Nurse! My pen! Hanif Kureishi’s hospital musings and the art of sickbed writing

The author has published 10,000 words since being left paralysed – about the able-bodied, sexual positions and racist taunts. From Hilary Mantel to Audre Lorde, we look at how illness changes a writer

“What could we possibly be afraid of after having admitted to ourselves that we had dealt face to face with death and not embraced it?” Audre Lorde asked herself in her journal in 1978, a few days after undergoing a mastectomy for breast cancer. “For once we accept the actual existence of our dying, who can ever have power over us again.”

Lorde insisted on the new clarity, creativity and power enabled by the revelations of illness. The women she saw as succumbing to the lure of prosthetic breasts had for her refused enlightenment. This is empowering but also relentless: why should the ill be wiser than anyone else? What makes Lorde’s Cancer Journals genuinely revelatory is that insights of this kind are packed in amid despair and anger – accounts of staring out of the window and masturbating into exhaustion.

There’s a particular value in writing in real time about illness, which we’ve seen in what Hanif Kureishi has been hurling out into the world from his hospital bed in Rome. Since his mysterious fall on 26 December, possibly following a fit, he has sent daily missives, dictated to his wife and son and published on Twitter and Substack, now amounting to 10,000 words.

Kureishi’s dispatches have proved incredibly popular. The Covid years confronted us with our mortality and reminded us that we’re all a constant amalgam of health and disease. Simultaneously we’re ground down by the attention economy, and here is the bite-sized revelation we can handle. There’s the intimacy of it: suddenly I get daily emails from Kureishi in my inbox, telling me how many hours of sleep he’s had and what it’s like to think about sex when your body has ceased to be sexual.

The broad movement of Kureishi’s letters is from self-pitying disbelief and despair to a more open sense of the insights that bodily disorder can bring. The early ones talk about living a “half life” and being a “vegetable”. One onlooker rightly commented on Kureishi’s Substack that the “half life” description is “an insult to millions of people living full and productive lives with disabilities”. Kureishi must know this, but he’s a man used to bearing the weights of insults – in one of the entries he itemises the terrible racist slurs he encountered in adolescence. It’s as though he’s invoking his own prejudice and shame in order to reach rock bottom and find somewhere to grow from.

‘Who can ever have power over us again?’ … Audre Lorde in 1983.
‘Who can ever have power over us again?’ … Audre Lorde in 1983. Photograph: Robert Alexander/Getty Images

On 9 January, the day Kureishi sits up for the first time, he tells his pianist doctor to try to make a wholly new sound on the piano, in order to find a new self. The doctor is alarmed, so Kureishi tells him that “fear is the engine of art, the engine of conversation and love”. Gradually, in the days that follow, he convinces himself of the truth of this in his own situation, relishing the creative thoughts he’s having amid the stillness, and celebrating his dependence on others even as he envies them their able-bodiedness. And in the hospital gym, he learns to find the “mutual work” between patients and therapists a source of “beauty, collaboration and respect”. He berates the able-bodied for the kinds of prejudices he displayed in his early letters. “It is as if we want to believe that we live in a world of many healthy and well-functioning people. We do not.”

The lineage behind him, of writers investigating illness as a source of truth and creativity, is long and complex. Alongside Lorde there is Gillian Rose, who in her incandescent 1995 memoir Love’s Work reveals the terrifying enmeshedness of life, death and love. And there is Susan Sontag, warning us not to moralise illness – which probably means not seeing the ill as wise, any more than we would see their illness as the result of moral failings. In the background of all this there was Schopenhauer, insisting on the body both as a seat of “pain and deficiency” and as “the ground of our knowledge”, and Nietzsche claiming that it’s because man is “courageous and richly endowed”, “discontented and insatiable”, that he is “the most chronically and profoundly sick of all sick animals”.

Susan Sontag, who warned against moralising about illness, pictured in 1980.
Susan Sontag, who warned against moralising about illness, pictured in 1980. Photograph: Ullstein Bild/Getty Images

It was Thomas Mann who turned Schopenhauer’s pessimism and Nietzsche’s ecstatic nihilism into a theory of art. In notes made for his Goethe and Tolstoy essay while writing The Magic Mountain, he defined sickness as “the truly human tragic contradiction”. In The Magic Mountain he found a form capable both of portraying the growth enabled by sickness and of ironising any notion of such growth. So its protagonist Hans Castorp, who has grown up romanticising both illness and death, comes in the snow to see that “who knows the body, life, knows death”, transcending the separation of mind and body, life and death. For Mann, as for Castorp, sickness was a kind of precondition of genius, but he also needed to see the comedy of illness, and especially of the medical world, in his fiction.

Castorp doesn’t write during his illness, though he reads and listens to music with new intensity. But the desire to work often consumes sick writers, whatever Virginia Woolf may have said about illness not being a major theme for literature. Kureishi returns lovingly in his letters to his first discovery of his vocation, and of the fountain pens he fears he’ll never hold again. “Writer” was an identity to hold up against the bullies who taunted him with other labels, so there’s a fear now that if he stops writing he’ll fall into their hands. Hilary Mantel wrote in her extraordinary memoir Giving up the Ghost that after her body was rendered unrecognisable by its medical maulings, she wrote in order to locate herself “if not within a body, then … between the lines where the ghosts of meaning are”. Meaning remained as elusive as ever but her disembodied self needed somewhere to hover.

Among the writers I’ve mentioned here, Kureishi is unique in dictating his writing to others. I’ve found the depiction of his relationship with his wife Isabella that has emerged through their collaborations to be the most moving aspect of his letters. We have the impression here of a woman at once utterly generous and rightly insistent that she has to survive this herself. Self-pity of the kind seen in Kureishi’s early letters can consume everything; this is the writer, after all, of Intimacy, the 1998 autobiographical novel in which an unfaithful husband showed endless interest in his own capacity for boredom and desire and very little curiosity about the brittle estrangement of his wife.

‘If not within a body’ … Hilary Mantel, who wrote about her illness in her memoir Giving up the Ghost.
‘If not within a body’ … Hilary Mantel, who wrote about her illness in her memoir Giving up the Ghost. Photograph: Jane Bown/The Observer

In Lorde’s journals, she worries about how it will feel to brush her chest against a lover and only feel one breast. Kureishi has similar anxieties, which he assuages by looking forward to renewing the act of cunnilingus and looking back to the sexual conquests of early middle age. His accounts of sex and drugs with a young woman in Amsterdam would be unbearably smug were it not for this interjection: “If this was a film, the camera would be close on Isabella’s face as she writes this down for me.” Isabella, mocking his limited insights into Italian politics, despairing of cleaning his teeth successfully, giving up in exhaustion and handing over to his son, is an autonomous figure here. The most powerful, painful moment is when she turns to him and asks: “Would you have ever done this for me?” Kureishi can’t answer. “I don’t know,” he dictates in the retelling. He may reveal more than he means to here. This isn’t a novel, where he’s in control; his writing escapes his grasp and reveals the pain of love. We give each other what we can, which is everything, but may also be terrifyingly imbalanced.

I wonder if Isabella is writing her own journal. I’d like to see them published together. I wonder, too, how Mann would write Kureishi – which of the insights of “our hero” would remain unsatirised? Nietzsche’s sick animal is a creature constantly spinning fictions and Kureishi is too good a writer not to be aware that this is what he’s doing. At the end of The Magic Mountain, Mann terminates Castorp’s revelations and sends him off to the front. I look forward to Kureishi’s own novel about these experiences and wait to see what larger sense of the historical world he’ll use it to reveal.


Lara Feigel

The GuardianTramp

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