to return. Almost overnight, a highly successful business – not to mention Ava's reputation – is ruined because of vicious, vengeful behavior and ignorance. But perhaps what is most noteworthy is the ever-present theme of denial. The woman wants Ava simply to take the letter back, if not the disease itself, so she will not have to deal with the possibility that her husband might have been infected as well. What better way to solve the problem of HIV than simply taking away the letter, a strategy of denial that functions no better than abstinence? Apparently, the woman prefers to attack Ava and attempt to force her to change reality rather than to confront her husband or send him for an HIV test. The difference in behavior between this woman and Ava is striking. The former wants someone to blame to avoid responsibility and perpetuate denial, while Ava wants to live her life honestly and responsibly. Ava's sexual practices leading up to her infection are similar to so many others who have contracted the disease. A lack of concern for proper protection combined with sexual indiscretions and denial helps explain why, culturally speaking, America is probably the most conducive place in the western world for the dissemination of the disease. Thus, the most prevalent prediction is that the newest wave of HIV will be much worse than its predecessor of the 80s. This prediction seems well substantiated. What is sometimes overlooked in the evaluation of AIDS is that it is in a very real sense a family disease. The ramifications for the families of AIDS patients are significant and take their toll on society as well (Hunter X). Presently, oOne million Americans are infected with HIV, while another half a million have died of AIDS. In the years 2002-2003 250,000 new cases of



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HIV have been reported. Not only is AIDS the most severe epidemic the world has ever known – having killed over 30 million people since its appearance in the early 80s – but it will also become the greatest epidemic the US has ever experienced. Despite their notoriety, the number of SARS and Ebola deaths are insignificant compared to AIDS (X). There are other important contributing factors that make the US the most infected country in the west. "The US has one quarter of the world's prisoners, creating a revolving door policy that generates infectious diseases," including an HIV rate that is 7 times greater than that of the general population (Hunter XI). Has anyone begun to investigate or ponder the relationship between so-called rehabilitation and the boom in STDs behind prison bars? Furthermore, the American sex industry, generating 20 billion dollars a year, is the world's largest and the US is "the center of an international sex business that recruits US teens and traffics women from other countries to meet an ever-growing demand" (Hunter XI). And many of those foreign recruits come from Southeast Asia, where AIDS is particularly rampant. Although What looks like crazy has nothing to do with the official sex trade, there is a particularly brutal, horrific event that illustrates the idea of women as physical possessions of young, angry men. Moreover, the narrative shows how these teenagers behave as poster children for the dissemination of HIV. The young gangster Frank treats his girlfriend like a piece of meat that can be passed around like party favors. Thus Frank decides to give away "his pussy" to his friend Tyrone when they come to terrorize Ava – after drinking and smoking crack – at her sister's home. But since they believe no one to be at home when they arrive, Frank and his girlfriend first engage in outdoor sex with buddy Tyrone as gawking spectator. Ava reports from her post at the window overlooking the front yard: I closed my eyes, but I could hear Frank clearly. 'Yeah, bitch, come on, bitch. You such a bad-ass, shit-talking bitch, what you got to say now?' 'Take it all, baby,' she said panting. 'This ain't nobody pussy but your pussy. Take all of it.' Frank slowed down and looked through the glass at Tyrone. 'You want some of this, Ty?' he said. The girl sat up. 'What you talkin' about, nigga? You can't be givin' me to him just like that!' 'What did you just say?' Frank said, still moving against her. 'Whose pussy is it?' She didn't say anything and he reached up and grabbed her hair, pulled her neck back hard.



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'Ow, Frankie! Stop it now!' His voice was low, ominous.' I said, whose pussy is it, bitch?' She struggled briefly, then surrendered. 'Your pussy,' she said. 'It's your pussy.' 'Goddamn right,' he said, stepping back and pulling up his pants so suddenly she would have stumbled to the ground if he hadn't caught her. 'Now, get your ass back to that car, and give my boy some of my pussy before you make me mad, you stupid bitch.' He leaned down to look in the window and laughed. 'You the man, Ty! Ride that bitch, brother! That's how she like it. Up the ass and shit." (17576)

Of course, safe sex is not a consideration here: misogyny rules. Furthermore, the girl, known only as "bitch," has been metonymically reduced to a sexual organ that can be transferred at will to whomever Frank desires. No less destructive, however, is that the couple, prolific drug users, engages in unprotected sex. But the jewel in the crown is that Tyrone also has unprotected anal sex with his friend's sexual "property." In "real-life" America, Americans have more sex partners and use more drugs than in any developed country, yet the US has poor HIV prevention programs. Moreover, because of the influence of the religious right, or "religiously motivated ignorance," as Susan Hunter would have it, a number of US teenagers engage in anal sex because, by doing so, they believe they are practicing abstinence and preserving their "virginity" (35). Unfortunately, anal sex is much riskier in terms of first time infection. "A 2004 study of 12,000 teens by Yale and Columbia Universities found that adolescents who pledged to remain virgins until marriage are four more times likely to take chances with anal sex than those who do not and are also less likely to use condoms" (Hunter 35). Quite often, the AIDS nightmare seems to be acted out in the novel, as if all possible real-life misbehaviors related to ignorance, fear, poverty, and hatred are the norm. As I have noted, the Christian right often prevents effective sex education.8 Thus, there has been a shift in AIDS infected communities from homosexuals and drug users to minorities, gender violence victims and the “religiously motivated ignorant” (Hunter XII). The perfect example of “religiously motivated ignorance” in the text is the behavior of Gerry, the reverend's wife, who does everything in her power to prevent Ava and her sister Joyce from creating a program that would help young black women from falling prey to uninformed sexual behavior. Joyce begins the "sewing circle" or "circus" to try and help the young black women of the church group prepare for some kind of future without drugs, disease, poverty and death.



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Joyce said when she started going to church regularly, she realized that a lot of the teenage girls she knew slightly from watching them grow up were there every Sunday, too. They weren't really religious. It was just a place to hang around together after the service and show off their babies and gossip a little about the boys who never came unless they were forced. Joyce thought they might like a chance to do more of the same, plus whatever other interesting experiences she could sneak in without scaring them away. They had enough social worker types in their lives already. (39)

Joyce, who is indeed a social worker, the stereotypical do-gooder who stands in direct opposition to women who contract AIDS, seeks desperately for a way to make a difference in their lives as she recognizes "These girls haven't got a chance…There aren't any jobs and there aren't going to be any. They're stuck up here in the middle of the damn woods, watching talk shows, smoking crack, collecting welfare, and having babies. What kind of life is that?" (39). This, then, is Joyce's motivation for getting the circle started, as she recognizes the endless problems of being poor, wild, and "idle" in Idlewild. She begins with nine young women and their more than a dozen children to create a safe and stimulating haven for them. As long as she instigates a somewhat conventional agenda, such as the nursery program that took place at the church on Sundays, she met with no objections from the minister and his wife, Gerry. The openness and the willingness to discuss their everyday problems soon led to a "dangerous" dynamic – at least to the fundamentalist mindset – as their attitudes toward and understanding of sex became a popular topic of discussion. Joyce intuitively understands that the recently arrived Reverend Anderson and his wife would not support any effort that went beyond traditional education, so she is making plans to have the center conduct its business independently of the church. "I know the circus is helping these girls and I'm not about to let Gerry Anderson mess it up by making them read Bible stories about obedience and chastity when they want to talk about domestic violence and birth control" (42). Once again, we have a tale of two didacticisms: Joyce’s strategy is to teach these young women about the reality of their world and how to deal with the potential dangers in it. Gerry Anderson expects that biblical imperatives of chastity and obedience – closely related to abstinence – will do the job. Abstinence is not merely ineffective; it is destructive, because of the dire consequences of its abject failure. Unfortunately, large sectors of American society similarly perpetuate the HIV and AIDS phenomena through ignorance, passivity, and sometimes outright interference.



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Although Gerry Anderson recognizes the enormity of the problem of teenagers becoming woefully inadequate single mothers, all she offers as a solution is the doctrine of sexual abstinence. As she knowledgably informs Ava of her view of wanton sexual behavior, "'Such a shame. Babies having babies without any thought to how they're going to care for them. I keep telling Joyce these girls need some old-fashioned lessons in how to say no. All that other just confuses them. We need to teach them how to cross their legs and keep their dresses down. It's a shame is what it is'" (52). The shame, of course, is the advice presented by a so-called upstanding member of the community. Unfortunately, Gerry’s behavior seems to be representative of too many black churches. While there are certainly black churches that are supportive of the victims of AIDS, many are unwilling to confront the enormity of the problem. Bill Maxwell, for example, reports of a black female pastor who challenges her peers “to drop the code of silence and to start assuming responsibility for helping to eliminate an epidemic that may be the greatest threat ever to the survival of black people as a viable group” (Maxwell 1) 9 Katie Hogan suggests – and I agree -- that denial in black communities is all about respectability to counter white bigotry (106). Like Gerry Anderson, some black women might deal with their hypersexual image created by racist rhetoric by adopting a conservative pose on sex, or a “conservative sexual rhetoric” (Hogan 107). As we learn later in the novel, Gerry Anderson is much worse than unrealistic and narrow minded, yet ironically her agenda is to maintain her and her family’s “respectability.” Her husband, the good reverend, turns out to have been banished from his last pastoral position, because he is an alcoholic and a pedophile, spurring his wife to greater lengths to make sure everyone around them exhibits angelic behavior. Of course, she would like to keep the church and the community out of the limelight, since the reverend is violating a legal agreement by continuing to "counsel young men" at the church. And most likely, at an unconscious level, she understands that abstinence hasn’t worked at all in her own family’s life, which makes her all the more determined to make it work for others. But even if her motives are pure, it is clear to Joyce and Ava that to rely on conventional methods to prevent unwanted parenthood and STDs is simply ineffective. As we have already observed, Frank's girlfriend might have wanted to "cross her legs and keep her dress down," but that wasn't deterrent enough for Frank not to pass on his sexual "property" to Tyrone, who also happens to be Gerry's grandson. Apparently living with the Andersons has not had much of an effect on the way he treats young



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women. To the contrary, it has merely exposed him to the sexual abuse of his drunken grandfather. What begins as a difference of opinion on sex education and sexually transmitted diseases develops into a full-blown feud between Joyce and Gerry. Despite promises to desist, Joyce continues her sex education sessions with the sewing circus at the church until Gerry catches them in the act, so to speak. Specifically, Joyce decides to hold a special session on AIDS and is immediately rewarded by her choice with a barrage of ignorance from one of the more self-styled and sophisticated young women. She finds the topic of AIDS amusing, as she confidently points out: "'Ain't nobody in here fucking no faggots…Excuse my French'" (91). Her declaration displays multiple levels of ignorance that are closely connected to the dissemination of AIDS. The obvious problem with her observation is that she implies that AIDS is restricted to the homosexual community, which is both incorrect and dangerous. No less problematic is the idea that she can easily determine someone's sexual orientation or that a man can only be interested in one sex. If that were the case, the down low wouldn't be such an important factor in the spreading of HIV among African American females. In the US, 600,000 men between the ages 1544 across the country are on the down low; probably more than a million in all age groups (Hunter18). Joyce's reply to the young woman's denial is a wake-up call for all the others, as she "asked them what they thought was the number one killer of young black folks all over America. They guessed homicide, drug overdose, cancer, and car accidents, in that order. When Joyce said AIDS, they thought she was kidding" (Cleage 91). At worst, they believed she was merely trying to frighten them into reading her pamphlets about the disease. Rather than claim otherwise, Joyce agrees and presents her didactic strategy: "'You need to be scared,' Joyce said calmly, 'if you want to stay alive'" (91). Unfortunately, denial and obstinacy seem to carry the day with a generation of young women that should be familiar with HIV and its dangers. As Ava notes, "the information is everywhere, but it seems to wash right over them" (91). What the novel does not say outright but has fixed in the margins of the text is that there is a horrific mistreatment of too many women in America. As Dr. Frances Priddy, a physician at Atlanta's Grady Memorial Hospital, bluntly notes, "AIDS in the United States is "taking on a female face" (quoted in Hunter 69)…The disease is growing 15 times faster among women than in men" (70). One reason is that rape is such as a potent transmitter of AIDS. The US has the greatest number of rapes in the West, partially because women's rights are not respected enough (76).



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Twenty percent of American women are beaten by their husband and cannot decline sex or demand that he use a condom, even if the woman knows her husband is sexually promiscuous (77). Moreover, women are 40% more likely to be poor than men in the US, which has the highest poverty rate and highest ratio of women's to men's poverty rate in any industrialized country. Poverty and ignorance of STDs often go hand in hand. Finally, the so-called women's bill of rights has been endorsed by most nations in the world, 175 including all the industrialized nations, yet the US, together with Iran, Afghanistan, Syria, Somalia and others have refused to endorse the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) (83). Joyce's work with the community is so important precisely because the young women of Idlewild all seem to be used and abused by their boyfriends and others. Moreover, Ava is correct that information about prophylactic behavior is available, but somehow beyond the reach of the young women of Idlewild, who lack even the most basic understanding of HIV and its transmission. But the obstinacy of these young women is no less a problem. One young teenage mother in the group has given up on condoms because her partner objects: "'My old man ain't havin' it,' a woman with a long blond ponytail of somebody else's hair said, shaking her head. 'He said he can't feel nothin' when he use 'em'" (Cleage 91). Another girl offers a similar complaint: "'My boyfriend say when we get it goin' good, he don't wanna stop and put no rubber on…" (92). Joyce's retort is shockingly simple: "'That's part of what we have to do,' Joyce said. That's when she reached into the shopping bag beside her and brought out the juicy jumbo. 'We're going to learn how to put it on for him'" (92). By demonstrating how to put a condom on a hotdog, Joyce hopes that women who take the initiative to make safe sex mandatory can actually make the condom a ritual part of lovemaking. Indeed, her strategy here is to introduce them to safe lovemaking rather than risky sexual submission. Unfortunately, as the often cynical Ava points out, it is not clear that their sexual activity has anything at all to do with making love. Fascinated by the hotdog and condom exhibit, each young woman manages to overcome her shyness and insecurity to attempt to put a condom on the hotdog. Just as we might begin to believe there is hope for sex education in the communities of America that need it most, the reverend's wife Gerry arrives to put an end to that utopian fantasy when she catches the group in flagrante delicto . 'What do you think you're doing?' Her voice, which was so beautifully spirit-filled on Sunday, sounded like the Devil speaking through that girl in The Exorcist. I turned toward the sound, fully expecting her head to be



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spinning around and pea soup to be spewing from her mouth. Clustered, guiltily now, around the table at the front of the room, we hadn't seen her come in. I wondered how long she had been standing there. The power of her outrage brought an immediate silence…The force of Gerry's outrage was so overpowering that the women fell back in her wake, groping behind them for their purses and their children, even while they hoped Joyce could save the situation. …'What in the name of all that is holy do you think you are doing with these girls?' Joyce didn't flinch. 'I'm trying to save their lives.' 'By exposing them to this…filth?' Gerry spit out the words. 'By telling them the truth.' (94).

