An Anatomist of Pleasure Gives Voice to the Body in Pain

Pain, it has been said, is the great censor, the eater of words. Pain shatters language; it remains untranslatable—not just anti-narrative but pre-narrative, calling us back to our first sounds. In the canon of illness writing, there are those accounts—Alphonse Daudet’s “In the Land of Pain” and Christina Crosby’s “A Body, Undone,” to name two—which closely observe how pain shapes a life, how it exists both within and alongside the self as antagonist and intimate companion (Nietzsche called his chronic pain his dog). Typically, however, writers do not sit long with their pain; they busy themselves with the history, the social meanings of sickness. Pain, on its own, seems to have no plot; as Emily Dickinson wrote, it “has an Element of Blank.”

Perhaps it is a great anatomist of pleasure who can fill in some of the blanks in the story of pain. Garth Greenwell, the author of two previous works of fiction, “What Belongs to You” (2016) and “Cleanness” (2020), has been lauded for his depiction of sex—our “densest form of communication,” he calls it. His sinuous, stately sentences have brought a formal feeling to scenes of cruising; public bathrooms have become versions of the nineteenth-century ballroom, full of their own occult codes, hierarchies, the season’s new beauties. The books have followed the same narrator—a writer and a Southerner by birth, who has spent time teaching poetry in Bulgaria. We meet him again in Greenwell’s latest novel, “Small Rain,” in the late summer of 2020. He is now living in Iowa, teaching at a college. He is working in his study when it happens: he feels a twisting pain in his stomach, as if “someone had plunged a hand into my gut and grabbed hold and yanked, trying to turn me inside out and failing and trying again,” he says. “Like that, while somebody else kneed me in the groin.” For eight hours, he crouches on all fours, waiting for the pain to subside. His partner—a man identified only as L—begs him to seek treatment, but the pandemic is blazing; hospitals seem unthinkably dangerous.

“When I try to remember my thoughts they come broken and scrambled,” the narrator later recalls. He has become “a creature evacuated of soul.” Finally, the pain prevails; he goes to the hospital, where he is labelled as the dreaded “interesting” case. Specialists flock to his bed. Days tick by. He struggles to understand the diagnosis of an infrarenal aortic dissection, a rip in the aorta. In nearly half of all cases, it is instantly fatal. “The words didn’t mean anything, I only understood one of them, aortic; there sprang into my mind a scrap of a poem, the blowing aorta pelting out blood, which I couldn’t place and was of no help at all.”

Each blood draw, each medical detail, is presented with documentary precision, lifted, one assumes, from life. Greenwell’s fiction often seems to skim from experience, and he has spoken about his own frightening hospitalization in 2020. His previous books were closely observed minuets of pleasure, power, humiliation between lovers. “Small Rain” again reports from the site of the narrator’s body, the body in the hands of strangers. The narrator becomes conversant in a new language—the language of the medical system—and a new vocabulary of touch. He learns whose hands are efficient, and whose are clumsy, whose touch renders him a body, a problem, or a person.

There is something almost showy about the formal challenge of this novel. It unfolds, for the most part, in a hospital bed, with only a strip of visible sky. There are few meaningful characters, just the rotating sequence of doctors, nurses, and cleaning personnel, masked and identifiable mostly by their hair styles—this one’s tight braids, another’s curls. “Place is at the heart of writing for me,” Greenwell has said. “More or less everything I’ve written has been spurred by a response to a particular place.” “Small Rain” is not a book about the hospital or the medical system, however; it unfurls internally, in the consciousness of a character, a consciousness aware of itself evolving, shaped by a terrible new pain and knowledge. Tangled in tubes, with machines that beep and bring constant news of his body, the narrator participates in a similar activity, of self-monitoring, retrieval, and discovery; he watches himself, he learns about himself, but he relies on an older technology—he uses the sentence.

What sort of technology is a sentence? It can reflect, like a mirror; it can reveal, like an X-ray. It can arrange and bring order to chaos, like a pair of hands. It can dilate, split, and suture, bridge the private and public selves. Form follows function, and Greenwell’s sentences are marked by their distinctive shape. Here are three examples from the first two books:

Are you mad at me, he asked, and I wasn’t quite, anger wasn’t really what I felt, or not yet. (“What Belongs to You”)

I wasn’t sure what I wanted, or what I wanted had changed. I had thought I wanted to make him laugh, that after that I wanted sex, but I didn’t want sex, I realized, or not only sex. (“Cleanness”)

Feeling a heat in my gut that I recognized as shame, but it wasn’t sharp yet, it was distant or dulled, and though I knew in the next days I would be miserable with it I turned away from it now. (“Cleanness”)

These sentences curve in on themselves and force themselves to fray—not only to reveal the hidden strands in even our simplest thoughts or wants (the seed of reluctance in desire, the spark of want in fear) but, it seems, to incapacitate our predilection for quick judgment. We trip on those crisscrossing clauses. Syntax becomes an instrument of slowness, an enforcer of patience and careful distinction. When the narrator pauses, in sex or conversation, to frisk his own feelings, to ask himself if he is experiencing pain or merely intensity, fear, or excitement, the writer does not intrude or resort to voice-over. The moment hangs open, framed by curiosity, and kept safe from the imperative to name and tame. This is the real setting of Greenwell’s fiction—not the hospital, the classroom, the night clubs in Sofia, but this space that exists within them, within ordinary life, a realm unlatched by those forked sentences, in which time is slowed, and a deep, receptive kind of contact with the other, with the self, is permitted to bloom.

In “Small Rain,” the attempt to capture pain in language transforms those sentences. Pain, the narrator observes, “had become a kind of environment, a medium of existence; I wasn’t impatient or bored, there was something fascinating and dreadful about the experience of my body. I began negotiating with it, with the pain or with my body.” Pain supplants his will, as desire once did. It arranges his days—sometimes it breaks old habits and reflexes, such as the mindless scrolling on his phone. It reorders his rhythm, his relationship with time. He stares out of the window, at the sparrows, with wonder—“unoccupied but not anxious or bored,” he realizes. “I had lost my sense of time as a thing that could be wasted.” Pain even unpicks the elaborate tone. Gone is Greenwell’s glittering ceremony, the long sentences tinkling with semicolons. Commas are inserted casually, idiosyncratically. The language is softer, mussed, exploratory. Pain makes a mockery of control; the armor of high style is loosened.

Greenwell’s writing has always revelled in how we are made singular by our desire, its strength and specificity. His narrator has shown us how his tastes have been shaped by his past, his wants occasionally emerging from the darkest and most fearful moments of his life, as if he has found a way to salvage them—in a sense, to give them use. Physical pain and vulnerability, he finds, do something different. Pain is deeply democratic. Pain makes him like everyone, anyone else—there is a common humanity that he finds and, with it, a kind of humor, as illicit and necessary as humor in a hospital always feels. Riding “the oxy hum,” our poet unleashes rapt and deeply stoned odes to the “ensouled” trees. He wonders at his capacity for wonder. He holds up a potato chip and loses his mind in admiration and horror. “It was thin and almost weightless, an amazing object, really, if you think about it, a miracle of engineering, a kind of transubstantiation of a root vegetable,” he marvels. “I knew it was pernicious, one of the manipulations of capitalism . . . really it symbolized in miniature the utter decadence of all genuine value, the fall of a culture, absolute bliss.” He goes on like this, for another few pages, ending with a thunderous coda on potato chip as document of civilization and barbarism.