A few days after my grandma was formally diagnosed with ALS, she wheeled into an appointment with her neurologist – a man who had ignored her requests for ALS testing for over a year – with a homemade T-shirt that said, “I told you so.” She had already lost the ability to speak. To eat. To move her mouth. Communication is planted in the jaw, but it can grow anywhere, like a weed bursting out of the grief of concrete. Maggie Nelson’s prose gives these weeds not only a body, but a nervous system; her latest book Pathemata: Or, the Story of My Mouth is an autobiography of pain.
Pathemata is a speculative memoir set during the COVID-19 pandemic, following the journey of the narrator, Maggie, as she attempts to find a cure for her unbearable chronic jaw pain. Experimental in form, Pathemata is told in accumulated vignettes, shifting in perspective from first person to second person to heart-wrenching epistolary and back again. It’s an anthology of the anguishes that plague Maggie. The death-by-text of her close friend C. Her marital issues with the half-present, non-monogamous H. Raising a son during a time of global isolation. The onslaught of sexists, their own debilitating epidemic: dentists, Buddhists, men in saunas. Pathemata is a glimmering collage of all the ways our human bodies can fail us.
This self-proclaimed “10,000-word pain history” is aptly named. The title, Pathemata, bears the meaning of “suffering” in the completed Greek phrase ‘Pathemata Mathemata,’ meaning “learning through suffering.” Nelson’s Pathemata is a creature built of sorrow-bones, fleshed out with spectral reality. As the essay fragments accumulate, they wear the context of all Maggie’s previous griefs. Only it hasn’t just become layered – it has become. Coalescence. All 32 teeth in the jaw smoothed over and merged into two white, seamless knives, slicing their gum tissue homes all to hell. Pathemata is structurally brilliant, laying the groundwork for emotional catharsis so elegantly that I wasn’t aware I was being devastated until I was destroyed. Take, for instance, the meticulous pacing of the informational reveal regarding Maggie’s father. During a medical appointment with a new GP, the narrator subtly muses on her failings as a human and their destructive consequences. The text reads,
“At the end of an awkward, blurry session which includes the GP telling me how she once saved her father-in-law’s life by doing CPR on him after he’d had a heart attack in his sleep—a story she tells in response to my disclosure that my father died of a heart attack in his—she asks me if, were I to fall ill, there is anything I would like to communicate to those I’d left behind, as sometimes doctors keep such things on file.”
When Maggie brings this conversation up to her therapist later, the therapist dissuades her from writing a will, instead encouraging her to write a letter to herself in the voice of her deceased father. After uncomfortably completing this assignment – an example of the titular ‘learning through suffering’ – the therapist never brings the letter up again. Likewise, the narrator doesn’t mention it again, and we are left to forget about it, until the very end of the novel, when the letter is revealed to us, a brutal oasis of heartache that serves to culminate every textual loss we’ve seen. The tonal shift from Nelson’s trademark lyricism to a clear, conversational tone creates a ravaging juxtaposition; we are being moved by the words of a man who is not a writer, as opposed to the writer's words. The cathartic impact of her father’s letter emphasizes the sorrowful motif of Maggie’s failing mouth. The emotional climax of the memoir is spoken through the imagined mouth of her father, not her own. For a writer’s mouth to fail is an irony bound in tragic orthodontics .
How apt this epistolary bombshell is in its parallels of memory. The way grief strikes us down on a clean, quiet day, years after we thought we had healed. I’m reminded of how I kiss the fuzzy grey cat socks my grandma gave me every time I take them out of the wash – how I cry in my laundry room, tears prickling amidst the congealed summer heat and tangy dryer sheets. Four weeks after her “I told you so” appointment, my grandma – Oma, we called her – passed away. It was summer, the same month she was born, and she went surrounded by her husband and her three children. I forget these small mercies. In the weeks I spent watching her die, my body turned into a rage room. I was destroyer and destroyed.
Much like when Maggie says her final goodbye to C over the phone, I struggled with what to say to my Oma when it was time. Maggie’s barrier with C was physical. The only barrier between my Oma and me was the simple tragedy of a failing mouth. I held her hand, and I told her thank you. I told her she was beautiful, and I loved her. She stared at me and held her big doe eyes open as wide as they could go. She did not blink the entire time I said goodbye. This was how she communicated while paralyzed. How she talked without speaking. On page 26 of Pathemata, Nelson writes, “[...] the only thing that frightens me more than pain and its viciousness is numbness, paralysis.” My Oma looked at me and tried to telepathically scream her words into my brain, but no matter how loud she thought, I never heard her.
The mouth exists as a stand-in for many intangibilities in Pathemata: passion, kindness, writing, grief, and the way we interact with other human beings, to name a few. In being overwhelmed by her jaw pain, the narrator feels like she has somehow failed, professionally as well as emotionally. Early in the book, Maggie’s insecurity takes breath in her musings about another more successful author, who is also struck with a failing mouth. The section reads,
"I am a visiting writer somewhere and the more esteemed visiting writer—who arrives with the reputation of a playboy—is trying to make time for me. He has a mouth condition wherein a bluish, bad-smelling ink periodically floods the flower of his tongue. [...] He holds a long seagull feather in front of his mouth to indicate when the affliction is in—the feather’s vane turns orange when the smelly ink comes around."
In searching for a cure for her jaw pain, Maggie is searching for a cure for the thing that makes her inhuman. Even the other flawed-mouthed writer she meets finds a way to hold his human mouth better: He’s not cured or fixed, but he uses his condition to turn a blooming feather into a weapon of lovely prose. Nelson shows us that even when life is visceral and jewel-toned and cancerous, our pain can produce small, gleaming pearls we must clutch under our tongues for protection.
Impish, whimsical, and raw, every syllable in Pathemata is sore and tender. As the story closes, Maggie returns to the dentist she saw at the start of the piece, and is informed that, despite it all, her mouth has not changed shape. Nelson writes, “Sometimes I wonder what I would have thought about all these years, if I hadn’t spent so much time thinking about the pain. Then I remember that I’ve thought about a lot of other things as well.” Nelson reminds us that living with pain is its own kind of grief, and the last stage of grief is acceptance. Grief strips us of our bodies. Pain strips us of our minds. To get rid of either is an amputation of sorts.