There is no turning back from this clash. Gerry disperses the girls in her outrage, vowing that such a "desecration" of God's house will never again occur on her watch. Yet this is the crux of the real life matter of AIDS education. How can young people learn how to protect themselves from the disease if the most powerful preventive measures – condoms – are associated with, of all things, immorality? What Gerry is unable and unwilling to understand is the ethically deficient position of denial and/or abstinence that she disseminates. Of course, the fictional Gerry is merely following in the footsteps of the US government. The latter claims that condoms provide only moderate protection against AIDS. Therefore, it is safer and better not to have sex, which is George Bush's policy (Hunter 59). As Joyce has already pointed out, despite what the President and Gerry may believe, reciting bible stories is not particularly effective in preventing pregnancies and the spread of STDs. Nor is the Reverend's sermon, "There's no hiding place down here," though the ironies of his recital are in direct contradiction to his personal behavior and to his wife's desperate attempt to sweep the discussion of AIDS, STDs, drug abuse, crime, teenage pregnancy and all the other troubling circumstances of the Idlewild community under the biblical altar. Joyce does not merely talk about how the community might better itself: she leads with an active, albeit sentimental example. Mostly because of her maternal feelings, but also in order to set a positive example for parenting in the community, Joyce decides to adopt the abandoned baby, Imani, who is also Frank the gang banger's niece. Imani's mother, Frank's youngest sister, is an HIV positive crack addict who runs away from the hospital soon after giving birth. "Fortunately" for Imani, she is not HIV positive herself, but is born addicted to crack. Of course, Frank and his sister are too busy smoking crack themselves to think about a baby, but that is just fine with Joyce, as it gives her an opportunity to rebuild her own fractured family. Her husband and two children had died in freakish accidents, while her sister, Ava, has come down with HIV. Not only does



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Joyce recreate a nuclear family, but she initiates the development of an extended family as well. At her encouragement, Ava decides to stay in Idlewild after she falls in love with Eddie Jefferson, a man who seems to have no difficulty loving Ava despite her illness. So the two sisters, Joyce and Ava, Eddy and the baby become a united and extended family, offering the baby Imani a chance at a life without drugs and AIDS. The novel may posit a conservative, Ozzie and Harriet position, presenting the nuclear family as the proper alternative for the community to follow, but for an impoverished small town of broken homes, Idlewild may not be able to afford the luxury of exploring alternative, postmodern lifestyles. Perhaps Eddie Jefferson is too good to be true, but the idea that a noninfected man can easily fall in love and remain by the side of an HIV positive woman is a powerful didactic and feel-good story. Why should infected people be emotionally or sexually beyond the pale, since there are safe ways to nurture and maintain a healthy sexual relationship? The key to a successful relationship between the two, and perhaps all relationships in general, is to live in the present. Ava's motto is to take things a day at a time. When she gets depressed, wondering exactly how much of Imani's life she will be able to experience, she forces herself to realize that she is healthy in the present and that's all there is. Recovering her even keel, she prepares herself for future lapses into self-pity, "I hope I can remember this feeling next time I'm blubbering into my pillow because I can't count on the next thirty years. One day at a time, I ought to have that shit tattooed on my forehead. One damn day at a time" (89). In light of her new philosophy, Ava begins to allow herself to fall in love with Eddie, although she is convinced it will only be painful and meaningless to do so. She realizes that her being HIV infected does not prevent her from having sexual fantasies but she is afraid to act. "I'm attracted to Eddie. Not curious about. Not affectionate toward. Attracted to, as in sexually" (108). Once again we learn the didactic lesson that there is nothing wrong with sex or sexual activity, even if not especially because of the presence of HIV, if it has a sound foundation in human emotion and affection and is not merely a mindless robotic act. She initially tries to remain Eddie's "friend," but it is clear that their relationship is headed toward spiritual and physical intimacy. After Eddie confesses to a particularly dark past, former drug dealer, drug user, military assassin in Vietnam, post-war criminal, murderer, and ex-con, Ava has a confession of her own to make. 'I'm HIV positive…I've known for a year and I feel fine…' His face hadn't registered any emotion at all and I was trying so hard to read his mind, I thought I was going to have a stroke.



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'I wanted to tell you because…' I couldn't say, because I want to make love with you, so I just stopped again… He reached over, picked up my hand, turned it over, and kissed my palm…It seemed as if all the nerve endings in my body had gathered right there where his mouth was pressing against my hand. His voice was gentle. 'Is that it?' 'Yes.' When he looked up at me, I felt like I could see every mistake I've ever made in his eyes, but no judgment, no anger, no shame, no questions except one: 'Do you want to be with me?' His voice was neutral. 'Yes.' Mine was not. 'So that means we have to use a condom, right?' He made it sound like the simplest thing in the world. (139).

Is Eddie's attitude naive or merely the "simplest thing in the world?" Why should the need to use a condom prevent them from falling in love with each other? Eddie is an intelligent man; he understands the gravity of Ava's situation,; but much like her, he is more concerned about living with AIDS than missing out on an opportunity to be with the love of his life. When Ava begins to explain all the sexual acts they cannot perform, all those that involve the exchange of bodily fluids, Eddie cuts her off and asks for a list of things they can do. He is willing and able to be educated in sexual etiquette for his HIV infected lover. Their love is a beautiful way to overcome the ugliness of their former lives, proving the old American adage that anyone can reinvent herself, with the proper mindset and behavior. In this novel, as it should be in real life, living a full life with AIDS is a rational, reasonable choice. Thus whenever Ava falters and begins to imagine a painful future with AIDS, Eddie becomes the rock upon which she can build her faith. When she questions his desire to be with her, his replies make sense for anyone capable of living life in the present, as if every day were one's last. 'Eddie?' I said. 'What, baby?'… 'You're not pretending, are you?' 'Pretending what?' 'That this is the beginning of something.' 'Isn't it?' 'You know what I mean.' 'No, I don't…I really don't.' I took another breath. 'Pretending,' I said, hating the whiny tone in my voice. 'That now we'll get together and get married and have some kids and all the rest of it.'



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He always took his own time answering questions, but this time it seemed like we stood there looking at each other for an hour before he said anything. 'I don't need any of that…I had a wife who was willing to help some people kill me so she could get high. I had two kids I wouldn't recognize if they walked in here right now because they were born when I was too young to raise them and too crazy to love them. I'm not planning anything and I'm not pretending anything and I'm not expecting you to do anything except love me as hard and as strong as I'm going to love you…Fair enough?' (143).

From this point on, Ava will have no qualms about living her life to the fullest because all she is required to do is, despite her infirmity, to be herself. She has found the perfect man, portrayed perhaps too rosily as a cross between a black Kung-Fu practicing Buddhist and Jesus the carpenter. Yet he will deal with any symptom that Ava ever has. Nothing can make him retreat from the love he has for her. As he puts it so eloquently, "I'm not here to watch you die… I'm here to help you live" (220). In What looks like crazy on an ordinary day, the culturally enlightened forces win out over the forces of cultural ignorance. Imani is saved from the clutches of a violent, crack-addicted family, the Reverend Anderson is exposed as an alcoholic and pedophile, Gerry, his wife, the ultimate hypocrite who had a daughter who died of AIDS, is thwarted in her efforts to put an end to the Sewing Circus and sex education, Joyce gets the chance to raise a child of her own and save the youth of her community, and Ava And Eddie have an opportunity to live their life in love. Despite the positive outcomes of the novel, and the affirmation of knowledge over the darkness of denial, there must be a recognition that living with AIDS can have no perfect ending. Towards the end of the novel, just before Ava and Eddie marry, Ava experiences night sweats, a symptom that may signify her transition from HIV to AIDS. Nevertheless, as Ava describes it, what looks like crazy on an ordinary day is for her to marry Eddy after contracting AIDS and loving every minute of it (244). Though dying with AIDS because of ignorance, denial and distain are "easy" choices, didactic education – as opposed to abstinence – has the cultural power both to mitigate the disease and rescue its victims from the margins of society. Unlike HIV/AIDS, erectile dysfunction is not to be avoided at all costs. That is to say, it seems to be a culturally accepted phenomenon, in the sense that there is nothing wrong with suffering from a condition that has such an effortless way to overcome the sexual limitations imposed by it.



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The products created to relieve sexual dysfunction seem to have a sexy aura themselves.



CHAPTER FIVE ERECTILE DYSFUNCTION: THE “IN” DISEASE

How could erectile dysfunction become an “in” disease? Why would men not object to the idea that sexual dysfunction, an issue of utmost sensitivity to the male ego, is a reasonable state of affairs? The explanation I propose is directly related to the status of the various medications available for erectile dysfunction. In short, to understand this phenomenon, we must first discuss the Blue Diamond, better known as Viagra, as an American icon. But before we begin our discussion of the iconic status of the blue diamond, we should situate this phenomenon in the context of the revolutionary and perhaps outlandish behavior of Americans in regard to all prescription drugs. In 2003, retail drug sales worldwide were $317 billion, with American consumers spending just over half that amount. The pill-taking life is a trend that has its origins in the 1950s, but only recently has it reached alarming proportions. To mention just one example, we should acknowledge that never before have anti-depressants been prescribed for preschoolers in such large amounts. It is as if one shouldn't wait too long before embracing a lifestyle dependent on drugs. Thus, I think it is fair to say that "Homo Pharmaceuticus" has arrived in America, as prescription drugs and the pursuit of happiness have become synonymous. As a result, what we once considered normal or a mundane part of the aging process is no longer tolerated. Baldness, incontinence, erectile difficulty and even the very concept of aging are out. These unacceptable "deficiencies" have become cultural concerns that the medical profession is expected to address, of which the most urgent seems to be erectile dysfunction. The journey to chemical perfection of the sexual experience received its biggest boost with the development of Viagra, whose name derives from an odd combination of the roots of the words tiger and Niagara, creating a vision of a powerful and erect stream of water. Viagra started out as a product for sexual enhancement in sexually dysfunctional elderly

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males, yet has transformed American society in ways that could not be imagined when the product first came to market. The drug companies refused, or we did, to accept the limiting marginalized role of the product so that it has become as liminal as Emersonian philosophy. Who would have predicted that the current Viagra ad portrays a seemingly horned and horny middle-aged man with the message, "Get back to mischief?" Who would have imagined that Mike Ditka would be pushing Levitra, Viagra's dark other, as a product of masculinity supposedly on par with an outstanding football hit to middle-aged men? Who would have thought, as did the creators of the Cialis campaign, that the best way to advertise a product of sexual enhancement initially targeting the elderly would be to show a giggling 30-something couple in a Jacuzzi, apparently imagining the sexual benefits of pharmacology? A discussion of these questions and their consequences should show that the Blue Diamond affects culture and society in so many ways, subtly and overtly, that it is reasonable to claim that the products of sexual enhancement, specifically Viagra, have revolutionized American society and thus have justified the blue diamond's status as an American icon. This chapter will briefly count and outline those ways. To start our investigation, we should note that more than half of American men over 40 either need or think they need a product of sexual enhancement to safeguard their sex lives. According to a Massachusetts survey, 52% of 1290 males from ages 40-70 suffered from erectile dysfunction. The drug companies have come to rely on these and similar statistics to expand their market even though there is no attempt to sort out minimal sexual snafus from chronic dysfunction. Apparently, anything less than perfection is unacceptable in matters of sexual performance. As a result, any instance of problematic function over a six-month period qualified as erectile dysfunction and thus was counted as part of the 52%. Moreover, in a noteworthy shift from past medical thinking, the psychological component seems to have disappeared in the diagnosis of erectile dysfunction. Do problems of the psyche have no effect on sexual performance? Are they not worth exploring? If someone is able to have an erection while sleeping but is incapable of having one during a real time sexual encounter, should Viagra be the solution instead of psychotherapy? Apparently, in a society of the quick fix, the pharmaceutical takes precedence over the psychological approach, only partially because the latter is much more expensive. According to the new norm, one should take the pill and get busy, without worrying about the underlying cause of imperfect sexual performance. If a quick fix is available, there is no longer an unwillingness to claim erectile dysfunction, real or imagined.



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Because of the above phenomena, one might argue that erectile dysfunction has become a cultural disease or, at the very least, a malady, which, despite its physical and psychological causes, has become a social norm via cultural manipulation. In other words, once the surveys begin to show high numbers of males suffering from erectile dysfunction the disease becomes pervasive and "real." In order to understand fully erectile dysfunction we should approach it holistically and allow for a cultural as well as physical or chemical explication. Indeed, I would argue that the advertising for the "cure" to the problem to some extent creates the malady as well. In a bizarre reversal of fortune, the disease has become desirable for the simple reason that the "cure" is so attractive. Males of all ages find it easier to belong to a group suffering from a sort of universal erectile dysfunction without nuance or distinction because the solution to their collective problem is so simple. Pop a sexy blue pill and the difficulties, real and imagined, go away. The disease may not even exist for many males who think they suffer from erectile dysfunction, but accepting such an "in" illness that has such a pleasurable solution is easier than undergoing psychological evaluation, introspection, proper diet, exercise, or any other regime that involves hard work. Why endure the discomfort of traditional self-help when better living through chemistry is available in an attractive shade of blue? In an apparent endorsement of this attitude, approximately 6 million American men and 23 million men worldwide have taken Viagra for erectile dysfunction since Pfizer released the "blue diamond" on the market 9 years ago (1998). These numbers do not include the millions of people who have purchased counterfeit pills currently available around the world at discount prices. Furthermore, the new competitors of Viagra, Levitra and Cialis, have already captured an additional million clients of their own. These numbers pale, however, in light of the grand scheme of the pharmaceutical companies that produce these products: to entice 30 million of the 60 million males in America over 40 to use their product. This says nothing, of course, of the numerous other middle-aged males worldwide or the young people in America and abroad who aren't necessarily suffering from impotence, but are looking for that dating edge. After all, not everyone has the charm and charisma of Oracle's CEO, (Larry Ellison), who really knows how to hit on the ladies. His idea of a great pick-up line and fail-safe dating system is approximately as follows: "Hi there. Would you like to own a BMW?" If giving away luxury cars puts a crimp on your dating budget, taking a drug that is proven to prevent erectile dysfunction might be the next best thing. It seems that the ultimate goal of the drug companies that produce these products of sexual



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enhancement is to have all males indulge on a regular basis, situating the use of Viagra on the same level as that of popping an Omega-3 fatty acid dietary supplement. Why not start your day with Cialis, the long-lasting version of Viagra, and be prepared for any sexual encounter that might come your way? And even if a sexual encounter might seem beyond the pale, as it did for Peter O’Toole’s character in “Venus,” the Blue Diamond retains its iconic value in the pill trading he and his cronies indulge in every morning. But let us return to our investigation of sexual function, sex, and sexuality by reevaluating the original group of elderly sexually dysfunctional males who were offered Viagra to preserve and rekindle the sexual union of matrimony. Their problems were "legitimate," often the result of disorders that interfere with circulation, such as hypertension, heart disease, and diabetes. In retrospect, Robert Dole, Pfizer's first spokesman for the Blue Diamond, seems to have been the perfect Puritan spokesman for a product that was initially marketed as consistent with mainstream Republican family values. In line with 17th-century Puritan thinking on the topic, sex, the earliest ads appeared to be saying, is ok, as long as it takes place only with one's heterosexual spouse. They also implied that a legitimate disease causing erectile dysfunction shouldn’t necessarily put an end to an officially sanctioned couple's sexual activity. Viewed in the above light, the Viagra phenomenon became a type of chemical self-realization, just as what was once said of Prozac. That is, the drugs of sexual enhancement do nothing more than to allow males to reassert their true sexual selves. With that goal in mind, many users imagine that there is nothing artificial about a product that restores their "natural" abilities. After all, they might argue, is a product of sexual enhancement any more intrusive or unnatural than taking a pill to prevent manic episodes or to lower high blood sugar? But the answer to that question, I would argue, is yes. We should at least acknowledge that there are problematic aspects of relying on Viagra and similar products for erectile function and that these products are overprescribed and even abused. For example, once our original target group, these elderly males, discovered that the Blue Diamond delivered the goods, so to speak, many of them abandoned their Puritan mores. That is to say, they decided to "spread the wealth," and seek out partners more appropriate to elderly male fantasies. Thus age differential has become less of a factor in determining the limits or possibilities of a sexual relationship once an elderly male has the confidence and ability to enjoy solid penetration with a younger female. Moreover, regardless of the age of the partner, with sexual confidence comes more temptation and thus



