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The Two Kinds of Decay
At twenty-one, just as she was starting to comprehend the puzzles of adulthood, Sarah Manguso was faced with another: a wildly unpredictable autoimmune disease that appeared suddenly and tore through her twenties, paralyzing her for weeks at a time, programming her first to expect nothing from life and then, furiously, to expect everything. In this captivating story, Manguso recalls her struggle: arduous blood cleansings, collapsed veins, multiple chest catheters, depression, the deaths of friends and strangers, addiction, and, worst of all for a writer, the trite metaphors that accompany prolonged illness. A book of tremendous grace, The Two Kinds of Decay transcends the very notion of what an illness story can and should be.
192 pages, Hardcover
First published January 1, 2008
92 people are currently reading
5413 people want to read
About the author
Sarah Manguso
26 books995 followersSarah Manguso is the author of nine books, most recently the novel LIARS.
Her previous novel, VERY COLD PEOPLE, was longlisted for the Wingate Literary Prize, the PEN/Jean Stein Book Award, and the Mark Twain American Voice in Literature Award.
Her other books include a story collection, two poetry collections, and four acclaimed works of nonfiction: 300 ARGUMENTS, ONGOINGNESS, THE GUARDIANS, and THE TWO KINDS OF DECAY.
Her work has been recognized by an American Academy of Arts and Letters Literature Award, a Guggenheim Fellowship, and the Rome Prize. Her writing has been translated into thirteen languages.
She grew up in Massachusetts and now lives in Los Angeles.
Her previous novel, VERY COLD PEOPLE, was longlisted for the Wingate Literary Prize, the PEN/Jean Stein Book Award, and the Mark Twain American Voice in Literature Award.
Her other books include a story collection, two poetry collections, and four acclaimed works of nonfiction: 300 ARGUMENTS, ONGOINGNESS, THE GUARDIANS, and THE TWO KINDS OF DECAY.
Her work has been recognized by an American Academy of Arts and Letters Literature Award, a Guggenheim Fellowship, and the Rome Prize. Her writing has been translated into thirteen languages.
She grew up in Massachusetts and now lives in Los Angeles.
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Displaying 1 - 30 of 294 reviews
August 13, 2020
I read this in one sitting. The writing is spare, it reminds me somewhat of early Ha Jin, specifically Waiting. Is it possible to be lyrical but forgo almost all descriptions and adjectives? I wasn't surprised reading about the author afterwards that she was a poet, but there is nothing poetic about the book. She kept it dry, but dry in the best sense, like a good martini, not like a university text.
The story is of the author's dreadful illness that was akin to a chronic version of Guillaume-Barre syndrome but was more severe and has no name. It's a neurological, auto-immune disease that produced antibodies in the blood with symptoms similar to Guillaume-Barre syndrome. Periodically she would become paralysed and need hospitalising to clean her blood of the antibodies and then, until they built up again, she would be sort of ok. The treatments, some surgical, are almost medical-porn they are so graphic.
Sarah tells us very little of her life directly, more indirectly as in how the disease affected it, until the last part. The last part of the book is stream-of-consciousness edited so it sticks to the point; her life during the illness and after it. Stream of consciousness is often so self-indulgent and frankly boring to read. But this isn't. It's almost mesmerising. I did nothing for hours just read.
The story is of what can happen to anyone, just like a car crash. You can't plan for it, there really isn't much other than getting the brakes tested and living healthily you can do to prevent either, and they may not work. If you enjoy good writing for it's own sake, this book is worth reading for that alone, it's a good story, well told.
I wish the author the best of health, forever.
The story is of the author's dreadful illness that was akin to a chronic version of Guillaume-Barre syndrome but was more severe and has no name. It's a neurological, auto-immune disease that produced antibodies in the blood with symptoms similar to Guillaume-Barre syndrome. Periodically she would become paralysed and need hospitalising to clean her blood of the antibodies and then, until they built up again, she would be sort of ok. The treatments, some surgical, are almost medical-porn they are so graphic.
Sarah tells us very little of her life directly, more indirectly as in how the disease affected it, until the last part. The last part of the book is stream-of-consciousness edited so it sticks to the point; her life during the illness and after it. Stream of consciousness is often so self-indulgent and frankly boring to read. But this isn't. It's almost mesmerising. I did nothing for hours just read.
The story is of what can happen to anyone, just like a car crash. You can't plan for it, there really isn't much other than getting the brakes tested and living healthily you can do to prevent either, and they may not work. If you enjoy good writing for it's own sake, this book is worth reading for that alone, it's a good story, well told.
I wish the author the best of health, forever.
August 10, 2016
I am surprisingly devoted to books about illness and death. Indeed, many of the best books I've read in the last year or two seem to center on wasting illnesses and unexpected mortality. I attribute this not to a morbid personality but to a desire to read about what really matters: birth and death and the quality of the life in between. Perhaps I feel that in reading these memoirs I am getting close to the bone of what it means to be human and experience frailty and fatality.
Much like Susannah Cahalan’s Brain on Fire: My Month of Madness or Elisabeth Tova Bailey’s The Sound of a Wild Snail Eating, this is a stunning memoir of helplessness in the face of a rare and misunderstood illness. (In tone and pace it falls somewhere between those two: the former is a racing, journalistic account, while the latter is a gentle, dreamy meditation.)
Manguso suffered from chronic idiopathic demyelinating polyradiculoneuropathy (CIDP), a persistent form of Guillain-Barré syndrome: an autoimmune disease that attacks the nervous system, causing spreading numbness and paralysis. Without the regular plasmapheresis sessions cycling her blood plasma through a machine to remove the antibodies, that paralysis could have spread to her lungs and suffocated her.
Her story comes in brief, few-page chapters made up of pithy paragraphs, which in turn consist of fairly short and matter-of-fact sentences. The approach is similar to that of Abigail Thomas in her memoirs; although I don’t usually warm to this spare kind of writing, in these cases I do, very much – it somehow captures the speechlessness of facing physical and emotional pain.
She is unflinching in documenting the selfishness and insularity her illness produced: “there were times that I cherished my rare disease for its irrefutable proof of my specialness.” At times it was as if she was in a suffering competition with everyone else – in a tacit one-upmanship with a neighbor whose mother died of Alzheimer’s, “how sure I was that mine was worse.”
Indeed, Manguso acknowledges that suffering didn’t effect for her all of those stereotypical benefits it’s supposed to bring – promoting spiritual well-being, fostering compassion; instead, it accomplished the very opposite: “The hardest thing I’d ever done, the hardest thing I’d ever have to do, had made me a worse person! That wasn’t how it was supposed to work.” But then again, making sense of suffering so as to put it to good use is a rather futile undertaking, as any religious practitioner weary of traditional theodicy will tell you.
“My disease has been in complete remission for seven years, but I still act as if I expect it to come back tomorrow,” Manguso confides. She may not have learned much from those horrible years of sickness and anxiety, but she does offer one piece of advice: “This is suffering’s lesson: pay attention. The important part might come in a form you do not recognize.”
I hope and expect, as a believer in bibliotherapy, that when suffering hits close to home for me – because it would surely be naïve and arrogant to assume that it is a question of if rather than when – books will remind me to pay attention and sift out those important parts from life's experiences.
