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Fever Dreams—Investigating the Memoir

WHEN SUSANNAH CAHALAN was twenty-four-years old, an up-and-coming journalist at the New York Post, she contracted a sudden, unidentifiable illness eventually diagnosed as “anti-NMDA-receptor autoimmune encephalitis.” What does that diagnosis mean? Cahalan wrote a book to find out. She knows how it began: she grew paranoid and anxious, convinced her apartment was infested with bedbugs. She broke into sudden fits of weeping. She had seizures. She couldn’t speak. She spent a month in the hospital and cannot remember most of it. “My body attacked my brain,” Cahalan started saying—a simplified way to describe an illness no one could explain.

Cahalan understands her memoir as an illumination of absence—a period of time when she was effectively absented from her own body—more than an act of retrospection. “Writing this book,” she says, “has been an exercise in my comprehending what was lost.” This confession of loss is also a confession of narrative fallibility: how can she recount what she can’t remember?

The answer is that she can’t. She can’t recount her life at all; she can only investigate it like a news story. In this premise—a reporter scooping her own past—her book fits into the budding sub-genre of the “investigative memoir,” most recently embraced by the New York Times journalist David Carr, whose The Night of the Gun is an account of his ill-remembered crack-addict past. Both writers are researching lives led by past selves to whom they feel only tenuously connected. For Cahalan this discovery is largely about reclamation, while for Carr it is an act of disavowal, but both writers deploy the tricks of their trade to compensate for limited memory: they interview; they look at photos and videos; they scrutinize police reports and medical notes. Like diligent journalists, both authors put a premium on the transparency of their methods.

As Ben Yagoda points out in Memoir: A History, we are living in an era that “will probably be remembered as the golden age of autobiographical fraud.” But these investigative memoirs are making a case for some asymptote of accuracy: proving themselves by confessing the impossibility of getting everything right, and then by telling you—in great detail—how hard they tried to get everything right anyway. They occupy an important fringe, illuminating from the margins of their genre an instability that already occupies its core. Their subjects—illness and addiction—crystallize with particular clarity the deceptions already intrinsic to memory.

When memory is lost, in some direct or conspicuous manner, we have to acknowledge what we should always acknowledge: that memory is constantly betraying us, constantly layering another self onto the self we actually inhabited. Which is to say, addiction and illness distill something that is already true about memory; we just have an easier time accepting this truth when it comes tagged as a pathology. Carr even points to a formula—the Ebbinghaus “forgetting curve”—that illustrates diminished retention of memory over time. Memory is a “courtesan of the brain,” Carr writes—or, in Cahalan’s case, its prisoner.

Cahalan opens her book with an isolated fragment: awakening in the hospital to find a tag on her wrist bearing the words flight risk. The detail suggests itself as perfect metaphor: her past self is constantly evading a present self that wants to capture it with narrative. But even this perception—so seemingly neat in its metaphoric suggestions—is unsteady: at the end of her book, Cahalan reveals that the memory is false. Nurses and family members have assured her that she wasn’t wearing a bracelet that read flight risk. Fall risk, maybe. But not flight risk. The memory is conjured, a vivid detail from a narrative she cannot access. This formally symmetrical frame—the book closes by refuting its opening anecdote—is also a conceptually convenient one: the predicament of being a “flight risk” is summoned not by confirmation of memory but by exposure of its evasions; this transcription of how recollection flees the recollecting self.

Cahalan eventually turns to what cannot flee from her grip: evidence. She quotes from a computer diary she kept during the initial stages of her illness: “Okay there’s no place to start but you have to, ok? And don’t be all ‘wow I didn’t spell check this’...who gives a shit what anyone things about me. I’m going to”—nothing after that. Going to what? The self who knows what isn’t around anymore. Cahalan writes: “Reading these entries now is like peering into a stranger’s stream of consciousness.” But it is not a stranger’s consciousness. It’s weirder than that. It is a homeless consciousness. If it doesn’t belong to Cahalan, it belongs to no one, which makes the memoir necessary: it offers a home to moments of consciousness that would otherwise be stranded in a kind of purgatory—not part of any life, but still part of what happened.

At various points, Cahalan offers us facsimile snippets of her own handwriting—usually attempts to understand her own illness: “4) A number of tests including MRI, CATSCAN, Spinal Tap, EEG. 5) They’ve come to to the conclusion that my brain my inflammed …” Her distorted grammar summons confusion better than any coherent sentence: it’s hard to know what “my” could mean—how “my” could apply to a brain that no longer belongs to anyone. But the unbelonging brain and its obliging hand still insist upon it anyway: My brain my inflammed, the “my” attached to swelling as well as to the mind, a pronoun of selfhood unwittingly forced into possession of this fever.