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opportunity to have sex outside the officially sanctioned relationships initially promoted by the drug companies. Another psychological/cultural complication of using Viagra is that the drug might also have a paradoxical effect, so that if one does not take it, the very concept of achieving an erection is beyond the pale. If men fear the sexual consequences of their not taking Viagra, that apprehension might easily become a self-fulfilling prophesy. Indeed, some physicians have already begun to refer to Viagra as psychologically addictive for a number of users. A further difficulty inherent in the use of products of sexual enhancement is that we tend to view the disease or dis-ease of erectile dysfunction strictly through the perspective of patriarchy. How can we be certain, for example, that just because men find it easier to function sexually women are necessarily overjoyed? Indeed, Viagra could also promote paranoia among the wives of sexually energized males: "Now that he can do it, who is he doing it with,?" might be one such paranoid introspection. Women might also undergo undo sexual pressure from husbands or lovers. After all, if hubby or lover boy has taken the pill at $10 a pop, one should not be wasteful, even if one or the other has had a change of heart or is no longer in the mood. In general it does not seem that the desires of women influenced the development of the products aimed at preventing erectile dysfunction. Can we be sure that women are pleased that their elderly male husbands are now willing and able to have sex with them? Who says they are interested in having sex with their husbands, or having sex at all? We seem to have made the assumption that Viagra is every bit as pleasing for women as it is for men. In a seeming preponderance of this mode of thought, the next big Viagra project is to produce an effective version for women. But unlike its male counterpart, Viagra for women will have to function as a mood enhancer if it is to have any value at all. Apparently, the drug companies' research shows that there will be enough of a market for this product, or that they will able to create the market as they go along, just as they did with the male version of the Blue Diamond. So we would be wise to prepare ourselves for the “Pink” Diamond as well. As I have already implied, the more the group of Viagra users moves to a kind of universal mode of behavior, the more cultural implications there are. As we have seen, although elderly married males were the original target group for Viagra, that reality has changed with a vengeance. For example, upon superficial reflection, one would suspect that the most unlikely group to embrace the use of Viagra would be males in their 20s and 30s. Yet there is no ignoring the ways that sexual practice among 30-



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something and even 20-something males has been influenced by Viagra and other performance enhancement drugs. A typical night out for a representative of either group might begin as follows: to head out the door with a wallet, 2 or 3 condoms, and a blue diamond or two. No, the second pill is not for the overly ambitious, but in yet another twist of fate, Viagra has taken on the value of currency and is used as a tip at bars and other hip locations. More important, Viagra has become a kind of party drug, to be taken together with Ecstasy or crystal methamphetamine as if to combine erectile possibility with the enhanced desire other drugs offer. In fact, the potent combination of Viagra and Ecstasy is known as Sextasy. Nevertheless, an erection is an erection is an erection, and if one does not suffer from erectile dysfunction the drug on its own will not have much of an effect. In this light, then, Viagra has become a misguided insurance policy for the sexually bold and restless. In accordance with its multiple possibilities, the pill might give one the confidence to consume alcohol with abandon, believing that Viagra will offset the effects of drinking. Moreover, in line with American optimism, there is always the hope that sexual prowess will increase even if there is no dysfunction to speak of. After all, the reasoning goes, if one has an opportunity to make a good thing better, why not go for it? Perhaps the overriding secret hope is that the pill will not only enhance sexual performance, but actually create desire where there is none. As one young forlorn male asked me in confidence, "is there any chance that my using Viagra or Cialis will help me see my wife as sexy and attractive? (Of course I recommended that he try horny goat). As amusing or pitiful as that might sound, to identify one's marital aspirations with the taking of the Blue Diamond is clearly a product of cultural rather than erectile dysfunction. In this state of affairs, even teenagers feel they must somehow engage a Viagra rules world. One sex therapist reports that 16-year-old boys have come to ask for a prescription for Viagra in order to have sex for the first time or enlarge their penises. Thus, it is fair to say that products of sexual enhancement have developed their own versions of urban legends and rewritten basic cultural assumptions about their limits, possibilities and potential. Another problematic aspect of the Viagra phenomenon is the way products of sexual enhancement are advertised. Mike Ditka, the ultimate macho male, with a distinguished career as an NFL tight end who is also a Super-Bowl winning coach, insisted that anyone not willing to try Levitra for improved sexual performance was simply too much of a sissy to do so. The millions who viewed his commercials, no doubt, must have wondered



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what was wrong with their sexual prowess if they found no need for enhancement. The drug's brilliant advertising campaign somehow created an equal alliance between virility and sexual dysfunction, with the latter leading to the former if one is "man" enough to use Levitra. The sports macho advertising theme works well for Levitra even without Ditka, as it does in the ad with the middle-aged quarterback who cannot successfully thread the needle – throw his old football through a tire swing – until he is willing to try Levitra. The viewer can only imagine that as an added bonus, our rugged quarterback not only regains his sexual prowess but improves his football-throwing accuracy as well. His young, sexy female partner stands beside him adoringly as he throws the ball through the tire time after time. There is even a little suspense and uncertainty generated by the TV commercial, as it is not quite clear what the couple's priorities will be: will they first embark upon a touch football game or a sexual encounter, with an outside chance of their combining the two activities in the bedroom? So whoever uses the product is apparently fortunate enough to recover two skills for the price of one. Rather than using sex to sell goods, sports are being used to sell satisfying sex. And if you can't march unimpeded down the field to score how good are you anyway? But the ultimate Viagra cultural paradox questions and perhaps redefines the very nature of the sex act itself. I would argue that Viagra, because it encourages the phallocentric view of sex, seems to have limited rather than enhanced sexual possibility. As a result, the only sexual act that has meaning, at least according to the advertising campaigns, is reduced to penile-vaginal penetration. Must one have a perfect erection all the time for couples to enjoy sex? As this view becomes more entrenched, the holistic view of legitimate sexual activity diminishes accordingly. In such a scenario, all other sexual activities – touching, kissing, stroking etc. – lose their value and meaning. So what does all this tell us about our sexual and cultural future? While unable to answer this question specifically, I would argue that the most interesting issue for future exploration is not just how Viagra and other drugs have changed our lives and become cultural icons, but whether they have redefined what it means to be human. Past assumptions about the human condition must take into consideration a new chemical reality that prolongs the quality and length of life. An elementary question worth considering in light of the way we now live is whether or not human beings will become happier and more satisfied because of their altered chemical state. As just a small cog in the cultural machine, I suspect that it will take more than a pill to overcome the fundamental existential conundrums that we have always engaged in connection with human life.



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So even with Viagra enhancing our quality of life, the Blue Diamond will do little to improve our metaphysical outlook. Apropos, our metaphysical outlook, there can be little doubt that chronic pain contributes little – at least in conventional and expected ways – to the amelioration of the human condition. Unlike erectile dysfunction, chronic pain has no easy “cure” and the result is ongoing discomfort that turns what was once a symptom into the disease itself. Therapy by David Lodge and Truth and Consequences by Alison Lurie explore different ways that chronic pain originates and can take over our very existence, albeit with a twist.



CHAPTER SIX CHRONIC PAIN IN DAVID LODGE’S THERAPY AND ALISON LURIE’S TRUTH AND CONSEQUENCES

What both Chronic Pain and Truth and Consequences make clear, is that pain is closely related to cultural factors, as “it [pain] has not had the same significance throughout the ages nor in the various different civilizations” (Rey 2). Moreover, chronic pain is most likely the ultimate postmodern illness, because it constitutes an immense, invisible crisis at the center of contemporary life” (The Culture of Pain 5). Unlike acute pain, “Chronic pain destroys our normal assumptions about the world. It …continually frustrates our hopes for gradual improvement” (Culture of Pain 71). In these novels chronic pain is unusual, because, to different extents, it is overcome by the sufferers as they learn to harness their pain to their desire to survive and to create a better life for themselves. In David Lodge’s Therapy, the protagonist not only suffers from chronic pain, but the latter becomes a focal point in his psychological therapy. Eventually he is able to overcome the chronic pain in his knee as symbolic of his “cure” of psychological malaise, though the cure does not come about because of his relationship with his therapist. In terms of therapy with a capital T, narrative in medicine, the foundation of the talking cure, begins with Freud (Mattingly and Garro 7). The talking cure is a reasonable approach to filling in the gaps between seemingly unrelated events. Moreover, narrative is an integral part of the healing process. Clients and therapists collaborate via narrative for a successful therapeutic experience. But rather than depend on his therapist, the protagonist in Therapy uses narrative – while conducting an imaginary dialogue with the existentialist philosopher Soren Kierkegaard – to cure himself of his pain. In the case of our central character, Tubby Lawrence Passmore, there is a clear connection between depression, his rationale for entering therapy, and the chronic pain he experiences. And this is true for “real” people as well: “Depression…seems an obvious candidate for defining postmodern

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illness...Major depression in the United States occurs in some 2 percent to 4 percent of the community, in 5 percent to 10 percent of primary care patients, and in 10 to 14 percent of medical inpatients” (Morris 61-62). In the case of pain, Over one thousand pain clinics have opened in U.S. cities since the 1960s. Depending on definitions and on the population studied, each year anywhere between 7 and 56 percent of Americans suffer from back pain alone. Migraines, toothaches, tendonitis, and irritable bowel syndrome are just a few of the pains for which patients seek medical help. Indeed, pain is the most common symptom that brings patients to doctors, and pain relief is big business for drug companies and advertisers. (Morris 64)

To a certain extent, society seems to be suffering from a postmodern obsession with pain. In our quest for secular salvation, we ironically come across “ever new ailments, from tennis elbow to runner’s knee” (64). Of course, it would be foolish to assume that pain has not always been part of human history, yet chronic pain is new as a diagnosis. “Chronic pain now grips so many people in the postmodern era that it is commonly and justifiably described as an epidemic” one that can “depress the immune system [and has] driven people to suicide” (Morris 109). Not only is pain very expensive – it cost the US economy a total of some $120 billion in each year in the early 1990s – but, as we have seen, by depressing the immune system, at its worst, “pain can kill” (109). Despite the above, people do not have to be passive victims of pain. One can learn to apply one’s inner strength to overcome pain, as did the novelist Reynolds Price. A victim of spinal cancer, his three surgeries saved his life but left him without the use of his legs. His greatest challenge, however, was the near constant unbearable pain resulting from the surgeries and intensive radiation care that had damaged his nervous system. Conventional painkillers were ineffective and mainstream medicine had nothing else to offer. He found a way to apply his mind to a new notion of pain. Traditionally, pain is something we feel until we are healed. But in his case, there was nothing to heal; the damage he had suffered was permanent, so that pain signified nothing. He decided to ignore it (Morris 115-119). What he had done, in effect, was to recognize the role the mind plays in experiencing pain, and he took steps to control it. His successful journey opens a new door to the understanding of pain, its nature, and how we can deal with it. Pain, then, has cultural dimensions if it is susceptible to the machinations of the mind. These very serious dimensions of chronic pain receive comedic treatment in Lodge’s novel, as the protagonist does figure out a way to



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control the pain in his body. From the preface onward we receive an inkling of Lodge’s strategy, which is to discuss vital issues via humor or superficial, bombastic pronouncements. The novel begins with an admonition from Soren Kierkegaard’s uncle, who has little sympathy for his nephew’s ennui: “You know what, Soren? There’s nothing the matter with you but your silly habit of holding yourself round-shouldered. Just straighten your back and stand up and your sickness will be over.” How wonderful it would be if life were so simple. Paradoxically, in this novel it is and it isn’t. The protagonist will attempt to utilize Kierkegaard’s existential philosophy to overcome his pain and depression and finds a rather simplistic if not unrealistic way to do so. Nevertheless, the less than perfect denouement of the novel indicates the difficulty of simplistic solutions to life and chronic pain, whether of the body or of the soul. In effect, the novel has Tubby Passmore learn from the mistakes that Kierkegaard has acknowledged he made in his own life. The latter had abandoned his fiancee to pursue the life of the mind. In an ironic albeit inexact doubling,; Tubby leaves his teenage first true love to pursue an active sex life, and ends up not as a philosopher, but as a disgruntled TV sitcom writer. Our introduction to the protagonist’s chronic pain is through a firstperson narrative that recreates past events, much like what a therapist would experience with a patient. Indeed, it is as if the reader were the therapist, required to make sense of the stories Tubby tells. Suddenly Tubby Passmore feels a sharp knee pain, for no apparent reason, a year before the narrative begins. He was doing nothing physical “…when [he] felt it: a sharp, piercing pain, like a red-hot needle thrust into the inside of the right knee and then withdrawn, leaving a quickly fading afterburn. I (Tubby) uttered a sharp, surprised cry and keeled over on to the bed (I was in the bedroom at the time). ‘Christ!’ I said, aloud, although I was alone. ‘What the fuck was that?’” (4). Tubby asks an excellent question, indeed. From that point on, the pain appears with “increasing frequency,” but without coherent cause and effect. As our narrator puts it, “there was nothing predictable about it. It rarely happened when I might have expected it, like when I was playing golf or tennis, but it could happen just after a game, in the club-house bar, or while driving home, or when I was sitting perfectly still in my study, or lying in bed” (4). I suspect his illness is postmodern because he is suffering from chronic pain: that is, pain is not the symptom of a disease, but the illness itself. It is also postmodern because Tubby, the narrator, acknowledges that to understand the pain that he feels in his knee might lead him to greater things, like understanding the pain in his “head...mind [and] soul” (5).



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Tubby does not suffer alone, since 25% of the population in the west live with chronic pain, from moderate to excruciating (Morris 111). Although Tubby realizes that worse things can happen to a person than what he is experiencing, “For instance: cancer, multiple sclerosis, motor neurone disease, emphysema, Alzheimer’s and AIDS, …he nevertheless ironically reaffirms that knowing that doesn’t make the pain in your (his) knee any easier to bear” (5). Tubby wonders if the catalyst to the mysterious knee pain might not be “compassion fatigue,” a cultural illness if ever there were one. He is referring to the notion that “we get so much human suffering thrust in our faces every day from the media that we’ve become sort of numbed, we’ve used up all our reserves of pity, anger, outrage, and can only think of the pain in our own knee” (5). To combat this numbness, he donates money to various charities, hoping to keep “compassion fatigue at bay” (6), but it doesn’t work. He claims he could give more money and hope for better results, but he decides to keep most of the considerable income he has earned as a TV sit-com writer and spend it on private medical treatment for his knee (6). Thus Tubby decides to explore his medical options to rid himself of his knee pain. He makes the grand rounds of medical opinion, beginning with his GP, who sends him to physical therapy. Next was a consultant who recommended arthroscopic micro-surgery, with Mr. Nizar, whom Tubby secretly refers to as “Knees ’R Us” (6). His surgeon suggests ordering a video tape of the procedure, so that both would have something to cherish afterwards. Since his pain returned after surgery, Tubby was wise to resist the impulse to tape his expected resurrection. When Tubby complains post op that he is still in pain, Mister Nizar finds it “quite annoying” (12). Tubby readily agrees, but feels that he himself is the party who should be most annoyed. Mr. Nizar has committed the typical postmodern faux pas of the medical profession. He has treated the disease, but cannot understand why the subjective illness, the pain in Tubby’s knee, has remained. He has been unable to treat the subject himself. Unwilling to let the patient have the last word, the surgeon comes up with an ironic diagnosis: “‘It must be idiopathic chondromalacia,’ said Nizar. When I asked him to explain he said, ‘Patella chondromalacia means pain in the knee, and idiopathic means it’s peculiar to you, old boy.’ He smiled as if awarding me a prize” (12). In other words, It is Tubby’s problem that he is still experiencing pain in the knee and his predicament has nothing to do with medical science. In effect, what Nizar has done is to promote a clash between his patient’s narrative and his own physician’s narrative. Patients discuss sickness in terms of life narratives and the lived body while many physicians deal with disease ahistorically or as “dehistoricized objects-in



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themselves” (‘Fiction and Historicity’ 51, quoting Young 1982: 275). Seeking another opinion, Tubby consults his physiotherapist who says he has the classic case of what surgeons call “Internal Derangement of the Knee,” better known as “I.D.K. or I Don’t Know” (13). Tubby actually sees some advantage to that diagnosis, since he won’t have to own up to the fact that he is terminally depressed; he can simply complain about the pain in his knee as a result of the exotic and fascinating IDK syndrome. While very amusing in British comedic fashion, the issues at stake are quite serious. First, there is the idea of chronic pain, which has become the diagnosis and not the symptom. Second, there is the suggestion that there is nothing entirely rational about ailments and that the I-don’t-know factor looms much larger in the world of medicine than many medical professionals care to admit. Third, there is the elevation of pain to signifier of depression, which suggests that pain has assumed a cultural dimension and has become a new subject worthy of medical attention, both in its physical and mental manifestations. Fourth, there is the lack of cause and effect. The pain appears when the pain appears, which makes it that much harder to comprehend. Tubby decides to cover all the bases, and tries to treat his pain in cognitive behavior therapy, but in effect his whole week is determined by running from one therapist to another: physiotherapy, cognitive therapy, aroma therapy and acupuncture. He also discusses his problem with his platonic mistress, Amy, with whom he meets clandestinely as if he were conducting an affair behind his wife’s back (14-15). As he puts it, “I’ve solved the monogamy problem, which is to say the monotony problem, without the guilt of infidelity. I have a sexy wife at home and a platonic mistress in London. What have I got to complain about? I don’t know” (31). Perhaps a platonic mistress can cause as much pain as the real thing. Unfortunately, “I don’t Know” is his response to almost all the conundrums that life has placed before him. In fact, Tubby is so distressed by his existence that he adapts the IDK syndrome for all phases of life. Why stop at knee pain, when IDK can also apply to whether or not to wear a tie, or what color tie to wear? Tubby recognizes the symptom’s potential for paralysis and seems to embrace it (17). To counteract this paralysis, as part of his therapy, he is asked to provide a self-description (19). He makes a list to summarize his life, in the hope that an “objective” evaluation will help him come to terms with his difficulties:



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Good Things 1. Professionally successful 2. Well-off 3. Good health 4. Stable marriage 5. Kids successfully launched in adult life 6. Nice house 7. Great Car 8. As many holidays as I want. Bad Things 1. Feel unhappy most of the time A few weeks later he adds: 2.