Much like Susannah Cahalan’s Brain on Fire: My Month of Madness or Elisabeth Tova Bailey’s The Sound of a Wild Snail Eating, this is a stunning memoir of helplessness in the face of a rare and misunderstood illness. (In tone and pace it falls somewhere between those two: the former is a racing, journalistic account, while the latter is a gentle, dreamy meditation.)
Manguso suffered from chronic idiopathic demyelinating polyradiculoneuropathy (CIDP), a persistent form of Guillain-Barré syndrome: an autoimmune disease that attacks the nervous system, causing spreading numbness and paralysis. Without the regular plasmapheresis sessions cycling her blood plasma through a machine to remove the antibodies, that paralysis could have spread to her lungs and suffocated her.
Her story comes in brief, few-page chapters made up of pithy paragraphs, which in turn consist of fairly short and matter-of-fact sentences. The approach is similar to that of Abigail Thomas in her memoirs; although I don’t usually warm to this spare kind of writing, in these cases I do, very much – it somehow captures the speechlessness of facing physical and emotional pain.
She is unflinching in documenting the selfishness and insularity her illness produced: “there were times that I cherished my rare disease for its irrefutable proof of my specialness.” At times it was as if she was in a suffering competition with everyone else – in a tacit one-upmanship with a neighbor whose mother died of Alzheimer’s, “how sure I was that mine was worse.”
Indeed, Manguso acknowledges that suffering didn’t effect for her all of those stereotypical benefits it’s supposed to bring – promoting spiritual well-being, fostering compassion; instead, it accomplished the very opposite: “The hardest thing I’d ever done, the hardest thing I’d ever have to do, had made me a worse person! That wasn’t how it was supposed to work.” But then again, making sense of suffering so as to put it to good use is a rather futile undertaking, as any religious practitioner weary of traditional theodicy will tell you.
“My disease has been in complete remission for seven years, but I still act as if I expect it to come back tomorrow,” Manguso confides. She may not have learned much from those horrible years of sickness and anxiety, but she does offer one piece of advice: “This is suffering’s lesson: pay attention. The important part might come in a form you do not recognize.”
I hope and expect, as a believer in bibliotherapy, that when suffering hits close to home for me – because it would surely be naïve and arrogant to assume that it is a question of if rather than when – books will remind me to pay attention and sift out those important parts from life's experiences.
March 10, 2022
The Two kinds of Decay
Sarah Manguso
“My existence shrank from an arrow of light pointing into the future forever to a speck of light that was the present moment. I got better at living in that point of life, making the world into that point. I paid close attention to it. I loved it very much”.
There is nothing sexy about neuropathy — and personally I’m not a stranger to rare puzzling autoimmune diseases myself..
But….
Sara Manguso’s 194 page memoir—[my first book by her]….wrote about her illness seductively poetic.
In 1995, she was diagnosed with Chronic Idiopathic Demyelinating Polyradiculoneurophy — CIDP a disease that poisons the blood.
Her story was gut-wrenching.
Her writing was gorgeous!
“Those who claim to write about something larger and more significant than the south sometimes fail to comprehend the dimensions of a self”.
“You can learn only from moving forward at the rate you are moved, as brightness, into brightness”.
Sarah Manguso
“My existence shrank from an arrow of light pointing into the future forever to a speck of light that was the present moment. I got better at living in that point of life, making the world into that point. I paid close attention to it. I loved it very much”.
There is nothing sexy about neuropathy — and personally I’m not a stranger to rare puzzling autoimmune diseases myself..
But….
Sara Manguso’s 194 page memoir—[my first book by her]….wrote about her illness seductively poetic.
In 1995, she was diagnosed with Chronic Idiopathic Demyelinating Polyradiculoneurophy — CIDP a disease that poisons the blood.
Her story was gut-wrenching.
Her writing was gorgeous!
“Those who claim to write about something larger and more significant than the south sometimes fail to comprehend the dimensions of a self”.
“You can learn only from moving forward at the rate you are moved, as brightness, into brightness”.
January 6, 2020
I love Manguso's writing and have been rationing her non-fiction for figurative rainy days. Her memoir about her "lost" nine years of dealing with a rare auto-immune disease and subsequent mental illness, does everything her other books does as well. She writes the most exquisite sentences and her use of paragraph breaks is wonderful, but here she also manages to give such an honest and unflinching insight into her suffering that this might be my favourite of her books so far. The book gets fairly graphic in its descriptions of different medical procedures but the matter of factness and the glimpses of Manguso's inner life made this a really satisfying reading experience nonetheless. Manguso is as navelgazing as ever - but I happen to really like that in her memoirs.
Content warning: detailed descriptions on medical procedures, involuntary section, suicidal ideation.
Content warning: detailed descriptions on medical procedures, involuntary section, suicidal ideation.
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September 21, 2024All autoimmune diseases invoke the metaphor of suicide. The body destroys itself from the inside.
A escritora norte-americana Sarah Manguso tinha 21 anos quando àquilo que pensava ser uma constipação se juntaram sintomas como cansaço, formigueiro nas mãos e uma dormência nos pés que, se se tivesse alastrado ao diafragma antes de ter sido levada para o hospital, a levaria a ser entubada. Depois de meses de internamentos, exames, medicação e tratamentos, foi-lhe diagnosticada uma doença autoimune, polineuropatia desmielinizante inflamatória crónica (PDIC), que a obrigou a ficar de cama durante longas temporadas, a interromper os estudos, a pôr a sua vida em suspenso.
Having spent my twenties expecting to die, I turned 30 and arrived in the afterlife with nothing left to do. I wrote to an older friend, asking him what I should do know that I was 30, having spent all my twenties expecting to die.
Passados sete anos, com a doença já em remissão, Manguso escreveu “The Two Kinds of Decay” com base em alguns apontamentos que tirou no hospital e em tudo aquilo de que se lembrava e que nos últimos tempos tentara esquecer até para tentar recuperar o tempo perdido.
Este é o segundo livro de memórias de Manguso que leio e o seu estilo segmentário e incisivo parece-me o ideal para falar de um assunto tão pesado e assustador e de práticas médicas verdadeiramente arrepiantes. Em capítulos curtos, dá conta não só das manifestações físicas e das consequências psicológicas desta doença debilitante, como vai elencando pessoas com quem se cruzou durante todo o processo, como outros doentes com quem conviveu e os bons e menos bons profissionais de saúde que dela cuidaram. Apesar de não se abster de relatar os momentos de maior sofrimento e impotência, não há autocomiseração nesta obra, optando antes por uma honestidade que me parece admirável.
Though during bad relapses I knew I was a better person temporarily, in general the disease made me furious, jealous, resentful, impatient, temperamental, spiteful. My sense of entitlement grew enormous. (…) The hardest thing I’d ever have to do, had made me a worse person!
Houve um dia em que Manguso achou ter atingido o seu limite, quando as lágrimas deram lugar a gritos de desespero e lhe foi diagnosticada uma depressão, o que a levou a ser internada numa ala psiquiátrica durante algumas semanas. Creio que nunca tinha lido nenhum livro sobre doenças autoimunes e este, apesar de amedrontar pela lotaria genética que é sermos ou não saudáveis, parece-me ser um nítido exemplo do que é enfrentar este desafio.
