On Porochista Khakpour’s ‘Sick’, or, When Marginal Identifiers Are No Excuse

With Sick, award-winning author Porochista Khakpour gives readers a memoir of life with advanced Lyme disease. By turns harrowing and bewildering, Sick is neither easy nor pleasant reading.

Briefly, and very topically, Lyme Disease is contracted by tick bites; this much is understood and universally agreed upon by the medical community. Early-stage Lyme Disease can be difficult to detect, meaning many afflicted individuals go untreated until their disease is chronic and their symptoms debilitating. For reasons beyond the scope of this review, chronic Lyme has caused raging debate within the medical community. It appears the tide is turning toward acceptance; suffice to say this reviewer believes chronic Lyme disease is real indeed. And that Khakpour has it.

Born in Tehran in 1978, Khakpour was five when her family fled the Iranian Revolution, settling in South Pasadena, California. There the Khakpours rented a cramped apartment sporting peeling paint and a moldy bathroom. South Pasadena is a notoriously smoggy city; Khakpour, a frail child, suffered its effects. She recounts a childhood of severe ear infections, fainting episodes, and shaking hands. Taking refuge in academic excellence, Khakpour eventually escaped across the country, enrolling in Sarah Lawrence College.

College life saw Khakpour engaging in heavy drug use. One night, a bad joint lands her in the emergency room. Hospital staff, alarmed by her vital signs, pepper Khakpour with questions. Has she been ill? Felt poorly? Khakpour waves off staff concerns. Hers is a life of heavy partying and minimal rest. Coursework is folded in when time permits.

After college, Khakpour is continuously on the move. She attends graduate school in Maryland, does a brief writing stint in Chicago, returns to Los Angeles, moves back to New York, lands a teaching gig in rural Pennsylvania, moves to Santa Fe, then does a guest professorship in Leipzig, Germany. From Germany, Khakpour returns to Los Angeles, where she receives a definitive Lyme diagnosis.

The above sums up 200 plus harried pages. Never once during this ceaseless movement is Khakpour entirely healthy, though she experiences moments of comparative wellness. At her worst — the majority of the memoir — Khakpour is sleepless for weeks on end, experiencing horrific anxiety, severe joint pain, spiking fevers, psychiatric symptoms, and crushing fatigue. Khakpour consults countless doctors, Western and non, is repeatedly hospitalized, tries various alternative health regimens, and swallows countless medications with varying degrees of relief. She becomes addicted to benzodiazepines and Neurontin. She remains gravely ill.

Sick is arranged geographically rather than chronologically, though place and time often overlap. Khakpour attributes her restiveness to fleeing Iran, an experience that left her with Post-Traumatic-Stress-Disorder. Concomitant with PTSD is a lifelong sense of inhabiting the wrong body, a sense of somatic wrongness Khakpour now recognizes is the core experience of the physically unwell self. Yet she also links her physical suffering to an inability to settle, writing: “I sometimes wonder if I would have been less sick if I had a home.”

With all due respect to the trauma of fleeing one’s homeland, Khakpour was five years old when her family fled Iran. She has spent 35 of her 40 years in the United States, where she has far more freedom than she would had her family stayed in Iran. I realize this sounds judgmental. It’s not intended to be. Rather, it’s to suggest another viewpoint.

Khakpour intends Sick in part, to show readers the lived experience of a sick “brown” woman (her words, not the reviewer’s) in white society where the default attitude toward her is mocking disbelief. Yet Sick’s sole example of a directly racist remark comes from a tow-truck driver, who tells Khakpour he doesn’t like most “Arabs”, but she’s okay. Nowhere else do we see directly racist doctors, nurses, or medical staff. When Khakpour collapses in a hotel lobby and begs the African-American paramedic not to take her to a racist hospital, she is met with a startled stare. Khakpour assumes the paramedic thought her white, writing:

That I’m a brown Middle Eastern woman, though every time illness turns me white — thin and pale to the point where everyone congratulates me as I transform to my sickest, a white woman in appearance. I’d even chemically straightened my usually curly, frizzy hair to a stick-straight silky whiteness that winter. Every part of me in illness became the white woman of their dreams.

Who, precisely, is congratulating Khakpour? The white woman of whose dreams?

At the close of Sick, Khakpour drops two narrative bombshells. The first is her identification as queer (again, her terminology, not the reviewer’s), which she opted to withhold until now because:

Perhaps it’s because I feel overwhelmed by all my marginal identifiers. But I question that omission; to leave that out would be disingenuous, too.

The point in my critique isn’t Khakpour’s sexual orientation. It’s this: after 237 pages, relationships with at least six men, a broken engagement, and not a single lesbian relationship, Khakpour’s announcement left your reviewer questioning what English literature courses calls narrative reliability.

Khakpour then describes herself as a “bad sick person”, somebody taking perverse pleasure in further damaging her health by continuing to smoke, drink, and indulge in occasional illegal drug use. Perfect patients do not exist. Every sick patient deviates from doctor’s orders. Yet Khakpour clearly expects her parents, boyfriends, and the American medical establishment to believe she is ill and help her through the worst parts of said illness. That’s a heavy expectation to impose when she won’t help herself.

And herein lies the crux: in Sick, we have a book whose subject matter could be neither more timely nor more fraught: a highly debated illness, the status of women in the Me-Too era, and the status of minorities and LGBTQ individuals during tumultuous times presented by a writer who is not entirely honest with her readers — and, perhaps, herself. And that is unfortunate.