Pain in knee. ( 23)

Clearly, the “bad things” have overwhelmed him. Another way that Tubby Laurence Passmore tries to engage his life is through the existentialist philosophy of Soren Kierkegaard (64). When he is unable to ejaculate during sex with his wife, he can’t help but think that he might be turning into a hermaphrodite, suffering from “Internal Derangement of the Hormones,” IDH, rather than of the knee, IDK(83). He begins to identify with Kierkegaard’s protagonist in the “Unhappiest Man,” as if the latter were speaking to Tubby’s condition (100). “According to Kierkegaard, the unhappy man is ‘always absent to himself, never present to himself’” (100). This sounds suspiciously like Tubby, someone who is always living in the past or future, but never in the present and is always expecting the worst. This takes away from the enjoyment he could experience when things turn out well, because he lives the anxiety of dread and failure. Ironically, he is only happy in nostalgia; yet he yearns for something in the past that made him unhappy. That seems to be the most reliable yardstick of living, much like Emily Dickinson’s poem, I like a look of Agony, Because I know it's trueMen do not sham Convulsion, Nor simulate, a Throe-

Unfortunately, in the postmodern world, Agony is no longer an ultimate truth, among other reasons because it may signify only human emptiness.



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Indeed, it sounds very much like Tubby’s pain in the knee, which is a result of the I-Don’t-Know syndrome. Before he can break with his past, and because of his sense of the morbid, Tubby is inspired by Kierkegaard to live with depression (122). He relies on Kierkegaard’s notebooks to review the philosopher’s encounter with depression and disappointment. Tubby reports that Kierkegaard had asked his doctor if his depression could be overcome by his willpower, but the doctor warned him against employing such a potentially harmful and destructive tactic. In reaction Kierkegaard declares: From that instant my choice was made. That grievous malformation with its attendant sufferings (which undoubtedly would have caused most others to commit suicide, if they had enough spirit left to grasp the utter misery of that torture) is what I have regarded as the thorn in my flesh, my limitation, my cross…(122)

So Tubby, like his hero Kierkegaard, initially resigns himself to living with depression. Only later will he attempt to rectify what he perceives as Kierkegaard’s mistakes. In any event, Tubby is not as helpless as he initially appears to be. Through authorial manipulation we get different narratives about the life of Tubby, ranging from the perspectives of his girlfriend to his ex-wife. Yet, as we eventually learn, these narratives are all anachronistically presented to the reader, created by Tubby as an exercise imagining what others might say about him. His self-portrait through their eyes is highly unflattering. Of course, some of his real life actions are highly unflattering as well. As such, he behaves with horrific jealousy, stalking his wife, imagining she is having an affair with her gay tennis coach. He also follows the coach and breaks into his home, only to discover him in bed with his male lover. Moreover, he finds it amusing to play god by manipulating the narratives he invents. Thus he “cures” his mistress Amy in the narrative he creates for her by having her finish her therapy through denial of men, sex and even therapy (162). Tubby writes himself out of Amy’s life without taking responsibility. Since he is free of his wife and no longer interested in Amy after they finally consummate their affair in a disastrous weekend in Tenerife, he imagines that he might be able to capture the glories and potential glories of his sexual past. Thus, out of desperation he flies to Los Angeles to call unannounced on an old flame, a failed attempt at a one night stand from Hollywood named Louise. Of course, he is unable to act on his rediscovered passion, as time has not stood still for her. As was to be



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expected, years later, she is no longer interested in him. (166). Louise suggests that Tubby investigate the benefits of Prozac, about which he knows nothing (168-69). She is surprised to discover that he is – unlike so many Americans –“pharmaceutically in the Stone Age” (168). As an alternative, Louise sets him up with her girlfriend Stella, an assignation which leads to nothing as well. Returning to London, Tubby convinces his wife, Sally, to talk to his therapist Dr. Marples, but she agrees only because she wants her to convince Tubby their marriage is over (191). Tubby’s therapeutic design is twofold: he wants to pressure Sally into giving him another chance and convince his therapist to put him on Prozac. Dr. Marples turns him down, as she tells him that it might change who he is (212), reminiscent of Peter Kramer’s perspective in his Conversations with Prozac. ‘I’ll put you on Prozac if you really want me to, she said. ‘But you must understand what’s entailed. I’m not talking about side-effects, now, I’m talking about effects. These new SRI drugs change people’s personalities. They act on the mind like plastic surgery acts on the body. Prozac may give you back your self-esteem, but it won’t be the same self.’ I thought for a moment. ‘What else do you suggest?’ I said. (212)

Dr. Marples suggests what we have already encountered in the novel, which is that he create narratives of various people in his life that would express the way he imagines they think about him. Since we have already encountered those narratives, as if they had been written by others, we know that that strategy is not going to work. Tubby is every bit as hard on himself when he imagines how others see him as he is when he subjectively investigates and explicates his own motivations and behaviors. So we follow Tubby to his impasse, vicariously experiencing the pain in the knee and the humiliation that accompanies his self-perceived failure in life. Moreover, though he is adept at writing a successful TV sitcom, he understands that he has completely lost his wife, Sally, as she throws the ultimate insult in his face when she walks out on him: “‘You don’t make me laugh anymore”’ (214). So desperate is he to amuse or communicate with anyone that he is reduced to having conversations with artifacts of artificial intelligence. Thus, he carries on a phone conversation with an automated bank teller. When the feminine computer voice replies to one of his intentional? mistakes with, “‘I’m sorry, there appears to be a problem,’” Tubby decides to respond verbally, “Too true, darling” (217). Moving pathetically from one type of therapy to another, from conventional to alternative medicine, he cannot even find the energy to



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deal with Grahame, a homeless young man who claims to have made an ideological choice to live on Tubby’s front porch. In the most unlikely of scenarios, Tubby begins to get on the right track and escape from his chronic pain in life by utilizing Kierkegaard as his moral compass in a most bizarre way. He relives his nostalgic past and imagines what might have been with his first girlfriend, Maureen. What could have been is highly appealing to him, especially because he shares a similar fate with Kierkegaard, who abandoned his only love, Regine, someone who could have made him happy. Yet Kierkegaard chose to suffer the misery of an artist rather than enjoy the intimacy of life with his beloved. Though Tubby doesn’t take his own artistry quite so seriously – his life parodies that of Kierkegaard throughout the novel – he recalls that he abandoned Maureen for selfish reasons. Maureen had tortured Tubby’s oversensitive hormones by alternately necking and petting with him only to announce a new development in their relationship, a course of abstinence, since as a good Catholic girl she had allowed the nuns at school to convince her that sex was evil and that girls who indulged in any sort of sexual activity were most certainly condemned to an afterlife in hell. Tubby, impatient with her sexual withdrawal, dumps her unceremoniously, albeit in perfectly realistic and cruel teenage fashion. To place his hopes in rediscovering Maureen almost 40 years after the fact to reify their relationship seems to push the boundaries of comedic credibility. Nevertheless, such is Tubby’s plan of action. His quest is no less than finding Maureen and winning her back, which grounds him in reality and rids him of indecisiveness (280). He desperately tries to look up Maureen, but ends up finding her husband, his old high-school nemesis, Bede Harrington. Tubby learns that life has not been especially kind to Maureen, making her experience of pain more convincing than his own. She is off on pilgrimage in Spain to overcome the tragedy of losing her son, Damien, who had been killed in Africa by bandits as he tried to distribute food to the needy (270-76). Tubby decides to find her. Tubby is finally able to write an authentic journal as he searches for her, more in tune with the spirit of writing that Dr. Marples had had in mind. He spends weeks tracking down all pilgrims walking the 1000-mile trek, the Camino de Santiago When he finally finds her he realizes she is at a point where a “woman’s looks begin irretrievably to desert her” (296), yet he does not lose his enthusiasm. Naturally, she has her own interpretation as to what had happened to them as teenagers and she has given little thought to Tubby’s “breaking her heart” over the past 40 years. As she points out, he was merely the first of many to do so and so she has



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no problem “forgiving” him. In fact, Maureen shocks Tubby, when she reveals that she had had an affair just after their breakup and she was able and willing to relinquish her virginity along with her Virgin Mary syndrome (297). Set up as a contrast to Tubby’s chronic knee pain, Maureen experiences a more obvious injury: She has badly hurt her leg from walking so much with a heavy backpack (300). Whether it make more sense to have an injury while on pilgrimage than it does from moral angst is an issue that Lodge does not openly address, though he seems to lean toward the former. In an act of solidarity and empathy, Tubby begins to walk with Maureen and his knee actually improves from his efforts (300). Tubby has a greater empathetic task to face when he succeeds in sleeping in the same bed with Maureen. Although she is unwilling to make love with him during the pilgrimage, she does reveal her mastectomy (307-08). Tubby surprises himself because he is not repulsed by her condition and, forty years later, has the patience to wait. He understands that having lost her son and her breast, Maureen has painful problems that overshadow his own. Tubby is even able to accept Maureen’s religious beliefs, as he realizes that his secular “worshipping” of Kierkegaard is not so different from her own behavior. Thus he is able to note ironically that Kierkegaard “would make a good patron saint of neurotics” (311). In an “all’s well that ends well” conclusion, Maureen, at the end of the pilgrimage, wants to make love with Tubby. To his great relief, he is once again able to ejaculate and his knee trouble is apparently gone for good (313). Ever the good Catholic, Maureen will remain married to Bede and suggests that Tubby attempt to reconcile with his wife, Sally. After all the positive changes Tubby makes in the 3 months he spends with her on pilgrimage, Maureen believes there might be hope. But Sally has decided to marry someone else, saving the novel from the realm of the absurd. In a postmodern compromise, Tubby is finally able to have a “normal” affair with Maureen and spends much time going on “pilgrimage” with her and Bede. What started out as a novel on chronic pain and therapy concludes as a romantic comedy. Chronic pain has turned out not to be chronic at all, but a result of the postmodern angst experienced by our successful yet selfdoubting protagonist. David Lodge introduces chronic pain to the realm of popular culture, but does not pursue its meaning to its “paranoid” conclusion. It will take Alison Lurie’s novel Truth and Consequences to show the disastrous, albeit occasionally uplifting, effects of chronic pain in modern life.



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Truth and Consequences, then, is a more sober view of chronic pain than its counterpart, Therapy. The novel exposes the harsh reality of living with chronic pain, not only for the person in pain, university professor Alan Mackenzie, but also for his spouse, Jane, a university administrator, who is forced to confront her reluctance to become an uncomplaining caregiver. While the novel is realistic because the pain of the injury (as well as that of the relationship) does not merely vanish at the conclusion of the work, and the two couples portrayed end their marriage in separation, the solution that Alan Mackenzie employs to come to terms with his suffering is reminiscent of 19th-century romanticism. That is, his suffering takes on a sublime quality, as he learns to see it as an artistic, inspirational gift, which he uses to create rather than merely to suffer. The opening of the novel is nothing less than startling, as Jane, working in her garden, does not recognize the man approaching her house. He appears to be an aging man with slumped shoulders, someone whom she believes she has never encountered. On a hot midsummer morning, after over sixteen years of marriage, Jane Mackenzie saw her husband fifty feet away and did not recognize him. She was in the garden picking lettuce when the sound of a car stopped on the road by the house made her look up. Someone was getting out of a taxi, paying the driver, and then starting slowly down the driveway: an aging man with slumped shoulders, a sunken chest, and a protruding belly leaning on a cane. The hazy sun was in her eyes and she couldn’t see his face clearly, but there was something about him that made her feel uneasy and a little frightened. He reminded her of other unwelcome figures: a property tax inspector who had appeared at the door soon after they moved into the house; an FBI official who was investigating one of Alan’s former students; and the scruffy-looking guy who one summer two years ago used to stand just down the road where the ramp to the highway began, waving at passing cars and asking for a lift downtown. If you agreed, before he got out he would lean over the seat and in a half-whiny, half-threatening way ask for the ‘loan’ of a couple of dollars. (1)

Eventually she recognizes the “stranger” as her husband, who was supposed to be at work. But what is extraordinary about Jane’s “vision” is the disturbing and even threatening nature of her associations. Unconsciously, at the novel’s very outset, Jane exposes the reader to the negative connotations of Alan’s presence in her world. The narrator’s physical description of Alan borders on the repulsive, with “slumped shoulders, a sunken chest, and a protruding belly [while] leaning on a cane.” To mistake her husband for a tax man, g-man or itinerant beggar



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says little better. It is almost as if Jane has unconsciously recognized Alan, but is disgusted with the specimen he has become. Clearly, he is no longer the strong, vibrant, healthy man of just the year before. In fact, with the weight he has put on, unable to exercise, he looks ten years older than his age of 50-something (2). Perhaps Jane thinks that because she had just driven him to work at the university, she could enjoy a well-earned respite from her role as caregiver. But as she learns, Alan returned in pain, cutting short her vacation, as he was unable to remain at work for even a few hours. We then encounter the dynamic of their chronic pain and how it affects their relationship. Truth and Consequences, then, deals not only with chronic pain and its destructive potential, but also with the complex roles of caregiver and care receiver. Jane is apologetic and feels guilty that Alan has returned home because of his unbearable pain, yet the more care and concern she exhibits, the more belligerent and aggressive he becomes. In David Morris’s terms, Alan is acting out the idea that Americans are “the world’s first generation to behave as if they have a constitutional right to be pain free (The Culture of Pain 71). The novel does a wonderful job of presenting the emotional dynamics of caregiver and care receiver, and the myriad ways each undermines the other and him and her self. Alan grudgingly accepts help, but only in a way that will inconvenience Jane, as if she were the cause of his pain (3). Alan has been suffering for the past 15 months from acute back pain that won’t quit. Nothing helps: not drugs, a back operation, exercise, therapy etc. He is a victim of chronic pain and his method for dealing with it just makes it worse. He drinks a lot of alcohol and overeats. Though Jane apologizes profusely throughout the novel for Alan’s condition and suffering, she feels she is doomed to caring for a “giant toddler,” albeit a baby with hard and knobby feet “with horny toenails” (5). Jane cannot help but ponder, “Who is this man lying on our sofa?,” where they once made love with abandonment. (5). Jane realizes that marriage as she knew it is over; no longer did they have a partnership, but each respectively had been reduced to “caregiver and caregetter” (5). She understands that the change in Alan’s health has affected her personality as well: “‘I’m not the same person either, she thought as she climbed the stairs. I’m tired and worried and no fun for anybody, including myself’” (5). The way she describes herself is very much the way she sees Alan, who is always complaining and has no patience for Jane’s concern or attention. Nevertheless, he is unable to perform the most basic tasks on his own.



