(New York: Bellevue Literary Press, 2020)
My epileptic brain is intimately related to my work as a writer. A few months after my 2011 diagnosis, I experienced my first episode of status epilepticus, and sustained a mild brain injury. I did not write anything for two years. Instead, I immersed myself in medical and health-related texts: Oliver Sacks’ case histories (e.g. The Man Who Mistook His Wife for a Hat and Other Clinical Tales and Musicophilia); Susan Sontag’s works of critical theory (e.g. Illness as Metaphor and AIDS and Its Metaphors); Eula Biss’ cultural commentaries (e.g. On Immunity: An Inoculation). Each book presented new options for exploring chronic illness as a literary motif and provided strong evidence that writing about the body through the body requires a distinct endurance that is incredibly difficult to achieve.
I was initially drawn to Lisa Olstein’s Pain Studies because, like me, she is primarily a poet and has struggled with neurological illness — she suffers from migraine — for much of her life. I have long been interested in migraine due to its commonalities with epilepsy, in particular its visual and other sensory disturbances, pain, and alterations of consciousness. For example, Olstein’s beautiful description of early headache-related auras as causing “a sudden barred strangeness to the light, an accordioning of sound, an inexplicable drag on the time signature of a moment or an afternoon – understood only in retrospect” is uncanny in its similarity to my experiences with simple- and complex-partial epileptic seizures.
As I hoped, I found in Pain Studies a kindred spirit in neurological malfunction. Olstein is at her most accessible when she speaks to her personal experiences attempting to manage her pain: her neurologist’s unsatisfactory explanations about what migraine even is, her discomfort negotiating the available treatments (not cures) for her condition, and the litany of potential side-effects are familiar territory to anyone who has the misfortune of dealing with chronic neurological illness. During an encounter with her neurologist, Olstein asks if migraine is still thought to be based on vasoconstriction. The neurologist replies:
We used to think it was the blood vessels in the brain narrowing or dilating or spasming. That was something people could picture. Now, at least according to the last conference I went to, they think it’s an at least sixteen-phase neurological cascade ranging all the way from the brain stem to the prefrontal cortex. To be honest,” she continues, “I didn’t really understand it. I could tell you more if I had the handout in front of me – there were some beautiful charts and images – I’ll see if I can find it for you.
It simply doesn’t get any realer than this, does it?
Olstein’s interaction with the neurologist segues into an exploration of possible cures — “many,” “elusive,” “fickle,” “beloved,” and “ours” — and moves us fluidly from the doctor’s clinic to Pliny the Elder’s first-century A.D. text Natural History. The chapter ends with an abrupt change in form. The standard memoir/essay format switches to lists in densely-packed paragraphs. The first list catalogs a partial list of medications and alternative therapies Olstein has tried and encompasses everything from acupuncture and tai chi to beta-blockers, bioidentical hormones, and anticonvulsants like Depakote. The second list — also partial — describes side effects Olstein has experienced:
Brain bog, constipation, depression, diarrhea, difficulty concentrating, dissociation, dizziness, fatigue, hypotension, inability to find words, increased headaches, irritability, lethargy, memory loss, mental changes (other), mood changes (other) muscle weakness, nausea, numbness, sexual problems, skin sensitivity, stuttering, sweating, tingling, tremor, twitching, weight gain, weight loss, withdrawal.
The format of the list adds to the power of its content. Rather than juxtaposing side effects many people might consider acceptable with those that are most definitely not, or arranging the list in order of increasing severity, Olstein arranges her list alphabetically. The effect is that the seriousness of the risk fluctuates unpredictably; we cannot settle into a pattern but, rather, are repeatedly startled. Too, packing the therapies tried and side effects experienced into tight paragraphs (instead of a single item per line spanning many pages) beautifully mirrors the claustrophobia of both illness and cure.
Form is an important aspect of Pain Studies and, I think, one worth exploring more closely. In a statement included in the book’s press packet, Olstein speaks to her approach:
[…] I was entering a new realm: writing about a subject I had long shied away from and working in prose rather than poetry. Diving into something I’d resolutely avoided – something I’d long been afraid to take on for reasons both rational and irrational – I knew it would be an experiment in form as well as in content and voice. I wanted to see what language would reveal about certain experiences, questions, and sources – what new awareness it might allow me, what new directions it might encourage me to follow. And I wanted to explore something central to my experience not just of migraine but in migraine.
Olstein’s arrival at the lyric essay is natural and likely a long time in the making. She began exploring the prose poem — arguably a cousin to the lyric essay — as early as 2009 with the publication of Lost Alphabet, one of four poetry collections published with Copper Canyon Press. Prose poetry defies a consensus definition — I have long fallen back on Peter Johnson’s explanation that “just as black humor straddles the fine line between comedy and tragedy, so the prose poem plants one foot in prose, the other in poetry, both heels resting precariously on banana peels.” It is not an inaccurate image but perhaps does give a false impression that writers find their way to a hybrid form by accident rather by intention.
Lost Alphabet is grounded in a fictional framework: a lepidopterist (narrator) has come to a village (setting) to study moths (plot). But it also employs metaphor, allegory, and lyricism in passages describing observations of moths — a balance is struck between modalities to encourage deeper exploration of the subject.
I digress momentarily to Lost Alphabet in an attempt to highlight the scrupulousness of Olstein’s choice to explore migraine via the lyric essay form. Pain Studies is an excavation — no mere poking around! — of pain and transcends the restraints of either prose or poetic forms. As the book pushes and pulls against its subject, Olstein returns again and again to pain’s incompatibility with language. Mid-way through the book, Olstein draws from Elaine Scarry’s The Body in Pain which argues that “physical pain does not simply resist language but actively destroys it.” Olstein responds:
Setting off from this port, Scarry promises to explore “why pain should require this shattering of language,” but I find myself wanting to linger here, in the shatter. What if alongside destruction is creation? Aren’t shards the material of mosaics? That is, what if instead of prelanguage, pain is extralanguage: outside the norms by which dominant modes of language typically order and mean? Might this outsideness encompass resistance (genius-rage) and untranslatability (unbridgeable divide), alongside the possibility – even the necessity – of invention?
Technique follows, to a greater or lesser extent, the territory the writer wishes to explore. Maybe it is because the pain of migraine is pre- or extra-language that Olstein offers so few descriptions of her physical experiences with the condition. Instead, she discusses chronic pain as presented by other artists (e.g. Virginia Woolf) or cultural icons (e.g. television’s Dr. House or Joan of Arc) — the links between each reference aren’t always apparent but, in laying the shards out, Olstein achieves a gorgeous mosaic.
The lyric essay is the ideal package for Olstein’s work: The form resists narrative and is built for meditative digression, webbing, subversive arguments. Olstein gives us all the above in spades, synthesizing poetry, ancient medicine, rock lyrics, Joan of Arc, visual art, and more to produce remarkable work. Pain Studies offers no easy answers and, in many ways, does little to clarify the experience of this neurological phenomenon. But, I suspect the tangles and subversions likely mirror the untranslatability of migraine. That is the beauty of her invention.
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Lisa Grgas is the Supervising Editor and Associate Poetry Editor at The Literary Review. Her work has appeared in Tin House, Adroit Journal, Luna Luna, Fractal, and elsewhere. She lives in Hoboken, NJ.