There are two kinds of decay: mine and everyone else’s.
This is the usual sort of book about illness. Someone gets sick, someone gets well.
Those who claim to write about something larger and more significant than the self sometimes fail to comprehend the dimensions of a self.
Most people consider their own suffering a widely applicable model, and I am no exception.
A escritora norte-americana Sarah Manguso tinha 21 anos quando àquilo que pensava ser uma constipação se juntaram sintomas como cansaço, formigueiro nas mãos e uma dormência nos pés que, se se tivesse alastrado ao diafragma antes de ter sido levada para o hospital, a levaria a ser entubada. Depois de meses de internamentos, exames, medicação e tratamentos, foi-lhe diagnosticada uma doença autoimune, polineuropatia desmielinizante inflamatória crónica (PDIC), que a obrigou a ficar de cama durante longas temporadas, a interromper os estudos, a pôr a sua vida em suspenso.
Having spent my twenties expecting to die, I turned 30 and arrived in the afterlife with nothing left to do. I wrote to an older friend, asking him what I should do know that I was 30, having spent all my twenties expecting to die.
Passados sete anos, com a doença já em remissão, Manguso escreveu “The Two Kinds of Decay” com base em alguns apontamentos que tirou no hospital e em tudo aquilo de que se lembrava e que nos últimos tempos tentara esquecer até para tentar recuperar o tempo perdido.
Este é o segundo livro de memórias de Manguso que leio e o seu estilo segmentário e incisivo parece-me o ideal para falar de um assunto tão pesado e assustador e de práticas médicas verdadeiramente arrepiantes. Em capítulos curtos, dá conta não só das manifestações físicas e das consequências psicológicas desta doença debilitante, como vai elencando pessoas com quem se cruzou durante todo o processo, como outros doentes com quem conviveu e os bons e menos bons profissionais de saúde que dela cuidaram. Apesar de não se abster de relatar os momentos de maior sofrimento e impotência, não há autocomiseração nesta obra, optando antes por uma honestidade que me parece admirável.
Though during bad relapses I knew I was a better person temporarily, in general the disease made me furious, jealous, resentful, impatient, temperamental, spiteful. My sense of entitlement grew enormous. (…) The hardest thing I’d ever have to do, had made me a worse person!
Houve um dia em que Manguso achou ter atingido o seu limite, quando as lágrimas deram lugar a gritos de desespero e lhe foi diagnosticada uma depressão, o que a levou a ser internada numa ala psiquiátrica durante algumas semanas. Creio que nunca tinha lido nenhum livro sobre doenças autoimunes e este, apesar de amedrontar pela lotaria genética que é sermos ou não saudáveis, parece-me ser um nítido exemplo do que é enfrentar este desafio.
There are two kinds of decay: mine and everyone else’s.
This is the usual sort of book about illness. Someone gets sick, someone gets well.
Those who claim to write about something larger and more significant than the self sometimes fail to comprehend the dimensions of a self.
Most people consider their own suffering a widely applicable model, and I am no exception.
Read
September 5, 2025I don't feel comfortable giving star ratings to somebody's memoir, particularly if it's a memoir of outlasting a disease or other torment that I will never know. Short, easy to read, didn't really click with me.
December 5, 2024
"Those who claim to write about something larger and more significant than the self sometimes fail to comprehend the dimensions of a self."
At the age of 20 Sarah Manguso got a cold that would not go away, which turned into an ongoing weakening, which turned into years of devastating illness. Eventually, after changing doctors, she was diagnosed with an extremely rare autoimmune illness, chronic idiopathic demyelinating polyradiculoneuropathy (CIDP) which is a kind of supercharged form of Guillain-Barre. I guess I should say it is like GB on steroids because massive doses of steroids was part of the only protocol to bring the disease under some control, and those steroids led to other serious and permanent physical harm, including suicidal depression that landed Manguso in a locked ward. The other main parts of the treatment were aphersis (having her plasma completely removed and replaced), and having infusions of gammaglobulin and other meds. For most of those years her life was no life at all. Though she pushed through and graduated from Harvard only one term late, and started her MFA at Iowa, she spent most of her 20's, living in her childhood bedroom barely able to move, too exhausted to even read or watch TV, unable to even roll over in bed because of the port implanted in her chest. Manguso walks the reader through the experience with a remarkable lack of self-pity and even more remarkable candor. The author is living through this thing, but also there is an eerie distance, like in bad movies when the spirit of a person in a coma hovers over their body and looks down at their inert form. It works here though, it is not cheesy or alienating, but rather sort of surreal. She says she needed to wait to write this until she had been in remission for seven years, and I expect that helped give her that remove. The experience is related in short vignettes framed around treatments, caregivers, and her own body. The whole is beautiful and magnetic.
At the age of 20 Sarah Manguso got a cold that would not go away, which turned into an ongoing weakening, which turned into years of devastating illness. Eventually, after changing doctors, she was diagnosed with an extremely rare autoimmune illness, chronic idiopathic demyelinating polyradiculoneuropathy (CIDP) which is a kind of supercharged form of Guillain-Barre. I guess I should say it is like GB on steroids because massive doses of steroids was part of the only protocol to bring the disease under some control, and those steroids led to other serious and permanent physical harm, including suicidal depression that landed Manguso in a locked ward. The other main parts of the treatment were aphersis (having her plasma completely removed and replaced), and having infusions of gammaglobulin and other meds. For most of those years her life was no life at all. Though she pushed through and graduated from Harvard only one term late, and started her MFA at Iowa, she spent most of her 20's, living in her childhood bedroom barely able to move, too exhausted to even read or watch TV, unable to even roll over in bed because of the port implanted in her chest. Manguso walks the reader through the experience with a remarkable lack of self-pity and even more remarkable candor. The author is living through this thing, but also there is an eerie distance, like in bad movies when the spirit of a person in a coma hovers over their body and looks down at their inert form. It works here though, it is not cheesy or alienating, but rather sort of surreal. She says she needed to wait to write this until she had been in remission for seven years, and I expect that helped give her that remove. The experience is related in short vignettes framed around treatments, caregivers, and her own body. The whole is beautiful and magnetic.
March 27, 2024
Joseph Heller is to Manguso what/who Zinedine Zidane is to me (although I already love Zizou long before I realised/found out we have something in common). Might elaborate, might not. In any case, I love this even though I can't say I relate to a lot of her experiences. Love how concise, precise it all is despite what it's all about. I adore how 'in control' of her writing and thoughts Manguso is. RTC later
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October 2, 2019I LOVE Sarah Manguso's work. This short memoir is haunting.
March 1, 2009
This book is very hard to read. The delicacy and impossibility of each phrase—delivered with the magnitude of several hours’ hospitalization is painful. It’s not spontaneity that tickles you, but a hard, hard, hard stone that is pushed through the canal and at one point relinquished so almost anything can have dire meaning because it has weight. Weight from a doctor saying: Look, here is the smallest violinst in the world playing you a Dvořák violin concerto to It is here again, this certainty I will soon die, this thing I already know that I have not forgotten for a single minute.
