We Tell Ourselves Stories: Leslie Jamison’s The Empathy Exams

Nathaniel Popkin

Minneapolis, MN: Graywolf Press, 2014. 218 pages. $15.00.
(Click on cover image to purchase)

The day I read Leslie Jamison’s new book of essays, The Empathy Exams, I took our family parakeet to the veterinary hospital. For weeks, the bird hadn’t sung. His feathers were puffed, wings droopy. His jowls were heavy, as if he’d been besieged with terrible news, and he was breathing heavily.

In the sterile triage room, the kind of aggressively neutral setting that Jamison seems drawn to in her essays, the veterinary doctor, whose name I didn’t catch, smiled warmly, compassionately, and recommended humane euthanasia. Was this really all we could do? Even in the best vet hospital in the nation, we were limited—by reality, and the capability of language. What’s to say when you’re about to lose a minor friend, an aesthetic pleasure really, a slash of fervid green in the gray kitchen? How should I feel?

These are Jamison’s questions in this beautiful, searching book. The eleven essays are joined by Jamison’s need, as an intellectual woman in her late twenties and a novelist of acute sensitivity, to make sense of sudden change: a “sinister” skin eruption, a lover who retreats without warning, a crippling streetcar accident, an unexpected arrest, an unprovoked punch in the face. If we’re the victim, how do we cope? If we’re a friend or a mother or a pen pal of the victim, how do we confront his pain? “When bad things happened to other people,” she writes, “I imagined them happening to me. I didn’t know if this was empathy or theft.”

Jamison’s self-questioning tone seduces the reader quickly. By the time of the above quote on page twenty, in the book’s title essay, “The Empathy Exams,” I’m hers—in part this is because she’s forthcoming about herself without testing the reader’s patience. We learn that she likes to drink, that she can be an emotional chameleon, that she’s had surgery on her nose, her jaw, and her heart, and that she’s had an abortion. This isn’t confession, but exploratory surgery. “I want to sit down in front of everyone I’ve heard—listen to their voices in my tape recorder like a child, like an agnostic, like a pluralist. I want to be the compassionate nurse, not the skeptical doctor,” she writes.

Jamison has worked as a medical actor, assuming the roles of patients with various conditions to aid in the training of doctors. Compassion and empathy can be taught through role-play and evaluation—empathy exams. She plays Stephanie, who suffers from a psychological condition called conversion disorder. Stephanie subconsciously redirects emotional pain into otherwise inexplicable violent seizures. Because the seizures appear to have no physiological cause, a physician or a family member might imagine that the patient can control herself and stop wildly kicking. She can’t. She also doesn’t seem to care.

To feel for Stephanie, Jamison writes, one must therefore be able to acknowledge “a horizon of context that extends perpetually beyond what you can see.” Trauma starts somewhere, moving eventually “out of wounds and across boundaries,” from the hidden heart to the broken body. Jamison wants to follow it, back and forth, from source to symptom.

The author has spent much of her twenties traveling. She is skilled at placing herself in the physical landscape while exploring guilt, shame, and need. She excels at using physical metaphor to heighten her point: empathy, like travel, is a means of searching for both connection to others and self-knowledge. Jamison was working as a Spanish teacher a few years ago in the ancient colonial city of Granada, Nicaragua, when she was mugged. Granada is the kind of place you can feel like you know, even as an outsider, until trauma forces you into retreat. “Only a man coming at me from behind, turning me around, hitting me hard. No deception. One of the most honest gestures I’ve ever seen,” she writes in the essay “Morphology of the Hit.” “My nose was broken. The bones of the bridge got shifted. The flesh swelled like it was trying to hide the fracture beneath. This is how speech swells around memory. How intellect swells around hurt.”

After the mugging in Grenada, Jamison moved to New Haven, a city with a difficult reputation for crime. She withered with fear. “There is a notion we absorb about suffering—that it should expand us, render us porous—but this didn’t happen to me,” she writes. “I felt shrunk.” Instead of focusing on the source of her fear, she spent time reading James Agee’s classic 1941 book of reportage Let Us Now Praise Famous Men, she tells us in the essay “Pain Tours (II).” Agee’s guilt about his interaction with the sharecropper families he portrays in the book replaces her own. “I loved getting sad about Agee because his sadness wasn’t mine,” she writes. The great wonder of this book is the way Jamison allows herself to absorb the pain of others. It’s a laudable literary urge that lends dimension to her stories. In the essay “Fog Count,” we observe the injustice done to Charlie Engle, in a West Virginia jail for tax fraud, but we also see Jamison struggle to separate herself from him. She can’t do it. The place itself—the incarcerated have doubled in West Virginia since 1990, she tells us—is nearly crushing. As she absorbs Engle’s dissonance and despair, she also absorbs the disquieting landscape, calling her friend’s house where she crashes after meeting Charlie at the penitentiary “a paradise on damaged land.”

Jamison is worthy of Agee when she allows place to press in on her search for empathy. Metaphor then meets reality. In the essays that take place in Frozen Head State Park, Tennessee, the silver mines of Potosí, Bolivia, and the “eerie and wondrous” Watts Towers in Los Angeles, landscapes of the heart merge with landscapes of man and nature. So powerful are these sequences that Jamison seems less convincing when she lets go of landscape. The essays that seek solace in ideas, in words alone, disconnected from place—“In Defense of Saccharin(e),” on the concept of sentimentality, and “Grand Unified Theory of Female Pain”—feel like intellectual, semantic debates inside the author’s head. Does it matter if sentimentality is, as Oscar Wilde observed, cheap emotion? In these essays, Jamison’s personal accounts feel cloying. It’s as if she really is better off landing her empathy on others, when her sensitivity sears the page.

This is most evident in the essay “Devil’s Bait,” her encounter with a group attending a conference in Austin, Texas, who have Morgellons disease, a condition that’s only been given credence recently, as the growing colony of sufferers have taken to the Internet to prove their pain real. They find themselves suffering from unidentifiable matter coming out of their bodies: thread, insulation-like fiber, crystals, larvae. “They didn’t know what this matter was, or where it came from, or why it was there,” Jamison writes, “but they knew—and this was what mattered, the important word—that it was real.” A 2012 study by the Centers for Disease Control suggested the condition was just as likely “delusional infestation.”

Jamison confesses that she once discovered something growing from her ankle, “a small pale maggot,” ultimately removed by a doctor. But the possibility that other parasites could still be alive underneath her skin obsessed her. Now she is face to face with dozens of people “covered in records—fossils or ruins—of the open, oozing things that once were,” all of them desperate for a cure. A woman named Kendra’s face and chin are replete with sores covered over with pancake makeup. “I’ve messed up part of my chin,” she tells Jamison. “It’s almost like trying to pull out a piece of glass.”

Once Morgellons arrives, it spreads. The conference attendees douse themselves with acid and fire in order to rid the invaders. “What does it look like when the self fights itself?” Jamison wonders. “When a person is broken into warring factions?” Throughout The Empathy Exams, she asks this of the people she meets, and of herself. Empathy as a mode of relating exists in the asking. We see ourselves in each other coming undone. From the first paragraphs of “Devil’s Bait,” I sensed that once I had tried to pull out a Morgellons growth. How could this be? It was a testament to Jamison’s power as a translator of human pain. I was feeling what she wanted me to feel.

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