The Empathy Exams: Essays

by Leslie Jamison

  Afterward, I ask her how it went. She tells me it’s been confirmed: Rita found threads around her eyes. But she shrugs as she says it—as if the discovery is just an anticlimax; offering none of the resolution or solidity it promised.

  “I’m fucking myself,” Kendra tells me, “the more I try to pick them away.”

  I agree. I nod.

  “The more I try to pick them away,” she continues, “the more come … like they want to show me I can’t get rid of them that easily.”

  Discussion

  In the end, I gave my miniscope away.

  I gave it to Sandra. I gave it to her because she was sick of using her jeweler’s loupe, because she was sad she hadn’t gotten one, and because I felt self-conscious about winning one when I wasn’t even looking for fibers in the first place.

  “That’s so generous,” she said to me when I gave it to her—and of course I’d been hoping she would say that. I wanted to do nice things for everyone out of a sense of preemptive guilt that I couldn’t conceptualize this disease in the same way as those who suffered from it. So I said, Here, take my miniscope, in hopes that might make up for everything else.

  That’s so generous. But maybe it wasn’t. Maybe it was just the opposite. Maybe I just took hours of her life away and replaced them with hours spent at the peephole of that microscope, staring at what she wouldn’t be able to cure.

  A confession: I left the conference early. I actually, embarrassingly, went to sit by the shitty hotel pool because I felt emotionally drained and like I deserved it. I baked bare skinned in the Texan sun and watched a woman from the conference come outside and carefully lay her own body, fully clothed, across a reclining chair in the shade.

  Acknowledgments

  I’ve left the kingdom of the ill. Dawn and Kendra and Paul and Rita remain. Now I get the sunlight and they don’t. They feed themselves horse dewormers and I don’t. But I still feel the ache of an uncanny proximity. They have no fear that isn’t mine, no dread of self I haven’t known. I kept telling them, I can’t imagine, and every once in a while, softer, I can.

  When does empathy actually reinforce the pain it wants to console? Does giving people a space to talk about their disease—probe it, gaze at it, share it—help them move through it, or simply deepen its hold? Does a gathering like this offer solace or simply confirm the cloister and prerogative of suffering? Maybe it just pushes on the pain until it gets even worse, until it requires more comforting than it did before. The conference seems to confirm, in those who attend, the sense that they will only ever get what they need here. It sharpens the isolation it wants to heal.

  I can only be myself when I’m here, is something I heard more than once. But every time I left the dim rooms of Westoak Baptist, I found myself wishing its citizens could also be themselves elsewhere, could be themselves anywhere—in the lavish Austin sunshine, for starters, or hunched over artisanal donuts at a picnic table on a warm night. I wanted them to understand themselves as constituted and contoured beyond the margins of illness.

  I think of how Paul always does his grocery shopping half an hour before closing time so he won’t see anyone he knows; I think of the bald man sitting behind me on the second day, whose name I never learned, who doesn’t do much besides shuttle between a bare apartment and an unnamed job; I think of a beautiful woman who wonders how any man could ever love her scarred.

  Kendra is terrified by the same assurances that offer her validation. She has proof of fibers in her skin but no hope of getting them out, only a vision of what it might look like to be consumed by this disease entirely: a thousand bloody photographs on her computer, a soup of larvae on her cell phone testifying to the passing days of her life.

  What did Kendra say? Some of these things I’m trying to get out, it’s like they move away from me. Isn’t that all of us? Sometimes we’re all trying to purge something. And what we’re trying to purge resists our purging. Devil’s bait—this disease offers a constant feeling of being lured, the promise of resolution dangling just out of reach. These demons belong to all of us: an obsession with our boundaries and visible shapes, a fear of invasion or contamination, an understanding of ourselves as perpetually misunderstood.

  But doesn’t this search for meaning obfsucate the illness itself? It’s another kind of bait, another tied-and-painted fly: the notion that if we understand something well enough, we can make it go away.

  Everyone I met at the conference was kind. They offered their warmth to me and to each other. I was a visitor to what they knew, but I have been a citizen at times—a citizen subject to that bodily unrest—and I know I’ll be one again. I was splitting my time between one Austin and another; I was splitting my time between dim rooms and open skies.