Hospitals are not sexy—without life, sterile. It is hard to read about clean, but she makes it sexy, young, elegant. Her passages read like soft, torpid hymns that are spoken quietly with a refreshed patience and knowledge. So the hymns aren’t about divinity, but grave reality, mundanity. And this hymn, with such gravitas, that should be sung with magnitude, is spoken with a clarity and plainness that attempts to show in plain spoken English the beauty of small, appreciable things that are almost missed with most stories about redemption.
She calls the two kinds of decay: mine and everyone else’s, but throughout the book I thought they were mental and physical. As her body decayed she pressed against allowing her mind to decay. To me, that’s what this book was about. Even in a hospital gown, desexualized with machines made for pumping, shooting and reviving (but not screwing—not even the slightest bit appealing) she found entertainment. She found the Soul in Hospital (take the “pit” out, har har). It’s like Jean-Dominique Bauby’s book or Laura Hillenbrand’s story, to follow the life of the mind as it traipses through fantasy though it is condemned to a concussion and impotence is fascinating and moving. This book is just like that flamboyant dancer leaping through the hallways in The Diving Bell and the Butterfly, finding the cute objects that make life more amusing and interesting, despite the suffering of being repressed by disease and incapacitation.
In “The Cheerleader” she describes in great detail the ridiculous escapade of a high school pep rally. She puts herself there, only for a moment, to show that she was one of two girls who “looked stoned” and sat in the back of the bleachers while everyone else cheered wildly for the Indian Warrior-like football team,
I was prescribed a strong antiemetic. In suppository form. And the nurse who pushed it into my ass had been one of the varsity cheerleaders from that 1988 pep rally.
Then she qualifies the story, the disgust and alienation with a lovely tune:
She radiated love without smiling. And when she finished her shift at seven that night, she sat with me, still in her tight white uniform, and we watched Dirty Dancing on television, talking a little during the commercials.
It’s this leap from the pretentious, judgmental academic girl to the vulnerable and willing-to-learn appreciative woman that makes this book so harrowing. It is not cynical. It is about the transformation from cynicism to appreciation. This story is about a “cheerleader” who she thought was vapid and bubbly, but in fact was a saint. And though the spectacle of a pep rally is obscene if you are a social reject in high school, you never know which one of those “assholes” will be the one fireman or national guardsman or nurse who puts an antiemetic up your ass with a smile,
That’s what she was like.
It’s a very imperfect sob story, because its coup de grâce is overcoming the second kind of decay: forfeit. She writes about insignificant flirtations, trivial components that—like a fly on the wall—must have wracked Emily Dickinson’s claustrophobia. But it’s her ability to be sarcastic, to be innovatively aggressive against this part of her psyche that wants aggravation that makes her fun. She struggles to find insignificance in the things that are killing her, to overpower them with diffusion, sarcasm, humor.
The chapter “The Vascular Surgeon,” she is described as the kind of patient who takes things very hard. This ruins her, and every time she hears it she cries in front of the surgeon who tells it to her. So, she describes in the chapter how she practices being sarcastic. Even though she is very emotional about the disease and how it is so terminal, she doesn’t want to be pigeon-holed as this depressed, livid burden. So she bites her lip and when the surgeon delivers bad news again, she says What can I say—I’m thrilled.
He laughed like a high school kid, the way the science fair winner laughs when the guy with the police record insults the science teacher
It is the appreciation of an almost nothing that makes it a real triumph. Just a grin. Like Kafka coughing up a cockaroach and the little thing giving him a thumbs up and scurrying behind the desk, never to be seen again. It’s that type of grin. Of a microscopic accomplishment retaining an eternity.
In the chapter “Steroids” she describes the power of food; or, I guess, overcoming weakness with ecstasy: And every meal, no matter how simple or cheap, tasted better than any other meal I’d ever eaten, and every piece of music I heard was more beautiful than any other piece of music I’d ever heard. This sounds like trite shorthand, but it is not.
I remember feeling well after having begun to take steroids, and how happy my mother was to cook a hamburger for me. I remember eating it. The kethup, the mustard—I can taste the condiments.
I’m not talking about the way ketchup and mustard taste in general. I mean I can taste the particular condiments that were on that particular hamburger I ate in 1995.
It’s this patience and slowness that is so hard to grasp. A practically paralyzed patient who spends nine years in the hospital, being sucked and harnessed and weakened and humiliated with shit and blood pouring out of her. What does it feel like to taste something like a hamburger, or to see something like a smile? It’s the power of such insignificant notions that makes a day bright instead of bleak. Makes a holiday out of Monday. She had to find this everyday, or she’d decay.
It will make you heavy.
Hospitals are not sexy—without life, sterile. It is hard to read about clean, but she makes it sexy, young, elegant. Her passages read like soft, torpid hymns that are spoken quietly with a refreshed patience and knowledge. So the hymns aren’t about divinity, but grave reality, mundanity. And this hymn, with such gravitas, that should be sung with magnitude, is spoken with a clarity and plainness that attempts to show in plain spoken English the beauty of small, appreciable things that are almost missed with most stories about redemption.
She calls the two kinds of decay: mine and everyone else’s, but throughout the book I thought they were mental and physical. As her body decayed she pressed against allowing her mind to decay. To me, that’s what this book was about. Even in a hospital gown, desexualized with machines made for pumping, shooting and reviving (but not screwing—not even the slightest bit appealing) she found entertainment. She found the Soul in Hospital (take the “pit” out, har har). It’s like Jean-Dominique Bauby’s book or Laura Hillenbrand’s story, to follow the life of the mind as it traipses through fantasy though it is condemned to a concussion and impotence is fascinating and moving. This book is just like that flamboyant dancer leaping through the hallways in The Diving Bell and the Butterfly, finding the cute objects that make life more amusing and interesting, despite the suffering of being repressed by disease and incapacitation.
In “The Cheerleader” she describes in great detail the ridiculous escapade of a high school pep rally. She puts herself there, only for a moment, to show that she was one of two girls who “looked stoned” and sat in the back of the bleachers while everyone else cheered wildly for the Indian Warrior-like football team,
I was prescribed a strong antiemetic. In suppository form. And the nurse who pushed it into my ass had been one of the varsity cheerleaders from that 1988 pep rally.
Then she qualifies the story, the disgust and alienation with a lovely tune:
She radiated love without smiling. And when she finished her shift at seven that night, she sat with me, still in her tight white uniform, and we watched Dirty Dancing on television, talking a little during the commercials.
It’s this leap from the pretentious, judgmental academic girl to the vulnerable and willing-to-learn appreciative woman that makes this book so harrowing. It is not cynical. It is about the transformation from cynicism to appreciation. This story is about a “cheerleader” who she thought was vapid and bubbly, but in fact was a saint. And though the spectacle of a pep rally is obscene if you are a social reject in high school, you never know which one of those “assholes” will be the one fireman or national guardsman or nurse who puts an antiemetic up your ass with a smile,
That’s what she was like.
It’s a very imperfect sob story, because its coup de grâce is overcoming the second kind of decay: forfeit. She writes about insignificant flirtations, trivial components that—like a fly on the wall—must have wracked Emily Dickinson’s claustrophobia. But it’s her ability to be sarcastic, to be innovatively aggressive against this part of her psyche that wants aggravation that makes her fun. She struggles to find insignificance in the things that are killing her, to overpower them with diffusion, sarcasm, humor.