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The origins of his chronic pain seem fairly innocuous. What had he done to deserve such a harsh fate? He had merely overextended himself, carrying heavy items before playing volleyball; during the game he inadvertently slips and falls and ruins his back. Initially, the couple had been sure that Alan’s pain wouldn’t last. He would simply rest a few days and return to his vibrant self. When time goes by and he makes no progress, he cannot stop himself from slipping into pain and depression. A highly sexually active couple, Jane and Alan find themselves having limited sexual activity, not enjoyable to either. Jane is afraid of letting go and hurting him and he would always make a move that would cause him to cry out with pain (7). They become “awkwardly self-conscious, as if they were two adolescents on a date” (7). Believing that he should take radical action, after a year of debilitating pain, Alan agrees to undergo surgery. Despite the expected 95% success rate of a diskectomy, Alan finds himself in the unlucky 5% whose situations worsen or remain the same after surgery. Losing his faith in doctors and conventional medicine, Alan develops his own pain regime: Since then, he had treated his pain himself. He used heating pads and icepacks, and wore an electronic device called a Tenz Unit that was supposed to block nerve impulses and sometimes did so. He also took a great many prescription and nonperscription drugs. Unfortunately, the drugs all had side effects and led to new complications and ailments. Alan now suffered intermittently from constipation, severe headaches, insomnia, chills, leg pain, groin pain, weakness, and fatigue. The Tenz Unit had caused an ugly raw red rash to appear on both sides of his lower back. He was also eating too much, and not only at meals. Jane would come upon him in the pantry gobbling peanuts out of a can, or cookies from a cellophane package (8-9).

What is almost worse than Alan’s situation is the fact that Jane bears witness to all his illness and weakness. Exposed so intimately to Jane’s observations and perhaps silent criticisms, Alan runs her mercilessly from errand to errand, and he yells at her when she takes too much time meeting his demands. Though he always apologizes for his behavior, his yelling has a cumulative effect on Jane, making her more and more resentful about having to provide constant care. Jane cannot help but think back to19th-century novels, when pain was portrayed as “ennobling and inspiring” (10). Of course, that has not been her experience with Alan, for either caregiver or care receiver. Jane and Alan both find out the hard way that “Pain is bad for the character” (10). Indeed, “when pain is intense and persistent or simply chronic, it always involves the entire being. It does not only limit itself to the painful region, but it is the whole person as an



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individual entity who then becomes affected as a result; his entire personality becomes doleful and his intellect becomes dulled” (Rey 3). This is certainly true of Alan, yet one of the ironies of the novel is that he will, indeed, find a way to make his pain “ennobling and inspiring.” Unfortunately, by the time he does so, Jane will no longer be part of his life. Perhaps what puts the greatest burden on their marriage is the idea that the trauma of chronic pain might become a permanent state of affairs. As the narrator informs us, “Time would continue to pass, but Alan would not get well. He no longer expected to get well, and Jane – though she constantly assured him otherwise – no longer expected it either. His illness would continue to wind itself around them greedily, choking their marriage just as the bindweed was choking her strawberries. They would never get rid of it.” (15). As people learn to live with chronic pain, the toll on their families rises. The pain is not only a personal issue, but a deep familial concern as well. In this case, it is fair to say that whatever their deficiencies, Alan and Jane could easily have remained happily married were it not for their “imprisonment” by Alan’s chronic pain. It simply brought out the worst in both of them. Alan envisages his pain as a living creature, dedicated to making his life miserable. “Alan imagined it as a lizard about ten inches long, its sharp scales mottled red and brown as if with blood and shit. It was there inside his back, gripping his spine with its dry twisted legs and claws, moving its jaw to bite and flicking its forked tongue. He knew what the lizard looked like because he had seen it sixteen months ago in New Mexico.” (16). During an architectural tour he had almost stepped on and had been surprised by a particularly ugly and frightening lizard, who didn’t run off, but stared at Alan with murderous intent. Alan finds it somehow more comforting to imagine a “rational” reason for his back pain, albeit one brought on by magical thinking, than it is to ponder the possibility of simple bad luck or perhaps that of an absurd universe. He decides to blame it on the lizard, as Alan fanaticizes that the creature had promised revenge: “I see you…I know you. And you will know me.” (17). And part of that “revenge” is the way Alan now treats his wife. Alan knows the effect his behavior has on Jane, but he is powerless to stop it: or so he believes. He does not realize that he has become, in effect, Jane’s lizard. Alan knew he was difficult and impossible, and was becoming more and more so. He also knew that as time went on his pain and self-absorption, his depression and anxiety, were driving his wife further and further from him. She never said this, never even hinted it, but he assumed that she was



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angry and full of despair. And the fact that she would not admit this somehow made him even angrier, at her dishonesty. (17)

Since he is convinced that his wife couldn’t possibly love him playing the role of irritable invalid, he does everything he can to make his conviction a self-fulfilling prophecy. He behaves in a manner that not even “saint” Jane will be able to tolerate. In any case, he no longer believes he loves his wife, once again a situation brought about through his chronic pain. In fact, he is resentful and consumed by jealousy because she is able to sleep comfortably: Often he woke in the middle of the night and lay moaning and shifting, trying not to wake Jane. At the same time, like a nasty child, he hated her for being asleep and not in pain, and sometimes, meanly and shamelessly, he would moan louder and toss about, trying to wake her, so that she could be more aware of how miserable he was. Sometimes he would succeed; more often, ashamed, he would get up, take another pill, and move to the guest room downstairs. (18)

The pain he experiences has diverse effects, and causes him to abandon his professional and private pursuits. He can’t write because he can’t sit. He can’t work out, so he becomes heavy and loses his muscle tone. His back pain leads to other complications throughout his body. He is even allergic to the glue that keeps his Tenz machine in place, so he develops a rash on his back. To alleviate his suffering, or at least to share it, Alan becomes friendly with a number of people with back pain, a kind of semi-secret society or support group. Only with them can he be himself (22). One of them convinces him to meditate and drink herbal tea. Out of desperation he gives it a try but finds only limited relief (23). He loses contact with his former friends, partly because he doesn’t want to see them and partly because they treat him differently. He thinks they behave as if he were at fault for being in pain such a long time (25). Alan’s life begins to change when Delia Delaney, a visiting scholar and author at his university and institute, enters his life. A beautiful woman, a temptress, who suffers from chronic migraines, Delia has more in common with Alan than Alan, and the reader, might suspect. Delia is a femme fatale seductress who sends her husband on her errands of acquisition, which is how he, Henry Hull, meets Jane, who is the coordinator of the Unger Center at the university. Henry wants a sofa placed in Delia’s office because of her migraines, though Delia does find other creative, sexual uses for the furniture (36). All four characters prefer



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to be in the company of their new found love interests: Henry with Jane and Alan with Delia, rather than with their spouses. Henry remarks that Delia becomes a different person when she has a migraine, someone he doesn’t really know (80). He is in a similar situation to Jane’s. She too has lost the person who was once Alan, and she lives to serve him much as Henry, the work-at-home freelance editor, chooses to serve the egocentric author Delia in all her needs. Delia is so needy that she has perfected the ability to become ill if she reads a bad review of her books (80). Reading a mostly favorable but somewhat critical review in the Times Literary Supplement she remarks, “‘The English are so sneaky and devious,’ she kept saying. ‘They destroy you with a thousand little needle-pricks. I can feel them now in my head’”(81). This seemingly innocuous remark has important implications for understanding the novel. On the face of the evidence, one might assume that Delia, clearly a user and abuser of male and female, doesn’t really suffer from migraines but uses them as one more weapon in her arsenal to fulfill her ultimate and ongoing crusade: always to get what she wants, when she wants it. Nevertheless, it is clear that cultural events, like the book review, do give her real headaches. She may exaggerate her malady, but she certainly suffers from migraines, often brought on by her position in and perspective of the world. As Henry and Jane become intimate through their common difficulties with their spouses, Henry remarks: “‘It’s no joke being a caregiver, right?” (84). Jane agrees but would like to defend Alan, pointing out that it’s difficult for the care getter as well. As Henry begins to seduce her, Jane almost unwillingly acknowledges that “‘We caregivers have got to stick together’”(85). None of her girlfriends could understand what she was going through as well as Henry (100). Alan and Delia are also able to commiserate about their chronic afflictions, albeit on her terms. When he enters her office and finds her disheveled and lying in the dark, he witnesses her illness at work. As she reveals, “‘I’m getting a migraine. Or I should say, a migraine is getting me’” (90). Her clever reversal of subject and object is more than a linguistic nicety. She touches upon what it means to come down with an illness that in Alan’s case is turned into a beast, while for Delia it is the illness that assumes the possessive and takes over her being. It’s a good way of noting who or what is in charge and control. In the case of her chronic illness, Delia is at the mercy of a horrific pain. Perhaps that is why she tries to control every other aspect of her life. During one of her migraine episodes, she convinces Alan to stay with her, and sing to her. He can’t resist and is drawn into her web. She finds it easy, even or



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perhaps especially in a moment of suffering, to cause people to fall in love with her, including all the men in the area as well as the lesbian resident scholar. The great irony for Alan is that while he is singing to her and dealing with her pain, he temporarily forgets about his own (90-92). As a reward for Alan’s efforts, Delia discusses various drugs that might help him, with morphine her sentimental favorite. Unlike everyone else in his community, Delia offers no sympathy to Alan for his back pain but does suggest practical solutions. He is immediately attracted to her because, ironically, she doesn’t pretend to identify with him (93). And he is as happy to discuss drugs with her as he is with his invalid acquaintances. Moreover, she is willing to share her prescription drugs with him (125). What Delia does for Alan that changes his life is to teach him how to direct his pain to another sphere. She would have him capitalize on his pain for artistic purposes, much as she does herself. She writes her best work in a half-dream half-awake state that usually follows her migraines. She finds his renditions of architectural ruins to be works of art and would like to encourage him to create. Her method for harnessing the power of her chronic illness is anything but postmodern. It is a direct return to the 19th-century notion of illness as romantic inspiration. As she puts it, “‘In the end you have to accept your affliction as a gift. You have to ask, what is it trying to tell you, to give you? What has it saved you from, what has it brought you?’”(94). Delia is convinced that “‘Inspiration comes from a dark, distant place, and it can’t come without pain” (94). Jane despises Delia precisely because she has convinced Alan to live again, something Jane has been unable to do. Of course, this is Delia’s worst sin. As Jane puts it, “I’m angry…at Delia, for charming and bullying her way into Alan’s life, making him jump over the moon like the stupid cow in the nursery rhyme, making him forget his pain, when I’ve been trying to do the same thing for a year and a half without success. It was so wrong, so unfair’” (105). The crisis in Jane and Alan’s marriage reaches a crescendo when Jane catches Alan hiding in Delia’s office behind the curtains. Delia is lying disheveled on the couch, and Jane spies Alan’s shoes. They have been engaged in sexual activity, as Delia informs him that she is willing to participate in any sexual act but coitus. Even Henry, her husband is denied the privilege of penetration, which is reserved solely for her migraines, the only force to which she succumbs. When Alan assures Jane that nothing happened, she responds: “‘I don’t believe you,’ Jane said when he finished [his explanation], her voice trembling. She sagged against the electric stove as if for warmth and support. ‘I think you’re just saying what Delia told you to say’” (147). Jane’s suspicions are all correct and she



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understands that only through Delia has Alan on occasion been able to transcend his pain. She instinctively and correctly grasps that Alan no longer finds her attractive, views her beauty – in comparison to that of Delia, fading, and that her kindness had become a “burden” (147). The great mystery, for Alan, is that Delia, who mistreats him, makes him feel better, while Jane, who does everything for him without complaint, makes him feel worse. When he is with Delia he feels that the pain is “beside him and not within him,” in contrast to way he feels when he is with Jane (149). Alan is eventually able to accept his artistic gift and draw the plans for his architectural facsimiles of famous ruins. “Sometimes he paused for a few moments [while sketching in the middle of the night], overcome with awe and gratitude for the revelation that had come to him. Delia was right, he thought: this gift he had received was a byproduct of pain and illness” (178). This amazing conclusion allows him to get on with his life, with or perhaps one day without, his chronic pain. From this point on Alan and Jane’s separation is inevitable. Jane tries to reconcile with Alan but both realize they have been disconnected by Alan’s reaction to pain and their love for Henry and Delia respectively. But Delia becomes a fleeting presence, marrying a multimillionaire for security and sharing an occasional rendezvous with Alan. Henry and Jane marry,while Alan becomes a successful artist with neither wife nor girlfriend. In terms of the cultural ramifications of chronic pain, the most important development in the novel is that Alan understands that his pain is “not wholly evil.” It is also the inspiration or perhaps source of his creativity. In a final irony, Alan will build a ruined temple of Venus for Delia and her new husband with the promise of sexual activity with Delia. They share a love based on creativity acquired through chronic pain, though Delia must also have tremendous financial security to feel at ease with her migraines, especially since she thinks her writing talent might abandon her at any moment. In this unusual novel, chronic pain surfaces as both destroyer and creator of relationships. The realistic aspect portrays the anatomy of a relationship unraveled by chronic pain, yet the narrative also reverts to 19th-century ideology to transform the pain into a culturally and artistically useful, productive phenomenon. We cannot get away from the almost utopian idea that chronic pain, ultimately, must be harnessed to serve some greater human good. In the following chapter on Alzheimer’s we find no way to harness the power of the disease for the better. There can be only one direction for Alzheimer suffers and that is descent. Johnathan Franzen and John Bayley



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explore the disintegration of their loved ones, and how the caretaker must also battle directly with and perhaps eventually succumb to the disease’s aftermath. There are no happy endings with Alzheimer’s or dementia, as the very notion of personhood in both cases is eventually destroyed.



CHAPTER SEVEN TAKING CARE OF ALZHEIMER’S IN JONATHAN FRANZEN’S “MY FATHER’S BRAIN,” AND JOHN BAYLEY’S IRIS

You can dig and dig. Forget about gold. You won't even come up with a piece of coal. Now you see it, now you don't. Alzheimer's is not a disease. It's a curse. It's not a disease; it's an evolutionary process reversing Darwin's logo and becoming the SURVIVAL of the UNFIT. A curse only for the carrier if there is no loving caretaker. If there is no alternative but a care facility then it's a tragedy. The Alzheimer person is blameless but not absolutely. I have seen flashes and moments when D is complicit. Even though she is innocent I have seen her become empowered with enough perverse insight to use her condition to manipulate. Leading me to the fool's paradise of false hope. I have been guilty of a nasty temper on more than one occasion when like at two thirty in the morning D has packaged in paper towels a tube of tooth paste, a tooth brush a bottle of perfume and awakens me kissing me goodbye. She's off to Gary, Indiana! To her house sold forty years earlier. In pursuit of her I am in jockey shorts half awake as I stumble into the lobby to overtake her and bring her back to her senses. She almost gets away into a cold winter day and we become entangled, locked in the revolving door, her finger nails digging into my arms. Finally with the help of the dazed doorman we wrestle her back into the lobby to the elevator and up to the thirty-fifth floor and back into the bedroom. "Good night my friend. And thanks for not calling the police." With my arms bleeding from finger nails as cutting as an alley cat I become more crazy than my nutty wife, bellowing ,"you fucking lunatic you father fucker - you mother of all bitches" - and feeling good as the days of accumulated despair fly away. Feeling delicious pleasure as the curses cascade and with true hasidic respect for the opposites I become loving and admiring of my wife for the curses she fires back, mortal wounds, "you son-of-a-bitch. I know what's in that tricky head of yours. Blaming capitalism and me for a failed life as an unpublished author. You need a psychiatrist. Asshole!" And then it stops. Dead air. The storm is over. Without segue we are in each other's arms hugging and ready for bed. I have learned I don't have to

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keep it all in when she becomes the bizarre lunatic. It's good for both of us to let go. [E-mail from a ninety-three-year-old caretaker who continues to care for his Alzheimer's suffering wife]

