After a few abortive attempts on other books (you’ll never drag them out of me … nor out of the compost bin where I hurled them), here is something which felt like a very great treat. Admittedly it scratched several of my itches before I even opened it – translated fiction, slim volume, the MacLehose imprimatur – but I was still delighted when I started it and felt myself to be in the presence of something like real literature.
The Sickness (La Enfermedad, tr. Margaret Jull Costa) is a small and piercing volume, a literary stiletto; quiet, intense and directed. It exerts an ambiguous pull on the reader’s inner hypochondriac, tickling delicately those intimations of mortality that we cannot look at directly but cannot bear to pull ourselves away from. (It might have helped that I began reading the book in the waiting room of an emergency out-of-hours dental pain clinic.)
It also fits neatly into my recent interest in books about fatherhood – here, the point of view is predominantly not that of the father but of the son. Dr Andrés Miranda has the usual difficulty of health professionals when it comes to personal involvement: too much knowledge. For a doctor used to dealing bad news to patients, the only thing worse than divining bad news about one’s own health would be learning it about one’s family. At the beginning of the book, Dr Miranda receives from a colleague some scans of his father’s chest. A combination of professional hunch, his colleague’s body language, and a son’s fear leads him to presume the worst without even looking at them.
So begins a sinuous exercise in examining our attitudes to illness and death. We typically say a book is “about” its subject, and here about is just the word: Tyszka writes around the topic, with Dr Miranda circling his father’s mortality with a combination of obsessively keen interest and logical dread. After years of dealing with the subject in his work, he finds himself in a strange country, addressing illness properly for the first time. Observations that may have seemed wry in knowing exchanges with colleagues – “health doesn’t exist, it’s a heaven that forms no part of existence” – now seem like a sick joke. The hospitalised death business takes on a new horror for him.
It remains a brutal violence. Right before their eyes, a life is being pitilessly laid waste, swept away. There’s a lot of gauze, a lot of cleanliness, a lot of qualified staff, but no pity. It’s a crime for which there are far too many witnesses, a legalised crime, a crime no one can stop.
In his novel Night Train (1997), Martin Amis’s narrator was a police officer who said, of the task of delivering the worst of all news to relatives: “When you’re bringing news of the kind I was bringing there are physical ramifications. The body feels concentrated. The body feels important. It has power, because it brings powerful truth.” If that’s the case, then it must be the suppression of the news – he doesn’t want to tell his father – that makes Dr Miranda feel so bad. “He never feels rested when he wakes up; he gets out of bed like someone coming home from a dark and arduous task, as if returning to the light after a fierce battle.” His father sleeps peacefully; Dr Miranda has taken on the burden of knowledge, is doing the suffering for him. Having always believed that it is unethical to withhold information from patients, he now wavers. If only his father would die immediately, without warning, he could spare him suffering! (Spare himself suffering.) “The difficulty lies in what is not yet over, in sickness.” He finds himself doubting the worth of his own vocation, the ideal he has lived since as a child he discovered “the existence of an order distinct from words, more physical, more tactile, less invisible.” Now, however, he is reduced to words again, thinking and wondering. “Mystery always helps make death a little more bearable. All this scientific exactitude is intolerable. What’s the point of it? Who does it help?”
The answer, which he has forgotten, is that exactitude – he makes it sound so contemptible – helps the desperate, the sick who need knowledge and certainty to lean on. The layman turns to the expert who understands what is happening, who has news – powerful truth – even if it’s not good news. This thread is expanded upon with the parallel story of Ernesto Durán, a patient of Dr Miranda’s who emails him obsessively about a mysterious affliction – “the sickness” – and whose correspondence leads to a borderline farcical subplot which I felt diluted the themes of the book rather than concentrating them. But the richness of the book (it packs a lot in to its 150 pages) is enhanced by Tyszka’s introduction of passages from other authors, from Charles Baudelaire to William Carlos Williams, on the subjects around sickness. It seems to be an acknowledgement that this is a meditation on a subject, disguised as a novel. But for all its provocations, it gets pretty deep into the heart with the central story, which spares the reader nothing.
One of Dr Miranda’s colleagues regularly wonders, “Why do we find it so hard to accept that life is pure chance?” It’s a sentiment echoed in one of the literary quotations in the story, from Chekhov’s ‘Ward No 6’, when a doctor says to a patient, “There is neither morality nor logic in my being a doctor and your being a mental patient, there is nothing more to it than idle chance.” The Sickness helps explain why we find it so hard to understand: because to do so is to accept that life is not a story with a moral, but is chaos which ends randomly. In working this knowledge into a story which takes on an understood form, and splices in a couple of seductive plots, Tyszka is either having his cake and eating it, or subversively spiking the drink.