  One of the speakers quoted nineteenth-century biologist Thomas Huxley:

  Sit down before fact as a little child, be prepared to give up every preconceived notion, follow humbly wherever and to whatever abyss Nature leads, or you shall learn nothing.

  I want to sit down in front of everyone I’ve heard—listen to their voices in my tape recorder like a child, like an agnostic, like a pluralist. I want to be the compassionate nurse, not the skeptical doctor. I want the abyss, not the verdict. I want to believe everyone. I want everyone to be right. But compassion isn’t the same thing as belief. This isn’t a lesson I want to learn.

  It wasn’t until the seventeenth century that the words pity and piety were fully distinguished. Sympathy was understood as a kind of duty, an obligation to some basic human bond—and what I feel toward this disorder is a kind of piety. I feel an obligation to pay homage or at least accord some reverence to these patients’ collective understanding of what makes them hurt. Maybe it’s a kind of sympathetic infection in its own right: this need to go-along-with, to nod-along-with, to support; to agree.

  Paul said, “I wouldn’t tell anyone my crazy-ass symptoms.” But he told them to me. He’s always been met with disbelief. He called it “typical.” Now I’m haunted by that word. For Paul, life has become a pattern and the moral of that pattern is, you’re destined for this. The disbelief of others is inevitable and so is loneliness; both are just as much a part of this disease as any fiber, any speck or crystal or parasite.

  I went to Austin because I wanted to be a different kind of listener than the kind these patients had known: doctors winking at their residents, friends biting their lips, skeptics smiling in smug bewilderment. But wanting to be different doesn’t make you so. Paul told me his crazy-ass symptoms and I didn’t believe him. Or at least, I didn’t believe him the way he wanted to be believed. I didn’t believe there were parasites laying thousands of eggs under his skin, but I did believe he hurt like there were. Which was typical. I was typical. In writing this essay, how am I doing something he wouldn’t understand as betrayal? I want to say, I heard you. To say, I pass no verdicts. But I can’t say these things to him. So instead I say this: I think he can heal. I hope he does.

  LA FRONTERA

  San Ysidro

  I’m at the busiest land border in the world. I get across quickly because I’m headed in the right direction, by which I mean the wrong direction. I’m going where no one wants to stay. On the opposite side of Highway 5, a sparkling line of gridlock points north toward the United States of America.

  Over there, the traffic lanes are supermarket aisles. You can buy popcorn, cookies, lollipops, cigarettes. You want coffee? You can get it from a boy barely tall enough to reach your car window. You want the paper in Spanish? Great. In English? Maybe. You want an animal-print towel? There are hundreds.

  I’m headed to a literary gathering held in Tijuana and Mexicali that’s been billed as an encuentro. I’ve gathered this means something between “festival” and “conference,” but when I think of encuentro I hear the word for “story” (cuento) coaxed from the word for “encounter” (encontrar)—an intersection that hints at what will happen at this upheaval of debauchery and roundtables: Stories will be currency, peo
ple will be signing books, people will be confused, people will be making book deals, people will be talking shit about Mexicali and wishing they were in Oaxaca. People will be having sex. Nothing will happen on time. Cookies will be served with Styrofoam cups of coffee in the morning. Cocaine will be served in bathroom stalls at night.

  This is 2010. I hear that Tijuana has gotten much better in the past two years, which is what the American media has recently begun to say as well. But variations and fluctuations are inevitably glossed over in conversations where we, up north, talk about how bad it’s gotten “down there.” Of course, down there isn’t one place but a thousand, and the truth is it’s gotten better in Tijuana and much worse in Tamaulipas and simply stayed horrible in Ciudad Juárez, where life is so violent it’s hard to understand the gradations between bad and worse.

  Someone tells me about living in Tijuana during the worst months—not so much about living under the constant threat of violence but about talking about living under constant threat of violence. It’s impossible to speak, she says, when you’re still in the middle of it.

  This is what it was like in Tijuana, a few years back: Even when people got together for dinner, somewhere private, they wouldn’t focus on what their lives had become: scared to go drinking, scared to go to work, scared to catch a bus or buy a pack of cigarettes or cross the fucking street. Now they can talk. Speaking is easier when the worst has been pushed out of earshot—past the point of being taunted, by delusions of safety, into some vengeful return.