The chapter “The Vascular Surgeon,” she is described as the kind of patient who takes things very hard. This ruins her, and every time she hears it she cries in front of the surgeon who tells it to her. So, she describes in the chapter how she practices being sarcastic. Even though she is very emotional about the disease and how it is so terminal, she doesn’t want to be pigeon-holed as this depressed, livid burden. So she bites her lip and when the surgeon delivers bad news again, she says What can I say—I’m thrilled.
He laughed like a high school kid, the way the science fair winner laughs when the guy with the police record insults the science teacher
It is the appreciation of an almost nothing that makes it a real triumph. Just a grin. Like Kafka coughing up a cockaroach and the little thing giving him a thumbs up and scurrying behind the desk, never to be seen again. It’s that type of grin. Of a microscopic accomplishment retaining an eternity.
In the chapter “Steroids” she describes the power of food; or, I guess, overcoming weakness with ecstasy: And every meal, no matter how simple or cheap, tasted better than any other meal I’d ever eaten, and every piece of music I heard was more beautiful than any other piece of music I’d ever heard. This sounds like trite shorthand, but it is not.
I remember feeling well after having begun to take steroids, and how happy my mother was to cook a hamburger for me. I remember eating it. The kethup, the mustard—I can taste the condiments.
I’m not talking about the way ketchup and mustard taste in general. I mean I can taste the particular condiments that were on that particular hamburger I ate in 1995.
It’s this patience and slowness that is so hard to grasp. A practically paralyzed patient who spends nine years in the hospital, being sucked and harnessed and weakened and humiliated with shit and blood pouring out of her. What does it feel like to taste something like a hamburger, or to see something like a smile? It’s the power of such insignificant notions that makes a day bright instead of bleak. Makes a holiday out of Monday. She had to find this everyday, or she’d decay.
It will make you heavy.
January 4, 2013
As hypocritical as this may sound, coming from a memoirist, I'm generally skeptical of the memoir form. So many memoirs end up as bleats of narcissism. But THE TWO KINDS OF DECAY seems, almost magically, to bypass narcissism completely, maybe because it's so concerned with the self's survival under conditions that seem designed to eradicate it. By the self I don't just mean the body, though the disease that Sarah Manguso contracted during her junior year in college was overwhelmingly corporeal, and her treatment subjected her body to insults that suggest both Kafka's Penal Colony (tests that involve being subjected to electroshock while holding your muscle tense, the muscle having a sensor needle jutting out of it) and the horrors of old age. But the primary component of the self is one's identity, and The Kinds of Decay is a gripping, provocative examination of who you become when everything you thought you were is stripped away. Manguso does this without self-pity but with a visceral recollection of the pain and fear and humiliation of her years of illness. Her language is beautiful in a way that feels unselfconscious and utterly forthright.
December 4, 2008
If you're going to write a memoir--and, let's face it, most people shouldn't--then it should be as starkly honed and beautiful as this one.
September 4, 2024
sarah manguso is really cementing herself as a standout author for me, someone whose books have so much sticking power in my mind.
the two kinds of decay chronicles manguso’s struggle in the 90s with CIDP, an autoimmune disease that causes paralysis and requires lengthy blood cleansing treatments and bouts of steroids. the disease also brought on severe depression, and manguso recounts the time she refers to as “lockdown” - when she was institutionalized.
the events of the memoir are grueling and manguso writes about them with sparse prose, which i love. even though she didn’t keep many journals throughout the 9 year period that she was sick, she pieces together the major turning points with raw descriptions of what was going on, physically and mentally. i really appreciated the clarity and brevity with which she wrote. the descriptions of what she was dealing with will haunt me for a while, i think.
very grateful to jessica from womb house books for speaking so highly of this book after her zoom event with sarah and sheila heti!
the two kinds of decay chronicles manguso’s struggle in the 90s with CIDP, an autoimmune disease that causes paralysis and requires lengthy blood cleansing treatments and bouts of steroids. the disease also brought on severe depression, and manguso recounts the time she refers to as “lockdown” - when she was institutionalized.
the events of the memoir are grueling and manguso writes about them with sparse prose, which i love. even though she didn’t keep many journals throughout the 9 year period that she was sick, she pieces together the major turning points with raw descriptions of what was going on, physically and mentally. i really appreciated the clarity and brevity with which she wrote. the descriptions of what she was dealing with will haunt me for a while, i think.
very grateful to jessica from womb house books for speaking so highly of this book after her zoom event with sarah and sheila heti!
November 23, 2016
Take this rating with a grain of salt because it's more out of personal taste (distaste?) than anything. I think the book is good for what it is. A quick and easy book that's worth borrowing from a friend/the library or buying an e-book. A provocative book club pick. If you're squeamish about gross medical procedures, there's a lot of that
Has some beautiful bits, particularly the first few chapters. As the book wore on, I got tired of the way Manguso tried to bring things full circle, to connect every thought/memory to another life event with coincidental thematic similarities.
The chapter about the nurse who didn't speak English well rubbed me the wrong way, along w mangusos general tone of elitism (her chapter about high school cheerleaders reads as more bitter than profound, I rolled my eyes a little at the chapter about her donning a tuxedo as a "champion for the downtrodden," for "homosexuals"--the chapter, unfortunately, doesn't get any more interesting than this). She writes at one point that her long hospitalization turned her into a one-upper of awful life stories. She writes at several points, in response to another persons pain, that she considers her own worse. Two Kinds of Decay feels like this. It's self absorbed. Manguso expels a decades worth of thoughts developed alone in a hospital bed like her bad blood plasma.
At the end of the book Manguso writes:
"Those who claim to write about something larger and more significant than the self sometimes fail to comprehend the dimensions of self."
And so I can't say this was a bad book because it was an honest/personal account of Mangusos experience with chronic illness, and it doesn't claim to be more. Mangusos narrative is valuable and worth reading. I learned a lot and found it interesting, I just didn't love reading it.
Has some beautiful bits, particularly the first few chapters. As the book wore on, I got tired of the way Manguso tried to bring things full circle, to connect every thought/memory to another life event with coincidental thematic similarities.
The chapter about the nurse who didn't speak English well rubbed me the wrong way, along w mangusos general tone of elitism (her chapter about high school cheerleaders reads as more bitter than profound, I rolled my eyes a little at the chapter about her donning a tuxedo as a "champion for the downtrodden," for "homosexuals"--the chapter, unfortunately, doesn't get any more interesting than this). She writes at one point that her long hospitalization turned her into a one-upper of awful life stories. She writes at several points, in response to another persons pain, that she considers her own worse. Two Kinds of Decay feels like this. It's self absorbed. Manguso expels a decades worth of thoughts developed alone in a hospital bed like her bad blood plasma.
At the end of the book Manguso writes:
"Those who claim to write about something larger and more significant than the self sometimes fail to comprehend the dimensions of self."
And so I can't say this was a bad book because it was an honest/personal account of Mangusos experience with chronic illness, and it doesn't claim to be more. Mangusos narrative is valuable and worth reading. I learned a lot and found it interesting, I just didn't love reading it.
