A Little Abstract, a Little Solid
by Francis Blagburn
Picador, 320pp, ISBN 9781509874699, £18.99
In her 1926 essay ‘On Being Ill’, Virginia Woolf wrote that ‘illness has not taken its place with love, battle, and jealousy among the prime themes of literature.’ Almost a century on and it’s still true. There is, of course, plenty of excellent writing about illness, and more of it arriving all the time, but it’s relatively rare for this to take the form of the novel.
You could argue that novelists and their publishers have a pretty good excuse: that pain 'actively destroys’ language by reducing the sufferer to pre-linguistic ‘sounds and cries’, as the essayist Elaine Scarry put it in The Body In Pain (1985). But not everyone is so defeatist. ‘That English lacks an adequate lexicon for all that hurts doesn’t mean it always will,’ asserts Anne Boyer in her meditation on breast cancer, The Undying, ‘just that the poets and marketplaces that have invented our dictionaries have not — when it comes to suffering — done the necessary work.’
When Garth Greenwell’s Small Rain was announced, then, it came as a relief. On a personal note, my wife has a chronic illness, and the idea that this novel could resonate with her experience of sickness and suffering, and mine of loving and caring, felt promising.
The book reacquaints us with the unnamed narrator of Greenwell’s previous two novels, What Belongs To You and Cleanness, no longer living in Bulgaria but settled in Iowa. The action opens with a breathless paragraph. An obliterating pain has struck him down, which he is struggling to explain to an anonymous mass of medical practitioners. He has been asked to verbalise it using a scale of one to 10 but — like the sufferer in Woolf’s essay who tries to describe his pain to a doctor only to discover 'language at once runs dry’ — he finds the pain ‘defied description . . . it demanded a different scale.’
So begins a novel that applies a poet’s ear to the linguistic maze of medical treatment, from the crude, sometimes militaristic metaphors that are so frequently used by staff (drugs ‘burn out’ veins, antibiotics are administered with a ‘carpet bomb approach’) to lyrical accidents (blood flowing around a tear in the inner layer of the aorta is known as a ‘false lumen’, which the narrator pauses to admire: ‘such a beautiful phrase’).
Cold hard information is hard to glean in the hospital. It is only through his passing acquaintance with someone who happens to work there that we confirm his condition, an aortic tear, is precarious and could be life threatening. Given he’s in his forties, this turns him into a medical marvel. He is prodded and looked at and studied as he remains bed bound, becoming a body in a system, a site of various intravenous technologies (‘I was wired in as much as the machines themselves’), stripped of everything that particularises him as person in the world, except the poetry inside his head, his love for his partner L, and the hope of returning to the home they are making together. Faced with the possibility of death, he meditates on questions of value: has a life dedicated to art and poetry been a life well lived? Is there such a thing as an art of living? Just how incredible is it to eat this potato chip?
As the word small in the title implies, this is, in a way, a humble novel. It’s also probably the first of Greenwell’s novels to feature occasional comic undertones (see: the potato chip). His descriptions of the pain itself are not overwrought, or even conspicuously lyrical. He does a lot with simple language:
It was like someone had plunged a hand into my gut and grabbed hold and yanked, trying to turn me inside out and failing and trying again. Like that, while somebody else kneed me in the groin.
Greenwell’s additive prose — all the repeated ands, as though the sentence is building, feeling around to create meaning — evokes a kind of poetic clumsiness that acknowledges, or contains within it, the difficulty of writing pain. The above description reminds me of the language I’ve heard my wife use when describing hers: violent and figurative, conversational and vivid. A little abstract, a little solid.
Greenwell is an apt writer to approach the theme of sickness precisely because he understands so deeply the problem Woolf identified in ‘On Being Ill’, that ‘We do not know our own souls, let alone the souls of others.’
Unknowability is perhaps the great theme of Greenwell’s novels so far: ‘we can never be sure of what we want,’ as the narrator puts it in Cleanness (2020). If there is a single writerly technique that defines all three books, it’s locating with surgical precision the moments where a person reveals some new part of themselves. This motif appears most strikingly in What Belongs To You (2016), when the narrator rejects his lover, Mitko, who responds with the threat of danger: ‘he wore a face I hadn’t seen before. . . I wondered whether it was a face he had just discovered or one he had hidden all along.’ But it’s in sickness that this inscrutability, this division, finds its truest form. When Mitko returns to him later in that book, now deeply ill, vulnerable, and facing death, the narrator reflects: ‘though I held him more tightly the space that had opened up between us remained, and I knew I would stay on the other side of it, the side of health.’
In Small Rain, the narrator has discovered that such a division is only ever fragile. He had thought his own syphilis had been adequately treated, but this is called into question while tertiary syphilis is investigated as a possible cause of the mysterious aortic tear. Facing the vulnerability of being a body, his relationship to love and care shifts. In What Belongs To You, he considers looking to be the greatest expression of affection. ‘Love isn’t just a matter of looking at someone, I think now, but also of looking with them, of facing what they face.’ Care, too, is construed this way. ‘That’s all care is,’ the narrator thinks, ‘it’s just looking at a thing long enough.’