One of Cahalan’s most remarkable and compelling approaches is to narrate her hospital surveillance videos: I remove the blanket and get up, repeatedly touching the wires on my head. This evidence simultaneously summons the lost self and reinforces its disconnectedness—as if Cahalan is shifting from close third-person (in her diaries) to distant third-person instead: no longer accessing the consciousness of a stranger but simply her physical movements through a cloistered world.

Ultimately, any investigative memoir’s most important proof of authenticity is not its archive of transcripts or documents, but its willingness to use this archive to reroute or to thwart its own narrative. The investigative memoir proves itself by exposing its limits—acknowledging what it can’t see or know—and by sacrificing appealing story features (suspense, closure, metaphor) for the sake of accuracy. Carr is particularly adept at this. He begins the book with an anecdote about the time his best friend waved a gun at him, but readily confesses that his friend contests this—claiming it was Carr’s gun instead. Carr tells us, simply: “This is a story about who had the gun.”

Carr follows this pattern throughout, invoking the specter of crazy anecdotes (“Eddie came to collect one time with a sawed-off”) only to deflate them almost immediately: “Eddie waves this off many years later.” He humbles himself by confessing his penchant for accentuating the drama of his past: “It’s funny how many of our stories include the specter of guns, but twenty years later I found that nobody ever owned one.” Of course, this kind of narrative gesture is not entirely humble. Carr purchases authenticity by relinquishing narrative excitement: the loaded gun mentioned in the first scene did not go off—in fact, it wasn’t there at all. He performs that relinquishment as a sort of ritual sacrifice. This undermining of his set-up is also a kind of generic retort to writers such as James Frey—memoirists who didn’t just let every gun story stand but ended up turning them into bazooka stories.

Cahalan takes a slower approach. Before she exposes her introductory anecdote as false, she lets it stand for hundreds of pages in order to deepen the dramatic impact of its dismantling. In the end, however, it’s not the refutation of her flight risk story that is her greatest gesture toward the instability of her narrative, it is a compromise embedded in the very frame and premise of her book: she has given up the possibility of a continuous protagonist, and offered us instead a story with no heroine at its center. We even see this confusion inscribed in Cahalan’s pronouns. Reading old diaries, she writes of their author: “she remains incomprehensible even to myself.” The grammar of the sentence cannot reconcile subject and object. My brain my inflammed: our protagonist isn’t a woman anymore. We have swelling where we might expect to find our heroine.

Arguably the most disturbing part of Cahalan’s story, and one of the most sensitively rendered, are the purgatorial swaths of time surrounding this lost month—periods of partial selfhood that do not slot neatly into the binary division between sick and well. On her way back to full recovery, for example, Cahalan goes through a long period in which she calls herself functional but boring. A self has returned, but it isn’t the self she identifies as her own. When people ask, “How are you?” she doesn’t know what to say: “How was I? I didn’t even know who ‘I’ was anymore.” Every cliché—no matter how trivial—pushes on the bruise of this absent self.

For Cahalan, the act of writing is an attempt to reclaim this absent self—and to draw some thread of continuity between all the selves in which “she” felt absent. The act of writing a memoir becomes the final chapter in her memoir—its most satisfying conclusion. The logic of constructing a memoir neatly inverts the logic of her disease. If the disease can be paraphrased as “My body attacked my brain,” then this account is the opposite: the recovered brain exposing the mechanisms of the body. As Cahalan puts it, the book is an attempt to “prove to myself that I could understand what had happened inside my body.”

In this act, Cahalan has managed to write a book that feels honest and uncomfortable. Her prose isn’t particularly stunning, but it’s not the point. She is leading us through the stages of a self getting lost and coming back together in ragged pieces; guiding us through the messy reassembling of a first-person pronoun, an “I” that both asserts itself and confesses its gaps: my brain my inflammed. His gun was my gun. My gun was. My gun wasn’t. My bracelet said Flight Risk. Maybe it said Fall Risk. Maybe it didn’t. Maybe it wasn’t there at all. This is a story about who had the gun. Maybe. Maybe this is a story about maybe. Maybe this is a story about flight. There isn’t always a gun, or a bracelet, but there is always a fleeing. This is a story about the fleeing.

Leslie Jamison is the author of The Gin Closet. Her second book, a collection of essays called The Empathy Exams, will be published by Graywolf in early 2014.