Why Is Illness So Hard to Write About?

Virginia Woolf once wrote that it is strange how illness, despite being so common and capable of profoundly transforming us, has remained outside the great themes of literature, along with love, war and jealousy. And the surprising thing is that, almost a hundred years later, this question still remains without a real answer. Most novels deal with passions and spectacular deaths, but describing physical suffering, the everyday nature of pain, always seems to defy words, even today, when the threshold of modesty has been lowered. The key point is this: we think that talking about an illness is just a matter of overcoming shame, but the real obstacle is that pain itself disintegrates language. When you're sick, you can't even think, let alone write. Then, when the pain passes, our memory becomes foggy: we remember having suffered, but we can no longer recreate that precise sensation, as if the body took its words away with it. Woolf, who in her essay “On Being Ill” called for “epic poems for typhoid; odes to pneumonia, lyrics to toothache,” never actually describes her own body, not even when she writes while ill. Her imagery is abstract, spiritual, as if physical reality were still too intimate or too elusive to be spoken aloud. On the other hand, there is D. H. Lawrence, the son of a miner, who grew up amid dust and bronchitis and who, in his novels, places illness at the center of life’s turning points. After a bout of pneumonia that almost killed him, Lawrence wrote to Louie Burrows: “My illness has changed me a lot; it has broken many of the old ties.” Shortly thereafter, he met Frieda Weekley, who would become his wife. Lawrence believed that illness revealed “unknown lands” within us, but he too often transforms physical experience into epiphanies of the soul, rather than a recounting of bodily details. Today, there are writers like Christine Smallwood, who opens her novel with the protagonist in a university bathroom passing blood and feces together, or Lena Dunham, who describes her removed uterus as “the Chinatown Chanel bag of nightmares, full of both subtle and glaring flaws.” These images would likely have shocked Woolf, but she herself wrote: “We are always afraid of originality, yet we feel that, once we have received the shock, we may rise again stronger and purified.” But even frankness alone does not solve the problem: literature is full of spectacular deaths, but real illness – the kind that lingers – remains elusive and difficult to turn into a plot. In “The Death of Ivan Ilyich,” Tolstoy focuses more on existential anguish than on the “everyday drama of the body.” The French writer Alphonse Daudet, suffering from a horrific form of syphilis, tried to describe his pain in “In the Land of Pain,” but he admitted that “words only come when everything is over, when things have calmed down.” Elaine Scarry, a scholar of physical pain, argues that “pain has no voice” and that the pain of others “flashes in the mind and then disappears.” Yet, in private, Woolf knew how to name her ailment: in her diary, she speaks of “a good deal of mouse gnawing at the back of the head” and of “a body lying like a workman’s coat.” So the difficulty is not incapacity, but censorship, modesty, perhaps fear of causing discomfort. In “Small Rain,” poet and novelist Garth Greenwell describes an aortic dissection – a tear in the body's main artery – with such precise details – the IV that hardly hurts until the nurse pushes it in further – that the pain finally becomes real on the page. But he too grapples with the dilemma faced by every author: how to remain faithful to the specific detail without losing the universal meaning? And how can we make sense of a story that, in reality, often offers neither healing nor death, but only the long limbo of chronic illness? After battling cancer, Susan Sontag goes so far as to say that “illness is not a metaphor” and that we must describe the actual geography, without romanticism. Yet, perhaps, the key is not to choose between testimony and symbol, but to find a balance. In her memoir “The Undying,” Anne Boyer describes chemotherapy and mastectomy with lucid anger: “Everything that was supposed to stay inside now seems to be falling out.” But she also turns her story into an indictment of a system that profits from suffering and imposes the rhetoric of “positive thinking.” Illness, she writes, “does not reveal hidden truths about the soul, but says a great deal about the world around us.” And in the end, after all the pain, Boyer admits: “I have lost some neural mitochondria, my beauty, many memories, much intelligence, and, optimistically, five or ten years of life to the healing forces of medical decimation.” But she adds: “The condition of being lost is, when it comes to being people, what finally makes us real.” Illness isolates us, it's true, but no one really goes through suffering alone: there are doctors, family members, nurses, and literature itself can be a way of being together. During COVID, Camus's “The Plague” came back into fashion because it shows precisely this: suffering is both individual and collective, and the duty of the doctor — like that of the novelist — is to hold together the masses and the individual, the case and the story. In the end, writing is the sign of a return to life: after days of illness, Woolf only felt alive again when she was able to write. So, the next time you think that illness is just a silent interlude, remember that trying to recount it, even poorly, is already a way to rediscover the thread of reality, and perhaps even of others. Suffering erases words, but it is precisely by trying to name it that we can come back to life. If this perspective has unlocked something for you, you can mark I'm In on Lara Notes: it's not a like; it's a way of saying that this idea is now part of you. And when you try to tell someone the story of Woolf or Boyer, on Lara Notes you can mark the moment with Shared Offline: that way, the conversation also remains in the memory of those who were there. This Note comes from The New Yorker and saves you 12 minutes of reading.