But in Small Rain, being looked at is more likely to be experienced as invasive; the narrator discovers that care, and love, is more meaningfully felt in the form of touch. It’s a remarkably tactile book, all the more so because of the absence of touch for so much of it. The setting of the pandemic, with its PPE and systemic isolation, is crucial –– in a recent talk in London, Greenwell mentioned that, as he was writing Small Rain, he drew on the literature of Aids, in which the sick body is centred. During this crisis, too, people were kept apart. Small Rain’s emphasis on touch is not only expressed through the narrator's love of L, but also through hospital care. It’s by being touched that his humanity is restored. Touch becomes a kind of care, and care a kind of love. Here’s the narrator reflecting on a typically meaningful detail:
The other woman, the nurse at the foot of the bed, placed her hand on my ankle where it stuck out from under the sheet. It was a shock, her touch, as she softly stroked or rubbed my ankle; it surprised me and also it made me feel something else, I felt tears spring to my eyes. She was the first person who had touched me in a way that had no medical purpose, no measurable end but comfort; and also I realised it was the first touch of that kind I had had in months from anyone except L. Since the pandemic began there had been no hugs, no shaking of hands, none of the daily unremarkable corporeality that I found I missed, even though I spent so much time alone. It was an animal need, maybe, some fundamental craving for the sociality the virus had thwarted; in any case I responded out of all proportion, I felt I loved her for that touch.
Greenwell is probably best known for his accomplished scenes of BDSM and sexual extremity. Invariably, such scenes are powerful, giving voice to the inchoate flux of sexual desire and power, but in Small Rain he achieves something just as, or perhaps even more, impressive for its subtlety, for the smallness of its focus. Here he is describing the narrator, still weakened by illness, but finally united with L, lying in bed together for the first time since their shared, but separate, ordeal. Again, it’s a kind of aria to the humanity of touch. This time, he makes care sexy:
It wasn’t really sex, what we did, I was too exhausted, too weak, we mostly used our hands. I wanted to touch him everywhere, after so many days unable to touch him, only our hands had touched in the hospital but now I stroked his back and his chest, his face, I sucked on his tongue in my mouth, and even that was a kind of exertion; when I came, from his hands and my own, while he kissed my neck and face, while he whispered to me his love, my heart was pounding, I had to close my eyes against the spinning dizziness I felt.
It’s in these subtleties that Small Rain excels. In What Belongs To You and Cleanness, the calm, digressive tone is routinely ripped out from underneath the reader’s feet by artfully obscene sections in which the narrator finds himself in objectively extraordinary and sometimes dangerous circumstances.
There’s danger in Small Rain, and the stakes are life and death, but it’s a different danger, a more public danger. During an early section describing his hospital treatment, I worried it might become a little repetitive by comparison to his other novels, unclear how the story could progress, how deeper waves of tension could emerge. I feared that settling down with the love of his life, L, might be great for the narrator, but less so for the dramatic tension. And most of all, I mourned the loss of the cultural, linguistic and geographic setting of Bulgaria, which is conjured so meaningfully in the first two books, now swapped for the almost pointedly ordinary setting of the Midwest and the hospital.
Happily, I found that Greenwell illustrates these locations just as vividly. (How could we not be transported to a Covid-era hospital room by 'the little sigh of the sanitizer pump’?) The narrator himself has taken time to move beyond ‘the usual prejudices about Iowa’ and ‘what I thought of then as the monoglot Midwest’, and his ability to appreciate the place feels like a deepening of his sense of humanity, rather than a dull domestication. Crucially, he manages to locate the drama. Moments of deep tension are made all the more unbearable due to their perceptive relatability, their veneer of normality.
In a particularly stressful section, he is assigned a nurse who’s new to the job, and lacks the professional skill or soothing manner of his other caregivers. Given the important business of keeping his pulse and systolic pressure within specific numerical limits — a crucial piece of information that, he panics, may have not successfully been passed on during the changeover of shifts — the scene is physically unpleasant to read, made more so by way of an anecdotal digression about well-meaning medical malpractice and the life-ruining effects it can have. We are inside the narrator’s helpless mind as he becomes increasingly frightened.
Another everyday moment that becomes high drama on the page is the unbearable scene in which he has to undergo a PET scan for an hour without being able to go to the toilet. His need to pee, his inability to do so on demand, the harried staff member running the scan, her barely disguised impatience, and the always unseen, looming presence of a queue of other patients who need care in the Covid-stretched hospital: all are in impossible conflict. It is a highly pressurised moment, almost culminating in an anxiety attack, but it’s also everyday life — to look at from the outside, it would just be a guy in hospital getting a scan.
This is Greenwell’s great accomplishment with Small Rain. The narrator is a guy getting a scan, and that’s enough. The novel sets down on the page the life and death drama that is being human, the great, universal suspense of having a body, because every body is doomed, one day, to fail. Until then, this book suggests, there’s the possibility that we might love it, and that others might too. That the body can be a site not only of pleasure, but of love, and of care.