The Paris Review

On Telling Ugly Stories: Writing with a Chronic Illness

Google “stock images of women with excruciating menstrual cramps,” “women having nervous breakdowns,” “women on hospital gurneys.” Make several of the women black even though your Google search will not produce these results. String them together on a chic laundry line with clothespins and hang it on your mantle, or maybe paste them into a photo collage, digital or print. Splatter the collage with blood. Untwist the women’s ovaries and take them away. Sew up their vaginal openings so their private parts look like the deformed hermetic triangles of Barbie dolls. You now have a visual rendering of life with endometriosis. It is a poor approximation. Throw the collage in the trash. Maybe it is too ugly after all.

In and out of invasive procedures to misdiagnose and then finally diagnose my symptoms—a colonoscopy, two upper endoscopies, a gastric emptying scan, an MRI, a vulvar biopsy, a dozen transvaginal ultrasounds, two mammograms before I was thirty-four, a laparoscopy, a laparotomy, a mosquito, a libido—I wrote a book. Several of its central characters are women suffering from chronic invisible illnesses, the kind of women in your collage. It means something to me to be able to produce when something is daily trying to take me out.

A chronic illness is a multilayered cruelty, especially when it is invisible. There are trips to the emergency room, to convenient care—which never ends up being as convenient as one might think—there is a lot of waiting around, and after all that waiting, there is a lot of “you’ll have to talk to your primary care physician during

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