  Tijuana

  Avenida Revolución is lined with the hollowed husks of cheap tourism. Empty bars stand like relics of a vanished civilization felled by its own hedonistic excess: silent dance floors framed by thatched walls and faux-jungle decor, balconies full of tiki torches and flapping banners advertising tequila happy hours no one is attending. The clubs feel like foreclosed homes. The tourists have been scared away. Some must still come, I suppose, but I don’t see any of them on the streets. The Centro Cultural Tijuana has a surprisingly lovely domed ceiling fitted with squares of glass that filter the sunlight into jeweled colors: fuchsia, tangerine, deep mint. But the only people I see inside are men selling bus tickets to other places.

  Everyone is hawking wares along the streets, but no one is buying. If I wanted, I could get all kinds of things: a zebra-striped burro, postcards showing ten pairs of titties and the red stump of a Tecate can in the sand, a little frog carved by an old man before my very eyes and fitted with an actual cigarette between its wooden lips. I could get a T-shirt printed with the stoic face of Pancho Villa or the inevitable face of Che, a T-shirt with a joke about beer, another T-shirt with a joke about beer, a T-shirt with a joke about tequila, a T-shirt with a joke about mixing beer and tequila, or a T-shirt that gets to the heart of what all this drinking is about (this one in English: “I Fuck on the First Date”). Conveniently enough, there’s a hotel across from all these kitsch bodegas that advertises rooms for ninety-nine pesos an hour. I don’t see anyone going in or coming out.

  The whole time I am thinking of Tijuana two years ago, the never talking. All across the border, other towns are still in the thick of this unspeaking. The people who call Ciudad Juárez the most dangerous city in the world are the ones who don’t live there.

  I think maybe if I walk the streets where someone was afraid, where an entire city was afraid, I’ll maybe understand the fear a little better. This is the grand fiction of tourism, that bringing our bodies somewhere draws that place closer to us, or we to it. It’s a quick fix of empathy. We take it like a shot of tequila, or a bump of coke from the key to a stranger’s home. We want the inebriation of presence to dissolve the fact of difference. Sometimes the city fucks on the first date, and sometimes it doesn’t. But always, always, we wake up in the morning and find we didn’t know it at all.

  I wake up in the morning and get huevos con jamón at a place called Tijuana Tilly’s. I could have gotten a waffle but I didn’t. I could have gotten pan francés with whipped cream, but I didn’t. I’m going authentic. I’m eating with a publicist named Paola and a novelist named Adán. They both get waffles. Paola tells me she can’t believe that DF (Mexico City) is quite possibly the safest place in Mexico these days. Not what she’s used to. Adán tells me Mexicali, where we’re going to meet the other writers for the conference, is relatively safe as well. Relatively is an important word around here.

  Mexicali, in any case, is two hours east. It first exploded during Prohibition, just like Tijuana, but otherwise they’re not much alike. Adán’s Spanish is fast and I’m not sure if I’m getting the gist of what he’s saying—or at least, the right gist—because it seems like he’s talking about an underground town full of Chinese people. As it turns out, my Spanish is close. During the 1920s, Chinese laborers outnumbered Mexicans in Mexicali by a ratio of eight to one, and a network of subterranean tunnels connected their opium dens and brothels to those eager and prohibited Americans living just across the border.

  Tijuana blurs. Once I leave, I’m eager to talk about it—the way you’re eager to talk about a dream when you wake up, afraid it will dissolve if you don’t pin the details to their places, sketch a path between absurdities. As soon as I leave it, I think, what was that city? It was an unlit hallway next to an office with broken windows (my hostel) and a plate of shredded pork cooked with oranges (my dinner). It was a band composed of young men called La Sonrisa Vertical (the Vertical Smile) and a band composed of old men, I don’t know what they were called, who asked repeatedly for more Charles Shaw Shiraz and played the hell out of their electric guitars. They had two eggs perched on their amp, maybe raw, maybe hardboiled, not making any sense but belonging absolutely where they were.