July 10, 2008
In bite sized and poetic chunks, Sarah Manguso tells what it's like to come down with a debilitating disease at a young age. The book jacket doesn't even name the disease, simply calling it "a wildly unpredictable disease that appeared without warning" when she was 21 years old. In fact, her disease, which is "something like" a chronic form of the neuologic disorder, Guillain-Barre syndrome, lacks a proper name as yet, but is referred to as chronic idiopathic demyelinating polyradiculoneuropathy or CIDP. In essence, her immune system was attacking her nervous system. It afflicted Manguso for nine years, after which she recovered.
Manguso gives a compelling description of her disease, from its often unpleasant treatments and symptoms to its effect on her life. Written in tight prose, the book is short and easy to read in one sitting. That's a good thing. Manguso wastes not a single word nor includes a single event which is misplaced or superfluous. The book is a simple tale of what it her life with CIPD was, told in almost stark language that has a spare beauty.
Readers can take many messages from it. It can be read as a depressing tale of how unfair life can be. It can be read as a story of how a person copes, however imperfectly, with a serious affliction, and endures. But perhaps it is best seen as both -- how as humans, we are strong and weak, and good and bad things happen to us, and how our biggest challenge is just to make the best of the hand we're dealt.
Manguso gives a compelling description of her disease, from its often unpleasant treatments and symptoms to its effect on her life. Written in tight prose, the book is short and easy to read in one sitting. That's a good thing. Manguso wastes not a single word nor includes a single event which is misplaced or superfluous. The book is a simple tale of what it her life with CIPD was, told in almost stark language that has a spare beauty.
Readers can take many messages from it. It can be read as a depressing tale of how unfair life can be. It can be read as a story of how a person copes, however imperfectly, with a serious affliction, and endures. But perhaps it is best seen as both -- how as humans, we are strong and weak, and good and bad things happen to us, and how our biggest challenge is just to make the best of the hand we're dealt.
May 20, 2019
SUCH. A. GOOD. READ.
lots of commentary on illness and life as someone with an illness. part of this book had me crying. parts of it had me laughing. and parts of it brought back that sickly feeling at the pit of my stomach that only hospital waiting rooms can inspire. I really recommend this to anyone with a chronic illness--or anyone wanting to understand what it can be like inside our heads as we deal with our illness on a daily basis.
lots of commentary on illness and life as someone with an illness. part of this book had me crying. parts of it had me laughing. and parts of it brought back that sickly feeling at the pit of my stomach that only hospital waiting rooms can inspire. I really recommend this to anyone with a chronic illness--or anyone wanting to understand what it can be like inside our heads as we deal with our illness on a daily basis.
September 21, 2017
Beautiful book. Reads like a prose poem and moves so lyrically through some tough subject matter that you can't even believe what you're reading about. I devoured this in a day, it's wonderful.
January 18, 2025
Manguso’s writing is addictive. This a straightforward memoir about medical suffering but there’s a healthy dose of poetry throughout.
October 17, 2010
The first word that initially came to mind after reading Sarah Manguso's book, The Two Kinds of Decay, was "stark." The subject matter could be what brought that word to mind. Add to that, the author's treatment of her memoir as distanced, if not clinical. Her writing is very controlled. She also shirks sentimentalities effectively, despite the painful and personal nature of the material. Further, the short chapters, block paragraphs, and abundance of white space seem to form a visual context of strict form.
These are a poet's tools, without a doubt. Though the style of the piece, its voice, and tone initially threw me, I appreciate the tools Manguso used a lot more now. She is consistent and uses her devices deftly and with purpose.
Manguso describes, studiously, with clarity and concision, medical procedures, characters and events from her life, her confessions, as well as the hows of living with a rare form of Guillain--Barre syndrome. The book could be a sort of polished journal in which she writes with disregard to time and instead writes in what sequence the details make sense to her. The book is a recounting, wound tightly to a couple of principles which I can very much appreciate and relate. She writes constantly from the point of observation, distance, and simply, so that nothing is missed and the reader is held close to the text until the end. In the end, the reader is not left with a hole, or depressed, and not even with apathy, but with a new way of seeing that the author herself has come to and shown quite well.
The book is poetic in a meaning-follows-form kind of way. The crisp precision of Manguso's narrative, the observant distance with which she relates her story, the segments of short chapters and blocked paragraphs which reveal a bounty of white space on the pages, and the chapter titles around which the author seems to write certain memories as if they were prompts, come to mind. I would even argue that there is a poetic turn where Manguso explains a way of seeing that has become a part of this work:
Further, an affirmation that the author is very studied in her treatment of the material. She writes a note about how such things (memoirs) should be written:
I believe that Sarah Manguso has done the job she has described above well. Because of this work, I have ordered her books of poems and am anxious to read them soon.
originally published for Explication. Analysis. Conversation. (http://explicanalyconvo.blogspot.com/), October 16, 2010 and crossposted at The Kitchen Sink (http://tlc-kitchensink.blogspot.com/).
These are a poet's tools, without a doubt. Though the style of the piece, its voice, and tone initially threw me, I appreciate the tools Manguso used a lot more now. She is consistent and uses her devices deftly and with purpose.
Manguso describes, studiously, with clarity and concision, medical procedures, characters and events from her life, her confessions, as well as the hows of living with a rare form of Guillain--Barre syndrome. The book could be a sort of polished journal in which she writes with disregard to time and instead writes in what sequence the details make sense to her. The book is a recounting, wound tightly to a couple of principles which I can very much appreciate and relate. She writes constantly from the point of observation, distance, and simply, so that nothing is missed and the reader is held close to the text until the end. In the end, the reader is not left with a hole, or depressed, and not even with apathy, but with a new way of seeing that the author herself has come to and shown quite well.
The book is poetic in a meaning-follows-form kind of way. The crisp precision of Manguso's narrative, the observant distance with which she relates her story, the segments of short chapters and blocked paragraphs which reveal a bounty of white space on the pages, and the chapter titles around which the author seems to write certain memories as if they were prompts, come to mind. I would even argue that there is a poetic turn where Manguso explains a way of seeing that has become a part of this work:
My existence shrank from an arrow of light pointing into the future forever to a speck of light that was the present moment. I got better at living in that point of light, making the world into that point. I paid close attention to it. I loved it very much.
Further, an affirmation that the author is very studied in her treatment of the material. She writes a note about how such things (memoirs) should be written:
I resisted as long as I could. A narrator must keep a safe distance from the story, but a lyric speaker must occupy the lyric moment as if it is happening. Or so it seems to me at this moment.
I believe that Sarah Manguso has done the job she has described above well. Because of this work, I have ordered her books of poems and am anxious to read them soon.
originally published for Explication. Analysis. Conversation. (http://explicanalyconvo.blogspot.com/), October 16, 2010 and crossposted at The Kitchen Sink (http://tlc-kitchensink.blogspot.com/).
February 9, 2022
Read for the Wellcome Prize 10th Anniversary Blog Tour in 2019. Original review:
Sarah Manguso’s The Two Kinds of Decay is a memoir which chronicles her experience of living with CIDP (Chronic Idiopathic Demyelinating Polyradiculoneuropathy). CIDP has been described as a chronic form of Guillain-Barre syndrome but, like many autoimmune diseases, is still poorly understood.