When is Alzheimer’s Alzheimer’s? That is the question, or at least one of them, central to one of the most debilitating diseases to confront the elderly of the 21st century. The popular concern with the disease is well portrayed in Joan Murray’s heartbreaking piece in the Sunday New York Times of May 13, 2007 titled “Someone’s Mother,” in which we encounter a 92-year-old woman who, wanting desperately to retain her independence and individuality, takes to the road for a hike. Murray stops her car to offer her a lift, but is unable to determine where the woman lives, what she is doing on the road, and what her name is. The elderly lady wants to be left of at the drugstore in the town of Nassau in New York, but refuses to supply any information about her outing or who she is. Murray is distressed because she feels it appropriate to talk to the woman authoritatively, albeit “with a tone I hadn’t used since my son was a teenager.” She is uneasy about simply dropping her off and leaving the woman to fend for herself. After consistent prodding on Murray’s part, the woman pleads with her not to take her to the police or inform anyone of her whereabouts. She admits, under pressure, that she cannot remember her name or her address, but begs the woman to drop her off so that her son wouldn’t be informed of his mother’s predicament, one similar to those that had occurred a number of times in the past. Her greatest fear, she acknowledges, is that her “son will find out” and put her in a home. Murray’s dilemma is painful and disturbing; she does not want to be irresponsible, yet she cannot bear to put an end to the woman’s freedom. After all, as her passenger asks, “‘can’t an old lady go for a walk on a nice day and get lost?’”(82). A reasonable question with no good answer. The best Murray can do is to compromise. She leaves the lady outside the drug store, as the latter assures her that “‘someone will come along who knows me. They always do’” (82). And so the piece ends with Murray extracting a promise from the woman to go inside the drug store for help, if no one who knows her comes along soon. Will she keep her promise, or even remember she made one? The unsaid of this piece is that Alzheimer’s, although never present by name, is nevertheless fiercely present by implication. As we have understood from Murray’s experience, ethics, a cultural product, and Alzheimer’s, a medical product, should be mutually inclusive. “Dementia has entered the domain of the ethical because of the fact of the person can be questioned and because, often, death is a matter of decision”



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(Cohen 8). Alzheimer’s is postmodern and cultural because it is unclear whether the disease is in effect until postmortem. There are tests for Alzheimer’s but they are not infallible. But even a postmortem examination of the brain is no longer an absolute, as sometimes brain plaque doesn’t present in patients diagnosed with Alzheimer’s. So one may legitimately question the very existence of the illness, at any given moment. What was once a natural part of the ageing process might now be pathological or simply a result of people living longer lives. Sharon R. Kaufman claims that dementia does cultural work. There is a “cultural ambivalence about whether the end of ‘meaningful life’ is reason enough for death” (23). Moreover, dementia, as a mutable category of knowledge and cultural form, obscures the distinction between life and death. In its various stages – early, moderate, advanced, severe, and end-stage – dementia is a condition both of death-in-life and of life-in-death. This ambiguity becomes more profound as the disease progresses, and it lies at the heart of the anguish about what to do. This ambiguity is what makes dementia so compelling for families; so unnerving in the context of the cultural importance of memory, control, and reason; and so unsettling to the existential order of things. (23)

For our purposes there is no clear distinction between dementia and Alzheimer’s. Thus, one question we should ask is whether or not old age is as Kaufman puts it, a “normal psychological process or a pathological condition” (25). When Alois Alzheimer described the condition named after him (1907), dementia was still considered part of the normal deterioration of life (25). The debate on the pathology of senility is still ongoing. Thus, “Debate remains lively today in clinical medicine and gerontological science about whether Alzheimer’s disease is a distinctly pathological state or a quantitative extreme of normal aging (Herskovits 1995). The plaques and tangles that characterize the disease can also be seen in healthy elderly brains on autopsy and sometimes are not present in the brains of those diagnosed with Alzheimer’s. In addition, some of the behavioral symptoms of Alzheimer’s (especially those of forgetfulness) can be found in normal, healthy, older persons. Attempts to distinguish normal aging from discrete medical conditions of the brain plague contemporary researchers and clinicians. Ambiguity about which conditions are normal or pathological is reflected in recent titles from the geriatric and gerontological literatures, such as ‘Dementia of the Aged: Disease or Atypical Accelerated Aging?” “Geriatric Ideology: The Myth



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of the Myth of Senility,’ and ‘Aging versus Disease: Which Changes Seen with Age Are the Result of Biological Aging?’ (26). Pia C. Kontos claims that “Alzheimer’s disease is regarded as the most bewildering and frightening condition facing the aging population in the 21st century…and represents a much feared stigmatizing label that carries with it the force of a sentence of social death…As Herskovitz notes, senility is characterized as ‘monstrosity’ by the lay media with ‘clichéd metaphors and representations in which Alzheimer’s is characteristically drawn in colourfully dramatic terms that paint vividly disturbing images. Alzheimer’s is described as a living death, a never ending funeral, and a private hell of devastation” (195). It is the unbecoming of the self, the loss of individual agency. Alzheimer’s can be a very slow death, as described by Jonathan Franzen, “like a prism that refracts death into a spectrum of its parts: death of autonomy, death of memory, death of self-consciousness, death of personality, death of the body” (30). Death occurs in phases, or” death in life, death before death, and never ending death” (30). Janice E. Graham informs us that the collection of data itself is yet another way that culture enters the dementia presentation. It is not only the collection of medical signs, symptoms, past cases, and knowledge from medical texts. “What is often unrecognized is that the culturally conditioned practices of the people and institutions that construct the data are also, often unknowingly, incorporated into the body of these databases” (80). Just as we diagnose, we put together data in relation to who we are. In other words, “scientific activity is not always about uncovering ‘nature.” It is (also) a fierce fight to construct reality” (83). In light of the above, it is fair to ask: when does one “pull the plug,” so to speak, on someone with problems of memory and take away his or her individuality? Is it not bad enough that Alzheimer’s will eventually do the latter on its own? In the following works, Jonathan Franzen’s essay titled “My Father’s Brain,” and John Bayley’s memoir of his wife Iris Murdoch, both authors wrestle with this question and many others, which present the challenges to cultural values that are inherent in a disease that attacks human individuality and exceptionality. *** While all human beings are very good at forgetting most of the things that happen in the course of their lifetimes, the inability to remember is nevertheless uncanny, because with dementia or Alzheimer’s, forgetting



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escapes the bounds of our control and threatens our personhood, the very essence of what it means to be human. In his engaging and moving essay, Jonathan Franzen discusses his memories of his father’s non-memory, his descent into the world of Alzheimer’s. What is especially interesting about his presentation is the way he works the cultural aspects of the disease into his writing. Since this is also a dissertation on non-memory and the unraveling of personhood, Franzen seems to turn his father’s brain into a cultural artifact, not least because Earl Franzen was entitled to a free brain autopsy as a result of his participation in a study on memory and aging conducted by Washington University (8). Franzen’s memories are consistently contrasted with his father’s disease, his inability to remember. Indeed, the very first words of the essay are “here’s a memory” (7), describing the way the author was initially introduced to the final state of “his father’s brain.” As we can discern immediately, Alzheimer’s takes its toll on family life, which may partly explain why Franzen harshly criticizes his mother, Irene, to whom he never refers by name in the essay: “On an overcast morning in February 1996, I received in the mail from my mother, in St. Louis, a Valentine’s package containing one pinkly romantic greeting card, two four-ounce Mr. Goodbars, one hollow filigree heart on a loop of thread, and one copy of a neuropathologist’s report on my father’s brain autopsy” (7). The defamiliarization of autopsy, presenting it as some kind of bizarre Valentine’s gift, is shocking, and somewhat humorous. And as we shortly learn, the author lambasts his mother for her love of “freebies,” which is why she convinced her husband to participate in the survey. Moreover, the author speculates that most likely his mother’s motivation for sending the autopsy along with Valentine’s Day paraphernalia was to save 32 cents on postage. While the freebies and postage certainly set the stage for the grotesque, the idea of receiving a Valentine from one’s mother can’t be far behind in its bizarreness. As Franzen goes to great lengths to explain, memory is far from a meta-phenomenon. More likely, people have memories of memories of noteworthy events and thus build up their memory over time, which might well explain why it is that Alzheimer’s sufferers cannot establish new memories but can often recall distant memories while their brains are still able to function beyond the basic level. In the case of Franzen’s memory, his recollection of his Valentine’s package is also based on his ability to recall “red,” “heart,” and “Mister Goodbar” from other contexts. And in an attempt to be cinematically cute, he explains that



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What my memory of that morning therefore consists of, according to the latest models, is a set of hardwired neuronal connections among the pertinent regions of the brain, and a predisposition for the entire constellation to light up – chemically, electrically – when any one part of the circuit is stimulated. Speak the words ‘Mister Goodbar’ and ask me to free-associate, and if I don’t say ‘Diane Keaton’(star of the 1977 film Looking for Mister Goodbar, ironically a film about the searching for the “perfect” man) I will surely say ‘brain autopsy.’ (8-9)

Perhaps no less important is that this is a memory with which the author is naturally obsessed, so that every time he revisits the memory it becomes more firmly embedded in “the architecture” of his brain. Franzen notes that Alzheimer’s is both his father’s disease and “story,” though we will have to learn of these events through the author’s recollections. That story, however, is not easy to tell because it is not quite clear where the ordinary forgetfulness of advanced age leaves off and Alzheimer’s begins. Alzheimer’s is a disease of classically ‘insidious onset.’ Since even healthy people become more forgetful as they age, there’s no way to pinpoint the first memory to fall victim to it. The problem was especially vexed in the case of my father, who not only was depressive and reserved and slightly deaf but also was taking strong medicines for other ailments. For a long time it was possible to chalk up his non sequiturs to his hearing impairment, his forgetfulness to his depression, his hallucinations to his medicines; and chalk them up we did. (11) The cultural implications are powerfully evident in Franzen’s description. Because of modern medicine we gain not only longevity, but risk greater exposure to dementia and Alzheimer’s. Moreover, as he suggests, the medicinal regime is able to cause secondary difficulties, as dementia becomes a reasonable possibility because of clashing medications. Thus declaring the Alzheimer’s “moment” of origin or onset is difficult in part because of the culture of medication itself. Franzen even seems to suggest that his parents’ marriage and Alzheimer’s are intricately connected, viewing the former as a latter-day version of Sartre’s play, No Exit, which engages the idea of existential hell (11). It seems that Franzen took his mother’s complaints about her husband with “a grain of salt” because she had always tended to exaggerate his “negative” characteristics. His mother interprets his father’s initial decline as almost intentional, his inappropriate acts committed in “bad faith” to aggravate her. As she writes in one of her letters to the author,



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It is extremely difficult living with a very unhappy person when you know you must be the major cause of the unhappiness. Decades ago, when Dad told me he didn’t believe there is such a thing as love (that sex is a ‘trap’) and that he was not cut out to be a ‘happy’ person I should have been smart enough to realize that there was no hope for a relationship satisfactory to me. But I was busy & involved with my children and friends I loved and I guess, like Scarlett O’Hara, I told myself I would ‘worry about that tomorrow.’ (12-13)

Eventually Franzen realizes that his mother, despite her agenda, is correct to worry about Earl’s deterioration. As she writes to her son, “Last week one day he had to skip his breakfasttime (sic) medication in order to take some motor skills tests at Wash U. where he is in the Memory & Ageing study. That night I awakened to the sound of his electric razor, looked at the clock & he was in the bathroom shaving at 2:30 AM” (13). Nevertheless, despite the above evidence, Franzen still believes that his mother is exaggerating his father’s difficulties. When his mother must undergo surgery and remain in the hospital for five weeks, Franzen volunteers to stay with Earl. Surprisingly that visit does not leave him with the impression that his father is in trouble. Indeed, Earl, because of his life-long good health, had expected to be around to follow the “court news,” much like King Lear or Cordelia. The author cannot resist noting that the king is Earl’s “anagrammatic namesake” (12). Although he does not say so, Lear is most likely the first literary figure in English who suffers from dementia, if not Alzheimer’s itself. At the time, Franzen believed that as a result of an adjustment in Earl’s medication, his father was “doing fine” (15). Franzen correctly assumes that the reader, in hindsight, will accuse him of “wishful thinking” (15). Yet his own explanation for his interpretation is much more sophisticated. He prefers to relate to the mind’s ability to perform a gestalt, to take parts and create a holistic vision, while ignoring the inconsistencies or missing parts. Despite the “blind spot” in our vision, the brain returns a “seamless whole” of the world around us (15). For somewhat selfish reasons (“I still needed him to be an actor in my story of myself”), Franzen fills in the blanks in his father’s performance so that he might see him “as the same old wholly whole Earl Franzen” (15). Convincing or not, this explanation displays the subjectivity involved in deciding whether any family member is acting appropriately. Within that subjectivity, Franzen is not so different from his mother, Irene, though their agendas do not fully coincide. What is perhaps surprising in Earl Franzen’s case, is that his decline is not linear, as he continues to make a number of lucid comebacks. It is impossible to determine to what extent the subjective observations of



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Franzen and his mother contribute to this state of affairs and to understand how to differentiate the symptoms of medication, old age, depression, and anxiety from those of dementia and Alzheimer’s. The very same man who rose in the middle of the night to shave was able, months later, to take first place in a game of bridge (17). How is that possible? Moreover, after receiving Prozac for his ‘nervousness & depression’ his spirits improved for a short time. Afterwards, his father surprisingly (in Franzen’s view) agreed to see a psychiatrist and a social worker, yet there was still no relief in sight for his father’s behavioral inconsistencies. However, as the author notes, no one had yet to mention Alzheimer’s or dementia as an explanation of his father’s condition (19). In any event, Franzen had no intention of exploring Alzheimer’s as a possible explanation of his father’s behavior. As he notes, “I remember my suspicion and annoyance, fifteen years ago [circa 1985], when the term ‘Alzheimer’s disease’ was first achieving currency. It seemed to me another instance of the medicalization of human experience, the latest entry in the ever-expanding nomenclature of victimhood…I spend a few minutes every month fretting about ordinary mental illness being trendily misdiagnosed as Alzheimer’s” (19). Before we can take issue with Franzen’s “diagnosis,” he immediately retreats from this position. From my current vantage, where I spend a few minutes every month fretting about what a self-righteous thirty-year-old I was, I can see my reluctance to apply the term ‘Alzheimer’s’ to my father as a way of protecting the specificity of Earl Franzen from the generality of a nameable condition. Conditions have symptoms; symptoms point to the organic basis of everything we are. They point to the brain as meat. And where I ought to recognize that the brain is meat, I seem instead to maintain a blind spot across which I then interpolate stories that emphasize the more soul-like aspects of the self. Seeing my afflicted father as a set of organic symptoms would invite me to understand the healthy Earl Franzen (and the healthy me) in symptomatic terms as well – to reduce our beloved personalities to finite sets of neurochemical coordinates. Who wants a story of life like that? (19-20)

Although it may not be particularly flattering to be part of a medical category, the alternative seems a lot worse. The struggles of Earl Franzen and family to make sense of his behavior are eventually mitigated by evaluating his conduct under the heading of Alzheimer’s, despite the harsh connotations of the disease. And although I have argued for the cultural aspects of Alzheimer’s, it is much more than a convenient categorizing of confusing symptoms. It is also and primarily a “real” disease with a solid scientific and genetic grounding. While all categories are, to a certain



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extent, convenient, Alzheimer’s is not an invention of the medical community but rather a discovery. Nevertheless, it took a lot more than Alois Alzheimer’s post-mortem discovery of plaques and tangles in the brain of the patient Auguste D. before Alzheimer’s became an accepted diagnosis in the medical community. In the 60s, senile dementia was thought to be nothing more than “a natural consequence of ageing” (22). Only when aging became a social reality with greater longevity in the US in the 70s, did the possibility of Alzheimer’s as a diagnosis become possible (22). “By the end of the eighties, at the crest of my annoyance with the clinical term and its sudden ubiquity, Alzheimer’s had achieved the same social and medical standing as heart disease or cancer – and had the research funding levels to show for it” (22). One unusual cultural aspect of certain diseases is to point out their “advantages.” Many researchers mention that patients find “something delicious in oblivion,” since every experience in the short term is understood as strikingly new, even if the patient has been having the same experience all day (23). In my personal experience, I have had the parent of a good friend ask me the same question 10 times in a one-hour conversation and become delighted at the same answer over and over again. Yet there is nothing really positive about an illness that leads an adult back to childhood and infancy until he or she can no longer perform even involuntary brain functions. For someone like Earl Franzen, an intensely private person, nothing could have been worse than an illness that took away his adulthood (24). For that reason Jonathan Franzen wishes his father had died of a heart attack instead (24). Because Earl descends into childhood, Irene Franzen is able to assume the dominant marital position she had always sought. She leads her husband around as if he were one of her children. The author claims that it is her opportunity to “settle some very old scores” (25).Ultimately, however, the Alzheimer’s experience brings the family closer together. Jonathan develops closer ties to his mother and brothers and learns that he can face the worst life has to offer (25). He is less afraid at the end of the Alzheimer’s experience than at the beginning. Franzen is encouraged by the fact that when Earl moves to a nursing home “he never failed to recognize [him] as someone he was happy to see” (27). Although he speaks a lot of nonsense he is reasonably clear on one issue: “his wish to be removed from ‘this hotel’ and his inability to understand why he couldn’t live in a little apartment and let my mother take care of him” (28). Yet when the family brings him home at Thanksgiving he behaves like a maddened, “unstrung marionette, eyes



