The Two Kinds of Decay by Sarah Manguso

The Barnes & Noble Review

Acclaimed poet Sarah Manguso thought she was suffering from a weeks-long head cold during her junior year at Harvard in 1995, before tingling, numbness, and shortness of breath suggested something more mysterious -- and dire. She soon found herself in the intensive care unit of the local hospital, where they administered the first of 50 rounds of aphersis, an excruciating four-hour process of removing and replacing toxic components in the blood. Thus began Manguso’s nine-year battle with a disease so rare it has no name. Its closest approximation is "chronic idiophathic demyelinating polyradiculoneuropathy" -- in other words, her immune system was decimating her nervous system. With spare, precise prose, gallows humor, and piercing observation, Manguso seizes and artfully organizes shards of memories of paralysis, breathlessness, extreme pain, and terror. She "grew used to being sick and looking forward to recovering" only to become "used to having no prognosis at all, because with a mysterious disease, all things are possible." Manguso masterfully evokes her yearnings to indulge her 20-something appetites (e.g., sex and alcohol) while instead forced to confront mortality -- enduring misdiagnoses and interminable hospital stays, encounters with former classmates turned nurses, and the death of a former lover. The Two Kinds of Decay is an indelible meditation on remembering what one longs to forget, by a woman emerging from the exile of illness. --Kera Bolonik

From the Publisher

The events that began in 1995 might keep happening to me as long as things can happen to me. Think of deep space, through which heavenly bodies fly forever. They fly until they change into new forms, simpler forms, with ever fewer qualities and increasingly beautiful names.

There are names for things in spacetime that are nothing, for things that are less than nothing. White dwarfs, red giants, black holes, singularities.

But even then, in their less-than-nothing state, they keep happening.

At twenty-one, just starting to comprehend the puzzles of adulthood, Sarah Manguso was faced with another: a wildly unpredictable disease that appeared suddenly and tore through her twenties, vanishing and then returning, paralyzing her for weeks at a time, programming her first to expect nothing from life and then, furiously, to expecteverything. In this captivating story, Manguso recalls her nine-year struggle: arduous blood cleansings, collapsed veins, multiple chest catheters, the deaths of friends and strangers, addiction, depression, and, worst of all for a writer, the trite metaphors that accompany prolonged illness. A book of tremendous grace and self-awareness, The Two Kinds of Decay transcends the very notion of what an illness story can and should be.

The Washington Post - Juliet Wittman

Hers is not a day-by-day description of this grueling time, but an impressionistic text filled with bright, poetic flashes. The use of such terms as "spacetime" at the start of the book is a little off-putting, but before long Manguso has earned them: She is attempting, after all, to give form to a vast, formless and terrifying experience. Many sick people learn to live in the moment, but the power of Manguso's writing makes that truism revelatory.

The New York Times - Emily Mitchell

The author of two books of poetry, Manguso brings the virtues of that form to the task of writing memoir. Her book is divided mostly into one- and two-page chapters titled like poems. She mixes high and low language, the crass and the scientific, with a lyric poet's sure-handedness. The chapters themselves…resemble her own poetry, broken into aphoristic, discrete sections on the page. This disjointedness gives the prose a rhythm that mirrors the confusion and fragmentation of illness…As much as anything, this book is a search for adequate descriptions of things heretofore unnamed and unknown. Manguso concludes her account with questions—and an exhortation to the reader to pay attention. Through her own attentiveness, Manguso has produced a remarkable, cleareyed account that turns horror into something humane and beautiful.

Publishers Weekly

In 1995, when Rome Prize-winning poet and fiction writer Manguso (Siste Viator) was a junior at Harvard, she suffered the first attack of a rare autoimmune disease called CIDP, which would turn her body against itself. CIDP attacks the myelin coating of the peripheral nerves. The result is increasing numbness, followed by paralysis spreading from the extremities inward, until the sufferer can no longer control his or her breathing, and dies. In short, lyrical chapters—the book free-associates between memories, while sticking to a rough chronological order—Manguso recounts the harrowing indignities of her treatments, frequent relapses, descents into steroid-induced clinical depression, crucial college sexual experiences had and missed, and trips back and forth between schools, hospitals and her parents' Massachusetts home. What makes this lightning-quick book extraordinary is not just Manguso's deadpan delivery of often unthinkable details, nor her poet's struggle with the damaging metaphors of disease, but the compassion she acquires as she comes to understand her pain in relation to the pain of others: "suffering, however much and whatever type, shrinks or swells to fit the shape and size of a life." (June)

Kirkus Reviews

Frank account of the autoimmune disorder that consumed the author in her 20s. The disease that plagued her in various ways for nine years had ravaging effects on Rome Prize winner Manguso (Hard to Admit and Harder to Escape, 2007, etc.), whose poetry and prose have never shied away from staring a subject in the face. In short chapters of slim paragraphs buffered by white spaces bearing as much emotive force as the poetic statements they insulate, she carefully unfurls the details of her eventual diagnosis of CIDP (chronic idiopathic demyelinating polyradiculoneuropathy), akin to Guillain-Barre syndrome. Manguso's condition first manifested in February 1995 as a head cold that wouldn't quit; by March it had escalated to numb feet and almost complete paralysis. She landed in the hospital and underwent her first apheresis, a four-hour procedure that took her blood's plasma (whose "devil antibodies" were stripping the myelin from her peripheral nerves and causing paralysis), removed it and replaced it with the plasma of others. The author endured more than 20 of these vampiric procedures before a central line was surgically implanted in her chest and a new neurologist recognized that curative treatment didn't involve apheresis but steroid and gamma globulin therapy. Manguso's abundant analytic and compositional gifts are evident throughout this harrowing memoir, from her expressions of hard-won appreciation for the relativity of suffering to a nuanced account of how serious illness can alter one's conception of time, robbing the afflicted of both compassion and accurate recall. "I waited seven years to forget just enough-so that when I tried to remember, I could do it thoroughly," she writes."There are only a few things to remember now, and the lost things are absolutely, comfortingly gone."A powerful, direct examination of memory and suffering.

What People Are Saying

In The Two Kinds of Decay, Sarah Manguso has miraculously elevated the act of memory. She has found honesty, fear, longing, and beauty in every moment of her young life, giving this book an intensity found nowhere else. You put it down panting with wonder and grief, but never with pity. A breakthrough in the memoir, and in writing. --Andrew Sean Greer, author of The Story of a Marriage

At the white-hot center of this book burns the intelligence and wit of Sarah Manguso, one of the most brilliantly talented writers at work today. She is a clear-eyed visionary, a connoisseur of the penetrating declarative, an unsentimental chronicler of the horrifying insult of illness and of the desires that drive us headlong into adulthood. With a poet's brevity, with riveting narrative energy, with searing insight and compassion, Manguso leads us into hell and back again; every step of the way, there's the thrill of knowing we're in the hands of a new literary master. --Julie Orringer, author of How to Breathe Underwater

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