Rather than attempting a chronological account of the nine years she spent suffering from CIPD, Manguso presents us with a series of arresting and disturbing vignettes. The first treatment she received for the condition, she explains, was apheresis, or the removal of her blood from her body in order to separate it into its constituent parts to allow the purging of the diseased part, which in her case, was the plasma. She was then reinfused with healthy plasma from a blood donor, a procedure that took four hours each time. This removed the antibodies secreted by her immune system that were destroying her healthy neurons and causing her symptoms, which included a creeping paralysis.
However, each time Manguso had to have the apheresis performed, she shook with cold, no matter how many heated blankets she covered herself with. Why?
The temperature in blood vessels is warmer than room temperature… I was very slowly infused with several liters of fluid that was thirty degrees [F] colder than the rest of my body… the cold infusions went in very close to my heart. I need to describe that feeling, make a reader stop reading for a moment and think, Now I understand how cold it felt.
But I’m just going to say it felt like liquid, thirty degrees colder than my body, being infused slowly but directly into my heart, for four hours.
The plasma infusions also gave her a persistent chemical taste in her mouth: ‘there was nothing I could do to change the taste of it. It wasn’t touching the surface of my tongue… it was in my tongue.’ She found that only sucking on wintergreen candy throughout the course of the treatment gave her some relief.
Manguso’s brief glimpses into the world of her illness mean that The Two Kinds of Decay, unlike other chronic illness memoirs such as Porochista Khakpour’s Sick, doesn’t become repetitive but remains continually riveting. Manguso doesn’t try to draw together her experiences into some great message about life – even the title of her memoir remains somewhat oblique – but simply presents them to us, in prose that is totally and brilliantly boiled down.
Since publishing The Two Kind of Decay in 2008 (it wasn’t published in the UK until 2011, hence its eligibility for the Wellcome Book Prize of that year), Manguso has gone on to publish three more works of biography, The Guardians (2012), Ongoingness (2015) and 300 Arguments (2017). I’m very glad to have been introduced to her writing.
Sarah Manguso’s The Two Kinds of Decay is a memoir which chronicles her experience of living with CIDP (Chronic Idiopathic Demyelinating Polyradiculoneuropathy). CIDP has been described as a chronic form of Guillain-Barre syndrome but, like many autoimmune diseases, is still poorly understood.
Rather than attempting a chronological account of the nine years she spent suffering from CIPD, Manguso presents us with a series of arresting and disturbing vignettes. The first treatment she received for the condition, she explains, was apheresis, or the removal of her blood from her body in order to separate it into its constituent parts to allow the purging of the diseased part, which in her case, was the plasma. She was then reinfused with healthy plasma from a blood donor, a procedure that took four hours each time. This removed the antibodies secreted by her immune system that were destroying her healthy neurons and causing her symptoms, which included a creeping paralysis.
However, each time Manguso had to have the apheresis performed, she shook with cold, no matter how many heated blankets she covered herself with. Why?
The temperature in blood vessels is warmer than room temperature… I was very slowly infused with several liters of fluid that was thirty degrees [F] colder than the rest of my body… the cold infusions went in very close to my heart. I need to describe that feeling, make a reader stop reading for a moment and think, Now I understand how cold it felt.
But I’m just going to say it felt like liquid, thirty degrees colder than my body, being infused slowly but directly into my heart, for four hours.
The plasma infusions also gave her a persistent chemical taste in her mouth: ‘there was nothing I could do to change the taste of it. It wasn’t touching the surface of my tongue… it was in my tongue.’ She found that only sucking on wintergreen candy throughout the course of the treatment gave her some relief.
Manguso’s brief glimpses into the world of her illness mean that The Two Kinds of Decay, unlike other chronic illness memoirs such as Porochista Khakpour’s Sick, doesn’t become repetitive but remains continually riveting. Manguso doesn’t try to draw together her experiences into some great message about life – even the title of her memoir remains somewhat oblique – but simply presents them to us, in prose that is totally and brilliantly boiled down.
Since publishing The Two Kind of Decay in 2008 (it wasn’t published in the UK until 2011, hence its eligibility for the Wellcome Book Prize of that year), Manguso has gone on to publish three more works of biography, The Guardians (2012), Ongoingness (2015) and 300 Arguments (2017). I’m very glad to have been introduced to her writing.
May 1, 2016
I could read the last chapter over and over.
February 20, 2024
I'm a recent fan of the books by Manguso, having read a number of them in short order, and there is nonfiction, as well as novels, but I see now that even in her novels she is channeling herself, as captured in her nonfiction. It doesn't really matter beyond being interesting to me. In any case, another fascinating and compelling work in her nonfiction, published some time ago. Who knew that a memoir about a terrible and rare illness could be so lyrical, and sometimes funny, and steer away from all the awful metaphors about sickness and character and sickness and war, etc.
January 28, 2025
I read this in a few hours, so it was a quick read! It was enjoyable and engaging, however some of the prose felt out of place at times.
January 2, 2020
In prose both spare and unsparing, Sarah Manguso captures the upheaval of corporeal crisis as only a poet could. "The Two Kinds of Decay" is comprised of short vignettes, which "can be held in the eye comfortably, at middle distance," and untangles the author's nine year process of getting sick and well from CIDP (a form of Guillain-Barre syndrome). A bullet outline of this memoir follows a conventional illness -> diagnosis -> treatment -> remission arc, but within this tidy structure Manguso manages to distill the paradox, contradictions and messiness of chronic illness.
Throughout the book, there is a palpable immediacy, a real feat considering Manguso did not begin "The Two Kinds of Decay" until 7 years into her remission. Many vignettes fling the reader right into the author's shoes-- no flowery narration or hard-won insight, just an unwieldy body in a paper gown before a white coat and the pointy stuff of nightmares. These sections make for a good squirm; at times, they left me wanting more. That said, I'm a glutton for catharsis, and I appreciate Manguso's refusal to make a metaphor of her pain, to make synonymous suffering and redemption-- "...the hardest thing I'd ever have to do, had made me a worse person. That wasn't how it was supposed to work." However, there were times when a lack of context felt irresponsible or damaging. Take for example the chapter "The Sikh," which details a botched central line implant. By including only the tangible details, namely the doctor's white turban signifying his Sikh faith, the text seems to equate (or at least associate) the doctor's religion and incompetence.
When Manguso's reflective voice surfaces, it's a scalpel to the chest, precise, cutting. Some passages absolutely clotheslined me: "How sure our neighbor was that her suffering was the only kind of suffering. And how sure I was that mine was worse." It's in these quips that Manguso's narrative economy yields big pay-offs. Whether you're interested in patient experiences, the existential conundrums of illness, or the art of memoir, "The Two Kinds of Decay" is well-worth devoting a quiet evening.