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mad and staring, mouth sagging, glasses smeared with strobe light and nearly falling off his nose” (28). The greatest of ironies is on his trip back to the home, where he apparently gathered the clarity occasionally evident in Alzheimer’s when the patient exerts his or her will to the utmost. While waiting for a chair to re-enter the home, Earl turns to his son and tells him “Better not to leave…than to have to come back” (29). With that comment it is clear that for a brief moment he fully understands the journey he has undertaken and how relentless it will be. Though his personhood will certainly die before his body, “the persistence of his will” is something that the author (and the reader) highly admires (30). When they begin sorting through his desk after that Thanksgiving, as they realize he will no longer be coming home, they find a stash of hidden reminders Earl had used to help him conceal his illness, like birthdates, etc. (32). And there is the uncanny farewell he experiences with his father, “the last words he ever spoke to me, three months before he died…’Thank you for coming. I appreciate your taking the time to see me.’ Set phrases of courtesy? A window on his fundamental self? I seem to have little choice about which version to believe” (32). Further strengthening the heroic version we would all like to believe, Earl had written a letter, when he was clearly an Alzheimer’s sufferer, just weeks before his final breakdown, in 1993. The unsent letter was to his six-year-old grandson, Nick. "Dear Nick, We got your letter a couple days ago and were pleased to see how well you were doing in school, particularly in math. It is important to write well, as the ability to exchange ideas will govern the use that one country can make of another country’s ideas"(35). The letter goes on in the same rational sobriety for another three paragraphs, and one cannot help ponder the different directions grandfather and grandson will take, with the author destined to move towards childhood and the letter's recipient away from it. It is an astonishing letter because of the effort Earl must have put into it and the results he achieved. Earl Franzen’s last act of will, so his son would like to believe, was to stop eating in April 1995 (35). In no uncertain terms Franzen declares, “I’ll go to my own grave insisting that my father was determined to die and to die, as best he could, on his own terms” (36). And when he does die, during his son’s last visit, Franzen notes that “There would be no new memories of him. The only stories we could tell now were the ones we already had” (38).

To tell his father's story, then, is an opportunity to create a thickly layered set of memories, the only "defense" against the devastation of Alzheimer's.



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*** In his memoir of his renowned wife, Iris Murdoch, John Bayley informs us early on in his narrative that “Alzheimer sufferers are not always gentle.” We have certainly encountered that phenomenon in “My Father’s Brain” and the same will occur in Iris. Nevertheless, we can also note that Alzheimer’s caretakers are not always gentle themselves. As is the case with “My Father’s Brain,” John Bayley cannot help but inject clashes, disappointments, resentments and perhaps even jealousy in his relationship with his once intellectually brilliant wife who will eventually, before her brain shuts down, come to have the greatest joy in life from watching TV cartoons for children. In general, though, Bayley maintains his high admiration for his spouse, and devotes himself to her care, even if the shoe is on the other foot, so to speak. The couple had led an independent life, each devoted to her own scholarly and literary pursuits, until Alzheimer’s created a harsh reality that demanded John Bayley’s total commitment to Iris’s total dependency. For more than four decades they had experienced “the strange and beneficent process in marriage by which a couple can, in the words of A.D. Hope the Australian poet, ‘move closer and closer apart’” (39). The closeness brought about by love and independence has been replaced by a closeness of necessary suffocation. There can be no more individuality in their relationship, because the personality of only one individual has survived. Bayley describes the changes in their lives that Alzheimer’s has brought about: Alzheimer sufferers are not always gentle: I know that. But Iris remains her old self in many ways. The power of concentration has gone, along with the ability to form coherent sentences, and to remember where she is, or has been. She does not know she has written twenty-seven remarkable novels, as well as her books on philosophy; received honorary doctorates from the major universities; become a Dame of the British Empire…If an admirer or friend asks her to sign a copy of one of her novels she looks at it with pleasure and surprise before laboriously writing her name and, if she can, theirs. ‘For Georgina Smith. For Dear Reggie…’ It takes her some time, but the letters are still formed with care, and resemble, in a surreal way, her old handwriting. She is always anxious to oblige. And the old gentleness remains. (34)

For Iris, albeit unknowingly, the very act of writing has become grotesque. A world-class novelist, who has devoted her life to and made her livelihood from the written word, now has trouble signing her name and can only offer a surreal exemplar of her handwriting. The cruelty of



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Alzheimer’s as an affliction of the brain of a great novelist is unthinkable, yet it has become Iris Murdoch’s, as well as John Bayley’s, life. Bayley not only presents a firm vision of life with Alzheimer’s for the victim, but does an excellent job of portraying the anxiety of the caretaker, clearly a cultural role. Thus he is unwilling to go bathing in the river with Iris, an act they had successfully performed for decades. Yet his reticence has nothing to do with Iris the swimmer, for he claims that she “still swims as naturally as a fish” (35). Rather, it is the “endless omnipresent anxiety of Alzheimer’s,” that prevents him from taking any chances. Much like Jonathan Franzen, Bayley objects to the universality of the disease, the attempt to make all Alzheimer sufferers and caretakers one large, unhappy family, so to speak. One woman whom he would occasionally meet whose husband suffered from Alzheimer’s likened their common experience to “being chained to a corpse” (42). Bayley politely plays along with this concept, yet is repelled by the idea that the woman’s husband and Iris could possibly have anything in common. How could our cases be compared? Iris was Iris. Troubles do not necessarily bring people together. I felt no togetherness at all. This lady wanted – needed – to dramatize her situation and claim me as a fellow actor. I felt I could not cooperate in the spirit, though out of politeness I made a show of doing so. My own situation, I felt, was quite different from hers. It’s not an uncommon reaction, as I’ve come to realize, among Alzheimer partners. One needs very much to feel that the unique individuality of one’s spouse has not been lost in the common symptoms of a clinical condition. (42)

If Alzheimer’s can be considered the creeping death of the personality, it is understandable how Bayley might want to avoid viewing Iris as anything less than unique. Moreover, there seems to be an unwanted symbiotic effect. When Iris is often unable to put together a coherent sentence, settling for “’you know, that person,’ or simply that” (43), Bayley feels his “own mind and memory faltering, as if required to perform a function too far outside their own beat and practice” (43). One loss of memory has led to another. At his most creative and moving, Bayley describes moments when Iris is able to go beyond the leonine face of Alzheimer to take on the beautiful face of the Virgin Mary. The Alzheimer face has been clinically described as the ‘lion face.’ An apparently odd comparison but in fact a very apt one. The features settle into a leonine impassivity which does remind one of the King of Beasts, and the way his broad expressionless mask is represented in painting and



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sculpture. The Alzheimer’s face is neither tragic nor comic, as a face can appear in other forms of dementia: that would suggest humanity and emotion in their most distorted guise. The Alzheimer face indicates only an absence: it is a mask in the most literal sense. That is why the sudden appearance of a smile is so extraordinary. The lion face becomes the face of the Virgin Mary, tranquil in sculpture and painting with a gravity that gives such a smile its deepest meaning. (45)

Bayley is combating in this passage Alzheimer’s most frightening characteristic: to take away meaning. Thus he restores the meaning of Iris within her sublime face, which tends to emerge most often at the telling of a silly, innocent joke. The freshness that Bayley appreciates in Iris’ face is difficult for the caretaker when the issue is time, “which constitutes an anxiety because its conventional shape and progression have gone, leaving only a perpetual inquiry. There are some days when ‘When are we leaving?’ never stops, though it is repeated without agitation” (51). Bayley is pleased, however, that Iris isn’t aware of anything wrong, that all seems normal for her, and that she sleeps “like a cat.” Moreover, she has been spared the “demonic parody” of exaggerated unpleasant traits. Alzheimer’s “has only been able to exaggerate a natural goodness in her” (59). For the minority of Alzheimer sufferers who are conscious of their own demise, the disease must be a living hell. Because the closeness of the couple had always been based on their ability to be separate, Alzheimer’s devastated their marital opus magnum, or the great work they had done to maintain the independence of each member of their partnership. As the disease progresses, Bayley notes that “Now we are together for the first time. We have actually become, as is often said of a happy married couple, inseparable…It is a way of life that is unfamiliar. The closeness of apartness has necessarily become the closeness of closeness. And we know nothing of it; we have never had any practice. (92) Although Bayley uses the pronoun “we,” it is clearly his own “I” that he is concerned with. The characteristic of Alzheimer’s that is most difficult for him is Iris’ “terror of being alone, of being cut off for even a few seconds from the familiar object” (92). And he is that “familiar object.” Similar to what Jonathan Franzen had realized about his father, Bayley understands that in Iris’s case, the onset of the disease, the exact moment she had Alzheimer’s, is hard to pinpoint. “Alzheimer’s is in fact like an insidious fog, barely noticeable until everything around has disappeared. After that, it is no longer possible to believe that a world outside fog exists. First we saw our friendly harassed GP, who asked Iris who the Prime Minister was. She had no idea but said to him with a big smile that



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it surely didn’t matter” (151). At this stage, with subsequent brain scans, the word Alzheimer becomes part of Bayley’s everyday vocabulary. While undergoing these exams, Iris’s final novel, Jackson’s Dilemma appeared to exceptionally good reviews. Bayley reads the reviews to Iris, something she had never previously been interested in. The irony is, of course, that she cannot understand what he is reading (151). After Bayley concentrates on the couple’s relationship in the first part of the memoir, the second section, titled “Now,” describes life with Alzheimer’s for both of them in diary-like, dated entries. The first entry, 20 February 1997, deals with Bayley’s attempt to establish a routine, something that “preserves sanity” (158), even though he is referring to getting Iris to watch her favorite TV show, Teletubbies. The puerile nature of the show leads Bayley to speculate about the nature of Iris’s mind and his own speculations concerning it. “The sense of someone’s mind. Only now an awareness of it; other minds are usually taken for granted. I wonder sometimes if Iris is secretly thinking: How can I escape? What am I to do? Has nothing replaced the play of her mind when she was writing, cogitating, living in her mind? I find myself devoutly hoping not”(159). What Bayley seems to imply is a certain romantic vision of the disease, as if beneath the veneer of Alzheimer’s, Iris’s powerful mind is somehow trapped but intact. His “devout” hope seems to be that she might escape her deleterious prison of disease and retain her old self. Perhaps only the outside world encounters Alzheimer’s behavior. “Is she still saying inside herself, like the blind man in Faulkner’s novel [Sanctuary], “‘When are they going to let me out?’” (172). It is an optimistic fantasy, to imagine that Iris’s real self remains a prisoner (who might one day escape?), but nothing more. There are many cultural aspects of the disease that Bayley laments, chief among them the very decline of language in his relationship with Iris. He can no longer speak to her the same way or discuss the same things that were once the essence of their communication. Of course he could, but it would create an even more frustrating, one-sided relationship. “We can still talk as we did then, but it doesn’t make sense anymore. I can’t reply in the way I used to then but only the way she speaks to me now. I reply with the jokes or nonsense that still makes her laugh. So we are still part of each other” (162). This shadow relationship, linguistically expressed, is a constant reminder that what remains of Iris Murdoch is an uncanny shell, a double, someone who looks just like her, but behaves very differently. When Bayley angrily tries to force her to acknowledge their situation and “relieve…[his] isolation,” Iris can only respond with ‘I



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love you,’ a remark that might have been highly appropriate in a context without Alzheimer’s (162). The uncertainty of the illness is also a major source of concern to Bayley. He wonders about Iris’s movement from stage to stage, how many stages there will be and, although he does not say so, he most likely is anxious about his ability to recognize those stages (165). Uncertainty is at its greatest in the mornings, when even healthy individuals are sometimes disoriented by a night’s sleep. Iris is a very good sleeper, yet Alzheimer’s “strike[s] her with full force” in the mornings, and [she] must be coaxed back into sleep (165). Bayley notes that he is relieved that Iris is unaware of his typing or reading while she remains in bed, as he would have found her sudden interest, after a lifetime of independence, intolerable. As it is they are forced to follow a routine of capture and pursuit. For most of the day, Iris follows Bayley around the house, something that exasperates him. Yet he acknowledges that he would be following her around if she paid him no attention, because of his obsessive anxiety for her welfare. If Jonathan Franzen labeled his parents’ entire marriage No Exit, we might do the same for Bayley and Murdoch’s final stage of partnership, albeit for very different reasons (166). As it is, Bayley worries that he “involuntarily mimic[s] the Alzheimer condition” (167). As the disease progresses, Bayley fights to preserve a routine, though Alzheimer’s, with its debilitating emptiness, will have none of it. For that reason he struggles with Iris to remove her trousers before she goes to bed, even though she prefers to sleep with everything she is wearing. The idea of sleeping with one’s pants on doesn’t particularly disturb Bayley, but the destruction of routine, somehow based on memory, frightens him (168). “Twice in the day, at ten in the morning and five in the evening, panic and emptiness descend, not because there is something we have to do but because there isn’t. Routine has no suggestions to make. All I can do is promise the next thing soon. A drink. Lunch, or supper” (168). To his credit, and in a struggle to have something organized for them to do, Bayley is not afraid to bring Iris to social engagements, even though he knows that Iris cannot “practice” at getting better. There is, after all, no return from the disease. On one occasion Bayley finds Iris engaged in a conversation with someone who works in an Insurance Adjustments office. Iris listens closely to what he has to say, learning how enjoyable the work is, and how good her interlocutor performs his tasks, consistently greeting a pause in his monologue to ask “‘What do you do?’” (169). Although this skit has played out a number of times, the man is undiscouraged and happily begins his speech again (169). Shades of the Alzheimer doppelganger? Always looking for cultural acclimation, Bayley



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imagines that some party goers might find it convenient to speak with an Alzheimer‘s sufferer. “Apart from making you feel you are performing a service to the community it is also in the short run less demanding and taxing than the conversational art of party discourse” (169). Underneath the cynicism, Bayley needs to feel that Iris still “belongs” in social settings and that she is not a burden to anyone but himself, as they return from the party only to have Iris ask him, “‘When do we go?’” (170). On particularly bad days, when the TV is out and he misses it more than Iris does, he can only ask, as he had previously wondered about Iris and the blind man in Sanctuary, “When are they going to let me out?” (173). Bayley can be painstakingly honest about his own shortcomings, one of which is most often the rage brought on by Iris’s inability to remember his instructions. Iris has a ritual of constantly watering plants that eventually brings about their destruction, yet no matter how often Bayley explains why she shouldn’t water them, to which she immediately concurs, she is unable to remember and is drawn to this, for her, very calming ritual. In his own words, Bayley “went bezerk” (175) at Iris’s compulsive behavior, so that in his moment of rage his memory is every bit as faulty as Iris’s. “In those moments of savagery neither of us has the slightest idea to what I am referring. But the person who is speaking soon becomes more coherent. Cold too, and deadly. ‘You’re mad. You’re dotty. You don’t know anything, remember anything, care about anything’” (175). Bayley despairs of falling into the Alzheimer’s trap, as he acknowledges that yelling at Iris is as productive as yelling at a small child. But anyone who devotes himself totally to the role of caregiver cannot help but help but lose his patience on occasion. It is as if “Anger sometimes seems now to be a way of still refusing to admit that there is anything wrong” (175). To scream at a person who has no disability yet does stupid things seems more justified, though Iris can only respond to any accusation with “well.” The latter is usually the start of an explanation, but in her case it is the explanation itself. As Jonathan Franzen had described earlier, through an act of will the Alzheimer’s patient will occasionally make an unexpected lucid remark that is completely in context. For Bayley this occurrence is distressing and frustrating. Iris has twice commented on her writing that “she feels now that she is sailing ‘into the darkness’” (179), a linguistically sophisticated metaphor unlike any of her ordinary remarks. Bayley fears she has a “terrible lucidity” vis-à-vis her current state and wonders how one could produce such a remark without the required “consciousness” (179). “And if consciousness can go on producing such words, why not many more, equally lucid?” (179) Were anyone able to answer that question,



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Alzheimer’s might well have a cure. Towards the end of Iris’s life, she and Bayley speak less and less, relying on a lifetime together to achieve what communication remains possible. What she is still capable of saying is for “public consumption. They are social statements. They have the air of last remarks before all the lights go out” (180). At the end of his memoir, Bayley turns to a meditation on marriage, that most cultural of institutions, which is the relationship most affected by the disease. Life is no longer bringing the pair of us ‘closer and closer apart’…Every day we move closer and closer together. We could not do otherwise. There is a certain comic irony – happily not darkly comic – that after more than forty years of taking marriage for granted, marriage has decided it is tired of this, and is taking a hand in the game. Purposefully, persistently, involuntarily, our marriage is now getting somewhere. It is giving us no choice: and I am glad of that…She is not sailing into the dark: the voyage is over, and under the dark escort of Alzheimer’s she has arrived somewhere. So have I. (183)

As a final irony, Bayley notes Iris’s disinterest in children throughout her life. “Now she loves them, on television or in real life. It seems almost too appropriate. I tell her she is nearly four years old now – isn’t it wonderful”? (185) The memoir ends with Iris still alive, living the routines she can no longer experience in any other way than of the moment. Thus, they both enjoy the Christmas celebration with Bayley’s brother, Michael. The relaxing time calls to Bayley's memory a Wittgenstein comment, once quoted to him by Iris, claiming that “death is not a human experience” (189). All that remains is to live in the moment, even if that moment is viewed through an Alzheimer’s glass darkly. We have compared two moving accounts of encountering Alzheimer’s in close family members. Bayley provides a passionate recollection of his caretaking experiences, focusing more on the travails of Irish Murdoch than he does on his own difficulties in living with the disease. Jonathan Franzen is much less the caretaker, more the outside observer who seems to examine his father’s brain through the prism of his self.



