The Two Kinds of Decay

Sarah Manguso

In 1995, midway through her sophomore year of college, Sarah Manguso is struck without warning by an autoimmune condition that she describes as a rarer form of the already rare Guillain-Barré syndrome. In the years that follow, Manguso undergoes a number of risky and painful treatments that often work only temporarily. She describes in one instance that her plasma was replaced more than fifty times, and the effects of the treatment lasted as long as the fresh plasma stayed clean of the antibodies, which for several months was only about two days. Thus is the premise for Manguso’s fourth book, The Two Kinds of Decay (Farrar, Straus and Giroux, 2008), a memoir recounting the author’s nine-year bout with the mysterious blood disease that was to shape the course of her 20s. Now in remission, Manguso looks back on that period of her life with as much perspective as she can muster. Now I can try to remember what happened, she writes in the opening lines of the book.Not understand. Just remember.

What Manguso accomplishes in The Two Kinds of Decay is similar to what Joan Didion has accomplished in her own 2005 memoir, The Year of Magical Thinking, written in the aftermath of the unexpected deaths of Didion’s husband and daughter in unrelated incidents within days of each other. As any writer will attest, writers do not, or perhaps cannot, simply turn off ‚the writer in them when real life is happening. Writers walk through life equipped with an awareness, a way of perceiving what is happening to them and those around them. For the memoirist, this perception is accompanied by a period of examination-a need to communicate individual experience while also seeking to find in it that which is universal-that which is applicable to us all. In the end, these perceptions are turned into craft.

Perhaps taking a cue from Didion, what Sarah Manguso has handed us is less of a story and more of a portrait. It is a picture constructed through language of tragic and emotionally painful years, an attempt to make sense of a period of time in the author’s life that feels in every way nonsensical. Stories imply a linear progression, a recounting of a sequence of events that terminates or concludes in some way. Like Didion, Manguso continues to grapple with what has happened to her-to seek meaning and understanding and to find a constructive way of remembering. For Manguso, the act of remembering is also an act of re-living: The events that began in 1995 might keep happening to me as long as things can happen to me. Think of spacetime, through which heavenly bodies fly forever.

Also notable is Manguso’s choice of form-short vignettes composed of simple and unadorned sentences that rarely run over a page or two, which bring a rhythm to the writing that has the effect of seeming like stanzas in a poem; indeed, two of her previous publications were books of poetry. Each vignette describes a separate reflection on a separate remembered experience, or, as Didion puts it in Magical Thinking, frames of memory that come to me now. Here, intensity is achieved through brevity, a technique that enables Manguso to effectively capture the surreal nature of the situation she has found herself in: My blood plasma had filled with poison made by my immune system. My immune system was trying to destroy my nervous system. It was a misperception that caused me a lot of trouble.

Manguso is also clearly intrigued by the hard science of the disease that ceaselessly ravages her body, and we can see in her writing a need to communicate the horrific technicalities of her affliction and treatment without watering them down. As her father is comforting her on the way to the hospital for the first time, Manguso recalls that his calmness is the reason I didn’t cry until almost twelve hours later, once I was in Intensive Care, my blood already churning through a machine, when a nurse explained to me that if the strength of my diaphragm weakened five more pounds per square inch of air pressure, I’d be intubated through a hole in my neck. With language that is not flowery or in any way over the top, the author avoids the pitfalls of sentimentality that always threaten to undermine stories of personal tragedy. At the same time, Manguso professes an acknowledgment of the limitations of language: By the time I had the permanent line, the cold infusions went in very close to my heart. I need to describe that feeling, make a reader stop reading for a moment and think, Now I understand how cold it felt. But I’m just going to say it felt like liquid, thirty degrees colder than my body, being infused slowly but directly into my heart, for four hours. There is a message about communication here, that some feelings and experiences will remain locked inside our bodies no matter how we attempt to describe them to others. There are simply places that words cannot take us.

What is ultimately endearing about Manguso’s memoir is that, throughout it all, the heroine never loses her sense of irony, managing to retain something that approximates a dark sense of humor towards the whole ordeal. The nurses always congratulated me on my impressive bladder volume. I once pissed 900 cc. That was my record.

Sarah Manguso was not the first and she won’t be the last to write a memoir of illness, whether it be about one’s own struggle or that of a loved one. But this is not to say that she has not created something beautiful and significant. Ultimately, The Two Kinds of Decay is a meditation on survival, on what it means to feel oneself as a heavenly body, flying through spacetime forever; on the way in which it is important to reflect on one’s experiences, whatever they are, and to find a way to appreciate that there are lessons to learn in whatever situations we ultimately find ourselves. While she confesses to feeling that she had lost what felt like a lot of time, Manguso also emerges from her trauma having learned the virtue of attentiveness. Perhaps one of the most notable things that one learns in the wake of a horrific illness is to impart what is learned to others. In this vein, The Two Kinds of Decay leaves off with this message: …to pay attention is to love everything.