How Does it Hurt? by Stephanie de Montalk (Victoria University Press, 2014), 360 pp., $40
Intractable pain is hardly the most glamorous of topics to write about, but the literature of the world would be significantly impoverished if writers only chose obviously ‘uplifting’ subject matter. Themes that seem, on the face of it, not to yield an optimistic outcome may falter at the box office or even remain permanently ensconced in the publisher’s in-tray. In general, we expect writers, fiction writers at any rate, to write despite the travails that life throws at them – but not about any suffering or disease that might impede the creation itself. Usually, of course, that choice has already been made by the writers themselves: they have elected for silent stoicism, rather than the honest revelation of their often almost unbearable physical or psychological pain. However, the psychological depression suffered by writers and artists is something that has come more clearly into focus in relatively recent times. In How Does It Hurt? we have a beautifully rendered account that focuses keenly on an almost unbearable level of suffering caused by nerve pain.
In the nineteenth century, many significant writers (not to mention other artists) died of either syphilis (Oscar Wilde, Guy de Maupassant, Frederich Nietzsche), or tuberculosis (D.H. Lawrence, Katherine Mansfield, Emily Bronte, Honore de Balzac). Speaking just off the top of my head, these ailments do not, as I recall, figure overly much in their output. By contrast, Thomas Mann wrote famously of tuberculosis in his marvelous novel The Magic Mountain and Graham Green of leprosy in his novels set in Africa, but neither was actually infected with the dread diseases of which they wrote with such inspired insight.
Writers, like other folk, may die in pain, but not because of it. But when you read of poet and biographer Stephanie de Montalk’s odyssey of suffering, in her superbly written account, you can only admire the fact that she still lives and still writes. Even the burden of my own chronic depression over the last 15 years, my manic depression, seems like the soft side of human suffering compared to what de Montalk has endured. My physical pain has largely been dental, rather than anything more serious. De Montalk’s chronic physical pain arrived thus: ‘In 2003, I slipped and fell heavily on a marble bathroom floor in Warsaw, injuring my pelvis. As the acute pain of that accident turned first into the severe chronic pain of an obscure nerve entrapment, and then into the intractable neuropathic pain of nerve damage, I became aware of much awkwardness around, and reluctance to speak plainly about, physical pain – continuing pain, in particular.’ So she has endured some 12 years of ongoing pain, often misunderstood, or else not believed in as actual rather than merely psychosomatic. Sometimes the pain eases a whit, only to return with frightening intensity.
De Montalk makes a crucial distinction between acute pain, often associated with disease, and her own less well-known malady of chronic pain where the patient is suffering constantly over many years for little apparent cause – no visible trauma, no readily identifiable disease. As if the pain wasn’t bad enough, it often does not readily respond to the usual painkillers. The sufferer is stuck with their suffering and quite often unsympathetic doctors. The condition is rare rather than common, but as is so often the case, once a condition of malaise is clearly identified for the first time, more and more cases come to light.
This is how de Montalk writes of her pain, using relentlessly uncomfortable and cruel metaphors that makes us wince in sympathy, though of course not actually suffer:
It burned: a smokeless flame, a coal smouldering. It drilled. It needled like crushed glass. It radiated out and pressed down, a non-existent weight from the vicinities of the left and the right ischial spines. On glorious Indian summer afternoons I lay on a sofa oblivious to the buzz of sun and cicadas, wondering why mainstream analgesics were having no effect, how pain of this degree and debilitation could be caused by bursitis or tendonitis. Repeated consultations uncovered nothing. An MRI scan of the pelvis and lumbar spine was normal. A bone scan picked up the three fractured ribs but found no sign of ischial entheistis, or inflammation. The blood tests were clear.
This passage says it all: various medical explanations are considered for the unrelenting pain but provide no clue. Indeed, medical science is baffled. Meanwhile the patient, i.e. Stephanie de Montalk, remains in unrelieved agony.
De Montalk must have found some mental, though not physical, comfort from discovering that at least three writers have suffered from comparable, chronic, difficult-to-diagnose pain. By means of an amiable literary conceit, she ‘flies’ to Paris in 1897 (six years before the aeroplane had been invented), to do a live interview with the famous French writer Alphonse Daudet, author of several novels, plays and short stories. His novel L’Immortel was a savage attack on the Académie française (aka the French Academy), that quasi-official body of distinguished French writers from which he was excluded. He is in good company, as Molière, Proust, Balzac, Flaubert, Diderot, Verne, Zola or Sartre were also not welcomed as members. By contrast, many of those who belonged were rather mediocre writers, and often Roman Catholic clergy or politicians. The academy’s 40-strong membership remains the putative watchdog of the French language. Yet, despite the fact that it has a distinguished past going back to the sixteenth century, its recommendations are often not followed.
In her imaginary and poignant interview, de Montalk revisits the pain Daudet experienced. Be warned, this isn’t comfortable reading:
Rats gnawing at your toes with razor teeth. A blade repeatedly thrust into your little finger. Intolerable flashes of pain in your heels and the soles of your feet. A pocket knife twisting beneath your big toenail. Muscles ground beneath the wheels of a wagon.
The horrors of a religious Inquisition, experienced on a daily basis. If that was not enough, Daudet adds that, worst of all, was a continuous spasm in his ribs like hoops of steel crushing his lower back. In Daudet’s case, morphine provided some relief though not, it would seem, for de Montalk. Other lesser-known writers, Harriet Marrineau (1802–1876), and the Polish poet Aleksander Wat (1900–1967), also suffered terrible chronic nerve pain. In the case of Wat, when the pain was too great for him to physically write he would whisper the words of his poems into a tape recorder. Too add to his agony, he was arrested on suspicion of having anti-Communist views and he also suffered from manic depression. After 13 years of suffering, he took his own life. All three of these historic writers, and de Montalk, have shown extraordinary courage in pursuing their art under appalling conditions of discomfort that would make most of us wilt. My guess is that writing itself serves as a partial antidote to – a distraction from the pain.
De Montalk’s book also has the kind of thorough and exhaustive, though never exhausting, footnotes, that made Oliver Sacks’ first classic book Awakenings famous. And while de Montalk’s bibliography gives evidence of an unusually wide range of relevant texts consulted, her own book deserves to be regarded as a classic on the singularly uncomfortable subject of ongoing human bodily suffering. De Montalk also pays warm thanks to the unswerving loyalty and continued support of her husband. It seems likely this book will be recognised for its excellence and may well win an award. If so, it will be a well-deserved honour.
MICHAEL MORRISSEY is a novelist, short-story writer, poet and anthologist who lives in Auckland. His many books include the 2011 memoir Taming the Tiger: A personal encounter with manic depression, published by Polygraphia NZ.