CONCLUSION

So where do we go from here? How can we expect the ongoing relationship between various diseases and the ways in which they are portrayed in popular and even high culture to develop? Though hindsight is always better than foresight, I do have a few ideas. I think I am on safe ground when I claim that the “market” for new diseases, disorders, and syndromes will continue to grow. That is, in postmodern times it has become acceptable to explain certain maladies, afflictions, etc. as a result of the world we live in. Some diseases, as we have seen in our exploration, come about as the direct result of cultural conditions. The most obvious example is chronic pain, which in previous generations signified the symptom of something, rather than the disease itself. As we become more tolerant in the west for the weaknesses of our fellow beings, we will find better ways to understand what it is that ails them. From chronic fatigue syndrome to Asperger’s, we will refine and expand our categories in order to include those on the margins of society, those who have been left out of the social or medical agenda because they cannot exist without a category to describe the problem. So I believe new diseases, disorders, and illnesses are an intrinsic part of our future as a species. The advantages to such a situation are clear cut. Fewer people will be left out of society because of the way they must function in the world. And greater understanding implies greater help, so that the afflicted can make their mark on culture despite and even because of their ailments. Who could have imagined two decades ago, for example, a TV show like Monk, in which the detective, despite his irritating and sometimes exasperating behavior, could use the skills of an obsessive compulsive to solve crimes? And as an additional bonus, despite his shortcomings, he is loved and admired by his supporting cast. The same holds true for the protagonist of the curious incident of the dog in the night-time, in which Chris manages to come out a “winner.” From tourettic detectives, to chronic pain sufferers and anorexic rope jumpers, there seems to be a place for everyone who in earlier times would be banished at best to the margins of society, and at worst to a ship of fools. The disadvantages are less obvious but no less important. As syndromes are invented or discovered (perhaps a combination of the two?)

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the markets for them grow accordingly. An excellent example is the booming industry that has sprung up around the concept of learning disabilities. While it is clearly beneficial to be labeled dyslexic or dysgraphic (despite the fact that the latter is still defined by the American Heritage Dictionary as “Impairment of the ability to write, usually caused by brain dysfunction or disease”) in order to avoid the blanket label of “stupid” that plagued earlier generations, it is also true that learning disabilities have turned into a cash cow, enriching the various psychologists and institutions that help the impaired function in the world of the written word. And of course, the greatest beneficiary, the pharmaceutical industry, benefits from new diseases and syndromes, since many of them are also treated by drugs. Even the treatment of learning disabilities promotes the use of the next generation of Ritalin, to help the sufferers of attention deficit disorder take exams more successfully. So, as Fredric Jameson would have it, everything is political and, apparently a matter of economics as well. The cultural materials at hand are also well disposed to accepting and manipulating these ailments, both for their freshness and for the opportunity to exploit their cultural and even economic potential. Why not create a movie like Fight Club, the stage for a paranoid schizophrenic, if not split personality, who is literally given the opportunity to take up arms against capitalism? That this is done in an amusing, capital-accumulating way posits the validity of the very system the movie is pretending to destroy. Thus, in Aristotelian comedic fashion, everyone goes home happy and nothing important is sacrificed. The same dynamic works as well for pieces like Iris, both the novel and the movie. The latter is more geared to mass entertainment, with the appropriate number of sex scenes given unnecessary emphasis and exaggeration. But once again, there is a dual purpose at work here. The obvious idea is to explore the cultural ramifications of Alzheimer’s and the effect it has on the caretakers and the victims. There is also the problem of what one can do with an Alzheimer’s sufferer, in terms of cultural opportunities. To commit a loved one to an institution is difficult. To become the caretaker, as John Bayley did, might be even harder. But as the disease becomes more prevalent in the 21st century, it is also an infirmity that has selling potential. That is, the audience for tales of Alzheimer’s is determined by the idea that just about everyone will be affected by the disease – directly or indirectly –, certainly within the so-called sixth degree of closeness. In the postmodern world everything is a potential commodity, even or perhaps especially the ailments that frighten us to death.



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In light of the above, my “prediction” is simple. As new disorders and syndromes appear in the medical and psychological literature, more and more cultural attention will be paid to them. In some ways they have become a staple of capitalist behavior and thought. If it is possible to be “green” and make money, why not be tolerant, humanitarian, and a concerned citizen of the world by demanding and insuring fair treatment for those who suffer? My jaded approach does allow, however, for the honest desire of our world to be inclusive rather than exclusive. We cannot help but appreciate and admire anyone who overcomes a handicap to find her way in the world. Those are the stories that represent the foundation of American mythology and much of the western world now as well. In terms of disease and its cultural representation, then, for all the reasons above it is fair to say that business is booming.



WORKS CITED

Baudrillard, Jean. “The Ecstasy of Communication.” Foster, Hal. Ed. The Anti-Aesthetic. New York: New Press, 1998. Bayley John. Iris. London: Duckworth, 1998. Bruch, Hilda. The Golden Cage. Cambridge, Mass: Harvard UP, 1978. Cleage, Pearl. What looks like Crazy on an ordinary day. New York: Avon, 1997. de Certeau, Michel. The Practice of Everyday Life. Berkeley: U of California P, 1984. Deleuze Gilles and Felix Guattari. Anti-Oedipus. Minnesota: U of Minnesota P, 10th printing, 2000. Dyer, Richard. Heavenly Bodies: Film Stars and Society. New York: St. Martin’s, 1986. Ferguson, Niall. "America has got Asperger's syndrome." Opinion.telegraph. 25.5.2004. http://opinion.telegraph.co.uk/opinion./main.jhitml First, Michael B. ed. DSM IV. Washington D.C.: American Psychiatric Association, 2000. Fiske, John. Understanding Popular Culture. London: Routledge, 1989. Garfinkel, Paul E. and David M. Garner. Anorexia Nervosa. New York: Brunner/Mazel, 1982. Franzen, Jonathan. “My Father’s Brain.” How to be Alone. New York: Picador, 2003. pp 7-38. Giroux, Henry. Brutalized Bodies and Emasculated Politics: Fight Club, Consumerism and Masculine Violence in Breaking into the Movies: Film and the Culture of Politics, Oxford: Blackwell, 2002. Good, Byron J. and Mary-Jo Delvecchio Good. “‘Fiction and ‘Historicity’ in Doctors’ Stories.” Mattingly Cheryl and Linda C. Garro eds. Narrative and the Cultural Contradiction of Illness and Healing. Berkeley: U of California P, 2000. Graham, Janice. “Diagnosing Dementia: Epidemiological and Clinical Data as Cultural Text.” pp. 80-105. Thinking about Dementia. Leibing Annette and Lawrence Cohen eds. New Brunswick: Rutgers UP, 2006. Grandin, Temple and Catherine Johnson. Animals in Translation. USA: Harcourt, 2006.

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Haddon, Mark. The curious incident of the dog in the night-time. United States: Doubleday, 2005. Harris, Sam. The End of Faith. New York: WW Norton, 2004. Hogan, Katie. Women Take Care. Ithaca: Cornell UP, 2001. Hunter, Susan. AIDS in America. New York: PALGRAVE MACMILLAN, 2006. Iggulden, Amy. "'Missing Link' between madness and genius." News.telegraph.11.6.2005. http://opinion.telegraph.co.uk/news/main.jhitml Jameson Fredric. Postmodernism or the Cultural Logic of Late Capitalism. London: Verso, 1991. Jankovic, Joseph. “Tourette’s Syndrome.” New England Journal of Medicine. 345 [2001: 1184-1192. Kaufman, Sharon R. “Dementia-Near-Death and ‘Life Itself.’” pp 23-42. Thinking about Dementia. Leibing Annette and Lawrence Cohen eds. New Brunswick: Rutgers UP, 2006. Kontos, Pia C. “Embodied Selfhood: An Ethnographic Exploration of Alzheimer’s Disease.”pp. 195-217. Thinking about Dementia. Leibing Annette and Lawrence Cohen eds. New Brunswick: Rutgers UP, 2006. Leibing Annette and Lawrence Cohen eds. Thinking about Dementia. New Brunswick: Rutgers UP, 2006. Lethem, Jonathan. Motherless Brooklyn. United Kingdom: Faber and Faber, 2000. Lodge, David. T herapy. USA: Penguin, 1995. Lurie, Alison. Truth and Consequences. USA: Penguin Group, 2005. Mattingly Cheryl and Linda C. Garro eds. Narrative and the Cultural Contradiction of Illness and Healing. Berkeley: U of California P, 2000. Maxwell, Bill. “Black Churches Must Address HIV/AIDS.” http://www.sptimes.com/2007/02/11/news_pf/News/Black/_churches_ must_a.shtml McNeil Jr., Donald G. ”Circumcision Halves H.I.V. Risk, U.S. Agency Finds.” The New York Times. December 14, 2006. Molloy, Harvey and Latika Vasil. “The Social Construction of Asperger Syndrome: the Pathologising of a Difference?” Disability & Society. 17 [2002]: 659-669. Morrice, Polly. "Autism as Metaphor." The New York Times. July 31, 2005. http://www.nytimes.com/2005/07/31/books/31/MORRICE.html Morris, David B. Illness and Culture in the Postmodern Age. Berkeley: U of California P, 1998. —. The Culture of Pain. USA: U of California P, 1991.



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Murray, Joan. “Someone’s Mother.” New York Times Magazine. May 13, 2007. Nasser, Mervat. “Culture and Weight Consciousness.” Journal of Psychosomatic Research. 32 [1988]: 573-577. New York Times. Magazine Desk. Sept. 22 2002. Section 6, page 14, column 5. “A Secret Society of the Starving.” Nietzsche, Friedrich. Will to Power. Walter Kaufmann ed. New York: Vintage, 1967. O’Neil, Sara. “The Meaning of Autism: Beyond Disorder.” Disability & Society. 23 [2008]: 787-799. Rey, Roselyne. The History of Pain. Cambridge: Harvard UP, 1995. Roazen, Paul. Brother Animal. New York: Knopf, 1969. Rosen, Jonathan. Eve’s Apple. New York: Random House, 1997. Sacks, Oliver. The Man Who Mistook His Wife for a Hat. New York: Touchstone, 1998. Sontag, Susan. Illness as Metaphor and Aids and its Metaphors. New York: Picador, 1989. Stice, E. et al. “Relation of Media Exposure to Eating Disorder Symptomatology: An Examination of Mediating Mechanisms.” Journal of Abnormal Psychology. 103 [1994]: 836-840. Wardle, Jane and Louise Marsland. “Adolescent Concerns about Weight and Eating; Social-Developmental Perspective.” Journal of Psychosomatic Research. 34 [1990]: 377-391. Zizek, Slavoj. The Sublime Object of Ideology. London: 9th impression, Verso: 2002.

Recommended Reading Altering American Consciousness, edited by Sarah W. Tracy and Caroline Jean Acker, University of Massachusetts Press, 2004. Procreation or Pleasure: Sexual Attitudes in American History, edited by Dr. Thomas L. Altherr, Robert E. Krieger Publishing Company, 1983. Sexuality in America, foreword by Robert T. Francoeur, edited by Patricia Barthalow Koch and David L. Weis, Continuum Publishing, 1998. The Viagra Myth, by Abraham Morgenthaler MD, Jossey-Bass, 2003. Philosophy of Sex, edited by Alan Soble, Helix, 1985.



NOTES  1

Of the multiple definitions of the postmodern, I prefer Fredric Jameson’s use of the term as he defines it in Postmodernism or the Cultural Logic of Late Capitalism, pp 1-55. There – despite the many similarities between them – he differentiates the postmodern from the modern on the basis of the former’s position in the economic structure of late capitalism. That is, postmodernism is the “logical” outcome of the excesses of the third stage [troisieme étage] of capitalism. 2 Particularly useful for this discussion is David B. Morris’ term, postmodern illness, which “is defined by an awareness of the elaborate interconnections between biology and culture” (11). 3 For cultural connections to anorexia/bulimia see also Jane Wardle, “Adolescent Concerns about Weight and Eating; a Social-Developmental Perspective,” E. Stice, “Relation of Media Exposure to Eating Disorder Symptomatology: An Examination of MediatingMechanisms,” and Mervat Nasser, “Culture and Weight Consciousness.” The most recent source I have come across, and perhaps the most disconcerting, is the New York Times Magazine article of Sept. 22, 2002, “A Secret Society of the Starving,” in which “pro-ana [anorexia] women defend themselves by labeling their habits a lifestyle, not a disease.” There are a number of Internet sites that encourage this so-called lifestyle. 4 The script of Fight Club is rife with castration anxiety and phallic imagery, including Marla’s dildo, the penis flashes in the movie, and the various castration scenes. For a full discussion of the Freudian psychology of Fight Club see Kim Werking, “Freud and Fight Club,” http:/www.ece.utexas.edu/`werking/freud%20 and%20fc%20final.htm 5 My insert in brackets. 6 Tyler Durden uses this phrase, which appears in Freud’s Civilization and its Discontents; Mark Twain also discusses the importance of soap as a way to reinforce the hegemony of western civilization at the expense of the other in Innocents Abroad. 7 Enrique Vila-Matas has written a novel entitled Bartleby and Co. in which he attempts to track down various literary Bartlebys, characters who suffer from an inability to engage the world. He does not refer to autism or Asperger's syndrome, but he does elevate the "Bartleby" syndrome to heroic proportions. 8 Sam Harris believes that organized religion itself, in our case Christianity, stands in the way of effective HIV prevention. “…even the most docile forms of Christianity currently present insuperable obstacles to AIDS prevention and family planning in the developing world, to medical research, and to the development of a rational drug policy – and these contributions to human misery alone constitute some of the most appalling failures of reasonableness in any age” (150). Even if Harris is exaggerating, there can be little doubt that the Christian right is an active agent in making the struggle against STDs highly problematic.

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 9

Although there is now greater interest in the Black Church to confront HIV and its affect on the African American community, there are still too many voices that continue to call for abstinence as the solution. For both sides of the issue see Smith J, Simmons E and Mayer KH, “HIV/AIDS and the Black Church: what are the barriers to prevention services?” Religion Newsweekly, Episodes # 329 and 519, “AIDS and the African-American Church” and “The Black Church and AIDS.”