Throughout the book, there is a palpable immediacy, a real feat considering Manguso did not begin "The Two Kinds of Decay" until 7 years into her remission. Many vignettes fling the reader right into the author's shoes-- no flowery narration or hard-won insight, just an unwieldy body in a paper gown before a white coat and the pointy stuff of nightmares. These sections make for a good squirm; at times, they left me wanting more. That said, I'm a glutton for catharsis, and I appreciate Manguso's refusal to make a metaphor of her pain, to make synonymous suffering and redemption-- "...the hardest thing I'd ever have to do, had made me a worse person. That wasn't how it was supposed to work." However, there were times when a lack of context felt irresponsible or damaging. Take for example the chapter "The Sikh," which details a botched central line implant. By including only the tangible details, namely the doctor's white turban signifying his Sikh faith, the text seems to equate (or at least associate) the doctor's religion and incompetence.
When Manguso's reflective voice surfaces, it's a scalpel to the chest, precise, cutting. Some passages absolutely clotheslined me: "How sure our neighbor was that her suffering was the only kind of suffering. And how sure I was that mine was worse." It's in these quips that Manguso's narrative economy yields big pay-offs. Whether you're interested in patient experiences, the existential conundrums of illness, or the art of memoir, "The Two Kinds of Decay" is well-worth devoting a quiet evening.
February 9, 2018
I'm not a very emotional person, but Sarah Manguso picked up my emotions like a plastic sack of eggs and threw them against a brick wall. Reading this wonderful memoir (5 stars, btw) was a decision that would result in me crying (not literally, but I would have if I had an ounce of emotions) because it reminded me why I love reading so damn much.
While keeping her distance from an obviously horrendous and traumatic experience, Manguso tells an honest, quick paced, truthful, and emotional story of her life and the disease that interrupted it. At a young age, Manguso was hospitalized with chronic idiopathic demyelinating polyradiculoneuropathy (CIDP), a persistent form of Guillain-Barré syndrome: an autoimmune disease that attacks the nervous system, causing spreading numbness and paralysis. If the disease wasn't treated regularly with her blood being cycled, removing the bad blood (or plasma) with new, fresh, and clean blood, than it would have spread to her lungs and suffocated her. Instead, she was left with this half hearted, poor excuse for a 'treatment,' which really just left her in the hospital, often paralyzed, and unable to live a normal life.
The story is told in what can only be described as flash nonfiction essays strung together to create a memoir read like a novel. It is not in chronological order, which fits with Manguso's hesitance to exist in space-time, but once read, you can get a decent overall picture of what her life was like in those years. You are able to see the empathy in the people around her, or really, lack there of. She makes clear the struggles, the successes, the metaphors, the fears, and the desires.
I don't want to go further in fear of reducing this wonderful memoir to a simple blog post that does not do it justice, but let me just say this: you can read this in one sitting and you should. Then re-read it. Then take a break to dwell on what you just read. Then read it again.
Experience it because it deserves to be experienced.
While keeping her distance from an obviously horrendous and traumatic experience, Manguso tells an honest, quick paced, truthful, and emotional story of her life and the disease that interrupted it. At a young age, Manguso was hospitalized with chronic idiopathic demyelinating polyradiculoneuropathy (CIDP), a persistent form of Guillain-Barré syndrome: an autoimmune disease that attacks the nervous system, causing spreading numbness and paralysis. If the disease wasn't treated regularly with her blood being cycled, removing the bad blood (or plasma) with new, fresh, and clean blood, than it would have spread to her lungs and suffocated her. Instead, she was left with this half hearted, poor excuse for a 'treatment,' which really just left her in the hospital, often paralyzed, and unable to live a normal life.
The story is told in what can only be described as flash nonfiction essays strung together to create a memoir read like a novel. It is not in chronological order, which fits with Manguso's hesitance to exist in space-time, but once read, you can get a decent overall picture of what her life was like in those years. You are able to see the empathy in the people around her, or really, lack there of. She makes clear the struggles, the successes, the metaphors, the fears, and the desires.
I don't want to go further in fear of reducing this wonderful memoir to a simple blog post that does not do it justice, but let me just say this: you can read this in one sitting and you should. Then re-read it. Then take a break to dwell on what you just read. Then read it again.
Experience it because it deserves to be experienced.
June 7, 2017
I'm not sure why, but I expected great things from Manguso's prose, and by great things I mean something like Paul Monette's health memoir writing. That is very much not Manguso's style. She's a poet, so the words are few and well-considered, but still less vibrant than I'd expect for a poet, though I get that not all poets aim for that. The disease itself and her experiences, wow. I did appreciate the vignette about how she and her friends started saving the caps from vials that have "FLIP OFF" printed on them (I may have to start doing that). And there were a few quotations that stood out: "The only hard thing I'd done in my life was recovering from a disease. My self-image had been highly susceptible to that event. It constituted most of my identity." "I don't know if I changed because of my disease or in spite of it." "Why is it important to me to know the beginning and end of this particular decay I think I'm writing about--which is just part of my own whole decay? And couldn't the decay be called by many other names--for instance, my life?"
November 30, 2017
The writer clearly lived through a debilitating disease and wrote a detailed journal. The disease is explained in clear detail and objective prose (almost poetic).
However, for me the overall feeling after reading it was the opposite of warmth. Susan seems so focused on describing her condition, that she sometimes forgets how to engage the reader. It also felt as if the book was ‘me first.’
The second half of the book got slightly better. There was more relatable content, including relationships with family and friends. Some mention on what this disease meant for her outlook on life, I.e. listen to your body.
It’s a quick read and one that got me to appreciate life and the delicate interplay of how our bodies (cells) operate.
However, for me the overall feeling after reading it was the opposite of warmth. Susan seems so focused on describing her condition, that she sometimes forgets how to engage the reader. It also felt as if the book was ‘me first.’
The second half of the book got slightly better. There was more relatable content, including relationships with family and friends. Some mention on what this disease meant for her outlook on life, I.e. listen to your body.
It’s a quick read and one that got me to appreciate life and the delicate interplay of how our bodies (cells) operate.
May 10, 2021
So I read this in, what, 2 days? Despite that I had to put this book down a lot in between reading. Especially at the start where my queasiness got the better of me (spoiler- many a mentioning of medical trauma and blood).
I love Sarah Mongusso’s writing. This is the third book of hers I’ve read, and I’m glad I read this one now, rather than first. Provides a lot of context to her writing and the personality that shines through. It is deadpan and witty and often achingly detached from an all together incredible overcoming of the two types of decay: suicidal depression and disease (which in this case I learn, may be part of the same root-bound tree).
I love Sarah Mongusso’s writing. This is the third book of hers I’ve read, and I’m glad I read this one now, rather than first. Provides a lot of context to her writing and the personality that shines through. It is deadpan and witty and often achingly detached from an all together incredible overcoming of the two types of decay: suicidal depression and disease (which in this case I learn, may be part of the same root-bound tree).
December 30, 2015
Disappointingly shallow book about something that could have been very profound. The author doesn't seem to get over her ableism through describing the progression of her illness, and the recovery. Author is outrightly narcissistic and extremely fatphboic, while offering a very superficial view of her life, and illness, and plays directly into society's already distorted views about bodies, abilities, and attractiveness. There is little nuance in this book, and little to learn from it, besides medical details of a rare illness.
July 2, 2008
One-sitting read: elegiac, shameless . . . the kind of work that reminds ecstasy is supposed to hurt a little. And it does.
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