  Mexicali

  If the road into Tijuana is clogged with guns and cars and men in uniform, the pageantry of American panic, the highway out is dust ravaged and ghostly, snaking from the outer barrios to the gaunt hills of a frontier desert. Beyond city limits, shacks perch on muddy slopes strewn with bits of wall and fence. Many have been wrapped or roofed in billboard posters. They look like presents. Their sides show the giant toothpaste tubes and human smiles of advertisements. Eventually, the slums give way to an infamous highway known as the Rumorosa, a roller coaster that twists and dips through the hairpin turns and rock-slide slopes of bleached red mountains.

  At a lookout point halfway to Mexicali, where the road drops off raggedly to our left, we emerge around a bend to see the partially blackened wreckage of a semi-truck. The cab is inches from the edge of the cliff. A man is curled fetal on the ground, bleeding from his forehead. He doesn’t look dead. There isn’t an ambulance in sight, but a priest stands over the man’s body, blocking him from the noon sun and muttering words of prayer, waving at the passing cars: Slow down, slow down. It must be ninety in October and this man wears black vestments that soak up the whole of the heat. His cross glitters silver. The grill of the truck glitters silver behind him.

  It’s not just that violence happens here—intentional, casual, accidental, incidental—it’s that the prospect and the aftermath of violence are constantly crowding you from all sides: men with machine guns on the Avenida Revolución, growling dogs leaping into SUVs to sniff for drugs, a drunk passed out in front of the panadería, a driver so tired or tweaking he barrels his semi into a cliff. We pass a soldier standing alert with a semiautomatic in his hands, apparently guarding the giant pile of scrap tires behind him. There’s nothing else in sight. The soldiers of the country stand ready against an uncontrollable violence, perched on trash, their guns pointed at thin air.

  In a 2010 op-ed in the New York Times, Elmer Mendoza reports that when a troop of Niños Exploradores (something like Boy Scouts) was brought to welcome officials visiting Ciudad Juárez, their scoutmaster took them through a call-and-response routine. “How do the children play in Juárez?” he called. The boys all dropped to the ground.

  At a drug checkpoint, our entire van is emptied out. Larger vehicles inevita
bly attract more suspicion. The soldiers empty our bags. It all feels pro forma, but still—of a climate, of a piece, setting a tone. As we drive away, I glance back and notice that another soldier, this one standing on a truck, had his machine gun trained on us the whole time.

  There are no flashy clubs in Mexicali, no zebra burros, no drink specials. You couldn’t find a smoking frog to save your life. You can get plastic bags full of chopped cactus or cigarettes for cheap. The closest thing to a Spanglish shot glass is the sound track at a club called SlowTime, where a woman’s voice moans over and over again: “Oh, you fucking me makes me bilingual.”

  The light is harsher in this city, everything dustier. The hotels advertise rates for four hours instead of one. I don’t know what this means, but it seems to mark an important difference in civic culture.

  Chinatown is alive and well aboveground. Restaurants serve bean curd with salsa and shark-fin tacos. I eat lunch at Dragón de Oro, whose parking lot runs up against the border itself, a thick brown fence about twenty feet high. The stucco homes and baseball diamonds of Calexico are barely visible through the slats.

  We are fifty strong, we encuentro-goers. There’s Oscar, a poet who tells me his vision of Heidegger over chilaquiles one morning, and Kelly, a simultaneous interpreter who is writing a Spanish glossary of erotic language. There’s Marco, another poet, who walks across the border to buy a new pair of Converse in Calexico. Marco informs me that he abandoned his “lyric self” about a year ago, once his city grew so violent he got scared to leave his house. He needs a new poetry these days. He’s interested in repurposing in general and Flarf in particular—an experimental poetic practice that involves sorting and distilling the vast innards of the Internet, whittling by way of search term, juxtaposing odd results, often to the point of absurdity, hilarity. Marco believes in hilarity. Marco teaches college students. His life sounds a lot like mine until it absolutely doesn’t. The night before coming to Mexicali, he stayed up till one thirty to finish grading a batch of papers, then decided to reward himself the next morning by hitting the snooze button. Fair enough. As it turned out, a grenade explosion woke him anyway, two minutes later, followed by a volley of machine-gun fire. “Like a conversation,” he says, “one voice and then the response.” He says it wasn’t anything unusual.